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An Overview of the Cox-2 Inhibitor Drug Controversy

In the Fall of 2004 it was learned that Cox-2 inhibitor drugs may cause some very serious side effects.

What exactly are Cox-2 inhibitors, why were they developed and what are those side effects?

In order to understand the functioning of Cox-2 inhibitors, we must first discuss nonsteroidal anti-inflammatory drugs, usually called “NSAIDs”. These include some very popular pain killers (Aspirin and Motrin) intended to relieve the inflammation of tendonitis, bursitis and arthritis. NSAIDs block both Cox-1 and Cox-2 enzymes. Cox-1 enzymes can be found in inflamed parts of the body as well as in the stomach. They produce prostaglandins, which help maintain the proper health of the stomach’s mucus lining. Cox-2 enzymes, which are not present in the stomach, also create prostaglandins, which the body uses to deal with inflammations.

Due to the impeding of Cox-1 enzymes, many people are presented with gastronomical side effects when they take NSAIDs. These side effects may include ulcers and stomach bleeding, bloating, heartburn, vomiting and nausea. And in the most serious cases, kidney or liver failure may be caused.

The drug companies correctly concluded that there would be a very significant market for an anti-inflammatory drug that did not include a Cox-1 inhibitor, but instead specifically only blocked the Cox-2 enzymes in the areas of the body that were inflamed. No Cox-1 inhibitors, no more gastronomical side effects, the reasoning went. A drug that only blocked Cox-2 enzymes would provide relief to millions of arthritis patients, without causing the stomach problems many suffered with the NSAIDs.

About a decade ago the Cox-2 inhibitor medications appeared in America’s drugstores. The medical establishment pronounced these Cox-2 inhibiting drugs as a major advance. Over the following years, drugs including Vioxx, Celebrex and Bextra were prescribed to countless patients suffering with inflammatory pains including arthritis. The results were good. These drugs reduced the pain, but did not show the gastronomical side effects associated with the older NSAIDs.

But in late 2004, notwithstanding the reduced incidence of stomach-related problems, the maker of Vioxx, Merck made the decision to pull the drug from pharmacy shelves. In doing so, Merck referred to an increased incidence of both strokes and heart attacks amongst patients taking the product for more than 18 months. Later in 2004, a Texas jury awarded damages of $1,000,000,000 to the widow of a Vioxx user. Early in 2006, an expert panel recommended that Vioxx be reintroduced onto pharmacy shelves. However the Food and Drug Administration is still looking at the matter.

Early in 2005, Bextra’s manufacturer decided to remove it from our pharmacies. The FDA’s view is that it offers no advantages over other NSAIDs, but may actually increase the chances of stroke and heart attack, and also cause serious skin problems. Regarding Celebrex, the Food and Drug Administration, while confirming an increase in heart attacks and strokes especially with high doses, concluded that the benefits of Celebrex may outweigh these potential side effects. So Celebrex can still be bought in pharmacies.

Research is being done to study the potential long-term side effects of each of these Cox-2 inhibitor drugs. For example, European scientists concluded that some popular NSAIDs are just as likely to raise the risk of heart attacks as are the Cox-2 drugs. Another recent study concluded that using Vioxx had a higher risk of cardiovascular side effects than does the other two drugs.

The debate continues.

Colin Albert operates the LifeFormulas web site, which presents a blog about his experiences with his ITV Ventures business. One of the supplements he sells from that business is FlexProtex, which includes a completely natural COX-2 inhibitor and a high-grade Glucosamine for increased joint functioning, as well as relief from discomfort.

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