BLOOD PRESSURE ELEVATION WITH ROFECOXIB IN OLDER ADULTS
Marty L Eng and Carlos H Rojas-Fernandez

OBJECTIVE: To report blood pressure elevation associated with rofecoxib use in 2 older adults.

CASE SUMMARIES: Two patients,aged 75 and 94 years,were prescribed rofecoxib for osteoarthritis pain.After the initiation of therapy,an elevation in systolic blood pressure measurement =17 mm Hg was observed. Upon withdrawal of rofecoxib, blood pressure in one patient returned to baseline measurements.In the second patient, sustained rofecoxib use resulted in blood pressure elevation and change in antihypertensive therapy.

DISCUSSION: It is well known that even a small elevation in blood pressure can significantly increase a person ’s risk for cardiovascular events. However, little is known about the potential magnitude of blood pressure elevation with the use of cyclooxygenase-2 inhibitors in the older adult population. In 2 older adults with osteoarthritis and hypertension, rofecoxib potentially led to a substantial elevation in blood pressure. In each case, adjustments of respective therapeutic regimens were made. The Naranjo probability scale indicates a probable relationship in both cases between the rofecoxib and blood pressure elevation.

CONCLUSIONS: These reports suggest that rofecoxib could produce greater elevation in blood pressure in older hypertensive adults than has been previously reported. Therefore, close monitoring of blood pressure for 1 –2 months after initiation of rofecoxib therapy is advisable. Further study is needed to determine the true clinical significance of these findings in older hypertensive adults.

J Pharm Technol 2004;20:80-4.