Traditional, non-selective NSAIDs inhibit both isoforms of cyclo‐oxygenase: COX‐1 and COX‐2.
These have demonstrated their value in the treatment of pain from bone disorders like osteoarthritis, but, are associated with adverse GI side-effects like abdominal bleeding because of their potent inhibition of the gastroprotective COX‐1 isoform.
Selective COX‐2 inhibitors have demonstrated comparable efficacy in chronic and acute pain, with significantly improved GI tolerability compared with traditional NSAIDs.
- Etoricoxib (NSAID)
- A specific cox -2 inhibitor, generally well tolerated, even at doses above the clinical dose range.
- Has a favorable pharmacokinetic profile for the management of inflammatory disorders with strong anti-inflammatory effects.
- Since its relatively selective for the cox-2 coenzyme, has a more favourable GI safety and similar efficacy in comparison with traditional NSAIDs (including naproxen, diclofenac and ibuprofen).