Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of pain, inflammation, and fever, but are associated with complications of peptic ulcer formation, perforation, and bleeding, mediated through the inhibition of cyclooxygenase-1 (COX-1). Several controlled studies have shown that the use of selective inhibitors of COX-2 (COXIBs) is associated with less peptic ulcer and bleeding complications than the use of nonselective NSAIDs. Whereas the increased risk of gastrointestinal complications with nonselective NSAIDs has been well demonstrated in epidemiologic studies, similar data are lacking for selective COXIBs.

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