Pain Treatment Cox 2 Inhibitors

COX-2 inhibitors are a hot topic in health news. At first, these drugs were called wonder drugs for the benefits they offered people with rheumatoid arthritis and osteoarthritis. However, recent research has revealed that COX-2 inhibitors, including Vioxx®, can increase the risk of heart attack and stroke in patients. However, for some people, the benefits offered by COX-2 inhibitors outweigh the risks.

The most common reason doctors prescribe COX-2 inhibitors is to treat arthritis. However, COX-2 inhibitors can also be used to treat pain associated with tendonitis and inflammatory joint pain caused by conditions other than arthritis.

Using COX-2 Inhibitors

COX-2 inhibitors are a relatively new analgesic designed to treat inflammation. They work by blocking COX-2, an enzyme in the body that produces the chemicals that cause swelling.

COX-2 inhibitors are part of a category of drugs called non-steroidal anti-inflammatory drugs, or NSAIDs. Traditional NSAIDs such as aspirin, naproxen and ibuprofen block both COX-1 and COX-2 enzymes. COX-1 enzymes are located throughout the body and especially in the stomach. As a result, traditional NSAIDs can irritate the stomach and even cause ulcers.

COX-2 enzymes are not located in the stomach. They are located specifically in the area of the body where inflammation is occurring. Since COX-2 inhibitors only block COX-2 enzymes, they do not affect the stomach in the way traditional NSAIDs do and do not increase a person’s risk of developing stomach ulcers.

COX-2 Inhibitors: Brand Names

Some brand names for COX-2 inhibitors include:

  • Bextra®
  • Celebrex®
  • Vioxx®

In 2004, drug company Merck voluntarily recalled Vioxx® due to its potential to cause cardiovascular problems. Bextra® was removed from the market in 2005.

COX-2 Inhibitors: Side Effects and Risks

While traditional NSAIDs can cause upset stomach, diarrhea, heartburn and even ulcers, those side effects are not typically associated with COX-2 inhibitors. However, in 2004, the makers of Vioxx® took the product off the market, due to worries over an increased risk of heart attack and stroke in people who were taking the prescription medication. Later, the makers of Bextra® followed suit.

Celebrex® is still on the market. However, many doctors are very careful about prescribing the medication. Doctors will carefully review a patient’s history before prescribing Celebrex®. Patients who have existing heart problems or high blood pressure are usually advised not to take the drug.

Some other side effects associated with COX-2 inhibitors are:

  • fluid retention
  • headaches
  • liver and kidney problems
  • nausea.

The chance of developing these side effects increases the longer you take a COX-2 inhibitor. Carefully discuss potential side effects with your doctor.

Also, it is important to note that COX-2 inhibitors have not been found to treat pain more effectively that traditional NSAIDs. However, they are able to treat inflammatory pain without increasing a person’s chance of stomach irritation and ulcers.

Natural COX-2 Inhibitors

 Some people claim that a diet rich in omega-3 fatty acids and antioxidants can reduce inflammation and can work much in the same manner as COX-2 inhibitors. Foods rich in omega-3 fatty acids include:

  • eggs
  • flax seed
  • kiwi fruit
  • salmon.

Antioxidants can be found in:

  • apples
  • beans
  • berries
  • red cabbage.

Other people stand by the use of ginger as a natural COX-2 inhibitor. Proponents recommend buying a fresh ginger root and slicing or grating it into food.

No studies have obtained conclusive results about the effectiveness of these natural alternatives to COX-2 inhibitors. However, since most of them would mean instituting a healthy diet, there is probably little harm in trying them out for a time. Your doctor can provide insight into how trying these alternatives might work in combination with a COX-2 inhibitor such as Celebrex® or a traditional NSAID.


MedicineNet (2005). COX-2 Inhibitors- Overview of COX-2 Inhibitor Drugs. Retrieved August 26, 2006, from the MedicineNet Web site:

U.S. Food and Drug Administration (2005). Celebrex Capsules – Patient Information Sheet. Retrieved August 26, 2007, from the Food and Drug Administration Web site:

U.S. Food and Drug Administration (2004). FDA Statement on the Halting of a Clinical trial of the COX-2 Inhibitor Celebrex. Retrieved August 26, 2007, from the Food and Drug Administration Web site: