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What are selective cyclo-oxygenase (COX) inhibitors?

Leopold D. Galland, MD
Internal Medicine
The search for a safer type of nonsteroidal anti-inflammatory drug (NSAID) led to the development of drugs called selective cyclo-oxygenase (COX) inhibitors. As their name suggests, they're selective in their effect, designed to inhibit only the so-called "bad" COX enzyme, without inhibiting the so-called "good" COX enzyme.

This approach created one of the most highly anticipated drug releases in the history of medicine: Vioxx.

Vioxx was a disaster; it increased the death rate from heart attacks and strokes and was withdrawn from the market.

What the scientists behind Vioxx failed to recognize is that all forms of the COX enzyme are important for health.

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