title: Gastrointestinal bleeds associated with rofecoxib.
abstract: Data suggest that cyclooxygenase (COX)-2 inhibitors are safer for the gastrointestinal tract than traditional nonsteroidal antiinflammatory drugs (NSAIDs). Rofecoxib, a COX-2-specific NSAID, does not inhibit the COX-1 enzyme, thereby decreasing the potential for gastrointestinal-related adverse effects. Patients who are at an increased risk for NSAID-related gastrointestinal bleeding are therefore appropriate candidates for COX-2 inhibitors. Although the agents provide benefits for many patients, gastrointestinal-related side effects may occur, and caution should be practiced when prescribing COX-2 inhibitors. We report two patients who were admitted to the hospital with diagnoses of gastrointestinal bleeds while they were taking rofecoxib.
authors.affiliation: Department of Pharmacy Practice, Creighton University School of Pharmacy and Allied Health Professions, and Alegent Health Bergan Mercy Medical Center, Omaha, Nebraska 68178, USA. pforal@creighton.edu
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Foral
authors.forename: Amy F
authors.initials: AF
authors.lastname: Wilson
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Nystrom
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006396:Hematemesis / Q000139:chemically induced; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use; D007783:Lactones / Q000009:adverse effects* / Q000627:therapeutic use; D007796:Laminectomy / Q000009:adverse effects; D008297:Male; D008551:Melena / Q000139:chemically induced; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D013450:Sulfones
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib; D007052:Ibuprofen