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Cyclooxygenase inhibitors 

Cyclooxygenase inhibitors
Cyclooxygenase inhibitors
Oxford Textbook of Rheumatology (4 ed.)

Burkhard Hinz

and Kay Brune


Cyclooxygenase (COX) inhibitors are widely used to relieve musculoskeletal pain. COX inhibitors are a group of heterogenous substances including non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen). Moreover, various selective cyclooxygenase-2 (COX-2) inhibitors with improved gastrointestinal tolerability as compared with conventional NSAIDs have been established for symptomatic pain treatment in recent years. This chapter addresses the pharmacology of all of these drugs with particular emphasis on their rational use based on their diverse pharmacokinetic characteristics and adverse drug reaction profiles. Referring to the current debate, cardiovascular side effects associated with the long-term use of COX-2 inhibitors and NSAIDs as well as novel insights into the safety profile of paracetamol are discussed.

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