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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.


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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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