ACUTE RENAL FAILURE WITH ROFECOXIB Morales and Mucksavage
1321
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erythema multiforme, or a diffuse maculopapular
or exfoliative dermatitis, and at least one of the
following symptoms: acute hepatocellular injury,
marked eosinophilia, or worsening renal
function.28–32 Although our patient had
decreased renal function, she did not have a rash,
and a complete blood count with differential was
normal.
The manufacturers of COX-2 inhibitors
caution against the administration of these agents
in patients with preexisting renal disease and
considerable dehydration.33–35 In addition,
growing evidence suggests that COX-2 inhibitors
should be prescribed with caution or not at all
for patients in whom traditional NSAIDs pose a
risk for renal failure, including those with heart
failure, sodium depletion, and preexisting hepatic
or renal insufficiency.
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