COX-2 inhibitors are a type of NSAID. They treat the pain and inflammation of many types of arthritis and other types of short-term pain. COX-2 inhibitors are as effective as traditional NSAIDs but cause less stomach and intestinal problems. Celecoxib (Celebrex®) is the only COX-2 inhibitor available in the U.S.
COX-2 inhibitors are a type of nonsteroidal anti-inflammatory drug (NSAIDs). NSAIDs relieve pain and fever and reduce inflammation.
Examples of older traditional NSAIDs include ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). Unlike these NSAIDs, COX-2 inhibitors work in a different way to reduce pain and inflammation.
COX-2 inhibitors are approved to treat mild-to-moderate pain and inflammation caused by:
There are two types of cyclooxygenase (COX) enzymes in your body, COX-1 and COX-2. Both enzymes make prostaglandins. Prostaglandins are hormone-like chemicals that cause inflammation, pain and fever.
The prostaglandins made by these two distinct enzymes have slightly different effects on your body.
In comparison, the more common NSAIDs (like ibuprofen and naproxen) usually affect both COX-1 and COX -2 enzymes. For this reason, these medications are called nonselective NSAIDs. Because COX-2 inhibitors more precisely target COX-2 enzymes, they’re called selective NSAIDs.
Some inflammation is good. It’s part of your body’s natural healing process. However, inflammation that continues for too long can lead to chronic inflammation. Chronic inflammation damages healthy cells, tissues and organs.
Celecoxib (Celebrex®) is the only COX-2 inhibitor available in the U.S.
Etoricoxib (Arcoxia®) and parecoxib (Dynastat®) are available in countries outside the U.S.
Other COX-2 inhibitors have been taken off the U.S. market because of safety concerns.
COX-2 inhibitors are available in pill form (taken by mouth) or as an oral liquid solution.
How long does a COX-2 inhibitor take to work?
Pain relief starts within 60 minutes of taking a dose. It takes a few days to reach COX-2 inhibitor’s full anti-inflammatory effects.
How long can I continue to take a COX-2 inhibitor?
For short-term (days to a couple of weeks) pain relief, you should take the lowest possible dose for the shortest possible time.
For ongoing pain relief for a condition like arthritis, your provider will review your health history and lab tests to determine if this is a safe drug choice for you to take on a more consistent basis. Your provider will review your health history and lab tests to determine if this is a safe drug choice for you.
Always follow the advice and dosing recommendations of your healthcare provider or the medication’s prescribing information. If you have any questions, call your provider.
Talk with your provider about the pros and cons of taking a COX-2 inhibitor. They are prescribed for the conditions listed in this article.
COX-2 inhibitors may be an especially useful NSAID choice if you:
COX-2 inhibitors may increase the risks of:
You and your healthcare provider will review your medical history and decide if a COX-2 inhibitor is a good medication choice for you.
COX-2 inhibitors are not approved for use in children under the age of 2.
Side effects are more likely to happen at higher dosages and when COX-2 inhibitors are taken for a long period.
If you develop other side effects, contact your provider for advice.
COX-2 inhibitors can interact with:
Your provider will want to check your blood pressure, look for symptoms of gastrointestinal bleeding and order blood work to check your kidney and liver function. Your provider will let you know how often you’ll need an office visit.
Call your healthcare provider right away if have these symptoms:
Ask your healthcare provider for other important symptoms to watch for. Never hesitate to call your provider if you have concerns about a possible symptom or experience a change in how you’re feeling.
Be sure to ask:
A note from Cleveland Clinic
COX-2 inhibitors are a type of NSAID. Unlike traditional NSAIDs, COX-2 inhibitors work in a different way to control inflammation and pain. COX-2 inhibitors are as effective as other NSAIDs at reducing pain and inflammation. However, they cause fewer stomach and intestinal problems, such as bleeding and ulcers. Only one COX-2 inhibitor is available in the U.S., celecoxib (Celebrex). You and your healthcare provider will discuss if a COX-2 inhibitor is the right NSAID choice for you.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2022.
Learn more about our editorial process.