COX-2 Inhibitor Drug Information
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
- What are COX-2 inhibitors, and how do they work?
- For what conditions are COX-2 inhibitors used?
- Are there any differences among the different types of COX-2 inhibitors?
- What are the side effects of COX-2 inhibitors?
- With which drugs do COX-2 inhibitors interact?
- Which COX-2 inhibitors are available?
What are COX-2 inhibitors, and how do they work?
COX-2 inhibitors are a subclass of nonsteroidal antiinflammatory drugs (NSAIDs). NSAIDs work by reducing the production of prostaglandins, chemicals that promote inflammation, pain, and fever. Prostaglandins also protect the lining of the stomach and intestines from the damaging effects of acid, promote blood clotting by activating platelets, and also affect kidney function.
The enzymes that produce prostaglandins are called cyclooxygenase (COX). There are two types of COX enzymes, COX-1 and COX-2. Both enzymes produce prostaglandins that promote inflammation, pain, and fever; however, only COX-1 produces prostaglandins that activate platelets and protect the stomach and intestinal lining.
NSAIDs block the COX enzymes and reduce production of prostaglandins. Therefore, inflammation, pain, and fever are reduced by all COX inhibitors. Since the prostaglandins that protect the stomach and promote blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and intestines, and increase the risk of bleeding. Unlike older NSAIDs that block both COX-1 and COX-2, the newer COX-2 inhibitors only block the COX-2 enzyme. Since COX-2 inhibitors do not block COX-1 (which primarily produces prostaglandins that protect the stomach and promote blood clotting) they do not cause ulcers or increase the risk of bleeding as much as the older NSAIDs. Nevertheless, COX-2 inhibitors are as effective as the older NSAIDs for treating inflammation, pain and fever.
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