• Type: NSAID
  • Dosage Forms: Capsule 18mg, 25mg, 35mg; ER Tablet 100mg, 0.1% opthalmic solution, topical gel 1-3%
  • Common Trade Names: Zorvolex

Adult Dosing

Pain, mild-moderate

  • Tablet PO 50mg TID, may administer 100mg as first dose

Ankylosing Spondylitis

  • PO Delayed Release 25mg 4x daily and 25mg qhs prn


  • 35mg PO TID

Pediatric Dosing


Special Populations

  • Pregnancy Rating: C, category D if >30wks after gestation
  • Lactation: probably safe
  • Renal dosing: monitor renal function closely if advanced renal disease
  • Hepatic dosing: max 54mg/day


  • allergy to class/drug
  • ASA or NSAID-induced asthma or urticaria
  • caution if:
    • renal impairment, dehydration, elderly or debilitated
    • history of GI bleed or ulcers, alcohol use, or coagulopathy
    • hepatic impairment
    • asthma
    • cardiovascular disease (or high risk of), including CABG surgery periop use, recent MI, CHF, HTN, smoker
    • fluid retention
    • PKU
    • prolonged use

Adverse Reactions


  • GI bleed, ulcer, perforation
  • blood dyscrasias, prolonged bleeding time, anemia
  • nephrotoxicity, renal papillary necrosis
  • MI, stroke, thromboembolism, HTN, CHF
  • hepatotoxicity, hepatic necrosis, pancreatitis
  • bronchospasm
  • exfoliative dermatitis, SJS/TEN


  • dyspepsia, nausea/vomiting, abdominal pain, diarrhea, constipation, flatulence
  • headache, dizziness, drowsiness, tinnitus
  • dizziness
  • rash, pruritus, urticaria, photosensitivity
  • fluid retention, peripheral edema
  • ecchymosis
  • elevated creatinine, ALT/AST
  • sinusitis


  • Half-life: 1.9 hours
  • Metabolism: liver; CYP450 (2C8, 2C9, 3A4 substrate), UGT (2B7 substrate)
  • Excretion: urine 65%, bile 35%
  • Mechanism of Action: exact MOA unknown; inhibits cyclooxyrgenase, reducing prostaglandin and thromboxane synthesis

See Also