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 Other COX-2 inhibitors including rofecoxib (Vioxx) and valdecoxib (Bextra) were withdrawn from the market due to potential cardiovascular side effects.