What type of drug is recommended for pain relief with less gastrointestinal risk?

COX-2 selective NSAIDs are designed to specifically target the cyclooxygenase-2 enzyme, which is involved in the inflammatory response and pain pathway. This selectivity reduces the production of certain prostaglandins that contribute to inflammation and pain while sparing those that maintain the protective lining of the gastrointestinal tract.

As a result, COX-2 selective NSAIDs generally present a lower risk of gastrointestinal side effects compared to non-selective NSAIDs, which inhibit both COX-1 and COX-2. The inhibition of COX-1, in particular, can lead to gastric irritation, ulcers, and bleeding due to its role in producing prostaglandins that protect the stomach lining.

While other options such as acetaminophen and topical NSAIDs also provide pain relief and may have a better gastrointestinal profile than non-selective NSAIDs, COX-2 selective NSAIDs remain a top option when considering a combination of efficacy for pain relief and reduced gastrointestinal risk, especially in patients who may be at higher risk for gastrointestinal complications.