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

Abstract

SUMMARYCyclo-oxygenase-2-selective inhibitors produce less gastric damage than conventional non-steroidal antiinflammatory drugs. Valdecoxib is a new orally administered cyclo-oxygenase-2-selective inhibitor, recently approved for use in osteoarthritis, rheumatoid arthritis and primary dysmenorrhoea in the USA. The drug has been evaluated in more than 60 clinical studies involving more than 14 000 patients and healthy volunteers. The analgesic efficacy of valdecoxib at a dose of 10 mg once daily in both osteoarthritis and rheumatoid arthritis is superior to that of placebo and similar to that of traditional non-steroidal anti-inflammatory drugs. Valdecoxib is effective in single doses of up to 40 mg for the alleviation of acute menstrual pain and has a rapid onset of action (within 30 min) and a long duration of analgesia (up to 24 h). Valdecoxib is well tolerated and has safety advantages compared with traditional non-steroidal anti-inflammatory drugs in terms of less gastrointestinal toxicity and a lack of an effect on platelet function. The incidence of adverse effects involving the kidney (fluid retention, oedema and hypertension) is similar to that of non-selective, nonsteroidal anti-inflammatory drugs.

A narrative review of medical, chiropractic, and alternative health practices in the treatment of primary dysmenorrhea

“…Clinical trials indicate that 40 mg of valdecoxib is effective for relieving menstrual pain while taking effect within 30 minutes and lasting up to 24 hours per dose. 75 Only time will tell if COX-2 inhibitors will become available without a prescription, as other drugs have done so in the past.…”

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

“…Three COX isoforms are known: COX-1, a constitutive form expressed in almost all tissues, COX-2, which is predominantly induced and constitutively expressed in a limited number of tissues (renal medulla, prostate, brain, and endothelium) (7,10,11), and COX-3, a COX-1-derived protein, most abundantly found in the cerebral cortex and heart (12). COX-2 is believed to be the main isoenzyme for pro-inflammatory prostaglandin production (7).…”

COX-2 Inhibitors, a Potential Synergistic Effect with Antineoplastic Drugs in Lung Cancer

“…It has been reported that long-term use of traditional NSAIDs is associated with serious gastrointestinal side effects that have been attributed to COX-1 inhibition [35,36]. As a result, COX-2 inhibitors were developed that had fewer gastrointestinal side effects according to clinical studies [37][38][39][40][41], but had anti-inflammatory activities that were similar to those of traditional NSAIDs. In the present study, we investigated the synergistic effect of COX-2 inhibitors, with chemotherapeutic agents, docetaxel and cisplatin on the apoptosis of lung cancer cell lines.…”