[Coxiber and risk of myocardial infarction--the apprehension might have been exaggerated]

Coxibs are a new group of non-steroidal anti-inflammatory drugs (NSAIDs), which inhibit cyclooxygenase-2 selectively. They can be prescribed for treatment of osteoarthritis, rheumatoid arthritis, primary dysmenorrhea, and acute pain. Their main advantage is a reduction in the frequency of serious gastrointestinal complications compared to NSAIDs, but they have the same tendency to induce oedema and renal side effects. The coxibs do not influence platelet function. Meta-analysis of studies with coxibs suggests that they increase the risk of heart attack, but according to recent information this may have been exaggerated. Coxibs should be used for patients at risk for gastrointestinal complications and bleeding, but perhaps not for patients at risk for arterial thrombotic diseases.