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ABSTRACT:The metabolism of rofecoxib, a potent and selective inhibitor of cyclooxygenase-2, was examined in vitro using human liver subcellular fractions. The biotransformation of rofecoxib was highly dependent on the subcellular fraction and the redox system used. In liver microsomal incubations, NADPH-dependent oxidation of rofecoxib to 5-hydroxyrofecoxib predominated, whereas NADPHdependent reduction of rofecoxib to the 3,4-dihydrohydroxy acid metabolites predominated in cytosolic incubations. In incubations with S9 fractions, metabolites resulting from both oxidative and reductive pathways were observed. In contrast to microsomes, the oxidation of rofecoxib to 5-hydroxyrofecoxib by S9 fractions followed two pathways, one NADPH-dependent and one NAD ؉ -dependent (non-cytochrome P450), with the latter accounting for about 40% of total activity. The 5-hydroxyrofecoxib thus formed was found to undergo NADPH-dependent reduction ("back reduction") to rofecoxib in incubations with liver cytosolic fractions. In incubations with dialyzed liver cytosol, net hydration of rofecoxib to form 3,4-dihydro-5-hydroxyrofecoxib was observed, whereas the 3,4-dihydrohydroxy acid derivatives were formed when NADPH was present. Although 3,4-dihydro-5-hydroxyrofecoxib could be reduced to the 3,4-dihydrohydroxy acid by cytosol in the presence of NADPH, the former species does not appear to serve as an intermediate in the overall reductive pathway of rofecoxib metabolism. In incubations of greater than 2 h with S9 fractions, net reductive metabolism predominated over oxidative metabolism. These in vitro results are consistent with previous findings on the metabolism of rofecoxib in vivo in human and provide a valuable insight into mechanistic aspects of the complex metabolism of this drug.Rofecoxib (VIOXX, a registered trademark of Merck and Co., Inc.) is a potent and selective inhibitor of cyclooxygenase-2 (COX-2 1 ), which is indicated for the treatment of osteoarthritis, rheumatoid arthritis, and pain. It has been shown to cause significantly fewer gastrointestinal side effects than naproxen, a nonselective COX inhibitor (Bombardier et al., 2000), consistent with the hypothesis that COX-2 selective inhibitors exhibit a gastrointestinal safety advantage over nonselective COX inhibitors (Donnelly and Hawkey, 1997;Jouzeau et al., 1997).In previous reports from this laboratory, the absorption, distribution, metabolism, and excretion of rofecoxib were examined in the rat, dog, and human (Halpin et al., 2000(Halpin et al., , 2002. Metabolism studies in laboratory animals and humans indicated that rofecoxib undergoes complex metabolism involving both oxidative and reductive reactions. Although the metabolic pathways of rofecoxib were qualitatively similar between the rat and human, oxidation to 5-hydroxyrofecoxib (5-hydroxyR) predominated in rats (Halpin et al., 2000), whereas reduction of rofecoxib to the corresponding isomeric 3,4-dihydrohydroxy acid (DHHA) derivatives was...