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Chemistry

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Also known as: 162011-90-7, Vioxx, Ceoxx, Mk 966, 4-(4-(methylsulfonyl)phenyl)-3-phenylfuran-2(5h)-one, 4-[4-(methylsulfonyl)phenyl]-3-phenylfuran-2(5h)-one
Molecular Formula
C17H14O4S
Molecular Weight
314.4  g/mol
InChI Key
RZJQGNCSTQAWON-UHFFFAOYSA-N
FDA UNII
0QTW8Z7MCR

Rofecoxib
Rofecoxib is a synthetic, nonsteroidal derivative of phenyl-furanone with antiinflammatory, antipyretic and analgesic properties and potential antineoplastic properties. Rofecoxib binds to and inhibits the enzyme cyclooxygenase-2 (COX-2), resulting in an inhibition of the conversion of arachidonic acid to prostaglandins. COX-related metabolic pathways may represent key regulators of cell proliferation and neo-angiogenesis. Some epithelial tumor cell types overexpress pro-angiogenic COX-2. (NCI04)
1 2D Structure

Rofecoxib

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
3-(4-methylsulfonylphenyl)-4-phenyl-2H-furan-5-one
2.1.2 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
2.1.3 InChI Key
RZJQGNCSTQAWON-UHFFFAOYSA-N
2.1.4 Canonical SMILES
CS(=O)(=O)C1=CC=C(C=C1)C2=C(C(=O)OC2)C3=CC=CC=C3
2.2 Other Identifiers
2.2.1 UNII
0QTW8Z7MCR
2.3 Synonyms
2.3.1 MeSH Synonyms

1. Mk 0966

2. Mk 966

3. Mk-0966

4. Mk-966

5. Refecoxib

6. Vioxx

7. Vioxx Dolor

2.3.2 Depositor-Supplied Synonyms

1. 162011-90-7

2. Vioxx

3. Ceoxx

4. Mk 966

5. 4-(4-(methylsulfonyl)phenyl)-3-phenylfuran-2(5h)-one

6. 4-[4-(methylsulfonyl)phenyl]-3-phenylfuran-2(5h)-one

7. Mk-966

8. Mk-0966

9. 4-[4-(methylsulfonyl)phenyl]-3-phenyl-2(5h)-furanone

10. Mk0966

11. Mk 0966

12. 3-(4-methylsulfonylphenyl)-4-phenyl-2h-furan-5-one

13. Rofecoxib (vioxx)

14. Trm-201

15. 3-phenyl-4-[4-(methylsulfonyl)phenyl]-2(5h)-furanone

16. 4-(4-(methylsulfonyl)phenyl)-3-phenyl-2(5h)-furanone

17. 0qtw8z7mcr

18. Chembl122

19. Nsc-720256

20. Nsc-758705

21. 4-(p-(methylsulfonyl)phenyl)-3-phenyl-2(5h)-furanone

22. 2(5h)-furanone, 4-[4-(methylsulfonyl)phenyl]-3-phenyl-

23. Chebi:8887

24. M01ah02

25. Mk966

26. Refecoxib

27. Ncgc00095118-01

28. 4-(4-methanesulfonylphenyl)-3-phenyl-2,5-dihydrofuran-2-one

29. Vioxx Dolor

30. 2(5h)-furanone, 4-(4-(methylsulfonyl)phenyl)-3-phenyl-

31. Vioxx (trademark)

32. Smr000466331

33. Ccris 8967

34. Vioxx (tn)

35. Hsdb 7262

36. Sr-01000762904

37. Unii-0qtw8z7mcr

38. Rofecoxibum

39. Rofecoxib (jan/usan/inn)

40. Rofecoxib [usan:inn:ban]

41. 3-phenyl-4-(4-(methylsulfonyl)phenyl))-2(5h)-furanone

42. Rofecoxib [usan]

43. 4-(4-methylsulfonylphenyl)-3-phenyl-5h-furan-2-one

44. Ks-1107

45. Mk 0996

46. Spectrum_000119

47. Rofecoxib [inn]

48. Rofecoxib [jan]

49. Specplus_000669

50. Rofecoxib [mi]

51. Rofecoxib [hsdb]

52. Spectrum2_000446

53. Spectrum3_001153

54. Spectrum4_000631

55. Spectrum5_001598

56. Rofecoxib [vandf]

57. Dsstox_cid_3567

58. Rofecoxib [mart.]

59. Rofecoxib [who-dd]

60. Schembl3050

61. Dsstox_rid_77084

62. Dsstox_gsid_23567

63. Bspbio_002705

64. Kbiogr_001242

65. Kbiogr_002345

66. Kbioss_000559

67. Kbioss_002348

68. Mls000759440

69. Mls001165770

70. Mls001195623

71. Mls001424113

72. Mls006010091

73. Bidd:gt0399

74. Divk1c_006765

75. Spectrum1504235

76. Spbio_000492

77. 3-(4-methanesulfonylphenyl)-2-phenyl-2-buten-4-olide

78. Gtpl2893

79. Trm201

80. Zinc7455

81. Rofecoxib [orange Book]

82. Dtxsid2023567

83. Bdbm22369

84. Kbio1_001709

85. Kbio2_000559

86. Kbio2_002345

87. Kbio2_003127

88. Kbio2_004913

89. Kbio2_005695

90. Kbio2_007481

91. Kbio3_002205

92. Kbio3_002825

93. Ex-a708

94. Cmap_000024

95. Hms1922h11

96. Hms2051g16

97. Hms2089h20

98. Hms2093e04

99. Hms2232g21

100. Hms3371p11

101. Hms3393g16

102. Hms3651f16

103. Hms3713b07

104. Hms3750i17

105. Hms3885e05

106. Pharmakon1600-01504235

107. Bcp03619

108. Tox21_111430

109. Ccg-40253

110. Mfcd00935806

111. Nsc720256

112. Nsc758705

113. S3043

114. Stk635144

115. Akos000280931

116. Ab07701

117. Cs-0997

118. Db00533

119. Nc00132

120. Nsc 720256

121. Nsc 758705

122. Sb19518

123. Ncgc00095118-02

124. Ncgc00095118-03

125. Ncgc00095118-04

126. Ncgc00095118-05

127. Ncgc00095118-08

128. Ncgc00095118-17

129. Ncgc00095118-18

130. Ac-28318

131. Br164362

132. Hy-17372

133. Nci60_041175

134. Sbi-0206774.p001

135. Cas-162011-90-7

136. Ft-0631192

137. R0206

138. Sw219668-1

139. C07590

140. D00568

141. Ab00052090-06

142. Ab00052090-08

143. Ab00052090_09

144. Ab00052090_10

145. 011r907

146. A810324

147. L000912

148. Q411412

149. Q-201676

150. Sr-01000762904-3

151. Sr-01000762904-5

152. Brd-k21733600-001-02-6

153. Brd-k21733600-001-06-7

154. 3-(4-methanesulfonyl-phenyl)-2-phenyl-2-buten-4-olide

155. 2(5h)-furanone, 4-[4-(methyl-sulfonyl)phenyl]-3-phenyl-

156. 3-(phenyl)-4-(4-(methylsulfonyl)phenyl)-2-(5h)-furanone

157. 3-phenyl-4-(4-(methylsulfonyl)phenyl)-2-(5h)-furanone

158. 4-(4-methanesulfonyl-phenyl)-3-phenyl-5h-furan-2-one

159. 4-(4-methylsulfonylphenyl)-3-phenyl-2,5-dihydro-2-furanone

2.4 Create Date
2004-09-16
3 Chemical and Physical Properties
Molecular Weight 314.4 g/mol
Molecular Formula C17H14O4S
XLogP32.3
Hydrogen Bond Donor Count0
Hydrogen Bond Acceptor Count4
Rotatable Bond Count3
Exact Mass314.06128010 g/mol
Monoisotopic Mass314.06128010 g/mol
Topological Polar Surface Area68.8 Ų
Heavy Atom Count22
Formal Charge0
Complexity556
Isotope Atom Count0
Defined Atom Stereocenter Count0
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Therapeutic Uses

/September 20, 2004/ Merck & Co., Inc. announced a voluntary withdrawal of Vioxx (rofecoxib) from the U.S. and worldwide market due to safety concerns of an increased risk of cardiovascular events (including heart attack and stroke) in patients on Vioxx. Vioxx is a prescription COX-2 selective, non-steroidal anti-inflammatory drug (NSAID) that was approved by FDA in May 1999 for the relief of the signs and symptoms of osteoarthritis, for the management of acute pain in adults, and for the treatment of menstrual symptoms, and was later approved for the relief of the signs and symptoms of rheumatoid arthritis in adults and children.

US FDA; MedWatch. The FDA Safety Information and Adverse Event Reprting Program. 2004 Safety Alerts for Drugs, Biologics, Medical Devises, and Dietary Supplements. Vioxx (rofecoxib). Washington, DC: Fodd Drug Admin. Available from, as of Oct 20, 2004: https://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#vioxx


Anti-inflammatory.

O'Neil, M.J. (ed.). The Merck Index - An Encyclopedia of Chemicals, Drugs, and Biologicals. 13th Edition, Whitehouse Station, NJ: Merck and Co., Inc., 2001., p. 1481


Rofecoxib is indicated for the relief of the signs and symptoms of osteoarthritis. /Included in US product labeling/

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


Rofecoxib is indicated for short-term use (5 days) for relief of acute pain, especially when anti-inflammatory actions may be desired, such as following dental or orthopedic surgery. /Included in US product labeling/

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


Rofecoxib is indicated for short-term use (5 days) for relief of the pain and other symptoms of primary dysmenorrhea. /Included in US product labeling

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


4.2 Drug Warning

/Merck & Co., Inc. announced a voluntary withdrawal of Vioxx (rofecoxib) from the U.S. and worldwide market/ due to safety concerns of an increased risk of cardiovascular events (including heart attack and stroke) in patients on Vioxx. Vioxx is a prescription COX-2 selective, non-steroidal anti-inflammatory drug (NSAID) that was approved by FDA in May 1999 for the relief of the signs and symptoms of osteoarthritis, for the management of acute pain in adults, and for the treatment of menstrual symptoms, and was later approved for the relief of the signs and symptoms of rheumatoid arthritis in adults and children.

US FDA; MedWatch. The FDA Safety Information and Adverse Event Reprting Program. 2004 Safety Alerts for Drugs, Biologics, Medical Devises, and Dietary Supplements. Vioxx (rofecoxib). Washington, DC: Fodd Drug Admin. Available from, as of Oct 20, 2004: https://www.fda.gov/medwatch/SAFETY/2004/safety04.htm#vioxx


There is controversy whether cyclooxygenase-2 (COX-2) specific inhibitors are associated with elevations in blood pressure requiring treatment in typical clinical practice. We examined the risk of new onset hypertension in a retrospective case-control study involving 17 844 subjects aged > or =65 years from 2 US states. Multivariable logistic models were examined to assess the relative risk of new onset hypertension requiring treatment in patients who used celecoxib or rofecoxib compared with patients taking either the other COX-2 specific inhibitor, a nonspecific NSAID, or no NSAID. During the 1999 to 2000 study period, 3915 patients were diagnosed and began treatment for hypertension; 4 controls were selected for every case. In no model was celecoxib significantly associated with the development of hypertension. Rofecoxib users were at a significantly increased relative risk of new onset hypertension compared with patients taking celecoxib (odds ratio (OR) 1.6; 95% confidence interval (CI), 1.2 to 2.1), taking a nonspecific NSAID (OR 1.4; 95% CI, 1.1 to 1.9), or taking no NSAID (OR 1.6; 95% CI, 1.3 to 2.0). There were no clear dosage or duration effects. In patients with a history of chronic renal disease, liver disease, or congestive heart failure, the relative risk of new onset hypertension was twice as high in those taking rofecoxib compared with celecoxib (OR 2.1; 95% CI, 1.0 to 4.3). In this retrospective case-control study of patients aged > or =65 years, rofecoxib use was associated with an increased relative risk of new onset hypertension; this was not seen in patients taking celecoxib.

PMID:15226279 Solomon DH et al; Hypertension 44 (2): 140-5 (2004)


In a double-blind study, 35 stable subjects on low-dose aspirin with > or = 2 previous acute coronary events and 2 of 2 screening CRP values >2.0 mg/L were randomized to the COX-2 inhibitor rofecoxib (25 mg) or placebo daily for 6 months. Serum CRP, interleukin-6 (IL-6), P-selectin, matrix metalloproteinase-9 (MMP-9), and brachial artery endothelial function were evaluated. In the placebo group, CRP (median) was 3.16 mg/L (25% and 75% quartiles, 1.90 and 5.78 mg/L) at baseline and 4.22 mg/L (25% and 75% quartiles, 2.04 and 6.25 mg/L) at 6 months; in the rofecoxib group, CRP was 3.45 mg/L (25% and 75% quartiles, 2.08 and 5.78 mg/L) at baseline and 1.41 mg/L (25% and 75% quartiles, 1.17 and 4.81 mg/L) at 6 months (P=0.03). Rofecoxib compared with placebo also lowered IL-6 at 6 months (P=0.0002). There was a significant off-drug effect on CRP and IL-6 levels in the rofecoxib group 3 months after treatment (P=0.005 and P=0.009, respectively). Rofecoxib did not significantly affect P-selectin, MMP-9, and brachial artery vasoreactivity. Prolonged COX-2 inhibition attenuates CRP and IL-6, does not modify P-selectin and MMP-9, and has no deleterious effect on endothelial function in stable patients with a history of recurrent acute coronary events and raised CRP. These results strengthen the rationale for evaluating the clinical benefit of COX-2 inhibition in patients with ischemic heart disease.

PMID:15302800 Bogaty P et al; Circulation 110 (8): 934-9 (2004)


A 73-year-old woman was prescribed rofecoxib 25 mg/day for rheumatoid arthritis in addition to other medications on which the patient had been stabilized. Six months after initiation of rofecoxib, linear plaques over the infra-orbital and bitemporal areas of both eyes were observed. Several itchy violaceous papules also developed on her right wrist and dorsum of the left foot. She also had a hyperpigmented macule on her right buccal mucosa. As the skin rash was localized and the patient was initially unwilling to undergo skin biopsy, rofecoxib was continued and a topical steroid was started. One month later, the patient was seen in the dermatology clinic, and the improvement of her skin reaction was significant. A skin biopsy performed during this visit was consistent with LDE. On the next day, her rheumatologist decided to discontinue the offending drug, rofecoxib. Two months later, all skin lesions had completely resolved. No rechallenge with rofecoxib was attempted. LDE is a rare skin reaction that can be associated with several drugs. Rofecoxib, a cyclooxygenase-2 inhibitor, has never before been reported to cause LDE. An objective causality assessment indicates that rofecoxib was the probable cause of the skin reaction.

PMID:15026562 Abu-Shraie NA, Alfadley AA; Ann Pharmacother 38 (5): 795-8 (2004)


For more Drug Warnings (Complete) data for ROFECOXIB (31 total), please visit the HSDB record page.


4.3 Drug Indication

For the treatment of osteoarthritis, rheumatoid arthritis, acute pain in adults, and primary dysmenorrhea, as well as acute treatment of migraine attacks with or without auras.


FDA Label


5 Pharmacology and Biochemistry
5.1 Pharmacology

Rofecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, is classified as a nonsteroidal anti-inflammatory drug (NSAID). Unlike celecoxib, rofecoxib lacks a sulfonamide chain and does not require CYP450 enzymes for metabolism. Like other NSAIDs, rofecoxib exhibits anti-inflammatory, analgesic, and antipyretic activity. NSAIDs appear to inhibit prostaglandin synthesis via the inhibition of cyclooxygenase (COX), which are responsible for catalyzing the formation of prostaglandins in the arachidonic acid pathyway. There are at least two isoenzymes, COX-1 and COX-2, that have been identified. Although the exact mechanisms have not been clearly established, NSAIDs exert their anti-inflammatory, analgesic, and antipyretic primarily through the inhibition of COX-2. The inhibition of COX-1 is principally responsible for the negative effects on the GI mucosa. As rofecoxib is selective for COX-2, it may be potentially associated with a decreased risk of certain adverse events, but more data is needed to fully evaulate the drug.


5.2 MeSH Pharmacological Classification

Cyclooxygenase 2 Inhibitors

A subclass of cyclooxygenase inhibitors with specificity for CYCLOOXYGENASE-2. (See all compounds classified as Cyclooxygenase 2 Inhibitors.)


5.3 ATC Code

M - Musculo-skeletal system

M01 - Antiinflammatory and antirheumatic products

M01A - Antiinflammatory and antirheumatic products, non-steroids

M01AH - Coxibs

M01AH02 - Rofecoxib


5.4 Absorption, Distribution and Excretion

Absorption

The mean oral bioavailability of rofecoxib at therapeutically recommended doses of 12.5, 25, and 50 mg is approximately 93%.


Approximately 72% and 14% of a radioactive rofecoxib dose is eliminated in the urine as metabolites and /in/ feces as unchanged drug, respectively.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2496


Time to peak concentration: Approximately 2 to 3 hours.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2496


At steady state, the apparent volume of distribution is about 91 and 86 L after a 12.5 and 25 mg dose, respectively.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


At recommended doses, the mean oral bioavailability is 93%. The peak plasma concentration and area under the plasma concentration-time curve are roughly proportional across the clinical dose range.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


For more Absorption, Distribution and Excretion (Complete) data for ROFECOXIB (11 total), please visit the HSDB record page.


5.5 Metabolism/Metabolites

Hepatic. Metabolism of rofecoxib is primarily mediated through reduction by cytosolic enzymes. The principal metabolic products are the cis-dihydro and trans-dihydro derivatives of rofecoxib, which account for nearly 56% of recovered radioactivity in the urine. An additional 8.8% of the dose was recovered as the glucuronide of the hydroxy derivative, a product of oxidative metabolism. The biotransformation of rofecoxib and this metabolite is reversible in humans to a limited extent (< 5%). These metabolites are inactive as COX-1 or COX-2 inhibitors. Cytochrome P450 plays a minor role in metabolism of rofecoxib.


The metabolism of rofecoxib, a potent and selective inhibitor of cyclooxygenase-2, was examined in vitro using human liver subcellular fractions. The biotransformation of rofecoxib was highly dependent on the subcellular fraction and the redox system used. In liver microsomal incubations, NADPH-dependent oxidation of rofecoxib to 5-hydroxyrofecoxib predominated, whereas NADPH-dependent reduction of rofecoxib to the 3,4-dihydrohydroxy acid metabolites predominated in cytosolic incubations. In incubations with S9 fractions, metabolites resulting from both oxidative and reductive pathways were observed. In contrast to microsomes, the oxidation of rofecoxib to 5-hydroxyrofecoxib by S9 fractions followed two pathways, one NADPH-dependent and one NAD+-dependent (non-cytochrome P450), with the latter accounting for about 40% of total activity. The 5-hydroxyrofecoxib thus formed was found to undergo NADPH-dependent reduction ("back reduction") to rofecoxib in incubations with liver cytosolic fractions. In incubations with dialyzed liver cytosol, net hydration of rofecoxib to form 3,4-dihydro-5-hydroxyrofecoxib was observed, whereas the 3,4-dihydrohydroxy acid derivatives were formed when NADPH was present. Although 3,4-dihydro-5-hydroxyrofecoxib could be reduced to the 3,4-dihydrohydroxy acid by cytosol in the presence of NADPH, the former species does not appear to serve as an intermediate in the overall reductive pathway of rofecoxib metabolism. In incubations of greater than 2 h with S9 fractions, net reductive metabolism predominated over oxidative metabolism. These in vitro results are consistent with previous findings on the metabolism of rofecoxib in vivo in human and provide a valuable insight into mechanistic aspects of the complex metabolism of this drug.

PMID:14570773 Slaughter D et al; Drug Metab Dispos 31 (11): 1398-408 (2003)


Metabolism of rofecoxib is primarily mediated through reduction by cytosolic enzymes. The principal metabolic products are the cis-dihydro and trans-dihydro derivatives of rofecoxib, which account for nearly 56% of recovered radioactivity in the urine. An additional 8.8% of the dose was recovered as the glucuronide of the hydroxy derivative, a product of oxidative metabolism. The biotransformation of rofecoxib and this metabolite is reversible in humans to a limited extent (<5%). Theses metabolites are inactive as COX-1 or COX-2 inhibitors.

Physicians Desk Reference. 58th ed. Thomson PDR. Montvale, NJ 2004., p. 2108


Rofecoxib has known human metabolites that include 5-hydroxy-rofecoxib.

S73 | METXBIODB | Metabolite Reaction Database from BioTransformer | DOI:10.5281/zenodo.4056560


5.6 Biological Half-Life

17 hours


Approximately 17 hours.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


5.7 Mechanism of Action

The anti-inflammatory, analgesic, and antipyretic effects of NSAIDs appear to result from the inhibition of prostaglandin synthesis. Although the exact mechanism of action has not been determined, these effects appear to be mediated through the inhibition of the COX-2 isoenzyme at the sites of inflammation with subsequent reduction in the synthesis of certain prostaglandins from their arachidonic acid precursors. Rofecoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which is important for the mediation of inflammation and pain. Unlike non-selective NSAIDs, rofecoxib does not inhibit platelet aggregation. It also has little to no affinity for COX-1.


Rofecoxib is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic, and antipyretic therapeutic effects. It has been proposed that rofecoxib inhibits the activity of the enzyme cyclooxygenase-2 (COX-2), resulting in a decreased formation of precursors of prostaglandins. Rofecoxib does not inhibit cyclooxygenase-1 (COX-1) isoenzyme in humans at therapeutic concentrations.

Thomson.Micromedex. Drug Information for the Health Care Professional. 24th ed. Volume 1. Plus Updates. Content Reviewed by the United States Pharmacopeial Convention, Inc. Greenwood Village, CO. 2004., p. 2495


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