Traditional NASIDs and Celebrex are Similar but Different

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Category: Medications & Supplementation Published on Thursday, 05 March 2015 Written by Yong Tsai, MD
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In 18th century England, an ingredient called Acetylsalicylic Acid was extracted from the bark of a willow tree and used to treat arthritic pain. The first arthritic wonder drug had been discovered…which we now know as aspirin. Aspirin suppresses the production of inflammatory substances that cause pain, swelling, and redness, commonly seen in arthritis.

Other drugs, such as “non-steroidal anti-inflammatory drugs” (NSAIDs), can mimic aspirin’s skill of inhibiting cyclooxygenase, an enzyme that helps your body produce prostaglandins. By decreasing prostaglandin production, a key chemical in the role in inflammation, aspirin and NSAIDs can reduce the pain (analgesic), swelling (anti-inflammation), and tenderness associated with arthritis. The effectiveness of both drugs depends on their dose. For example, lower doses of aspirin and NSAIDs are sufficient to relieve pain, but higher doses are required to relieve inflammation. With osteoarthritis, inflammation is rare or very mild, therefore only a low dose, as in Advil or Aleve, may be needed to achieve optimal effects. However, because of the intense inflammation associated with rheumatoid, gouty, and other inflammatory arthritis, a higher prescribed dose is required.

A major benefit of NSAIDs versus aspirin is its higher potency and longer half-life. You may need to take fewer NSAIDs than you would aspirin, and they are less toxic and they cause fewer gastrointestinal disturbances. Although all NSAIDs operate in basically the same way, their actions are not identical. Not everyone responds the same way to a particular NSAID. One may be more effective for you and you may need to try different ones before finding the one that is right for you.

Because heartburn and stomach upset are common with a long term use of high doses of aspirin and NSAIDs, some patients may develop ulcers and GI bleeding, kidney function impairment in the elderly, tinnitus, or even deafness. Studies have shown that it is best to take aspirin and NSAIDs with food to help prevent stomach irritation and further research is being done to find relief for other side effects.

In the early 1990s, researcher found that there were two types of enzymes involved in prostaglandin production: cyclooxygenas-1 (COX-1) associated with protecting the digestive system from its own erosive acids and cyclooxygenas-2 (COX-2) associated with pain and inflammation. Celebrex (COX-2 inhibitors), available in generic form, is in many ways similar to traditional non-steroidal anti-inflammatory drugs (NSAIDs) and is formulated to be easier on the stomach. They are able to block only the pro-inflammatory prostaglandins, leaving those that help protect the stomach lining alone, which would prevent stomach ulcers and bleeding. As far as other side effects are concerned, such as water retention and aggravation of hypertension, Celebrex appear to be no different than the traditional NSAIDs.

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