Update on cyclooxygenase-2 inhibitors.
Nonsteroidal anti-inflammatory drugs represent the most commonly used medications for the treatment of pain and inflammation, but numerous well-described side effects can limit their use. Cyclooxygenase-2 (COX-2) inhibitors were initially touted as a therapeutic strategy to avoid not only the gastrointestinal but also the renal and cardiovascular side effects of nonspecific nonsteroidal anti-inflammatory drugs. However, in the kidney, COX-2 is constitutively expressed and is highly regulated in response to alterations in intravascular volume. COX-2 metabolites have been implicated in mediation of renin release, regulation of sodium excretion, and maintenance of renal blood flow. This review summarizes the current state of knowledge about both renal and cardiovascular side effects that are attributed to COX-2 selective inhibitors.
Harris
Raymond C
RC
Division of Nephrology, S3322 MCN, Vanderbilt University School of Medicine, Nashville, TN 37232, USA. ray.harris@vanderbilt.edu
Breyer
Matthew D
MD
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002320:Cardiovascular Physiological Phenomena / Q000187:drug effects*; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000502:physiology*; D011507:Proteinuria / Q000503:physiopathology; D012083:Renin / Q000187:drug effects; D014882:Water-Electrolyte Balance / Q000187:drug effects
D052246:Cyclooxygenase 2 Inhibitors; D012083:Renin