Coxibe

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

COX-2 inhibitors; COX-2 selective inhibitors

Definition
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Coxibe, also known as COX-2 inhibitors, are among the non-steroidal anti-inflammatory drugs (NSAIDs). They inhibit the enzyme cyclooxygenase-2 (COX-2) and thus the formation of prostaglandins from arachidonic acid. S.u. Celecoxib, Parecoxib, Valdecoxib.

General information
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While the traditional non-steroidal anti-inflammatory drugs, such as acetylsalicylic acid, ibuprofen or diclofenac, inhibit both cyclooxygenases (cyclooxygenase 1 and 2), COX-2 inhibitors only block cyclooxygenase-2. Coxibe is therefore also suitable for patients who cannot tolerate the usual non-steroidal anti-inflammatory drugs due to gastrointestinal side effects. In the case of coxibs, a significant reduction in severe side effects in the gastrointestinal tract has been demonstrated by several clinical studies. Also the rate of mild mucosal changes that do not cause complaints was lower. Selective COX-2 inhibitors are considered a subgroup of NSAIDs. Their efficacy is comparable to that of classical NSAIDs. However, by reducing the gastrointestinal side effects, they have advantages over the classic NSAIDs. However, even with COX-2 inhibitors, the contraindications and interactions must be taken into account because the protective protection of the vascular system is also reduced when COX-2 is inhibited.

Note(s)
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Cave! The active ingredient rofecoxib (Vioxx, Vioxx dolor) was withdrawn from the market by the manufacturer MSD (MERCK & SHARP & DOHME) in September 2004 due to increased relative risk of heart attacks and strokes. The withdrawal of the preparations is based on the results of the APPPROVe study (Adenomatous Polyp Prevention on VIOXX).

Cave! Sales of the active ingredient valdecoxib were suspended by the manufacturer Pfizer in April 2005 on the recommendation of the FDA due to the risk of severe allergic skin reactions!

Literature
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  1. New recommendations to modernize drug manufacturing. FDA Consumption 41: 4

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Last updated on: 29.10.2020