Care Guides - Drug treatment - COX-2 inhibitors

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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.

Review Date: 6/29/2011
Reviewed By: Andrew W. Piasecki, MD, Camden Bone and Joint, LLC, Orthopaedic Surgery/Sports Medicine, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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