Cyclooxygenase (COX) inhibitors, are medications that prevent pain and swelling by interfering with either COX-2 or COX-1 and 2 together. There are a number of different medications that work in this way. All are in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs). Aspirin, acetaminophen, and celecoxib are common types of COX inhibitors.
In 2011, there are no medications on the market that inhibit only COX-1, but medications that block both the COX-1 and COX-2 enzymes are available. These drugs work by preventing the release of chemicals that cause swelling and pain. Blocking COX-1 can damage the protective layer of the stomach, which can lead to irritation or severe problems with the lining of the stomach, so these medications are usually only taken in small doses or for short periods of time.
Some of the common COX inhibitors that block both COX-1 and COX-2 are aspirin, ibuprofen, and acetaminophen. They all reduce pain and swelling without the use of steroids. Though they can be used to treat specific conditions, they are more often used for general relief of pain, such as that caused by injury, headache, or arthritis. These drugs can also thin the blood, which is a factor in their interference with COX-1, and can decrease the risk of heart attack or stroke.
Valdecoxib, rofecoxib, and celecoxib are the three types of COX inhibitors that affect only COX-2. In 2011, only celecoxib is still available in the United States, though it is possible to purchase rofecoxib in other parts of the world. Rofecoxib and valdecoxib were pulled from the market because both of them increase the risk of heart attack or stroke.
Celecoxib is the only type of COX-2 inhibitor that is still in use as of 2011. It is used to treat pain and inflammation, especially when they are caused by menstrual cramps or arthritis. When used to treat various types of arthritis, celecoxib does not stop the progression of the disease but can be used safely for long-term relief from symptoms. Abdominal side effects are common with the use of this medication, though it causes less irritation and inflammation in the lining of the stomach than COX inhibitors that block the production of both COX-1 and COX-2. A patient’s risk of stroke or heart attack is increased when taking celecoxib, but this risk may be deemed acceptable in certain cases.