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Related Experiment Videos

Gastrointestinal bleeds associated with rofecoxib.

Pamela A Foral1, Amy F Wilson, Kelly K Nystrom

  • 1Department of Pharmacy Practice, Creighton University School of Pharmacy and Allied Health Professions, and Alegent Health Bergan Mercy Medical Center, Omaha, Nebraska 68178, USA. pforal@creighton.edu

Pharmacotherapy
|March 20, 2002
PubMed
Summary

Cyclooxygenase (COX)-2 inhibitors may offer gastrointestinal safety compared to traditional NSAIDs. However, this report details two cases of gastrointestinal bleeding in patients taking rofecoxib, highlighting the need for caution.

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Area of Science:

  • Gastroenterology
  • Pharmacology

Background:

  • Traditional nonsteroidal anti-inflammatory drugs (NSAIDs) carry risks of gastrointestinal bleeding.
  • Cyclooxygenase (COX)-2 inhibitors were developed to reduce these risks by selectively targeting the COX-2 enzyme.
  • Rofecoxib, a COX-2 specific NSAID, inhibits COX-2 while sparing COX-1, theoretically decreasing gastrointestinal adverse events.

Observation:

  • The study presents two cases of patients experiencing gastrointestinal bleeds.
  • Both patients were taking rofecoxib at the time of their admission.
  • This observation contrasts with the expected gastrointestinal safety profile of COX-2 inhibitors.

Findings:

  • Despite the theoretical safety of COX-2 inhibitors, gastrointestinal bleeding can still occur.
  • Rofecoxib, a specific COX-2 inhibitor, was associated with gastrointestinal bleeds in the reported cases.

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  • These findings underscore that no NSAID is entirely free from gastrointestinal risks.

    • Implications:

    • Clinicians should exercise caution when prescribing COX-2 inhibitors, including rofecoxib.
    • Patients at high risk for gastrointestinal bleeding should be closely monitored even when using COX-2 selective agents.
    • Further research may be needed to fully elucidate the gastrointestinal safety profile of specific COX-2 inhibitors in diverse patient populations.