Celecoxib-Induced Upper Gastrointestinal Hemorrhage and Ulceration

Andrew S. Crawford, DO, Joseph G. White, MD

Disclosures

South Med J. 2002;95(12) 

In This Article

Abstract and Introduction

COX-2 inhibitors are a new class of nonsteroidal anti-inflammatory drugs with a reported benefit of less gastric and duodenal ulceration and hemorrhage. We describe a 67-year-old man taking a higher than usual dose of celecoxib (Celebrex) for osteoarthritis with resultant gastric erosions, ulceration, and a significant gastrointestinal (GI) hemorrhage.

The newest drugs in the class of nonsteroidal anti-inflammatory drugs (NSAIDs) are the COX-2 inhibitors, which have been designed to selectively inhibit cyclooxegenase-2 (COX-2), while sparing cyclooxegenase-1 (COX-1). The purported benefit of selective inhibition of COX-2 is effective anti-inflammatory activity with decreased gastric and duodenal ulceration and bleeding for patients with osteoarthritis and rheumatoid arthritis. We describe a patient who had a bleeding duodenal ulcer and significant gastric ulceration while taking supratherapeutic doses of celecoxib (Celebrex), the first of the COX-2 drugs to be approved in the United States.

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