COX2preferential
COX2preferential refers to nonsteroidal anti-inflammatory drugs (NSAIDs) that inhibit the cyclooxygenase-2 (COX-2) enzyme more potently than cyclooxygenase-1 (COX-1). This distinction matters because COX-2 is largely inducible at sites of inflammation, while COX-1 is constitutively expressed and contributes to gastric mucosal protection and platelet function. Drugs described as COX2preferential have higher affinity or efficacy at COX-2 relative to COX-1, but they are not necessarily exclusive COX-2 inhibitors.
Pharmacology and terminology: Inhibitory selectivity is often expressed by comparing IC50 or Ki values for COX-1
Examples and spectrum: Celecoxib is widely cited as COX-2 selective. Meloxicam is frequently described as COX-2
Clinical considerations: COX2preferential NSAIDs can offer GI safety advantages relative to nonselective NSAIDs but may carry
Regulatory context: Some COX-2–preferential or selective agents have undergone safety reviews or withdrawal due to cardiovascular
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