Which NSAID is associated with the lowest risk of GI bleeding?

Celecoxib is the correct choice when considering the NSAID associated with the lowest risk of gastrointestinal (GI) bleeding. This is primarily due to its selective inhibition of the COX-2 enzyme, which is responsible for producing prostaglandins that mediate inflammation but also protect the gastric mucosa. By sparing the COX-1 enzyme, which contributes to the maintenance of the gastric lining, celecoxib minimizes the risk of adverse GI effects, including bleeding and ulcers that are more prevalent with non-selective NSAIDs.

In contrast, other NSAIDs like naproxen, piroxicam, and ketorolac are non-selective and inhibit both COX-1 and COX-2. This inhibition can lead to decreased protective gastric prostaglandins, increasing the risk of GI complications such as bleeding and ulceration. Piroxicam, in particular, is known to have a higher risk of GI issues due to its long half-life and potency, which can result in prolonged exposure to its effects. Ketorolac, although effective for pain management, is also associated with significant GI risk when used, especially in higher doses or for extended periods. Thus, the choice of celecoxib represents an important consideration in managing