Page 112 - Athletic Health Handbook
P. 112
also increase cardiovascular risk.35 NSAIDs with the use of a proton appears to decrease the risk of an
Based upon meta-analysis, celecoxib pump inhibitor. adverse GI event. The physician
200 mg/day or naproxen 1,000 may wish to incorporate proton
mg/day appears to be safe in patients Summary pump inhibitor therapy even for
with a low or moderate risk of low GI-risk patients taking NSAIDs
cardiovascular disease.26 The sports medicine practitioner for more then several days.
must understand that COX-1
Among COX-1 and COX-2 and COX-2 inhibitors carry a risk In conclusion, the routine use of
inhibitors, celecoxib appears to be of cardiovascular, renal, and/or NSAID therapy for a brief period
associated with a lower risk of renal gastrointestinal events and identify appears beneficial for short-term pain
dysfunction, while rofecoxib and the those athletes who may be at risk.36 relief following acute exercise-induced
older non-selective NSAIDs appear All NSAIDs should be avoided in injury. However, conflicting data
to increase the risk of renal dysfunc- the athlete with significant cardiovas- exists whether short-term NSAID
tion. Gastrointestinal adverse events cular, renal, and GI disease. In use may impair bone healing. The
have also been well documented patients at low or moderate risk of clinical effects on tissue healing
with COX-1 NSAIDs but appear renal disease, celecoxib 200 mg/day remain relatively unknown warrant-
to be reduced with the use of appears to be safe. In at-risk patients ing continued critical evaluation of
COX-2 inhibitors (Table 2). Finally, in whom NSAID use is critical, their use in the athletic population.
gastrointestinal protection appears celecoxib 200 mg/day in conjunction
to be enhanced for either class of with a proton pump inhibitor

COX-2 INHIBITORS AND NON-SELECTIVE NSAIDS 112
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