COX-2 inhibitors

COX-2 inhibitors are another type of NSAID. These medications were developed with the aim of reducing the common side effects of traditional NSAIDs. COX-2 inhibitors are commonly used for arthritis and pain resulting from muscle sprains, strains, back and neck injuries, or menstrual cramps. They are as effective as NSAIDs and may be the right choice with less risk of stomach damage.

• Generic (brand) names. Celecoxib (Celebrex, Elyxyb).
• How they work. COX-2 inhibitors work in a slightly different way than traditional NSAIDs. COX-2 inhibitors block only the COX-2 enzyme — the one that's more likely to cause pain and inflammation.

• Benefits and risks. By acting only on COX-2 enzymes, they allow COX-1 enzymes to continue to function. COX-1 enzymes protect the lining of the stomach. NSAIDs, on the other hand, block COX-1 and can cause side effects such as thinning of the stomach lining. This can lead to ulcers and bleeding.

  The risk of stomach bleeding tends to be lower if you take a COX-2 inhibitor, but bleeding can still occur. This is true especially at higher doses. And COX-2 inhibitors can lead to headaches, dizziness, high blood pressure, kidney problems, fluid retention and high blood pressure. These medications may increase the risk of a heart attack or stroke.

• Bottom line. Older adults may be at higher risk of common COX-2 side effects compared with younger adults. If these medications help you manage chronic pain, aim to take the lowest effective dose for the shortest time possible. Follow up closely with your healthcare team.