Rofecoxib is a type of nonsteroidal anti-inflammatory drug (NSAID) commonly used in the treatment of acute pain conditions, including osteoarthritis. It has been marketed by Merck and Company under a variety of trade names, however it was withdrawn from the market in 2004 due to side effects associated with the drug. These side effects include an increased risk of stroke as well as myocardial infarction (heart-attack). Up until the time it was withdrawn Rofecoxib was very widely used, with over 2 million people being prescribed the drug bringing Merck and Co. a sales revenue of as much as $2.5 billion.

Rofecoxib exhibits many of the side effects generally associated with NSAIDs. However it was shown in trials to increase the risk of potentially fatal cardiovascualar occurences, leading to its withdrawal. The side effects may result from maleic anhydride metabolites formed when the drug is metabolised under physiological conditions.

The group of NSAIDs known as COX-2 selective inhibitors (coxibs) includes the drug Rofecoxib. They are called COX-2 selective because the drugs act specifically on one form of cyclooxygenase (COX) enzyme, viz. the COX-2, whereas pre-coxib NSAIDs would inhibit both COX-1 and COX-2. This selectivity gives coxibs the ability to ease pain and inflammation while keeping gastrointestinal side effects to a minimum. Common non-selective NSAIDs such as aspirin and ibuprofen are typically associated with adverse gastrointestinal side effects.

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