Recently, a new class of NSAIDs
has become available, the COX2 inhibitors. Currently available in this class is celecoxib (Celebrex). Selective blockade of cyclooxygenase permits analgesia and an anti-inflammatory effect while minimizing the risk of GI toxicity and bleeding. The COX2 inhibitors have been shown to be equally effective as other NSAIDS
, but do not show evidence of greater analgesia. The COX2 inhibitors are considerably more expensive than other over-the-counter NSAIDS
. However, if an NSAID is truly needed and there is concern of GI bleeding, the total cost may be lowered by using one of these agents rather than adding a relatively expensive prophylactic drug such as misoprostol or a pump-inhibitor to counteract the side effects of NSAIDs
. Other COX-2 inhibitors including rofecoxib (Vioxx) and valdecoxib (Bextra) were withdrawn from the market due to potential cardiovascular side effects.