Cyclooxygenase 2 Specific Inhibitor

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Contents 1 More Specific Terms 2 Adverse-effects 3 Drug-interactions 4 Mechanism-of-action 5 Notes 6 More General Terms 7 Additional Terms 8 References

More Specific Terms

• celecoxib (Celebrex)
• etoricoxib (Arcoxia)
• lumiracoxib (Prexige)
• parecoxib (Dynastat)
• rofecoxib (Vioxx)
• valdecoxib (Bextra)

Adverse-effects

• hypertension (especially systolic hypertension)
• diminished renal function
• peripheral edema
• heart failure
• upper GI bleed (probably less-likely than non-selective NSAIDs)
  
• drug adverse effects of NSAIDs
• drug adverse effects of COX-2-specific inhibitors

Drug-interactions

• as likely as non-selective NSAIDs to potential upper GI bleeding when used in combination with warfarin [8]
  
• drug interaction(s) of lithium carbonate with NSAIDs
• drug interaction(s) of NSAIDs with SSRIs
• drug interaction(s) of aspirin with NSAIDs
• drug interaction(s) of NSAIDs with beta blockers
• drug interaction(s) of NSAIDs with ARBs
• drug interaction(s) of NSAIDs with ACE inhibitors
• drug interaction(s) of NSAIDs, diuretics & angiotensin II receptor antagonists
• drug interaction(s) of NSAIDs, diuretics & ACE inhibitors
• drug interaction(s) of NSAIDs & loop diuretics
• drug interaction(s) of NSAIDs & aspirin

Mechanism-of-action

• selectively inhibit cyclo- oxygenase-2 ( COX-2)
• inhibition of prostacyclin production
• do NOT inhibit platelet aggregation

Notes

• December 23, 2004: The U.S. Food and Drug Administration ( FDA) issued a public health advisory concerning use of non-steroidal anti-inflammatory drug products ( NSAIDs) including those known as COX-2 selective agents. [5]

More General Terms

• non-steroidal anti-inflammatory agent (NSAID)

Additional Terms

• cyclooxygenase-2 (COX2, PGH synthase-2, prostaglandin endoperoxide synthase-2)

References

1. Prescriber's Letter 7(10):55 2000
2. Prescriber's Letter 8(6):31-32 2001
3. Journal Watch 23(13):103, 2003 Spiegel BMR et al, Ann Intern Med 138:795, 2003
4. Prescriber's Letter 11(11): 2004 Safety of COX-2 Inhibitors and Their Place in Therapy Detail-Document#: [1] (subscription needed) [2]
5. url>http://www.fda.gov/cder/drug/advisory/nsaids.htm</url>
6. Prescriber's Letter 12(2): 2005 Update on the Safety and Use of COX-2 Inhibitors and Traditional NSAIDs Detail-Document#: [3] (subscription needed) [4]
7. Prescriber's Letter 12(3): 2005 COX-2 Inhibitor Safety: An Update Detail-Document#: [5] (subscription needed) [6]
8. Journal Watch 25(6):46, 2005 Battistella M, Mamdami MM, Juurlink DN, Rabeneck L, Laupacis A. Risk of upper gastrointestinal hemorrhage in warfarin users treated with nonselective NSAIDs or COX-2 inhibitors. Arch Intern Med. 2005 Jan 24;165(2):189-92. PMID: [7]
9. Prescriber's Letter 12(5): 2005 FDA Announces Important Changes and Additional Warnings for COX-2s and NSAIDs Detail-Document#: [8] (subscription needed) [9]
10. FDA MedWatch COX-2 Selective (includes Bextra, Celebrex, and Vioxx) and Non-Selective Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) [10]

cyclooxygenase-2 (COX-2) specific inhibitor