The Government of India banned “Diclofenac and its formulations for veterinary use” in July 2008 with a view to conserving vultures and, in July 2015, allowed use of the drug as a single-dose injection for humans only. According to wildlife veterinarians, the key cause of vulture deaths is food poisoning.
People will no longer be able to purchase diclofenac tablets, used to treat pain and inflammation, from pharmacies without a prescription from their doctor due to the small risk of heart problems.
COX-2 inhibitors are NSAIDs that selectively block the COX-2 enzyme and not the COX-1 enzyme. Blocking this enzyme impedes the production of prostaglandins by the COX-2 which is more often the cause the pain and swelling of inflammation and other painful conditions.
Coxibs selectively inhibit COX-2, low-dose aspirin selectively inhibits COX-1, while traditional nonsteroidal antiinflammatory drugs (NSAIDs) nonselectively inhibit both COX isoforms.
In contrast to previous concepts, acetaminophen inhibited COX-2 by more than 80%, i.e., to a degree comparable to nonsteroidal antiinflammatory drugs (NSAIDs) and selective COX-2 inhibitors.
COX inhibitors divide into non-selective nonsteroidal anti-inflammatory drugs (NSAIDs), COX-2 selective nonsteroidal anti-inflammatory drugs (c2s NSAIDs), and aspirin. NSAIDs include ibuprofen, naproxen, ketorolac, and indomethacin. C2s NSAIDs only include celecoxib.
Diclofenac is a non-steroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body. When you apply diclofenac gel to your skin, it works in the same way as when you take it as a tablet or capsule. But the gel only works on the area you have put it on.
Celecoxib is a prescription nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed for many types of joint pain and inflammation. The medication is sold under the brand name Celebrex, or in generic form. Celecoxib is a type of medication known as a COX-2 inhibitor because of the way it works in the body.
The Natural Approach:Natural alternatives such as herbal extracts of turmeric, ginger, rosemary, green tea and their active phytochemical constituents are reported to be effective COX-2 inhibitors. Others such as Boswellia serrata extract (boswellic acids) inhibit the formation of inflammatory leukotrienes.
Selective COX-2 inhibitors increase the risk of myocardial infarction and stroke. This has been attributed to their ability to inhibit endothelial COX-2 derived prostacyclin (PGI2) but not platelet COX-1 derived thromboxane A2 (TXA2).
Aspirin inhibits COX-1 (cyclooxygenase-1). Its effect on COX-2 is more delicate: it "turns off" COX-2's production of prostaglandins but "switches on" the enzyme's ability to produce novel protective lipid mediators. Aspirin is a widely used non-steroidal anti-inflammatory drug (NSAID).
Extensive evaluation of the safety and efficacy of NSAIDs and selective COX-2 inhibitors has revealed that both drugs are equally effective and are associated with increased risk of GI, renal, and CV, adverse effects.
To summarize the renal side effects of COX-2 inhibitors, it now is evident that similar to nonselective NSAID, selective COX-2 inhibition may cause edema, hypertension, and even acute renal failure in a minority of patients. Their combination with NSAID may reduce adverse renal effects.
NSAIDs inhibit the rate-limiting enzyme cyclooxygenase (COX) in prostaglandin synthesis and two COX isoforms have been identified, COX-1 and COX-2. The COX-1 isoform produces cytoprotective prostaglandins and is present in most tissues, including the gastrointestinal mucosa, kidneys, and platelets.
COX2, also known as prostaglandin-endoperoxide synthase 2, is an enzyme that is responsible for the production of prostaglandins during inflammation (Chen & Tansey, 2011).
Selective inhibitors of COX-2-selective NSAIDs are effective antiinflammatory and analgesic drugs with improved upper-GI safety compared to traditional NSAIDs. Data on the cost-effectiveness of COX-2-selective NSAIDs indicate that they should be limited to patients at high risk for upper-GI adverse effects.
Aspirin is one of a group of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). It's widely used to relieve mild to moderate pain and inflammation. It's available over the counter in 300 mg tablets and is usually taken in doses of 300–600 mg four times a day after food.
At least in some cases, PGs derived from COX-1 contribute significantly to the generation of inflammation. In such cases, significant anti-inflammatory effects are only observed at doses of drugs that produce inhibition of both COX-1 and COX-2.
Over-the-counter NSAID medications include aspirin, ibuprofen (Advil, Motrin, and other brand names), and naproxen (Aleve), but selective COX-2 inhibitor NSAIDs are prescription medications that are more specialized in the way they work on inflammation.
