What is a Cox-2 Inhibitor?

Tricia Christensen
Tricia Christensen

A COX-2 inhibitor is a special kind non-steroidal anti-inflammatory drug (NSAID) that may be preferred because it often affects the stomach less than other NSAIDs. Like all NSAIDs, COX-2 inhibitors are useful in addressing pain due to inflammation, and in reducing fever. Their advantage of being gentler on the stomach is due to the way they work.

Clecoxib may cause stomach pain.
Clecoxib may cause stomach pain.

Many NSAIDS block production of enzymes called cyclooxygenase 1 and 2 or COX-1 and COX-2. Blocking COX-1 can prove problematic for many people because it shuts down the enzyme’s ability to protect stomach lining. People who take things like ibuprofen or aspirin for lengthy periods of time may find good effect in treating pain or inflammation, but relatively bad effect when it comes to gastrointestinal symptoms. Over time some people develop bleeding in the stomach or ulcerations that can be very serious.

The reasoning behind the COX-2 inhibitor is thus explained. These medicines only block the enzyme COX-2. This allows COX-1 to continue to work and provide better protection to the gastrointestinal tract.

That doesn’t mean that a COX-2 inhibitor can’t cause intestinal damage, and the medication available in places like the US, celecoxib, does carry warning labels about its potential to cause intestinal bleeding. It’s simply that this selective inhibitor may be less likely to result in stomach problems like ulcerations. That risk should not be understood as completely eliminated.

In 2010 in the US, celecoxib is the only COX-2 inhibitor available through prescription. The other two well-known inhibitors Vioxx® and Bextra® were withdrawn from the market in many places because they showed an elevated risk of causing cardiac events. Celecoxib does carry a higher risk for developing stroke or heart attack, but this risk is not thought as severe as the other drugs it resembles.

As with all medication, celecoxib is best taken under a doctor’s guidance. It can interact with medicines like lithium and warfarin, and people can have side effects from the medicine such as stomach pain, headache, gassiness or difficulty sleeping. Some people allergic to sulfa drugs are also allergic to celecoxib.

There are some interesting studies on possible applications of the COX-2 inhibitor to treat different types of medical conditions. It appears that some tumors or abnormal growths produce COX-2 at high rates, and this suggests that a selective inhibitor might be able to reduce growth or possibly eliminate abnormal lesions. Investigation of these medicines as possibly cancer-fighting is ongoing. Additionally, there is interest in developing new COX-2 inhibitors with fewer side effects or problems.

Tricia Christensen
Tricia Christensen

Tricia has a Literature degree from Sonoma State University and has been a frequent wiseGEEK contributor for many years. She is especially passionate about reading and writing, although her other interests include medicine, art, film, history, politics, ethics, and religion. Tricia lives in Northern California and is currently working on her first novel.

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