COX-2 Selective NSAID (Parenteral)

Parecoxib

Brand names: Dynastat

Parecoxib is a parenteral selective COX-2 inhibitor (a prodrug of valdecoxib) used for short-term management of postoperative pain.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

After conversion to valdecoxib it selectively inhibits cyclo-oxygenase-2, reducing prostaglandin-mediated inflammation and pain with relatively less effect on platelet function.

Prescribing in practice

It is contraindicated after coronary artery bypass graft surgery owing to an increased risk of serious cardiovascular and thrombotic events.
Avoid in serious cardiovascular disease, active gastrointestinal bleeding and significant renal impairment, and use the shortest effective duration.
Serious skin reactions and hypersensitivity, including in patients with aspirin- or NSAID-sensitive asthma, have been reported.

Monitoring

Monitor renal function, blood pressure and for gastrointestinal or hypersensitivity reactions, particularly in at-risk patients.

Counselling the patient

This is a short-course injection for pain after surgery.
Report any rash, swelling or breathing difficulty immediately.

Evidence & guidelines

Selective COX-2 inhibitors carry a known cardiovascular safety signal, with parecoxib specifically contraindicated post-CABG per MHRA and SPC warnings.

Reference: NICE Analgesics Review; Dynastat SPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways