Treatment Options

COX-2 inhibitors are a type of non-steroidal anti-inflammatory drug (NSAID). Although NSAIDs are widely prescribed and available, it has long been known that they can produce serious side effects. The cause of these side effects was discovered in the early 1990s when researchers demonstrated that there are actually two COX enzymes, dubbed COX-1 and COX-2. They are so similar in structure that NSAIDS interact with both of them. However, the COX-1 enzyme does not play a role in inflammation and pain. It is found throughout the body, especially in the gastrointestinal tract, kidneys, and blood platelets. It is believed that blocking this COX-1 enzyme leads to the stomach and kidney damage that NSAIDs can cause. By comparison, COX-2 is found primarily in inflamed tissue. With this finding, pharmaceutical companies raced to produce medications that only interact with COX-2. These are called COX-2 inhibitors, and they are as effective as NSAIDs in treating pain, but don?t cause damage to the stomach.

Recently two of the available COX-2 inhibitors, rofecoxib (Vioxx) and valdecoxib (Bextra) were withdrawn from the market due to an increased risk of adverse cardiovascular events in patients taking these medications. Celecoxib (Celebrex) is still available for use, but should be used at the lowest possible dose (not to exceed 200 mg twice daily) and with extreme caution in patients with existing cardiovascular disease.

Drugs in the class

Celecoxib Capsules (Celebrex)