rofecoxib + bupivacaine

Rofecoxib + bupivacaine is a non-fixed combination of two drugs used together for perioperative pain management, particularly in surgical settings. Rofecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor classified as a nonsteroidal anti-inflammatory drug (NSAID), which reduces inflammation and pain by inhibiting prostaglandin synthesis. Bupivacaine is an amide-type local anesthetic that blocks sodium channels on neuronal membranes, preventing nerve impulse transmission and providing local or regional anesthesia. The combination has been studied for its ability to provide superior analgesia compared to either agent alone, with evidence showing that preemptive oral administration of rofecoxib combined with postoperative intraarticular bupivacaine significantly prolongs analgesia duration and reduces opioid requirements after procedures such as arthroscopic knee surgery[1][3]. Rofecoxib was previously marketed for various pain conditions but was withdrawn from the market due to cardiovascular safety concerns[8][10].