Letter to the Editor

Side Effects of Conventional Nonsteroidal Anti-inflammatory Drugs and Celecoxib: More Similarities than Differences

Authors: Claudia Stöllberger, MD, Josef Finsterer, MD

Abstract

Cyclooxygenase-2 (COX-2) inhibitors are a new class of nonsteroidal anti-inflammatory drugs (NSAIDs) with a reported benefit of less gastric and duodenal ulceration. Nevertheless, it has been shown that COX-2 inhibitors are not completely “ulcer-proof.”1 Whereas the gastrointestinal side effects of NSAIDs are a matter of concern and interest, the cardiovascular and renal side effects of these drugs are less well appreciated. NSAIDs, including both conventional and COX-2 inhibitors, inhibit the synthesis of prostaglandins.

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References

1. Crawford AS, White JG. Celecoxib-induced upper gastrointestinal hemorrhage and ulceration. South Med J 2002; 95: 1444–1446.
 
2. Curhan GC, Willett WC, Rosner B, et al. Frequency of analgesic use and risk of hypertension in younger women. Arch Intern Med 2002; 162: 2204–2208.
 
3. Fogari R, Zoppi A, Carretta R, et al; Italian Collaborative Study Group. Effect of indomethacin on the antihypertensive efficacy of valsartan and lisinopril: A multicentre study. J Hypertens 2002; 20: 1007–1014.
 
4. Feenstra J, Heerdink ER, Grobbee DE, et al. Association of nonsteroidal anti-inflammatory drugs with first occurrence of heart failure and with relapsing heart failure: The Rotterdam Study. Arch Intern Med 2002; 162: 265–270.
 
5. Chan FK, Hung LC, Suen BY, et al. Celecoxib versus diclofenac and omeprazole in reducing the risk of recurrent ulcer bleeding in patients with arthritis. N Engl J Med 2002; 347: 2104–2110.