Urticaria and angioedema from cyclooxygenase-2 inhibitors

Cyclooxygenase-2 (COX-2) inhibitors celecoxib and rofecoxib have generally been well tolerated. It has been unclear if specific COX-2 inhibitors would cross react with acetylsalicylic acid and typical nonsteroidal antiinflammatory drugs to cause urticaria or angioedema. There are no reports in the literature of hives or angioedema resulting from their use. We describe 3 patients who developed urticaria and/or angioedema from COX-2 inhibitors. With the increasing use of COX-2 inhibitors, one needs to be aware of these side effects and of possible cross reactivity between celecoxib and rofecoxib.