Coxib

Coxib refers to a class of nonsteroidal anti-inflammatory drugs (NSAIDs) that selectively inhibit the cyclooxygenase-2 (COX-2) enzyme. Traditional NSAIDs, like ibuprofen and naproxen, inhibit both COX-1 and COX-2. COX-1 is primarily responsible for maintaining the lining of the stomach and for platelet aggregation, while COX-2 is induced during inflammation and pain. By selectively targeting COX-2, coxibs aim to reduce inflammation and pain while potentially causing fewer gastrointestinal side effects, such as ulcers and bleeding, compared to non-selective NSAIDs.

The development of coxibs was a significant pharmaceutical advancement, aiming to provide pain relief with an improved safety profile. Examples of coxibs include celecoxib, etoricoxib, and rofecoxib. However, concerns arose regarding the cardiovascular safety of some coxibs. Studies indicated an increased risk of heart attack and stroke associated with their use, particularly with long-term administration or in patients with pre-existing cardiovascular conditions.

This led to the withdrawal of certain coxib drugs from the market, such as rofecoxib (Vioxx) and valdecoxib (Bextra). Celecoxib remains available but is prescribed with caution, often with recommendations for the lowest effective dose and for the shortest duration necessary. Patients considering coxib therapy should discuss their individual risk factors and potential benefits with a healthcare professional.