Review of Celebrex and COX-2

Amy Beth Dukoff, D.M.D.
Celebrex and COX-2
A Product Review

Amy Dukoff	ELEBREX IS A COX-2, nonsteroidal, anti-inflammatory drug. Celebrex is made by Searle/Pfizer and is the brand name for celecoxib. The recommended dose is 200 mg daily or 100 mg twice a day. COX-2 is an isoform of cyclooxygenase (COX). Cyclooxygenases are used in the cyclooxygenase pathway of the inflammatory process. Cyclooxygenases occur in two isoforms: COX-1 and COX-2. They are used in the metabolism of arachidonic acid to produce prostaglandins. COX-1 affects upper gastrointestinal tract mucosal protection and platelet aggregation. COX -1 is seen in many tissues, yet COX-2 presence may go unnoticed. They both are important in mediating inflammation and pain. Celebrex inhibits COX-2 and not COX-1. Therefore, the upper gastrointestinal mucosal protection remains, and studies have shown that COX-2 non-inflammatory drugs have a lower incidence of gastrointestinal ulceration than conventional non-steroidal anti-inflammatories. Celebrex does have some limitations. It cannot be taken with Bactrim or Septra. Also, if your patient is on Librium, you should be cautious with its use, Furthermore, for some patients the expense can be a factor, since Celebrex costs $2.50 per pill. As with all non-steroidal anti-inflammatories, one must take heed of the contra-indications for this family of drugs. March-April 2001
	FEEDBACK? We welcome your responses and questions. Please feel free to visit the Endo Forum and add your comments about any of the articles in Endo-Mail.