Ordinary or Conventional NSAIDs or Non Steroidal Anti-Inflammatories block both COX-1 and COX-2 enzyme. Cyclooxygenase-1 or COX-1 has a very important function in the body and this is the maintenance and protection of the stomach lining against acids. The inhibition of COX-1 enzyme due to the long term use of NSAIDs would often result into stomach irritation and in some cases it results into ulcers. The newer COX-2 Inhibitors are more specific in inhibiting the COX-2 enzyme but not the COX-1 enzyme. COX-2 enyzme is the main cause of pain and inflammation. COX-2 inhibitors reduces the incidence of stomach ulcers and bleeding during arthritis treatment. The effectiveness of COX-2 Inhibitors in reducing pain and inflammation is the same or even more effective than traditional NSAIDs.
Side Effects and Precautions of COX-2 Inhibitors:
Since prostaglandins are involved in the regulation of blood pressure, there is an associated cardiovascular risk with COX-2 specific inhibitors. There is an increased risk of cardiovascular death, heart attack, stroke, or heart failure with the long term use of COX-2 inhibitors.
Forms, Dosage and Brandnames of COX-2 Inhibitors:
Adults: Celebrex (Celecoxib) 800 mg/day
Vioxx (Rofecoxib)
Bextra (Valdecoxib
Prexige (Lumiracoxib)
Arcoxia (Etoricoxib)
Pregnant Women: Pregnant women are encouraged to avoid COX–2 inhibitors during the third trimester. Consult your doctor if you want to take this medication.
Children: No research has been done about the effects of COX–2 inhibitors on children
References about COX-2 Inhibitors:
The cost-effectiveness of acetaminophen, NSAIDs, and selective COX-2 inhibitors in the treatment of symptomatic knee osteoarthritis”; C. C. Kamath, H. M. Kremers, D. J. Vanness, W. M. O’Fallon, R. L Cabanela, S. E. Gabriel; Value Health 2003, Mar-Apr;6 (2); 144-57.
“At what care level are cyclo-oxygenase-2 inhibitors prescribed?”; Montero, Fernandez MJ, Rodriguez, Alcala FJ, Valles Fernandez N, Lopez de Castro, F, Esteban, Tudela M, Cordero, Garcia B; Aten Primaria 2002 Oct 30:363-7.
“You and A: Arthritis drugs. Pain and confusion”; Francesca Lunzer Kritz; Washington Post; Sept. 4, 2001; HE01.
“Vioxx (rofecoxib) reduces night-time osteoarthritis pain better than celecoxib or acetaminophen”; European League Against Rheumatism (EULAR) conference proceedings.
Page last updated: May 02, 2009
