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Published Online, 24 February 2004, www.theannals.com, DOI 10.1345/aph.1D296.
 The Annals of Pharmacotherapy: Vol. 38, No. 4, pp. 700-704. DOI 10.1345/aph.1D296
© 2004 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Nephrotoxic Potential of Selective Cyclooxygenase-2 Inhibitors

Gurbir K Sandhu, BSc Pharm (Hons)

PharmD Student, College of Pharmacy, Idaho State University, Pocatello, ID

Catherine A Heyneman, PharmD MS

Director, Idaho Drug Information Service; Associate Professor of Pharmacy Practice, College of Pharmacy, Idaho State University

Reprints: Catherine A Heyneman PharmD MS, College of Pharmacy, Idaho State University, Campus Box 8356, Pocatello, ID 83209-8356, fax 208/282-3003, cathy{at}otc.isu.edu

OBJECTIVE: To determine the relative nephrotoxic potential of cyclooxygenase (COX)-2 inhibitors.

DATA SOURCES: A MEDLINE search (1996–February 2004) identified clinical trials evaluating the nephrotoxicity of COX-2 inhibitors versus traditional nonsteroidal antiinflammatory drugs (NSAIDs). Key search terms included cyclooxygenase inhibitors, nonsteroidal antiinflammatory agents, nephrotoxicity, and chemically induced.

DATA SYNTHESIS: Three clinical trials determined that COX-2 inhibitors have similar adverse effects on the kidney when compared with nonselective NSAIDs, while 2 studies concluded that COX-2 inhibitors are less nephrotoxic than nonselective NSAIDs. All 5 trials utilized low numbers of subjects, short-term therapy, and surrogate markers of kidney damage.

CONCLUSIONS: COX-2 inhibitors may not offer distinct advantages over nonselective NSAIDs with respect to kidney function. Longer trials in patients with comorbidities are warranted. These agents should be used cautiously or not at all in patients with predisposing conditions.

Key Words: celecoxib, cyclooxygenase-2 inhibitors, nephrotoxicity, rofecoxib

Published Online, February 24, 2004. www.theannals.com, DOI 10.1345/aph.1D296


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J. Zhang, E. L. Ding, and Y. Song
Adverse Effects of Cyclooxygenase 2 Inhibitors on Renal and Arrhythmia Events: Meta-analysis of Randomized Trials
JAMA, October 4, 2006; 296(13): 1619 - 1632.
[Abstract] [Full Text] [PDF]

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R. C. Harris and M. D. Breyer
Update on Cyclooxygenase-2 Inhibitors
Clin. J. Am. Soc. Nephrol., March 1, 2006; 1(2): 236 - 245.
[Abstract] [Full Text] [PDF]


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