rofecoxib rofecoxib rofecoxib is a cox-2 selective nonsteroidal anti-inflammatory drug (nsaid). it was marketed by merck & co. to treat osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, acute pain conditions, migraine, and dysmenorrhea. rofecoxib was approved in the us by the us food and drug administration (fda) in may 1999, and was marketed under the brand names vioxx, ceoxx, and ceeoxx. rofecoxib was available by prescription in both tablet-form and as an oral suspension. rofecoxibclinical datapronunciation/ˌrɒfɪˈkɒksɪb/ trade namesvioxx, ceoxx, ceeoxx, otherspregnancycategory au: c routes ofadministrationby mouth & i.matc codem01ah02 (who) legal statuslegal status withdrawn worldwide pharmacokinetic databioavailability93%protein binding87%metabolismliverelimination half-life17 hoursexcretionbile duct/kidneyidentifiers iupac name 4-(4-methylsulfonylphenyl)-3-phenyl-5h-furan-2-one cas number162011-90-7 ypubchem cid5090iuphar/bps2893drugbankdb00533 ychemspider4911 yunii0qtw8z7mcrkeggd00568 ychebichebi:8887 ychemblchembl122 ycomptox dashboard (epa)dtxsid2023567 echa infocard100.230.077 chemical and physical dataformulac17h14o4smolar mass314.36 g·mol−13d model (jsmol)interactive image smiles o=c2occ(=c2\c1ccccc1)\c3ccc(cc3)s(=o)(=o)c inchi inchi=1s/c17h14o4s/c1-22(19,20)14-9-7-12(8-10-14)15-11-21-17(18)16(15)13-5-3-2-4-6-13/h2-10h,11h2,1h3 ykey:rzjqgncstqawon-uhfffaoysa-n y (verify) rofecoxib gained widespread use among physicians treating patients with arthritis and other conditions causing chronic or acute pain. worldwide, over 80 million people were prescribed rofecoxib at some time. in september 2004, merck voluntarily withdrew rofecoxib from the market because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use. merck withdrew the drug after disclosures that it withheld information about rofecoxib's risks from doctors and patients for over five years, allegedly resulting in between 88,000 and 140,000 cases of serious heart disease. rofecoxib was one of the most widely used drugs ever to be withdrawn from the market. in the year before withdrawal, merck had sales revenue of us$2.5 billion from vioxx. in 2005 the fda issued a memo concluding that risks for serious cardiovascular (cv) events seem to be as great for non-selective nsaids as for cox-2 selective agents such as rofecoxib, according to long-term controlled clinical trials. based on data up to 2015, the fda reasserted the likelihood of an increased risk of serious adverse cardiovascular events from cox-2 selective and non-selective nsaids, dependent on dose and duration. in november 2017, massachusetts-based tremeau pharmaceuticals announced its plan to return rofecoxib (trm-201) to market as a treatment for hemophilic arthropathy (ha). tremeau announced that the fda had granted an orphan designation for trm-201 (rofecoxib) for the treatment of ha, and that they had received fda feedback on their development plan. ha is a degenerative joint disease caused by recurrent intra-articular bleeding. it is the largest cause of morbidity in patients with hemophilia and has no currently approved treatment options in the united states. traditional nsaids are avoided in this population due to their effects on platelet aggregation and risk of gastrointestinal ulcers, and high potency opioids are the current standard of care in treating ha. mode of action