Which NSAID should be preferred for patients with a history of GI issues?

Celecoxib is preferred for patients with a history of gastrointestinal (GI) issues primarily due to its selective inhibition of COX-2 enzymes. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, diclofenac, and indomethacin inhibit both COX-1 and COX-2 enzymes, which can lead to reduced production of protective gastric mucosa and increase the risk of GI complications such as ulcers and bleeding.

The COX-2 enzyme is primarily responsible for mediating pain and inflammation, while COX-1 plays a key role in maintaining the gastric lining. By selectively blocking COX-2, celecoxib minimizes the undesirable effects on the GI system, making it a safer option for those with a history of GI problems. This selectivity is particularly beneficial in managing pain while mitigating the risk of exacerbating existing GI issues.

In contrast, other NSAIDs without this selectivity can pose a higher risk and may be less suitable for these patients. Therefore, celecoxib provides a more favorable risk profile for individuals with a history of gastrointestinal complications.