Gastrointestinal Bleeds Associated with Rofecoxib

Abstract

Data suggest that cyclooxygenase (COX)-2 inhibitors are safer for the gastrointestinal tract than traditional nonsteroidal antiinflammatory drugs (NSAIDs). Rofecoxib, a COX-2-specific NSAID, does not inhibit the COX-1 enzyme, thereby decreasing the potential for gastrointestinal-related adverse effects. Patients who are at an increased risk for NSAID-related gastrointestinal bleeding are therefore appropriate candidates for COX-2 inhibitors. Although the agents provide benefits for many patients, gastrointestinal-related side effects may occur, and caution should be practiced when prescribing COX-2 inhibitors. We report two patients who were admitted to the hospital with diagnoses of gastrointestinal bleeds while they were taking rofecoxib.

The pharmacological properties and clinical use of valdecoxib, a new cyclo‐oxygenase‐2‐selective inhibitor

“…33 In general, these findings show that valdecoxib produces fewer ulcers than produced by non-selective NSAIDs. They are in agreement with safety data obtained with other COX-2-selective inhibitors, including celecoxib 37,38 and rofecoxib, [39][40][41] and are supported by experimental data in the rat showing that the inhibition of both COX-1 and COX-2 is required for NSAID-induced gastric injury. 42 Valdecoxib is also superior to non-selective NSAIDs with regard to ulcer complications of the upper gastrointestinal tract (perforation, bleeding and gastric outlet obstruction).…”