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Millions of Americans were committed users of Cox-2 inhibiting drugs until the discovery in 2004 of their unintended side effects. So what are Cox-2 inhibitors, and what side effects can they produce? In order to understand the functioning of Cox-2 inhibitors, we must first review nonsteroidal anti-inflammatory drugs, otherwise known as “NSAIDs”. These are very commonly prescribed drugs (Aspirin and Motrin) created to treat the inflammation of arthritis, bursitis and tendonitis. NSAIDs block both Cox-1 as well as Cox-2 enzymes. Cox-1 enzymes can be found in inflamed parts of the body as well as in the stomach. Cox-1 enzymes produce prostaglandins, that help maintain the proper health of the stomach’s mucus lining. Cox-2 enzymes, although not found in the stomach, also produce prostaglandins, which reduce inflammation throughout the body. Because of the impeding of Cox-1 enzymes, a lot of patients suffer gastronomical side effects when they take NSAIDs. These side effects can involve heartburn, stomach pain, diarrhea, vomiting, ulcers and bleeding in the stomach. And in the most serious cases, kidney or liver failure may result. The drug companies calculated that there would be a very significant market for an anti-inflammatory medication that did not include a Cox-1 inhibitor, but instead specifically only inhibited the Cox-2 enzymes in the inflamed areas of the body. No Cox-1 inhibitors, no more gastronomical side effects, the reasoning went. So drugs that only inhibited Cox-2 enzymes would provide relief to millions of arthritis and other patients, but without the usual gastronomical side effects many suffered with the NSAIDs. About a decade ago the Cox-2 inhibitor drugs appeared in America’s drugstores. The medical establishment hailed these Cox-2 inhibitors as a major advance. During the next few years, drugs including Vioxx, Bextra and Celebrex were prescribed to many millions of Americans suffering with arthritic and other inflammatory pains. And the results were good. These Cox-2 inhibitors reduced the pain, without the gastronomical side effects associated with the older NSAIDs. But in late 2004, despite the reduced incidence of stomach-related problems, Merck (the manufacturer of Vioxx) decided to pull the drug from pharmacy shelves. In doing so, Merck referred to an increased risk of heart attack and stroke amongst users taking the product for eighteen months or more. Later that same year, a jury in Texas awarded a quarter of a billion dollars in damages to the widow of a Vioxx user. Early in 2006, an expert panel recommended the reintroduction of Vioxx onto the market. However the Food and Drug Administration is still studying the issue. In the spring of 2005, Bextra’s manufacturer decided to remove it from our pharmacies. The opinion of the FDA is that Bextra delivers no advantages over other NSAIDs, but may actually increase the risk of stroke and heart attack, and also cause serious skin-related conditions. As regards Celebrex, the FDA, while acknowledging an increase in the risk of stroke and heart attack especially with larger doses, concluded that its benefits may outweigh these possible side effects. As a result Celebrex can still be bought in pharmacies. Research is being done to study the possible long-term effects of all three of these Cox-2 inhibitor drugs. As an example, European scientists concluded that a number of NSAIDs are equally likely to raise the risk of heart attacks as are the Cox-2 inhibitors. And a recent study concluded that using Vioxx had a higher risk of cardiovascular side effects than Bextra or Celebrex. The studies and research are ongoing.
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Michael Rupkalvis oversees the LifeFormulas web site, which offers a blog about his day-to-day activities with his ITV Ventures home-based business. Amongst the products he sells from that business is Flex Protex, which combines a completely natural Cox-2 inhibitor and a high-grade Glucosamine for improved joint health and mobility, as well as relief from pain.
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