[Undesired effects of NSAIDS and coxibs].
Some 15-30% of patients receiving classical NSAID treatment go on to develop gastrointestinal ulcers. In 0.1-0.2%, hemorrhage and perforations occur in the stomach or bowel. The greater the cox-2 selectivity of an analgesic, the lower is its toxicity. The superiority of cox-2 inhibitors in this respect has been shown in comprehensive studies. Since, however, there have been individual reports of an increase in complications under treatment with coxibs, these agents are no longer recommended for use in patients with coronary heart disease and/or cerebrovascular disease. On the basis of the current data, however, it is also to be expected that EMEA and FDA will soon make similar recommendations with regard to the classical NSAIDs.