Drug treatment - COX-2 inhibitors

COX-2 inhibitors are a special class of NSAIDs that block the body's production of a substance that causes inflammation and pain. They are less likely to cause stomach ulcers and gastrointestinal bleeding than other NSAIDS. COX-2 inhibitors are much more expensive than standard NSAIDs like ibuprofen. Celecoxib (Celebrex) is a COX-2 inhibitor.

Possible side effects

COX-2 inhibitors can cause the following side effects:

• Heart attack and stroke. Several COX-2s have been taken off the market due to the risk of fatal and non-fatal cardiovascular events. The FDA asked the manufacturer of Celebrex to place a strong warning on its label to alert patients to the potential for such risks.
• Stomach pain and diarrhea.
• Poor kidney function, especially if you are over 65 years old. If you develop fluid build up, notify your doctor right away.
• Negative interactions with medications for high blood pressure, heart disease, and seizures. Make sure that the doctor prescribing COX-2 inhibitors knows about all of the other drugs you are taking.
• Rash.

People who should not use COX-2 inhibitors

If you are allergic to NSAIDs, sulfa drugs, or aspirin, you cannot take COX-2 inhibitors. Also, if you are pregnant or planning to become pregnant in the near future, you should not use COX-2 inhibitors.

If you had a heart attack or have a history of blockages in your coronary arteries, ask your doctor if COX-2s are right for you. People with a history of other heart conditions or risk factors, such as diabetes, high blood pressure, or high cholesterol, should use COX-2 inhibitors with caution.

References

US Food and Drug Administration. FDA Public Health Advisory: FDA Announces Important Changes and Additional Warnings for COX-2 Selective and Non-Selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) . Rockville, MD: Center for Drug Evaluation and Research; April 7, 2005.

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