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Benjamin Yang

Celebrex — Mechanism of action, benefits, and weaknesses

Celebrex (celecoxib) is a COX-2 (cyclooxygenase-2) inhibitor, belonging to the class of non-steroidal anti-inflammatory drugs (NSAIDs). COX-2 enzyme is responsible for the ultimate production of prostaglandins which cause pain in arthritis. Celebrex (or Vioxx, a similar drug made by Merck) specifically inhibits COX-2, and does not affect COX-1 enzyme. Widely used pain-killers such as aspirin and ibprofen inhibit both COX-2 and COX-1. Inhibition of COX-1 is associated with side effects such as stomach ulcer and bleeding.

Pharmacia is undertaking research effort to develop the drug to treat Alzheimer’s disease, schizophrenia, atherosclerosis, Lou Gehrig’s disease, migraine headaches, and cancer. COX-2 enzyme is present at an unusually high level in each of these conditions. In fact, the drug has already been approved as a preventive treatment for patients with a precursor form of a rare type of colon cancer.

Celebrex’s main competitor in the marketplace is Vioxx. Celebrex has not been associated with increased incidence of heart problems, while Vioxx has. A recent finding concluded that Celebrex causes just about the same amount of stomach problems such as ulcer as generic pain-killers, while Vioxx causes fewer gastrointestinal problems.

(Discovery Medicine, Vol. 1, No. 9, p5, 2002)

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