Non Steroidal Anti-Inflammatory Drugs (NSAID’s)

 

Traditional NSAID’s have been available since aspirin was discovered about a century ago. These medications reduce swelling and joint pain associated with arthritis and other conditions. Over decades, several compounds of this class have been created. Some are available without a prescription, such as ibuprofen and naproxen. Despite their benefits, they all pose risks of side effects, including gastrointestinal (G.I.) bleeding and hypertension.

COX-2 Inhibitors (see article) were developed as an alternative to minimize the G.I. side effects, while maintaining their beneficial properties. These included celecoxib (Celebrex), rofecoxib (Vioxx), and valdecoxib (Bextra); the latter two were removed from the market over safety concerns, and so at this time (December, 2005), Celecoxib (Celebrex) is the only COX-2 Inhibitor available in the United States. There is also a traditional NSAID (diclofenac) combined with misoprostol in a formulation called arthrotec. Misoprostol provides protection from G.I. bleeding.

Meloxicam (Mobic) is an NSAID that was introduced in Europe a decade ago. It is notable because at low dosage, it behaves as a “COX-1 Sparing” agent, which means that it has potentially reduced G.I. side effects as compared to traditional NSAID’s. This benefit is diminished at higher dosage (over 15 mg/day).

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