The effect of three cyclo-oxygenase inhibitors on intensity of primary dysmenorrheic pain.
OBJECTIVE
To determine the effect of 3 different cyclo-oxygenase (COX) inhibitors on primary dysmenorrheic pain.


METHODS
Eleven female patients self-medicated with either placebo (sugar), 25 mg of the COX-2 specific inhibitor rofecoxib, 50 mg of the nonselective COX inhibitor diclofenac potassium, or 7.5 mg of the COX-2 selective inhibitor meloxicam, over 4 menstrual cycles. Pain was assessed using the McGill Pain Questionnaire and a visual analog scale.


RESULTS
The pain response index, present pain index, and visual analog scale were highly correlated as measures of intensity of pain (r=0.81 to 0.96, P<0.0001). Rofecoxib and diclofenac potassium both decreased the duration of dysmenorrheic pain compared with placebo (P<0.001) and with meloxicam (P<0.01), and were equally effective in improving pain, compared with placebo, after each capsule (P<0.001). When compared with placebo, both drugs also provided 50% or more pain relief, after each capsule (P<0.0048). Meloxicam, although superior to placebo, was not as effective as rofecoxib and diclofenac potassium in reducing pain, and when compared with placebo, was associated with providing 50% or more of pain relief only after the third and fourth capsules (P=0.016).


CONCLUSIONS
Rofecoxib and diclofenac potassium, when taken in recommended doses, were equally effective in alleviating pain associated with primary dysmenorrhea.
Chantler
Ingrid
I
Brain Function Research Group, School of Physiology, University of Witwatersrand, Parktown, Johannesburg, South Africa. ingrid.chantler@wits.ac.za
Mitchell
Duncan
D
Fuller
Andrea
A
D000328:Adult; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004412:Dysmenorrhea / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D000077239:Meloxicam; D010147:Pain Measurement; D012651:Self Medication; D013450:Sulfones / Q000627:therapeutic use; D013843:Thiazines / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use
D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; D013843:Thiazines; D013844:Thiazoles; C116926:rofecoxib; D004008:Diclofenac; D000077239:Meloxicam