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Review of the selective COX-2 inhibitors celecoxib and rofecoxib: focus on clinical aspects

Published online by Cambridge University Press:  21 May 2015

Peter S. Loewen*
Affiliation:
Internal Medicine, Pharmaceutical Sciences Clinical Service Unit, Vancouver Hospital and Health Sciences Centre, Vancouver, BC; University of British Columbia, Vancouver; Advanced Pharma-cotherapeutics, Doctor of Pharmacy Program, UBC Chair, UBC Clinical Research Ethics Board; The Journal of Informed Pharmacotherapy
*
Rm. G261A, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver BC V6T 2B5; 604 822-7985, fax 604 822-9742, [email protected]

Abstract:

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The selective cyclooxygenase-2 (COX-2) inhibitors celecoxib and rofecoxib were designed to have similar efficacy but less gastrointestinal toxicity than traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Their efficacy has been demonstrated in the treatment of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, postoperative dental pain and dysmenorrhea. These agents produce fewer endoscopic ulcers, symptomatic ulcers and gastrointestinal bleeds than traditional NSAIDs; although the absolute benefit is small and the gastropreserving effect is negated by concurrent use of low-dose aspirin for cardiovascular risk reduction. Nephrotoxicity and hyptertension remain concerns with COX-2 inhibitors, as they are with traditional NSAIDs. COX-2 inhibitors may be safe alternatives to traditional NSAIDs for patients with aspirin-sensitive asthma.

Type
Pharmacotherapy • Pharmacothérapie
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

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