Which NSAID has the lowest cox1:cox2 ratio?

Rofecoxib is classified as a selective COX-2 inhibitor, meaning it primarily inhibits the COX-2 enzyme while sparing COX-1 to a greater extent than non-selective NSAIDs. Because of this selective action, rofecoxib has the lowest COX-1 to COX-2 ratio among the options listed. This selectivity is significant in pain management, as COX-2 inhibition is often responsible for the anti-inflammatory effects of NSAIDs while minimizing gastrointestinal side effects traditionally associated with COX-1 inhibition.

The other options, being either non-selective NSAIDs or less potent COX-2 selective agents, exhibit a higher COX-1 to COX-2 ratio. Non-selective NSAIDs generally block both COX-1 and COX-2, leading to a greater risk of gastrointestinal issues due to COX-1 inhibition, which is involved in protecting the stomach lining. As a result, they do not achieve the low COX-1 to COX-2 ratio that rofecoxib provides, making rofecoxib the correct choice for this question.