Parecoxib

Parecoxib is suspected to cause serious birth defects when it is administered during the last trimester of pregnancy. Like other medicines known to inhibit prostaglandin, it may cause premature closure of the ductus arteriosus or uterine inertia. NSAID use in the second or third trimester may cause foetal renal dysfunction, and in severe cases this can lead to a reduction in amniotic fluid volume or oligohydramnios. These effects may appear shortly after treatment starts and are usually reversible. Pregnant women on NSAIDs should be closely monitored for amniotic fluid volume. Parecoxib is contraindicated in the third trimester of pregnancy. Administration of a single dose of parecoxib to lactating women after caesarean section led to a relatively small amount of parecoxib and its active metabolite valdecoxib passing into human milk. This gave a low relative dose for the infant (approximately 1% of the weight-adjusted maternal dose). Parecoxib must not be administered to women who breast-feed.