Cox-2 Inhibitors (cont.)
The other cyclooxygenase, COX-2,
also produces prostaglandins, but the COX-2 enzyme is located specifically in
areas of the body that commonly are involved in inflammation but not in the
stomach. When the COX-2 enzyme is blocked, inflammation is reduced; however,
since the COX-2 enzyme does not play a role in protecting the stomach or
intestine, COX-2 specific NSAIDs do not have the same
risk of injuring the stomach or intestines.
Older NSAIDs (for example, aspirin, ibuprofen, naproxen, etc.) all act by blocking
the action of both the COX-1 and COX-2 enzymes. COX-2 inhibitors selectively
block the COX-2 enzyme and therefore have a lower risk of causing ulcers of the
stomach or intestine.
What are side effects of COX-2 inhibitors?
Common side effects of COX-2 inhibitors include:
COX-2 inhibitors may increase the
risk of serious, even fatal stomach and intestinal adverse reactions, such as
ulcers, bleeding, and perforation of the stomach or intestines but to a lesser
extent than other nonselective NSAIDs that block both COX-1 and COX-2. These
events can occur at any time during treatment and without warning symptoms.
People allergic to sulfonamides, for example, trimethoprim
(Trimpex, Proloprim, Primsol) and
sulfamethoxazole (Bactrim), aspirin or other NSAIDs may experience allergic
reactions to COX-2 inhibitors and should not take them.
NSAIDs, including COX-2 inhibitors, may increase the
risk of heart attacks, stroke,
and related conditions. This risk may increase in patients with risk factors for
heart disease and related conditions and with longer duration of
use. NSAIDs should not be used after
coronary artery bypass graft (CABG) surgery.
Which COX-2 inhibitors are available in the United States?
Celecoxib (Celebrex) is the only COX-2 inhibitor available in the
United States. Rofecoxib (Vioxx) and valdecoxib (Bextra) were withdrawn from the market in 2004
and 2005, respectively, because they excessively increased the risk of heart
attacks and strokes with long term use.
Reference: FDA Prescribing Information
Last Editorial Review: 7/22/2009
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Nonsteroidal Antiinflammatory Drugs (NSAIDs) - Describes Nonsteroidal Antiinflammatory Drugs (NSAIDs), which are medications used primarily to treat inflammation, mild to moderate pain, and fever.
- Abdominal Pain - Learn about abdominal pain (pain in the stomach / abdomen) including causes, symptoms, how abdominal pain is diagnosed, and how abdominal pain is treated.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
Latest Medical News
Back to Medications Index
Arthritis RSS