Cardiovascular adverse effects of coxibs

(1) All nonsteroidal antiinflammatory drugs (NSAIDs), including coxibs, can worsen arterial hypertension and heart failure. (2) Combining a standard NSAID with a vitamin K antagonist increases the risk of bleeding. The same applies to coxibs. (3) Available data point to a higher risk of severe cardiovascular events with rofecoxib than with naproxen. (4) There is no reason to postpone aspirin therapy at antiplatelet doses in patients who are also receiving another NSAID. Rofecoxib should not be used in patients with coronary disease