COX-2 inhibitor

(redirected from COX-2 selective inhibitor)
Also found in: Dictionary, Thesaurus, Encyclopedia, Wikipedia.
Related to COX-2 selective inhibitor: Coxib

COX-2 inhibitor

A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.

Prostanoids that mediate inflammation, pain, and fever are synthesized through the action of cyclooxygenase-2 (COX-2), an enzyme that is constitutively expressed in the brain but can be induced in other tissues by cytokines. In both osteoarthritis and rheumatoid arthritis, COX-2 inhibitors have been shown to be superior in pain relief to acetaminophen and placebo, and equivalent to nonselective nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and naproxen. In rheumatoid arthritis, COX-2 inhibitors are not disease-modifying drugs. Because nonselective NSAIDs inhibit not only COX-2 but also inhibit COX-1, which plays a role in platelet aggregation and gastric mucosal protection, their use is associated with a higher risk of gastrointestinal bleeding than that of selective COX-2 inhibitors. Like NSAIDs, however, the selective agents can cause liver and kidney toxicity, fluid retention, and hypertension. One of them (rofecoxib) was withdrawn by the manufacturer after 5 years on the market because of an unacceptably high incidence of heart attack and thrombotic stroke in patients receiving it for 18 months or more. For these reasons and because they are more expensive than NSAIDs, COX-2 inhibitors are indicated chiefly in patients who are at increased risk of gastrointestinal bleeding.

COX-2 inhibitor

n.
Any of a class of nonsteroidal anti-inflammatory drugs that selectively block prostaglandin formation so as to cause minimal gastrointestinal side effects.

COX-2 inhibitor

Cyclooxygenase-2 inhibitor Pain management A class of analgesics with fewer side effects than those of conventional NSAIDs–which inhibit both cyclooxygenases–COX-1 and COX-2; COX-1 protects the gastric mucosa, preventing ulcers, bleeding, and other digestive tract problems. See COX-2, Prostaglandin.

COX-2 in·hib·i·tor

(in-hibi-tŏr)
A drug class that relieves inflammation and pain by inhibiting the action of cyclooxygenase-2.
References in periodicals archive ?
Hence, there appears to be comparable efficacy between the COX-2 selective inhibitors and the NS-NSAIDs, with the recognition that some patients may respond to one therapy and not another.
There is evidence regarding a possible risk for CV thrombo-embolic events with COX-2 selective inhibitors as well as the NS-NSAIDs.
On the basis of the findings, it is reasonable to suggest that IV COX-2 inhibitors (both NS-NSAIDs and COX-2 selective inhibitors, because both classes of drugs inhibit COX-2 activity) should not be used in patients at high risk for a CV event.
Because aspirin and COX-2 selective inhibitors compete for different binding sites, the combination of aspirin and COX-2 may be more preferable, in the right patient, than its combination with a NS-NSAID.
Because the COX-2 selective inhibitors have been shown to have no effect on platelet aggregation, at least within clinical doses, they appear to be the drugs of choice for those patients who require concomitant anticoagulation with warfarin and an NSAID.
120,121) Despite the increased risk for CV thromboembolic events seen with COX-2 selective inhibitors, because similar risks are observed with the NS-NSAIDs, when the available evidence is taken together, an overall assessment is to continue to allow access to these drugs.
NS-NSAIDs used in combination with proton pump inhibitors or other gastroprotective strategies may suffice in place of the COX-2 selective inhibitors in some patients.
There are several differences among the COX-2 selective inhibitors.