How COX-2 Inhibitors work on arthritis:
Traditional NSAIDs blocks both COX-1 and COX-2 enzyme. Cyclooxygenase-1 or COX-1 enzymes are responsible for the maintenance and protection of the stomach lining. By inhibiting COX-1, long term users of NSAIDs would often end up with stomach irritation and stomach ulcers. Newly designed COX-2 inhibitors are more specific in inhibiting Cyclooxygenase-2 which is mainly responsible for pain and inflammation. COX-2 inhibitors reduce the risk of stomach ulceration and bleeding as they reduce pain and inflammation from arthritis.
Side Effects and Precautions of COX-2 Inhibitors:
Since prostaglandins are involved in the regulation of blood pressure, there is an associated cardiovascular risk with COX-2 specific inhibitors. There is an increased risk of cardiovascular death, heart attack, stroke, or heart failure with long term use of COX-2 inhibitors.
Forms, Dosage and Brandnames of COX-2 Inhibitors:
Adults: Celebrex (Celecoxib) 800 mg/day
Pregnant Women: Pregnant women are encouraged to avoid COX–2 inhibitors during the third trimester. Consult your doctor if you want to take this medication.
Children: No research has been done about the effects of COX–2 inhibitors on children
References about COX-2 Inhibitors:
The cost-effectiveness of acetaminophen, NSAIDs, and selective COX-2 inhibitors in the treatment of symptomatic knee osteoarthritis”; C. C. Kamath, H. M. Kremers, D. J. Vanness, W. M. O’Fallon, R. L Cabanela, S. E. Gabriel; Value Health 2003, Mar-Apr;6 (2); 144-57.
“At what care level are cyclo-oxygenase-2 inhibitors prescribed?”; Montero, Fernandez MJ, Rodriguez, Alcala FJ, Valles Fernandez N, Lopez de Castro, F, Esteban, Tudela M, Cordero, Garcia B; Aten Primaria 2002 Oct 30:363-7.
“You and A: Arthritis drugs. Pain and confusion”; Francesca Lunzer Kritz; Washington Post; Sept. 4, 2001; HE01.
“Vioxx (rofecoxib) reduces night-time osteoarthritis pain better than celecoxib or acetaminophen”; European League Against Rheumatism (EULAR) conference proceedings.