Current COX-2 drugs
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Three major cox-2 inhibitor drugs, celecoxib (Celebrex) and rofecoxib (Merck's Vioxx), and Pfizer's Bextra all were, at one time, prescription alternatives to commonly prescribed non-steroidal anti-inflammatory (NSAIDs) drugs used to treat osteoarthritis and rheumatoid arthritis.
These anti-inflammatory drugs demonstrated the same efficacy for reducing inflammation as traditional NSAIDs, but with fewer gastrointestinal side effects due to the suppression of the Cox-2 enzyme. The Cox-1 enzyme required for protection from stomach ulcers was not blocked.
Both Vioxx and Bextra were removed from the market because of a marked association with cardiovascular deaths with the former and severe skin toxicity with the latter.
The FDA reviewed the findings of the Journal of American Medical Association and concluded that the remaining Cox-2 inhibitor drug, Celebrex, was associated with increased cardiovascular risk. However, the data to date indicates that the risk with Celebrex is no different than the risk from traditional NSAIDS.
Physicians should be cautious about prescribing any NSAIDs, COX-2 or not, for patients with a history of heart disease.
Celebrex, when combined with aspirin has the same gastrointestinal risk as non-COX-2 NSAIDS. Patients with a history of sulfa allergy should not use Celebrex because it is a sulfa based drug.
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