Last reviewed 01/2018

  • this is a non-steroidal anti-inflammatory drug which was licensed for the symptomatic treatment osteoarthritis (1)
  • the sparing of the COX-1 isoenzyme should, in theory, result in reduced gastrointestinal side-effects and improves tolerability. However the evidence that COX-2 selectivity reduces the risk of serious upper gastrointestinal side effects, particularly gastrointestinal bleeding and ulcer perforation, points towards some reduction of risk but the advantage over conventional non-steroidal anti-inflammatory drugs appears small (1)

Note that there has been a voluntary worldwide withdrawal of the 'COX-2 selective NSAID' rofecoxib (Vioxx/VioxxAcute) by the manufacturer. This follows new clinical trial results showing an increased risk of confirmed serious thrombotic events (including myocardial infarction and stroke) compared to placebo, following long-term use (2)


  1. Drug and Therapeutics Bulletin (2000), 38 (11), 81-86.
  2. Committee on Safety of Medicines (September 30th 2004). DOH Cascade.