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</li> <li id="toc-Adverse_effects" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Adverse_effects"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Adverse effects</span> </div> </a> <ul id="toc-Adverse_effects-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Research</span> </div> </a> <button aria-controls="toc-Research-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Research subsection</span> </button> <ul id="toc-Research-sublist" class="vector-toc-list"> <li id="toc-Research_history" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Research_history"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Research history</span> </div> </a> <ul id="toc-Research_history-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research_fraud" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Research_fraud"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Research fraud</span> </div> </a> <ul id="toc-Research_fraud-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Early_COX-2-inhibiting_drugs" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Early_COX-2-inhibiting_drugs"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Early COX-2-inhibiting drugs</span> </div> </a> <ul id="toc-Early_COX-2-inhibiting_drugs-sublist" class="vector-toc-list"> <li id="toc-VIGOR_study_and_publishing_controversy" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#VIGOR_study_and_publishing_controversy"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3.1</span> <span>VIGOR study and publishing controversy</span> </div> </a> <ul id="toc-VIGOR_study_and_publishing_controversy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Neuroblastomas" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Neuroblastomas"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Neuroblastomas</span> </div> </a> <ul id="toc-Neuroblastomas-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Cyclooxygenase-2 inhibitor</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 15 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-15" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">15 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%AB%D8%A8%D8%B7%D8%A7%D8%AA_%D8%B3%D9%8A%D9%83%D9%84%D9%88%D8%A3%D9%83%D8%B3%D8%AC%D9%8A%D9%86%D8%A7%D8%B2-2" title="مثبطات سيكلوأكسجيناز-2 – Arabic" lang="ar" hreflang="ar" data-title="مثبطات سيكلوأكسجيناز-2" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/COX-2-Hemmer" title="COX-2-Hemmer – German" lang="de" hreflang="de" data-title="COX-2-Hemmer" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Inhibidores_selectivos_de_la_COX-2" title="Inhibidores selectivos de la COX-2 – Spanish" lang="es" hreflang="es" data-title="Inhibidores selectivos de la COX-2" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%85%D9%87%D8%A7%D8%B1%DA%A9%D9%86%D9%86%D8%AF%D9%87_%D8%A7%D9%86%D8%AA%D8%AE%D8%A7%D8%A8%DB%8C_%DA%A9%D9%88%DA%A9%D8%B3%DB%B2" title="مهارکننده انتخابی کوکس۲ – Persian" lang="fa" hreflang="fa" data-title="مهارکننده انتخابی کوکس۲" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Coxib" title="Coxib – French" lang="fr" hreflang="fr" data-title="Coxib" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Inibitori_selettivi_della_COX-2" title="Inibitori selettivi della COX-2 – Italian" lang="it" hreflang="it" data-title="Inibitori selettivi della COX-2" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/COX-2_%D0%B8%D0%BD%D1%85%D0%B8%D0%B1%D0%B8%D1%82%D0%BE%D1%80%D0%B8" title="COX-2 инхибитори – Macedonian" lang="mk" hreflang="mk" data-title="COX-2 инхибитори" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Inibidores_seletivos_da_cicloxigenase-2" title="Inibidores seletivos da cicloxigenase-2 – Portuguese" lang="pt" hreflang="pt" data-title="Inibidores seletivos da cicloxigenase-2" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/COX-2_inhibitors" title="COX-2 inhibitors – Simple English" lang="en-simple" hreflang="en-simple" data-title="COX-2 inhibitors" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Koksib" title="Koksib – Slovenian" lang="sl" hreflang="sl" data-title="Koksib" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/COX-2_inhibitor" title="COX-2 inhibitor – Serbian" lang="sr" hreflang="sr" data-title="COX-2 inhibitor" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/COX-2_inhibitor" title="COX-2 inhibitor – Serbo-Croatian" lang="sh" hreflang="sh" data-title="COX-2 inhibitor" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Coxiber" title="Coxiber – Swedish" lang="sv" hreflang="sv" data-title="Coxiber" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Koksibler" title="Koksibler – Turkish" lang="tr" hreflang="tr" data-title="Koksibler" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9A%D0%BE%D0%BA%D1%81%D0%B8%D0%B1%D0%B8" title="Коксиби – Ukrainian" 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0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Globalize plainlinks metadata ambox ambox-content ambox-globalize" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><span><img alt="Globe icon." src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/48px-Ambox_globe_content.svg.png" decoding="async" width="48" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/73px-Ambox_globe_content.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Ambox_globe_content.svg/97px-Ambox_globe_content.svg.png 2x" data-file-width="350" data-file-height="290" /></span></span></div></td><td class="mbox-text"><div class="mbox-text-span">The examples and perspective in this article <b>may not represent a <a href="/wiki/Wikipedia:WikiProject_Countering_systemic_bias" title="Wikipedia:WikiProject Countering systemic bias">worldwide view</a> of the subject</b>.<span class="hide-when-compact"> You may <a class="external text" href="https://en.wikipedia.org/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit">improve this article</a>, discuss the issue on the <a href="/wiki/Talk:Cyclooxygenase-2_inhibitor" title="Talk:Cyclooxygenase-2 inhibitor">talk page</a>, or <a href="/wiki/Wikipedia:Article_wizard" title="Wikipedia:Article wizard">create a new article</a>, as appropriate.</span> <span class="date-container"><i>(<span class="date">September 2015</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <p><b>Cyclooxygenase-2 inhibitors</b> (<b>COX-2 inhibitors</b>), also known as <b>coxibs</b>, are a type of <a href="/wiki/Nonsteroidal_anti-inflammatory_drug" title="Nonsteroidal anti-inflammatory drug">nonsteroidal anti-inflammatory drug</a> (NSAID) that directly target cyclooxygenase-2 (<a href="/wiki/COX-2" class="mw-redirect" title="COX-2">COX-2</a>), an <a href="/wiki/Enzyme" title="Enzyme">enzyme</a> responsible for <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> and <a href="/wiki/Pain" title="Pain">pain</a>. Targeting selectivity for COX-2 reduces the risk of <a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">peptic ulceration</a> and is the main feature of <a href="/wiki/Celecoxib" title="Celecoxib">celecoxib</a>, <a href="/wiki/Rofecoxib" title="Rofecoxib">rofecoxib</a>, and other members of this drug class.<sup id="cite_ref-Lipfert_Seitz_Arndt_1987_pp._210–213_1-0" class="reference"><a href="#cite_note-Lipfert_Seitz_Arndt_1987_pp._210–213-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>After several COX-2–inhibiting drugs were approved for marketing, data from clinical trials revealed that COX-2 inhibitors caused a significant increase in heart attacks and strokes, with some drugs in the class having worse risks than others. <a href="/wiki/Rofecoxib" title="Rofecoxib">Rofecoxib</a> (sold under the brand name Vioxx) was taken off the market in 2004 because of these concerns, while <a href="/wiki/Celecoxib" title="Celecoxib">celecoxib</a> (sold under the brand name Celebrex) and traditional NSAIDs received <a href="/wiki/Boxed_warning" title="Boxed warning">boxed warnings</a> on their labels. Many COX-2–specific inhibitors have been removed from the US market. As of December 2011, only Celebrex (celecoxib) is still available for purchase in the United States. In the European Union, celecoxib, <a href="/wiki/Parecoxib" title="Parecoxib">parecoxib</a>, and <a href="/wiki/Etoricoxib" title="Etoricoxib">etoricoxib</a> have been approved for use by the <a href="/wiki/European_Medicines_Agency" title="European Medicines Agency">European Medicines Agency</a>.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Paracetamol" title="Paracetamol">Paracetamol</a> (acetaminophen) inhibits COX-2 almost exclusively within the brain and only minimally in the rest of the body, although it is not considered an NSAID, since it has only minor <a href="/wiki/Anti-inflammatory" title="Anti-inflammatory">anti-inflammatory</a> activity.<sup id="cite_ref-Hinz_20083_3-0" class="reference"><a href="#cite_note-Hinz_20083-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-integrada_4-0" class="reference"><a href="#cite_note-integrada-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some COX-2 inhibitors are used in a single dose to treat pain after surgery.<sup id="cite_ref-TirunagariDerry2009_5-0" class="reference"><a href="#cite_note-TirunagariDerry2009-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BulleyDerry2009_6-0" class="reference"><a href="#cite_note-BulleyDerry2009-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> In this role <a href="/wiki/Etoricoxib" title="Etoricoxib">etoricoxib</a> appears as good as, if not better than, other pain medications, and <a href="/wiki/Celecoxib" title="Celecoxib">celecoxib</a> appears to be about as useful as <a href="/wiki/Ibuprofen" title="Ibuprofen">ibuprofen</a>.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>NSAIDs are often used in treatment of acute <a href="/wiki/Gout" title="Gout">gout</a> attacks. COX-2 inhibitors appear to work as well as nonselective NSAIDs, such as aspirin.<sup id="cite_ref-:0_9-0" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> They have not been compared to other treatment options such as <a href="/wiki/Colchicine" title="Colchicine">colchicine</a> or <a href="/wiki/Glucocorticoids" class="mw-redirect" title="Glucocorticoids">glucocorticoids</a>.<sup id="cite_ref-:0_9-1" class="reference"><a href="#cite_note-:0-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cancer">Cancer</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=2" title="Edit section: Cancer"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>COX-2 appears to be related to cancers and abnormal growths in the intestinal tract. Overexpression of COX-2 produces excess prostaglandins, which have been shown to increase the possibility of <a href="/wiki/Colorectal_cancer" title="Colorectal cancer">colorectal cancer</a>.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> COX inhibitors have been shown to reduce the occurrence of cancers and <a href="/wiki/Precancer" class="mw-redirect" title="Precancer">precancerous</a> growths. The National Cancer Institute has done some studies on COX-2 and cancer.<sup id="cite_ref-urlCOX-2_Inhibitors_and_Cancer_–_National_Cancer_Institute_12-0" class="reference"><a href="#cite_note-urlCOX-2_Inhibitors_and_Cancer_–_National_Cancer_Institute-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> COX-2 can act as an <a href="/wiki/Anti-tumor" class="mw-redirect" title="Anti-tumor">anti-tumor</a> enzyme, but only in specific cases.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> The FDA has approved Celebrex for treatment of <a href="/wiki/Familial_adenomatous_polyposis" title="Familial adenomatous polyposis">familial adenomatous polyposis</a> (FAP).<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> COX-2 inhibitors are currently being studied in <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> and appear to be beneficial.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Neuropsychiatric_disorders">Neuropsychiatric disorders</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=3" title="Edit section: Neuropsychiatric disorders"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>COX-2 inhibitors have been found to be effective in suppressing inflammatory neurodegenerative pathways, with beneficial results in animal studies for <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">major depressive disorder</a>, as well as <a href="/wiki/Schizophrenia" title="Schizophrenia">schizophrenia</a>, <a href="/wiki/Bipolar_disorder" title="Bipolar disorder">bipolar disorder</a>, and <a href="/wiki/Obsessive-compulsive_disorder" class="mw-redirect" title="Obsessive-compulsive disorder">obsessive-compulsive disorder</a>.<sup id="cite_ref-:1_17-0" class="reference"><a href="#cite_note-:1-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> These need to be confirmed in human clinical trials.<sup id="cite_ref-pmid20047157_18-0" class="reference"><a href="#cite_note-pmid20047157-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Current studies support an association of disorders such as these with chronic inflammation, which appears to decrease with the use of COX-2 inhibitors.<sup id="cite_ref-:1_17-1" class="reference"><a href="#cite_note-:1-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Other_targets">Other targets</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=4" title="Edit section: Other targets"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The inhibition of COX-2 is paramount for the <a href="/wiki/Anti-inflammatory" title="Anti-inflammatory">anti-inflammatory</a> and <a href="/wiki/Analgesic" title="Analgesic">analgesic</a> function of the selective COX-2 inhibitor celecoxib. However, with regard to this drug's promise for the therapy of advanced cancers, it is unclear whether the inhibition of COX-2 plays a dominant role, and this has become a controversial and intensely researched issue. In recent years, several additional intracellular components (besides COX-2) were discovered that appear to be important for mediating the anticancer effects of celecoxib in the absence of COX-2.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Moreover, a recent study with various malignant tumor cells showed that celecoxib could inhibit the growth of these cells, even though some of these cancer cells didn't even contain COX-2.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>Additional support for the idea that other targets besides COX-2 are important for celecoxib's anticancer effects has come from studies with chemically modified versions of celecoxib. Several dozen <a href="/wiki/Analog_(chemistry)" class="mw-redirect" title="Analog (chemistry)">analogs</a> of celecoxib were generated with small alterations in their <a href="/wiki/Chemical_structure" title="Chemical structure">chemical structures</a>.<sup id="cite_ref-zhu_21-0" class="reference"><a href="#cite_note-zhu-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Some of these analogs retained COX-2 inhibitory activity, whereas many others didn't. However, when the ability of all these compounds to kill tumor cells in <a href="/wiki/Cell_culture" title="Cell culture">cell culture</a> was investigated, it turned out that the antitumor potency did not at all depend on whether or not the respective compound could inhibit COX-2, showing that inhibition of COX-2 was not required for the anticancer effects.<sup id="cite_ref-zhu_21-1" class="reference"><a href="#cite_note-zhu-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> One of these compounds, 2,5-dimethyl-celecoxib, which entirely lacks the ability to inhibit COX-2, actually turned out to display stronger anticancer activity than celecoxib itself<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> and this anticancer effect could also be verified in highly drug-resistant tumor cells<sup id="cite_ref-pmid16123214_24-0" class="reference"><a href="#cite_note-pmid16123214-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> and in various animal tumor models.<sup id="cite_ref-pmid17431104_25-0" class="reference"><a href="#cite_note-pmid17431104-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid15846081_26-0" class="reference"><a href="#cite_note-pmid15846081-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Adverse_effects">Adverse effects</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=5" title="Edit section: Adverse effects"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Analysis of clinical trial data revealed that there was a significant increase in the rate of vascular events like <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">myocardial infarction</a> or <a href="/wiki/Stroke" title="Stroke">stroke</a> with COX-2 inhibitors compared with <a href="/wiki/Placebo" title="Placebo">placebo</a>.<sup id="cite_ref-AHA_27-0" class="reference"><a href="#cite_note-AHA-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-BMJ_28-0" class="reference"><a href="#cite_note-BMJ-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> These results led Merck to voluntarily withdraw (rofecoxib) from the market in September 2004 and to regulatory authorities imposing a boxed warning on the label of celecoxib.<sup id="cite_ref-AHA_27-1" class="reference"><a href="#cite_note-AHA-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> Traditional NSAIDs were also found to have cardiovascular risks, leading to similar <a href="/wiki/Boxed_warning" title="Boxed warning">boxed warnings</a>.<sup id="cite_ref-AHA_27-2" class="reference"><a href="#cite_note-AHA-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> </p><p>The cause of the cardiovascular problems became, and remains, a subject of intensive research.<sup id="cite_ref-Cannon_29-0" class="reference"><a href="#cite_note-Cannon-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> As of 2012 results have been converging on the hypothesis that the adverse cardiovascular effects are most likely due to inhibition of COX-2 in <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessels</a>, which leads to a decrease in the production of <a href="/wiki/Prostacyclin" title="Prostacyclin">prostacyclin</a> in them. Prostacyclin usually prevents <a href="/wiki/Platelet_aggregation" class="mw-redirect" title="Platelet aggregation">platelet aggregation</a> and <a href="/wiki/Vasoconstriction" title="Vasoconstriction">vasoconstriction</a>, so its inhibition can lead to excess clot formation and higher blood pressure.<sup id="cite_ref-Cannon_29-1" class="reference"><a href="#cite_note-Cannon-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=6" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Research_history">Research history</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=7" title="Edit section: Research history"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Discovery_and_development_of_cyclooxygenase_2_inhibitors" title="Discovery and development of cyclooxygenase 2 inhibitors">Discovery and development of cyclooxygenase 2 inhibitors</a></div> <p>The COX-2 enzyme was discovered in 1988 by Daniel Simmons, a <a href="/wiki/Brigham_Young_University" title="Brigham Young University">Brigham Young University</a> researcher.<sup id="cite_ref-pmid1849272_30-0" class="reference"><a href="#cite_note-pmid1849272-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> The mouse COX-2 gene was cloned by UCLA scientist Harvey Herschman, a finding published in 1991.<sup id="cite_ref-pmid1712772_31-0" class="reference"><a href="#cite_note-pmid1712772-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> </p><p>The basic research leading to the discovery of COX-2 inhibitors has been the subject of at least two lawsuits. Brigham Young University has sued <a href="/wiki/Pfizer" title="Pfizer">Pfizer</a>, alleging breach of contract from relations BYU had with the company at the time of Simmons's work.<sup id="cite_ref-urlUniversity_sues_Pfizer_over_COX-2_research_32-0" class="reference"><a href="#cite_note-urlUniversity_sues_Pfizer_over_COX-2_research-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> A settlement was reached in April 2012 in which Pfizer agreed to pay $450 million.<sup id="cite_ref-Settlement_34-0" class="reference"><a href="#cite_note-Settlement-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> The other litigation is based on United States Pat. No. 6,048,850<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> owned by <a href="/wiki/University_of_Rochester" title="University of Rochester">University of Rochester</a>, which claimed a method to treat pain without causing gastro-intestinal distress by selectively inhibiting COX-2. When the patent issued, the university sued Searle (later Pfizer) in a case called, <i>University of Rochester v. G.D. Searle & Co.</i>, 358 F.3d 916 (Fed. Cir. 2004). The court ruled in favor of Searle in 2004, holding in essence that the university had claimed a method requiring, yet provided no written description of, a compound that could inhibit COX-2 and therefore the patent was invalid.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> </p><p>In the course of the search for a specific <a href="/wiki/Enzyme_inhibitor" title="Enzyme inhibitor">inhibitor</a> of the negative effects of <a href="/wiki/Prostaglandin" title="Prostaglandin">prostaglandins</a> that spared the positive effects, it was discovered that prostaglandins could indeed be separated into two general classes that could loosely be regarded as "good prostaglandins" and "bad prostaglandins", according to the structure of a particular <a href="/wiki/Enzyme" title="Enzyme">enzyme</a> involved in their <a href="/wiki/Biosynthesis" title="Biosynthesis">biosynthesis</a>, <a href="/wiki/Cyclooxygenase" title="Cyclooxygenase">cyclooxygenase</a>. </p><p>Prostaglandins whose synthesis involves the <a href="/wiki/Cyclooxygenase" title="Cyclooxygenase">cyclooxygenase-I</a> enzyme, or COX-1, are responsible for maintenance and protection of the <a href="/wiki/Gastrointestinal_tract" title="Gastrointestinal tract">gastrointestinal tract</a>, while prostaglandins whose synthesis involves the cyclooxygenase-II enzyme, or COX-2, are responsible for inflammation and pain. </p><p>The existing nonsteroidal anti-inflammatory drugs (<a href="/wiki/NSAID" class="mw-redirect" title="NSAID">NSAIDs</a>) differ in their relative specificities for COX-2 and COX-1; while aspirin and ibuprofen inhibit COX-2 and COX-1 enzymes, other NSAIDs appear to have partial COX-2 specificity, particularly <a href="/wiki/Meloxicam" title="Meloxicam">meloxicam</a> (<a href="/wiki/Mobic" class="mw-redirect" title="Mobic">Mobic</a>).<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Aspirin is ≈170-fold more potent in inhibiting COX-1 than COX-2.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> Studies of meloxicam 7.5 mg per day for 23 days find a level of gastric injury similar to that of a <a href="/wiki/Placebo" title="Placebo">placebo</a>, and for meloxicam 15 mg per day a level of injury lower than that of other NSAIDs; however, in clinical practice meloxicam can still cause some <a href="/wiki/Peptic_ulcer" class="mw-redirect" title="Peptic ulcer">ulcer</a> complications. </p><p><a href="/wiki/Valdecoxib" title="Valdecoxib">Valdecoxib</a> and rofecoxib were about 300 times more potent at inhibiting COX-2 than COX-1, but too toxic for the heart, suggesting the possibility of relief from pain and inflammation without gastrointestinal irritation, and promising to be a boon for those who had previously experienced adverse effects or had <a href="/wiki/Comorbidity" title="Comorbidity">comorbidities</a> that could lead to such complications. Celecoxib is approximately 30 times more potent at inhibiting COX-2 than COX-1, with etoricoxib being 106 times more potent. </p> <div class="mw-heading mw-heading3"><h3 id="Research_fraud">Research fraud</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=8" title="Edit section: Research fraud"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Between 1996 and 2009, <a href="/wiki/Scott_Reuben" title="Scott Reuben">Scott Reuben</a> purportedly conducted clinical research on the use of COX-2 inhibitors, often in combination with <a href="/wiki/Gabapentin" title="Gabapentin">gabapentin</a> or <a href="/wiki/Pregabalin" title="Pregabalin">pregabalin</a>, for the prevention and treatment of <a href="/wiki/Postoperative_pain" class="mw-redirect" title="Postoperative pain">postoperative pain</a>, research which was found in 2009 to have been faked. Reuben pleaded guilty, paid fines, and served six months in jail, and lost his <a href="/wiki/Medical_license" title="Medical license">medical license</a>.<sup id="cite_ref-sciam0310_41-0" class="reference"><a href="#cite_note-sciam0310-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> A 2009 review of <a href="/wiki/Systematic_review" title="Systematic review">meta-articles</a> used in <a href="/wiki/Evidence-based_medicine" title="Evidence-based medicine">evidence-based medicine</a> found that while some reviews were no longer valid when the Reuben studies were removed, the conclusions in the majority of them remained unchanged.<sup id="cite_ref-Marret_42-0" class="reference"><a href="#cite_note-Marret-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> The review found that the key Reuben claims that needed to be re-examined were "the absence of detrimental effects of coxibs on <a href="/wiki/Bone_healing" title="Bone healing">bone healing</a> after <a href="/wiki/Spinal_surgery" class="mw-redirect" title="Spinal surgery">spine surgery</a>, the beneficial long-term outcome after preemptive administration of coxibs including an allegedly decreased incidence of chronic pain after surgery, and the analgesic efficacy of <a href="/wiki/Ketorolac" title="Ketorolac">ketorolac</a> or <a href="/wiki/Clonidine" title="Clonidine">clonidine</a> when added to <a href="/wiki/Local_anesthetics" class="mw-redirect" title="Local anesthetics">local anesthetics</a> for <a href="/wiki/Intravenous_regional_anesthesia" title="Intravenous regional anesthesia">intravenous regional anesthesia</a>."<sup id="cite_ref-Marret_42-1" class="reference"><a href="#cite_note-Marret-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid21350225_43-0" class="reference"><a href="#cite_note-pmid21350225-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Early_COX-2-inhibiting_drugs">Early COX-2-inhibiting drugs</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=9" title="Edit section: Early COX-2-inhibiting drugs"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Celebrex (and other brand names for celecoxib) was introduced in 1999 and rapidly became the most frequently prescribed new drug in the United States. By October 2000, its US sales exceeded 100 million prescriptions per year for $3 billion, and was still rising. Sales of Celebrex alone reached $3.1 billion in 2001. A <a href="/wiki/Spain" title="Spain">Spanish</a> study found that between January 2000 and June 2001, 7% of NSAID prescriptions and 29% of NSAID expenditures were for COX-2 inhibitors. Over the period of the study, COX-2 inhibitors rose from 10.03% of total NSAIDs prescribed by specialty physicians to 29.79%, and from 1.52% to 10.78% of NSAIDs prescribed by <a href="/wiki/Primary_care_physician" title="Primary care physician">primary care physicians</a> (98.23% of NSAIDs and 94.61% of COX-2 inhibitors were prescribed by primary care physicians). For specialty physicians, rofecoxib and celecoxib were third and fifth most frequently prescribed NSAIDs but first and second in cost, respectively; for primary-care physicians they were ninth and twelfth most frequently prescribed NSAIDs and first and fourth in cost. </p><p>Sales and marketing efforts were supported by two large trials, the Celecoxib Long-term Arthritis Safety Study<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> (CLASS) in <i><a href="/wiki/JAMA_(journal)" class="mw-redirect" title="JAMA (journal)">JAMA</a></i>, and the Vioxx Gastrointestinal Outcomes Research (VIGOR).<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> The VIGOR trial was later proven to have been based on faulty data, and Vioxx was eventually withdrawn from the market.<sup id="cite_ref-Smith_2006_46-0" class="reference"><a href="#cite_note-Smith_2006-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="VIGOR_study_and_publishing_controversy">VIGOR study and publishing controversy</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=10" title="Edit section: VIGOR study and publishing controversy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The VIGOR (Vioxx Gastrointestinal Outcomes Research) trial, "which was the making of Merck's drug rofecoxib (Vioxx),"<sup id="cite_ref-Smith_2006_46-1" class="reference"><a href="#cite_note-Smith_2006-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> was at the center of a dispute about the ethics of medical journals. In the VIGOR trial, over 8,000 patients were randomized to receive either naproxen or rofecoxib (Vioxx). Both studies concluded that COX-2 specific NSAIDs were associated with significantly fewer adverse gastrointestinal effects. In the CLASS trial which compared Celebrex 800 mg/day to <a href="/wiki/Ibuprofen" title="Ibuprofen">ibuprofen</a> 2400 mg/day and <a href="/wiki/Diclofenac" title="Diclofenac">diclofenac</a> 150 mg/day for <a href="/wiki/Osteoarthritis" title="Osteoarthritis">osteoarthritis</a> or <a href="/wiki/Rheumatoid_arthritis" title="Rheumatoid arthritis">rheumatoid arthritis</a> for six months, Celebrex was associated with significantly fewer upper gastrointestinal complications (0.44% vs. 1.27%, <i>p</i> = 0.04), with no significant difference in incidence of <a href="/wiki/Cardiovascular" class="mw-redirect" title="Cardiovascular">cardiovascular</a> events in patients not taking aspirin for cardiovascular <a href="/wiki/Prophylaxis" class="mw-redirect" title="Prophylaxis">prophylaxis</a>. </p><p>The VIGOR trial results were published in 2000 in the <i>New England Journal of Medicine</i><sup id="cite_ref-VIGOR_2000_47-0" class="reference"><a href="#cite_note-VIGOR_2000-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> Bombardier and his research team claimed that there was "an increase in myocardial infarction in the patients given rofecoxib (0.4%) compared with those given naproxen (0.1%)" and "patients given naproxen experienced 121 side effects compared with 56 in the patients taking rofecoxib," a "marvellous result for Merck" which "contributed to huge sales of rofecoxib."<sup id="cite_ref-Smith_2006_46-2" class="reference"><a href="#cite_note-Smith_2006-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> Merck's scientists incorrectly interpreted the finding as a protective effect of naproxen, telling the FDA that the difference in heart attacks "is primarily due to" this protective effect.<sup id="cite_ref-Cardio_48-0" class="reference"><a href="#cite_note-Cardio-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup> In September 2001, the United States <a href="/wiki/Food_and_Drug_Administration" title="Food and Drug Administration">Food and Drug Administration</a> (FDA) sent a warning letter to the CEO of Merck, stating, "Your promotional campaign discounts the fact that in the VIGOR study, patients on Vioxx were observed to have a four to five fold increase in myocardial infarctions (MIs) compared to patients on the comparator nonsteroidal anti-inflammatory drug (NSAID), Naprosyn (naproxen)."<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> This led to the introduction, in April 2002, of warnings on Vioxx labeling concerning the increased risk of cardiovascular events (heart attack and stroke). By 2005 <i>The New England Journal of Medicine</i> published an editorial accusing the Bombardier et al. of deliberately withholding data.<sup id="cite_ref-Curfman_2006a_50-0" class="reference"><a href="#cite_note-Curfman_2006a-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> </p><p>Claire Bombardier, a University of Toronto rheumatologist, had claimed that the VIGOR trial showed that <a href="/wiki/Vioxx" class="mw-redirect" title="Vioxx">Vioxx</a> 50 mg/day had benefits over <a href="/wiki/Naproxen" title="Naproxen">naproxen</a> for rheumatoid arthritis, specifically that Vioxx reduced the risk of symptomatic ulcers and clinical upper gastrointestinal events (<a href="/wiki/Gastrointestinal_perforation" title="Gastrointestinal perforation">perforations</a>, <a href="/wiki/Gastric_outlet_obstruction" title="Gastric outlet obstruction">obstructions</a> and <a href="/wiki/Upper_gastrointestinal_bleeding" title="Upper gastrointestinal bleeding">bleeding</a>) by 54%, to 1.4% from 3%, the risk of complicated <a href="/w/index.php?title=Upper_gastrointestinal_event&action=edit&redlink=1" class="new" title="Upper gastrointestinal event (page does not exist)">upper gastrointestinal events</a> (complicated perforations, obstructions and bleeding in the <a href="/wiki/Upper_gastrointestinal_tract" class="mw-redirect" title="Upper gastrointestinal tract">upper gastrointestinal tract</a>) by 57%, and the risk of bleeding from anywhere in the gastrointestinal tract by 62%. An enormous <a href="/wiki/Marketing" title="Marketing">marketing</a> effort capitalized on these publications; Vioxx was the most heavily advertised prescription drug in 2000, and Celebrex the seventh, according to <a href="/wiki/IMS_Health" title="IMS Health">IMS Health</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Neuroblastomas">Neuroblastomas</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=11" title="Edit section: Neuroblastomas"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Small tumors of the <a href="/wiki/Sympathetic_nervous_system" title="Sympathetic nervous system">sympathetic nervous system</a> (<a href="/wiki/Neuroblastoma" title="Neuroblastoma">neuroblastoma</a>) appear to have abnormal levels of COX-2 expressed.<sup id="cite_ref-pmid15492235_51-0" class="reference"><a href="#cite_note-pmid15492235-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> These studies report that overexpression of the COX-2 enzyme has an adverse effect on the tumor suppressor, <a href="/wiki/P53" title="P53">p53</a>. p53 is an apoptosis <a href="/wiki/Transcription_factor" title="Transcription factor">transcription factor</a> normally found in the <a href="/wiki/Cytosol" title="Cytosol">cytosol</a>. When <a href="/w/index.php?title=Cellular_DNA&action=edit&redlink=1" class="new" title="Cellular DNA (page does not exist)">cellular DNA</a> is damaged beyond repair, p53 is transported to the <a href="/wiki/Cell_nucleus" title="Cell nucleus">nucleus</a> where it promotes p53 mediated apoptosis.<sup id="cite_ref-Lau_2007_52-0" class="reference"><a href="#cite_note-Lau_2007-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> Two of the metabolites of COX-2, <a href="/w/index.php?title=Prostaglandin_A2&action=edit&redlink=1" class="new" title="Prostaglandin A2 (page does not exist)">prostaglandin A2</a> (PGA2) and A1 (PGA1), when present in high quantities, bind to p53 in the cytosol and inhibit its ability to cross into the nucleus. This essentially sequesters p53 in the cytosol and prevents apoptosis.<sup id="cite_ref-Lau_2007_52-1" class="reference"><a href="#cite_note-Lau_2007-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> Coxibs such as Celebrex (celecoxib), by selectively inhibiting the overexpressed COX-2, allow p53 to work properly. Functional p53 allows DNA damaged neuroblastoma cells to commit <a href="/wiki/Suicide" title="Suicide">suicide</a> through apoptosis, halting tumor growth. </p><p>COX-2 up-regulation has also been linked to the <a href="/wiki/Phosphorylation" title="Phosphorylation">phosphorylation</a> and activation of the E3 <a href="/wiki/Ubiquitin_ligase" title="Ubiquitin ligase">ubiquitin ligase</a> <a href="/w/index.php?title=HDM2&action=edit&redlink=1" class="new" title="HDM2 (page does not exist)">HDM2</a>, a <a href="/wiki/Protein" title="Protein">protein</a> that mediates p53 ligation and tagged destruction, through <a href="/wiki/Ubiquitination" class="mw-redirect" title="Ubiquitination">ubiquitination</a>.<sup id="cite_ref-Lau_2007_52-2" class="reference"><a href="#cite_note-Lau_2007-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> The mechanism for this neuroblastoma HDM2 hyperactivity is unknown. Studies have shown that COX-2 inhibitors block the phosphorylation of HDM2 preventing its activation. In vitro, the use of COX-2 inhibitors lowers the level of active HDM2 found in neuroblastoma cells. The exact process of how COX-2 inhibitors block HDM2 phosphorylation is unknown, but this mediated reduction in active HDM2 concentration level restores the cellular p53 levels. After treatment with a COX-2 inhibitor, the restored p53 function allows DNA damaged neuroblastoma cells to commit suicide through apoptosis reducing the size of growth of the tumor.<sup id="cite_ref-Lau_2007_52-3" class="reference"><a href="#cite_note-Lau_2007-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Cyclooxygenase-2_inhibitor&action=edit&section=12" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist reflist-columns references-column-width" style="column-width: 32em;"> <ol class="references"> <li id="cite_note-Lipfert_Seitz_Arndt_1987_pp._210–213-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-Lipfert_Seitz_Arndt_1987_pp._210–213_1-0">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFLipfertSeitzArndt1987" class="citation journal cs1">Lipfert P, Seitz R, Arndt JO (February 1987). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-198702000-00016">"Studies of local anesthetic action on natural spike activity in the aortic nerve of cats"</a>. <i>Anesthesiology</i>. <b>66</b> (2). Ovid Technologies (Wolters Kluwer Health): 210–213. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-198702000-00016">10.1097/00000542-198702000-00016</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/3813081">3813081</a>. <q>Non-steroidal anti-inflammatory drugs (NSAIDs) are the competitive inhibitors of cyclooxygenase (COX), the enzyme which mediates the bioconversion of arachidonic acid to inflammatory prostaglandins (PGs).</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Anesthesiology&rft.atitle=Studies+of+local+anesthetic+action+on+natural+spike+activity+in+the+aortic+nerve+of+cats&rft.volume=66&rft.issue=2&rft.pages=210-213&rft.date=1987-02&rft_id=info%3Adoi%2F10.1097%2F00000542-198702000-00016&rft_id=info%3Apmid%2F3813081&rft.aulast=Lipfert&rft.aufirst=P&rft.au=Seitz%2C+R&rft.au=Arndt%2C+JO&rft_id=https%3A%2F%2Fdoi.org%2F10.1097%252F00000542-198702000-00016&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.ema.europa.eu/en/human-regulatory/post-authorisation/data-medicines-iso-idmp-standards/public-data-article-57-database">"Public data from Article 57 database"</a>. <i>European Medicines Agency</i>. 17 September 2018. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20181002145031/https://www.ema.europa.eu/en/human-regulatory/post-authorisation/data-medicines-iso-idmp-standards/public-data-article-57-database">Archived</a> from the original on 2018-10-02<span class="reference-accessdate">. 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"Understanding NSAIDs: from aspirin to COX-2". <i>Clinical Cornerstone</i>. <b>3</b> (5): 50–60. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS1098-3597%2801%2990069-9">10.1016/S1098-3597(01)90069-9</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11464731">11464731</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+Cornerstone&rft.atitle=Understanding+NSAIDs%3A+from+aspirin+to+COX-2&rft.volume=3&rft.issue=5&rft.pages=50-60&rft.date=2001&rft_id=info%3Adoi%2F10.1016%2FS1098-3597%2801%2990069-9&rft_id=info%3Apmid%2F11464731&rft.aulast=Green&rft.aufirst=GA&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMalhotraShafiqPandhi2004" class="citation journal cs1">Malhotra S, Shafiq N, Pandhi P (March 2004). <a rel="nofollow" class="external text" href="http://www.medscape.com/viewarticle/47342">"COX-2 inhibitors: a CLASS act or Just VIGORously promoted"</a>. <i>MedGenMed</i>. <b>6</b> (1): 6. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140734">1140734</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15208519">15208519</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=MedGenMed&rft.atitle=COX-2+inhibitors%3A+a+CLASS+act+or+Just+VIGORously+promoted&rft.volume=6&rft.issue=1&rft.pages=6&rft.date=2004-03&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1140734%23id-name%3DPMC&rft_id=info%3Apmid%2F15208519&rft.aulast=Malhotra&rft.aufirst=S&rft.au=Shafiq%2C+N&rft.au=Pandhi%2C+P&rft_id=http%3A%2F%2Fwww.medscape.com%2Fviewarticle%2F47342&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMontero_FernándezRodríguez_AlcaláValles_FernándezLópez_de_Castro2002" class="citation journal cs1 cs1-prop-foreign-lang-source">Montero Fernández MJ, Rodríguez Alcalá FJ, Valles Fernández N, López de Castro F, Esteban Tudela M, Cordero García B (October 2002). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20070708175025/http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista.pubmed_full?inctrl=05ZI0105&rev=27&vol=30&num=6&pag=363">"[At what care level are cyclo-oxygenase-2 inhibitors prescribed?]"</a>. <i>Atencion Primaria</i> (in Spanish). <b>30</b> (6): 363–367. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0212-6567%2802%2979048-3">10.1016/s0212-6567(02)79048-3</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7676627">7676627</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12396942">12396942</a>. Archived from <a rel="nofollow" class="external text" href="http://db.doyma.es/cgi-bin/wdbcgi.exe/doyma/mrevista.pubmed_full?inctrl=05ZI0105&rev=27&vol=30&num=6&pag=363">the original</a> on 2007-07-08<span class="reference-accessdate">. Retrieved <span class="nowrap">2008-09-01</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Atencion+Primaria&rft.atitle=%5BAt+what+care+level+are+cyclo-oxygenase-2+inhibitors+prescribed%3F%5D&rft.volume=30&rft.issue=6&rft.pages=363-367&rft.date=2002-10&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7676627%23id-name%3DPMC&rft_id=info%3Apmid%2F12396942&rft_id=info%3Adoi%2F10.1016%2Fs0212-6567%2802%2979048-3&rft.aulast=Montero+Fern%C3%A1ndez&rft.aufirst=MJ&rft.au=Rodr%C3%ADguez+Alcal%C3%A1%2C+FJ&rft.au=Valles+Fern%C3%A1ndez%2C+N&rft.au=L%C3%B3pez+de+Castro%2C+F&rft.au=Esteban+Tudela%2C+M&rft.au=Cordero+Garc%C3%ADa%2C+B&rft_id=http%3A%2F%2Fdb.doyma.es%2Fcgi-bin%2Fwdbcgi.exe%2Fdoyma%2Fmrevista.pubmed_full%3Finctrl%3D05ZI0105%26rev%3D27%26vol%3D30%26num%3D6%26pag%3D363&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKritz2001" class="citation news cs1">Kritz FL (September 4, 2001). "You and A: Arthritis drugs. Pain and confusion". <i>Washington Post</i>. p. HE01.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Washington+Post&rft.atitle=You+and+A%3A+Arthritis+drugs.+Pain+and+confusion&rft.pages=HE01&rft.date=2001-09-04&rft.aulast=Kritz&rft.aufirst=FL&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1">"Will the promise of the COX-2 selective NSAIDs come to fruition?". <i>Drugs & Therapy Perspectives</i>. <b>17</b> (11). 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"Cyclooxygenase-2 is expressed in neuroblastoma, and nonsteroidal anti-inflammatory drugs induce apoptosis and inhibit tumor growth in vivo". <i>Cancer Research</i>. <b>64</b> (20): 7210–7215. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1158%2F0008-5472.CAN-04-1795">10.1158/0008-5472.CAN-04-1795</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15492235">15492235</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:10865602">10865602</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cancer+Research&rft.atitle=Cyclooxygenase-2+is+expressed+in+neuroblastoma%2C+and+nonsteroidal+anti-inflammatory+drugs+induce+apoptosis+and+inhibit+tumor+growth+in+vivo&rft.volume=64&rft.issue=20&rft.pages=7210-7215&rft.date=2004-10&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A10865602%23id-name%3DS2CID&rft_id=info%3Apmid%2F15492235&rft_id=info%3Adoi%2F10.1158%2F0008-5472.CAN-04-1795&rft.aulast=Johnsen&rft.aufirst=JI&rft.au=Lindskog%2C+M&rft.au=Ponthan%2C+F&rft.au=Pettersen%2C+I&rft.au=Elfman%2C+L&rft.au=Orrego%2C+A&rft.au=Sveinbj%C3%B6rnsson%2C+B&rft.au=Kogner%2C+P&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDaiStaffordAlexander2005" class="citation journal cs1">Dai C, Stafford RS, Alexander GC (January 2005). "National trends in cyclooxygenase-2 inhibitor use since market release: nonselective diffusion of a selectively cost-effective innovation". <i>Archives of Internal Medicine</i>. <b>165</b> (2): 171–177. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchinte.165.2.171">10.1001/archinte.165.2.171</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15668363">15668363</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Internal+Medicine&rft.atitle=National+trends+in+cyclooxygenase-2+inhibitor+use+since+market+release%3A+nonselective+diffusion+of+a+selectively+cost-effective+innovation&rft.volume=165&rft.issue=2&rft.pages=171-177&rft.date=2005-01&rft_id=info%3Adoi%2F10.1001%2Farchinte.165.2.171&rft_id=info%3Apmid%2F15668363&rft.aulast=Dai&rft.aufirst=C&rft.au=Stafford%2C+RS&rft.au=Alexander%2C+GC&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSolomonAvorn2005" class="citation journal cs1">Solomon DH, Avorn J (January 2005). "Coxibs, science, and the public trust". <i>Archives of Internal Medicine</i>. <b>165</b> (2): 158–160. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchinte.165.2.158">10.1001/archinte.165.2.158</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15668360">15668360</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Internal+Medicine&rft.atitle=Coxibs%2C+science%2C+and+the+public+trust&rft.volume=165&rft.issue=2&rft.pages=158-160&rft.date=2005-01&rft_id=info%3Adoi%2F10.1001%2Farchinte.165.2.158&rft_id=info%3Apmid%2F15668360&rft.aulast=Solomon&rft.aufirst=DH&rft.au=Avorn%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACyclooxygenase-2+inhibitor" class="Z3988"></span></li></ul> 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href="/wiki/Non-steroidal_anti-inflammatory_drug" class="mw-redirect" title="Non-steroidal anti-inflammatory drug">Non-steroidal anti-inflammatory drugs</a> (NSAIDs) (primarily <a href="/wiki/ATC_code_M01#M01A" title="ATC code M01">M01A</a> and <a href="/wiki/ATC_code_M02#M02A" title="ATC code M02">M02A</a>, also <a href="/wiki/ATC_code_N02#N02BA" title="ATC code N02">N02BA</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Pyrazolone" title="Pyrazolone">pyrazolones</a> /<br /><a href="/wiki/Pyrazolidine" title="Pyrazolidine">pyrazolidines</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aminophenazone" title="Aminophenazone">Aminophenazone</a></li> <li><a href="/wiki/Ampyrone" title="Ampyrone">Ampyrone</a></li> <li><a href="/wiki/Azapropazone" title="Azapropazone">Azapropazone</a></li> <li><a href="/wiki/Clofezone" title="Clofezone">Clofezone</a></li> <li><a href="/wiki/Difenamizole" title="Difenamizole">Difenamizole</a></li> <li><a href="/wiki/Famprofazone" title="Famprofazone">Famprofazone</a></li> <li><a href="/wiki/Feprazone" title="Feprazone">Feprazone</a></li> <li><a href="/wiki/Kebuzone" title="Kebuzone">Kebuzone</a></li> <li><a href="/wiki/Metamizole" title="Metamizole">Metamizole</a></li> <li><a href="/wiki/Mofebutazone" title="Mofebutazone">Mofebutazone</a></li> <li><a href="/wiki/Morazone" title="Morazone">Morazone</a></li> <li><a href="/wiki/Nifenazone" title="Nifenazone">Nifenazone</a></li> <li><a href="/wiki/Oxyphenbutazone" title="Oxyphenbutazone">Oxyphenbutazone</a></li> <li><a href="/wiki/Phenazone" title="Phenazone">Phenazone</a></li> <li><u><a href="/wiki/Phenylbutazone" title="Phenylbutazone">Phenylbutazone</a></u></li> <li><a href="/wiki/Propyphenazone" title="Propyphenazone">Propyphenazone</a></li> <li><a href="/wiki/Sulfinpyrazone" title="Sulfinpyrazone">Sulfinpyrazone</a></li> <li><a href="/wiki/Suxibuzone" title="Suxibuzone">Suxibuzone</a><sup>‡</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Salicylic_acid" title="Salicylic acid">salicylates</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><u><a href="/wiki/Aspirin" title="Aspirin">Aspirin (acetylsalicylic acid)</a></u><sup>#</sup></li> <li><a href="/wiki/Aloxiprin" title="Aloxiprin">Aloxiprin</a></li> <li><a href="/wiki/Benorilate" title="Benorilate">Benorylate</a></li> <li><a href="/wiki/Carbasalate_calcium" title="Carbasalate calcium">Carbasalate calcium</a></li> <li><a href="/wiki/Diflunisal" title="Diflunisal">Diflunisal</a></li> <li><a href="/wiki/Dipyrocetyl" title="Dipyrocetyl">Dipyrocetyl</a></li> <li><a href="/wiki/Ethenzamide" title="Ethenzamide">Ethenzamide</a></li> <li><a href="/wiki/Guacetisal" title="Guacetisal">Guacetisal</a></li> <li><a href="/wiki/Magnesium_salicylate" title="Magnesium salicylate">Magnesium salicylate</a></li> <li><a href="/wiki/Methyl_salicylate" title="Methyl salicylate">Methyl salicylate</a></li> <li><a href="/wiki/Salsalate" title="Salsalate">Salsalate</a></li> <li><a href="/wiki/Salicin" title="Salicin">Salicin</a></li> <li><a href="/wiki/Salicylamide" title="Salicylamide">Salicylamide</a></li> <li><a href="/wiki/Salicylic_acid" title="Salicylic acid">Salicylic acid (salicylate)</a></li> <li><a href="/wiki/Sodium_salicylate" title="Sodium salicylate">Sodium salicylate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Acetic_acid" title="Acetic acid">acetic acid</a> derivatives<br />and related substances</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aceclofenac" title="Aceclofenac">Aceclofenac</a></li> <li><a href="/wiki/Acemetacin" title="Acemetacin">Acemetacin</a></li> <li><a href="/wiki/Alclofenac" title="Alclofenac">Alclofenac</a></li> <li><a href="/wiki/Amfenac" title="Amfenac">Amfenac</a></li> <li><a href="/wiki/Bendazac" title="Bendazac">Bendazac</a></li> <li><a href="/wiki/Bromfenac" title="Bromfenac">Bromfenac</a></li> <li><a href="/wiki/Bufexamac" title="Bufexamac">Bufexamac</a></li> <li><a href="/wiki/Bumadizone" title="Bumadizone">Bumadizone</a></li> <li><u><a href="/wiki/Diclofenac" title="Diclofenac">Diclofenac</a></u></li> <li><a href="/wiki/Difenpiramide" title="Difenpiramide">Difenpiramide</a></li> <li><a href="/wiki/Etodolac" title="Etodolac">Etodolac</a></li> <li><a href="/wiki/Felbinac" title="Felbinac">Felbinac</a></li> <li><a href="/wiki/Fenclozic_acid" title="Fenclozic acid">Fenclozic acid</a></li> <li><a href="/wiki/Fentiazac" title="Fentiazac">Fentiazac</a></li> <li><a href="/wiki/Indometacin" title="Indometacin">Indometacin</a></li> <li><a href="/wiki/Indometacin_farnesil" title="Indometacin farnesil">Indometacin farnesil</a></li> <li><a href="/w/index.php?title=Isoxepac&action=edit&redlink=1" class="new" title="Isoxepac (page does not exist)">Isoxepac</a></li> <li><a href="/wiki/Ketorolac" title="Ketorolac">Ketorolac</a></li> <li><a href="/wiki/Lonazolac" title="Lonazolac">Lonazolac</a></li> <li><a href="/wiki/Mofezolac" title="Mofezolac">Mofezolac</a></li> <li><a href="/wiki/Oxametacin" title="Oxametacin">Oxametacin</a></li> <li><a href="/w/index.php?title=Prodolic_acid&action=edit&redlink=1" class="new" title="Prodolic acid (page does not exist)">Prodolic acid</a></li> <li><a href="/wiki/Proglumetacin" title="Proglumetacin">Proglumetacin</a></li> <li><a href="/wiki/Sulindac" title="Sulindac">Sulindac</a></li> <li><a href="/w/index.php?title=Tiopinac&action=edit&redlink=1" class="new" title="Tiopinac (page does not exist)">Tiopinac</a></li> <li><a href="/wiki/Tolmetin" title="Tolmetin">Tolmetin</a></li> <li><a href="/wiki/Zomepirac" title="Zomepirac">Zomepirac</a><sup>†</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oxicam" title="Oxicam">oxicams</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ampiroxicam" title="Ampiroxicam">Ampiroxicam</a></li> <li><a href="/wiki/Droxicam" title="Droxicam">Droxicam</a></li> <li><a href="/wiki/Isoxicam" title="Isoxicam">Isoxicam</a></li> <li><a href="/wiki/Lornoxicam" title="Lornoxicam">Lornoxicam</a></li> <li><a href="/wiki/Meloxicam" title="Meloxicam">Meloxicam</a></li> <li><u><a href="/wiki/Piroxicam" title="Piroxicam">Piroxicam</a></u></li> <li><a href="/w/index.php?title=Pivoxicam&action=edit&redlink=1" class="new" title="Pivoxicam (page does not exist)">Pivoxicam</a></li> <li><a href="/wiki/Tenoxicam" title="Tenoxicam">Tenoxicam</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Propionic_acid" title="Propionic acid">propionic acid</a><br />derivatives (<a href="/wiki/Profens" class="mw-redirect" title="Profens">profens</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alminoprofen" title="Alminoprofen">Alminoprofen</a></li> <li><a href="/wiki/Benoxaprofen" title="Benoxaprofen">Benoxaprofen</a><sup>†</sup></li> <li><a href="/wiki/Carprofen" title="Carprofen">Carprofen</a><sup>‡</sup></li> <li><a href="/wiki/Dexibuprofen" title="Dexibuprofen">Dexibuprofen</a></li> <li><a href="/wiki/Dexketoprofen" title="Dexketoprofen">Dexketoprofen</a></li> <li><a href="/wiki/Fenbufen" title="Fenbufen">Fenbufen</a></li> <li><a href="/wiki/Fenoprofen" title="Fenoprofen">Fenoprofen</a></li> <li><a href="/wiki/Flunoxaprofen" title="Flunoxaprofen">Flunoxaprofen</a></li> <li><a href="/wiki/Flurbiprofen" title="Flurbiprofen">Flurbiprofen</a></li> <li><u><a href="/wiki/Ibuprofen" title="Ibuprofen">Ibuprofen</a></u><sup>#</sup></li> <li><a href="/wiki/Ibuproxam" title="Ibuproxam">Ibuproxam</a></li> <li><a href="/wiki/Indoprofen" title="Indoprofen">Indoprofen</a><sup>†</sup></li> <li><a href="/wiki/Ketoprofen" title="Ketoprofen">Ketoprofen</a></li> <li><a href="/wiki/Loxoprofen" title="Loxoprofen">Loxoprofen</a></li> <li><a href="/wiki/Miroprofen" title="Miroprofen">Miroprofen</a></li> <li><u><a href="/wiki/Naproxen" title="Naproxen">Naproxen</a></u></li> <li><a href="/wiki/Oxaprozin" title="Oxaprozin">Oxaprozin</a></li> <li><a href="/wiki/Pelubiprofen" title="Pelubiprofen">Pelubiprofen</a></li> <li><a href="/wiki/Piketoprofen" title="Piketoprofen">Piketoprofen</a></li> <li><a href="/wiki/Pirprofen" title="Pirprofen">Pirprofen</a></li> <li><a href="/wiki/Suprofen" title="Suprofen">Suprofen</a></li> <li><a href="/wiki/Tarenflurbil" title="Tarenflurbil">Tarenflurbil</a></li> <li><a href="/wiki/Tepoxalin" title="Tepoxalin">Tepoxalin</a><sup>‡</sup></li> <li><a href="/wiki/Tiaprofenic_acid" title="Tiaprofenic acid">Tiaprofenic acid</a></li> <li><a href="/wiki/Vedaprofen" title="Vedaprofen">Vedaprofen</a><sup>‡</sup></li> <li><a href="/wiki/Zaltoprofen" title="Zaltoprofen">Zaltoprofen</a></li> <li><i><a href="/wiki/COX-inhibiting_nitric_oxide_donator" title="COX-inhibiting nitric oxide donator">COX-inhibiting nitric oxide donator</a></i>: <a href="/wiki/Naproxcinod" title="Naproxcinod">Naproxcinod</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><i>n</i>-arylanthranilic<br />acids (<a href="/wiki/Fenamate" class="mw-redirect" title="Fenamate">fenamates</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Azapropazone" title="Azapropazone">Azapropazone</a></li> <li><a href="/wiki/Clonixin" title="Clonixin">Clonixin</a></li> <li><a href="/wiki/Etofenamate" title="Etofenamate">Etofenamate</a></li> <li><a href="/wiki/Floctafenine" title="Floctafenine">Floctafenine</a></li> <li><a href="/wiki/Flufenamic_acid" title="Flufenamic acid">Flufenamic acid</a></li> <li><a href="/wiki/Flunixin" title="Flunixin">Flunixin</a></li> <li><a href="/w/index.php?title=Flutiazin&action=edit&redlink=1" class="new" title="Flutiazin (page does not exist)">Flutiazin</a></li> <li><a href="/wiki/Glafenine" title="Glafenine">Glafenine</a><sup>†</sup></li> <li><a href="/wiki/Meclofenamic_acid" title="Meclofenamic acid">Meclofenamic acid</a></li> <li><u><a href="/wiki/Mefenamic_acid" title="Mefenamic acid">Mefenamic acid</a></u></li> <li><a href="/wiki/Morniflumate" title="Morniflumate">Morniflumate</a></li> <li><a href="/wiki/Niflumic_acid" title="Niflumic acid">Niflumic acid</a></li> <li><a href="/wiki/Tolfenamic_acid" title="Tolfenamic acid">Tolfenamic acid</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/COX-2_inhibitor" class="mw-redirect" title="COX-2 inhibitor">COX-2 inhibitors</a><br />(coxibs)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Apricoxib" title="Apricoxib">Apricoxib</a></li> <li><u><a href="/wiki/Celecoxib" title="Celecoxib">Celecoxib</a></u> (<a href="/wiki/Celecoxib/tramadol" title="Celecoxib/tramadol">+tramadol</a>)</li> <li><a href="/wiki/Cimicoxib" title="Cimicoxib">Cimicoxib</a><sup>‡</sup></li> <li><a href="/wiki/Deracoxib" title="Deracoxib">Deracoxib</a><sup>‡</sup></li> <li><a href="/wiki/Etoricoxib" title="Etoricoxib">Etoricoxib</a></li> <li><a href="/wiki/Firocoxib" title="Firocoxib">Firocoxib</a><sup>‡</sup></li> <li><a href="/wiki/Lumiracoxib" title="Lumiracoxib">Lumiracoxib</a><sup>†</sup></li> <li><a href="/wiki/Mavacoxib" title="Mavacoxib">Mavacoxib</a><sup>‡</sup></li> <li><a href="/wiki/Parecoxib" title="Parecoxib">Parecoxib</a></li> <li><a href="/wiki/Robenacoxib" title="Robenacoxib">Robenacoxib</a><sup>‡</sup></li> <li><a href="/wiki/Rofecoxib" title="Rofecoxib">Rofecoxib</a><sup>†</sup></li> <li><a href="/wiki/Valdecoxib" title="Valdecoxib">Valdecoxib</a><sup>†</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Aminopropionitrile" title="Aminopropionitrile">Aminopropionitrile</a></li> <li><a href="/wiki/Benzydamine" title="Benzydamine">Benzydamine</a></li> <li><a href="/wiki/Chondroitin_sulfate" title="Chondroitin sulfate">Chondroitin sulfate</a></li> <li><a href="/wiki/Diacerein" title="Diacerein">Diacerein</a></li> <li><a href="/wiki/Fluproquazone" title="Fluproquazone">Fluproquazone</a></li> <li><a href="/wiki/Glucosamine" title="Glucosamine">Glucosamine</a></li> <li><a href="/wiki/Glycosaminoglycan" title="Glycosaminoglycan">Glycosaminoglycan</a></li> <li><a href="/wiki/Hyperforin" title="Hyperforin">Hyperforin</a></li> <li><a href="/wiki/Nabumetone" title="Nabumetone">Nabumetone</a></li> <li><a href="/wiki/Nimesulide" title="Nimesulide">Nimesulide</a></li> <li><a href="/wiki/Oxaceprol" title="Oxaceprol">Oxaceprol</a></li> <li><a href="/wiki/Proquazone" title="Proquazone">Proquazone</a></li> <li><a href="/wiki/Superoxide_dismutase" title="Superoxide dismutase">Superoxide dismutase / orgotein</a></li> <li><a href="/wiki/Tenidap" title="Tenidap">Tenidap</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">NSAID<br />combinations</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ibuprofen/famotidine" title="Ibuprofen/famotidine">Ibuprofen/famotidine</a></li> <li><a href="/wiki/Hydrocodone/ibuprofen" title="Hydrocodone/ibuprofen">Ibuprofen/hydrocodone</a></li> <li><a href="/wiki/Oxycodone/ibuprofen" title="Oxycodone/ibuprofen">Ibuprofen/oxycodone</a></li> <li><a href="/wiki/Ibuprofen/paracetamol" title="Ibuprofen/paracetamol">Ibuprofen/paracetamol</a></li> <li><a href="/wiki/Bupivacaine/meloxicam" title="Bupivacaine/meloxicam">Meloxicam/bupivacaine</a></li> <li><a href="/wiki/Naproxen/diphenhydramine" title="Naproxen/diphenhydramine">Naproxen/diphenhydramine</a></li> <li><a href="/wiki/Naproxen/esomeprazole" title="Naproxen/esomeprazole">Naproxen/esomeprazole</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">Key: <u>underline</u> indicates initially developed first-in-class compound of specific group; <sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-Essential Medicines</a>; <sup>†</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">withdrawn drugs</a>; <sup>‡</sup><a href="/wiki/Veterinary_medicine" title="Veterinary medicine">veterinary use</a>.</div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Anti-inflammatory_and_antirheumatic_products" title="Category:Anti-inflammatory and antirheumatic products">category</a></li> <li><span class="noviewer" typeof="mw:File"><span title="Commons page"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/12px-Commons-logo.svg.png" decoding="async" width="12" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/18px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/24px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></span></span> <a href="https://commons.wikimedia.org/wiki/Category:Anti-inflammatory_drugs" class="extiw" title="commons:Category:Anti-inflammatory drugs">commons</a></li> <li><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Symbol_portal_class.svg" class="mw-file-description" title="Portal"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/16px-Symbol_portal_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/23px-Symbol_portal_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/e/e2/Symbol_portal_class.svg/31px-Symbol_portal_class.svg.png 2x" data-file-width="180" data-file-height="185" /></a></span> <a href="/wiki/Portal:Medicine" title="Portal:Medicine">portal</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Pharmacology:_enzyme_inhibition" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Enzyme_inhibition" title="Template:Enzyme inhibition"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Enzyme_inhibition" title="Template talk:Enzyme inhibition"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Enzyme_inhibition" title="Special:EditPage/Template:Enzyme inhibition"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Pharmacology:_enzyme_inhibition" style="font-size:114%;margin:0 4em"><a href="/wiki/Pharmacology" title="Pharmacology">Pharmacology</a>: <a href="/wiki/Enzyme_inhibitor" title="Enzyme inhibitor">enzyme inhibition</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Class</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Competitive_inhibition" title="Competitive inhibition">Competitive inhibition</a></li> <li><a href="/wiki/Uncompetitive_inhibitor" class="mw-redirect" title="Uncompetitive inhibitor">Uncompetitive inhibition</a></li> <li><a href="/wiki/Non-competitive_inhibition" title="Non-competitive inhibition">Non-competitive inhibition</a></li> <li><a href="/wiki/Suicide_inhibition" title="Suicide inhibition">Suicide inhibition</a></li> <li><a href="/wiki/Mixed_inhibition" title="Mixed inhibition">Mixed inhibition</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Substrate</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Oxidoreductase" title="Oxidoreductase">Oxidoreductase</a> (EC 1)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>1.1 <a href="/wiki/Aldose_reductase_inhibitor" title="Aldose reductase inhibitor">Aldose reductase</a></li> <li><a href="/wiki/Statin" title="Statin">HMG-CoA reductase</a></li></ul> <ul><li>1.3 <a href="/wiki/5%CE%B1-Reductase_inhibitor" title="5α-Reductase inhibitor">5α-Reductase</a></li></ul> <ul><li>1.4 <a href="/wiki/Monoamine_oxidase_inhibitor" title="Monoamine oxidase inhibitor">Monoamine oxidase</a></li></ul> <ul><li>1.5 <a href="/wiki/Dihydrofolate_reductase_inhibitor" title="Dihydrofolate reductase inhibitor">Dihydrofolate reductase</a></li></ul> <ul><li>1.13 <a href="/wiki/Lipoxygenase_inhibitor" class="mw-redirect" title="Lipoxygenase inhibitor">Lipoxygenase</a></li></ul> <ul><li>1.14 <a href="/wiki/Aromatase_inhibitor" title="Aromatase inhibitor">Aromatase</a></li> <li><a href="/wiki/COX-2_inhibitor" class="mw-redirect" title="COX-2 inhibitor">COX-2</a></li></ul> <ul><li>1.17 <a href="/wiki/Xanthine_oxidase_inhibitor" title="Xanthine oxidase inhibitor">Xanthine oxidase</a></li> <li><a href="/wiki/Ribonucleotide_reductase_inhibitor" title="Ribonucleotide reductase inhibitor">Ribonucleotide reductase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Transferase" title="Transferase">Transferase</a> (EC 2)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>2.1 <a href="/wiki/COMT_inhibitor" class="mw-redirect" title="COMT inhibitor">COMT</a></li> <li><a href="/wiki/Thymidylate_synthase_inhibitor" title="Thymidylate synthase inhibitor">Thymidylate synthase</a></li></ul> <ul><li>2.4 <a href="/wiki/PARP_inhibitor" title="PARP inhibitor">PARP</a></li></ul> <ul><li>2.5 <a href="/wiki/Dihydropteroate_synthase_inhibitor" title="Dihydropteroate synthase inhibitor">Dihydropteroate synthetase</a></li> <li><a href="/wiki/Farnesyltransferase_inhibitor" title="Farnesyltransferase inhibitor">Farnesyltransferase</a></li></ul> <ul><li>2.6 <a href="/wiki/GABA_transaminase_inhibitor" title="GABA transaminase inhibitor">GABA transaminase</a></li></ul> <ul><li>2.7 <a href="/wiki/Nucleotidyltransferase" title="Nucleotidyltransferase">Nucleotidyltransferase</a> <ul><li><a href="/wiki/Integrase_inhibitor" title="Integrase inhibitor">Integrase</a></li> <li><a href="/wiki/Reverse-transcriptase_inhibitor" title="Reverse-transcriptase inhibitor">Reverse transcriptase</a></li></ul></li> <li><a href="/wiki/Protein_kinase_inhibitor" title="Protein kinase inhibitor">Protein kinase</a> <ul><li><a href="/wiki/Tyrosine_kinase_inhibitor" title="Tyrosine kinase inhibitor">Tyrosine kinase</a> <ul><li><a href="/wiki/Janus_kinase_inhibitor" title="Janus kinase inhibitor">Janus kinase</a></li></ul></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Hydrolase" title="Hydrolase">Hydrolase</a> (EC 3)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>3.1 <a href="/wiki/Phosphodiesterase_inhibitor" title="Phosphodiesterase inhibitor">Phosphodiesterase</a></li> <li><a href="/wiki/Acetylcholinesterase_inhibitor" title="Acetylcholinesterase inhibitor">Acetylcholinesterase</a></li> <li><a href="/wiki/Ribonuclease_inhibitor" title="Ribonuclease inhibitor">Ribonuclease</a></li></ul> <ul><li>3.2 <a href="/wiki/Polygalacturonase_inhibitor" title="Polygalacturonase inhibitor">Polygalacturonase</a></li> <li><a href="/wiki/Neuraminidase_inhibitor" title="Neuraminidase inhibitor">Neuraminidase</a></li> <li><a href="/wiki/Alpha-glucosidase_inhibitor" title="Alpha-glucosidase inhibitor">Alpha-glucosidase</a></li></ul> <ul><li>3.4 <a href="/wiki/Protease_inhibitor_(pharmacology)" title="Protease inhibitor (pharmacology)">Protease</a>: <a href="/wiki/Exopeptidase_inhibitor" title="Exopeptidase inhibitor">Exopeptidase</a> <ul><li><a href="/wiki/Dipeptidyl_peptidase-4_inhibitor" title="Dipeptidyl peptidase-4 inhibitor">DPP-4</a></li> <li><a href="/wiki/ACE_inhibitor" title="ACE inhibitor">ACE</a></li></ul></li> <li><a href="/wiki/Endopeptidase_inhibitor" title="Endopeptidase inhibitor">Endopeptidase</a> <ul><li><a href="/wiki/Trypsin_inhibitor" title="Trypsin inhibitor">Trypsin</a></li> <li><a href="/wiki/Renin_inhibitor" title="Renin inhibitor">Renin</a></li></ul></li> <li><i>Mixed</i> <ul><li><a href="/wiki/Enkephalinase_inhibitor" title="Enkephalinase inhibitor">Enkephalinase</a></li> <li><a href="/wiki/Matrix_metalloproteinase_inhibitor" title="Matrix metalloproteinase inhibitor">Matrix metalloproteinase</a></li> <li><a href="/wiki/Oxytocinase_inhibitor" class="mw-redirect" title="Oxytocinase inhibitor">Oxytocinase</a></li></ul></li></ul> <ul><li>3.5 <a href="/wiki/Histone_deacetylase_inhibitor" title="Histone deacetylase inhibitor">Histone deacetylase</a></li> <li><a href="/wiki/Beta-lactamase_inhibitor" class="mw-redirect" title="Beta-lactamase inhibitor">Beta-lactamase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lyase" title="Lyase">Lyase</a> (EC 4)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li>4.1 <a href="/wiki/Dopa_decarboxylase_inhibitor" class="mw-redirect" title="Dopa decarboxylase inhibitor">Dopa decarboxylase</a></li></ul> <ul><li>4.2 <a href="/wiki/Carbonic_anhydrase_inhibitor" title="Carbonic anhydrase inhibitor">Carbonic anhydrase</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Miscellaneous</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Steroidogenesis_inhibitor" title="Steroidogenesis inhibitor">Steroidogenesis inhibitor</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Prostanoid_signaling_modulators" style="padding:3px"><table class="nowraplinks hlist mw-collapsible mw-collapsed navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Prostanoid_signaling_modulators" title="Template:Prostanoid signaling modulators"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Prostanoid_signaling_modulators" title="Template talk:Prostanoid signaling modulators"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Prostanoid_signaling_modulators" title="Special:EditPage/Template:Prostanoid signaling modulators"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Prostanoid_signaling_modulators" style="font-size:114%;margin:0 4em"><a href="/wiki/Prostanoid" title="Prostanoid">Prostanoid</a> <a href="/wiki/Cell_signaling" title="Cell signaling">signaling</a> <a href="/wiki/Receptor_modulator" title="Receptor modulator">modulators</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Receptor_(biochemistry)" title="Receptor (biochemistry)">Receptor</a><br /><small>(<a href="/wiki/Ligand_(biochemistry)" title="Ligand (biochemistry)">ligands</a>)</small></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_D2_receptor" title="Prostaglandin D2 receptor"><abbr title="Prostaglandin D2 receptor">DP (D<sub>2</sub>)</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin D2 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_D2_receptor_1" class="mw-redirect" title="Prostaglandin D2 receptor 1"><abbr title="Prostaglandin D2 receptor 1">DP<sub>1</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin D2 receptor 1</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Prostaglandin_D2" title="Prostaglandin D2">Prostaglandin D<sub>2</sub></a></li> <li><a href="/wiki/Treprostinil" title="Treprostinil">Treprostinil</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=Asapiprant&action=edit&redlink=1" class="new" title="Asapiprant (page does not exist)">Asapiprant</a></li> <li><a href="/wiki/Laropiprant" title="Laropiprant">Laropiprant</a></li> <li><a href="/w/index.php?title=Vidupiprant&action=edit&redlink=1" class="new" title="Vidupiprant (page does not exist)">Vidupiprant</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_D2_receptor_2" class="mw-redirect" title="Prostaglandin D2 receptor 2"><abbr title="Prostaglandin D2 receptor 2">DP<sub>2</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin D2 receptor 2</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Indometacin" title="Indometacin">Indometacin</a></li> <li><a href="/wiki/Prostaglandin_D2" title="Prostaglandin D2">Prostaglandin D<sub>2</sub></a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=ADC-3680&action=edit&redlink=1" class="new" title="ADC-3680 (page does not exist)">ADC-3680</a></li> <li><a href="/w/index.php?title=AZD-1981&action=edit&redlink=1" class="new" title="AZD-1981 (page does not exist)">AZD-1981</a></li> <li><a href="/w/index.php?title=Bay_U3405&action=edit&redlink=1" class="new" title="Bay U3405 (page does not exist)">Bay U3405</a></li> <li><a href="/wiki/Fevipiprant" title="Fevipiprant">Fevipiprant</a></li> <li><a href="/w/index.php?title=MK-1029&action=edit&redlink=1" class="new" title="MK-1029 (page does not exist)">MK-1029</a></li> <li><a href="/w/index.php?title=MK-7246&action=edit&redlink=1" class="new" title="MK-7246 (page does not exist)">MK-7246</a></li> <li><a href="/w/index.php?title=QAV-680&action=edit&redlink=1" class="new" title="QAV-680 (page does not exist)">QAV-680</a></li> <li><a href="/wiki/Ramatroban" title="Ramatroban">Ramatroban</a></li> <li><a href="/wiki/Setipiprant" title="Setipiprant">Setipiprant</a></li> <li><a href="/w/index.php?title=Timapiprant&action=edit&redlink=1" class="new" title="Timapiprant (page does not exist)">Timapiprant</a></li> <li><a href="/w/index.php?title=TM30089&action=edit&redlink=1" class="new" title="TM30089 (page does not exist)">TM30089</a></li> <li><a href="/w/index.php?title=Vidupiprant&action=edit&redlink=1" class="new" title="Vidupiprant (page does not exist)">Vidupiprant</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_E2_receptor" title="Prostaglandin E2 receptor"><abbr title="Prostaglandin E2 receptor">EP (E<sub>2</sub>)</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin E2 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_EP1_receptor" title="Prostaglandin EP1 receptor"><abbr title="Prostaglandin EP1 receptor">EP<sub>1</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin EP1 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Beraprost" title="Beraprost">Beraprost</a></li> <li><a href="/wiki/Enprostil" title="Enprostil">Enprostil</a></li> <li><a href="/wiki/Iloprost" title="Iloprost">Iloprost (ciloprost)</a></li> <li><a href="/wiki/Latanoprost" title="Latanoprost">Latanoprost</a></li> <li><a href="/wiki/Lubiprostone" title="Lubiprostone">Lubiprostone</a></li> <li><a href="/wiki/Misoprostol" title="Misoprostol">Misoprostol</a></li> <li><a href="/wiki/Prostaglandin_E1" title="Prostaglandin E1">Prostaglandin E<sub>1</sub> (alprostadil)</a></li> <li><a href="/wiki/Prostaglandin_E2" title="Prostaglandin E2">Prostaglandin E<sub>2</sub> (dinoprostone)</a></li> <li><a href="/wiki/Sulprostone" title="Sulprostone">Sulprostone</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=AH-6809&action=edit&redlink=1" class="new" title="AH-6809 (page does not exist)">AH-6809</a></li> <li><a href="/w/index.php?title=ONO-8130&action=edit&redlink=1" class="new" title="ONO-8130 (page does not exist)">ONO-8130</a></li> <li><a href="/w/index.php?title=SC-19220&action=edit&redlink=1" class="new" title="SC-19220 (page does not exist)">SC-19220</a></li> <li><a href="/w/index.php?title=SC-51089&action=edit&redlink=1" class="new" title="SC-51089 (page does not exist)">SC-51089</a></li> <li><a href="/w/index.php?title=SC-51322&action=edit&redlink=1" class="new" title="SC-51322 (page does not exist)">SC-51322</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_EP2_receptor" title="Prostaglandin EP2 receptor"><abbr title="Prostaglandin EP2 receptor">EP<sub>2</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin EP2 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/w/index.php?title=Butaprost&action=edit&redlink=1" class="new" title="Butaprost (page does not exist)">Butaprost</a></li> <li><a href="/wiki/Misoprostol" title="Misoprostol">Misoprostol</a></li> <li><a href="/wiki/Prostaglandin_E1" title="Prostaglandin E1">Prostaglandin E<sub>1</sub> (alprostadil)</a></li> <li><a href="/wiki/Prostaglandin_E2" title="Prostaglandin E2">Prostaglandin E<sub>2</sub> (dinoprostone)</a></li> <li><a href="/wiki/Treprostinil" title="Treprostinil">Treprostinil</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=AH-6809&action=edit&redlink=1" class="new" title="AH-6809 (page does not exist)">AH-6809</a></li> <li><a href="/w/index.php?title=PF-04418948&action=edit&redlink=1" class="new" title="PF-04418948 (page does not exist)">PF-04418948</a></li> <li><a href="/w/index.php?title=TG_4-155&action=edit&redlink=1" class="new" title="TG 4-155 (page does not exist)">TG 4-155</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_EP3_receptor" title="Prostaglandin EP3 receptor"><abbr title="Prostaglandin EP3 receptor">EP<sub>3</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin EP3 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Beraprost" title="Beraprost">Beraprost</a></li> <li><a href="/w/index.php?title=Carbacyclin&action=edit&redlink=1" class="new" title="Carbacyclin (page does not exist)">Carbacyclin</a></li> <li><a href="/w/index.php?title=Cicaprost&action=edit&redlink=1" class="new" title="Cicaprost (page does not exist)">Cicaprost</a></li> <li><a href="/wiki/Enprostil" title="Enprostil">Enprostil</a></li> <li><a href="/wiki/Iloprost" title="Iloprost">Iloprost (ciloprost)</a></li> <li><a href="/w/index.php?title=Isocarbacyclin&action=edit&redlink=1" class="new" title="Isocarbacyclin (page does not exist)">Isocarbacyclin</a></li> <li><a href="/wiki/Latanoprost" title="Latanoprost">Latanoprost</a></li> <li><a href="/wiki/Misoprostol" title="Misoprostol">Misoprostol</a></li> <li><a href="/wiki/Prostaglandin_D2" title="Prostaglandin D2">Prostaglandin D<sub>2</sub></a></li> <li><a href="/wiki/Prostaglandin_E1" title="Prostaglandin E1">Prostaglandin E<sub>1</sub> (alprostadil)</a></li> <li><a href="/wiki/Prostaglandin_E2" title="Prostaglandin E2">Prostaglandin E<sub>2</sub> (dinoprostone)</a></li> <li><a href="/w/index.php?title=Remiprostol&action=edit&redlink=1" class="new" title="Remiprostol (page does not exist)">Remiprostol</a></li> <li><a href="/wiki/Ricinoleic_acid" title="Ricinoleic acid">Ricinoleic acid</a></li> <li><a href="/wiki/Sulprostone" title="Sulprostone">Sulprostone</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=L-798106&action=edit&redlink=1" class="new" title="L-798106 (page does not exist)">L-798106</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_EP4_receptor" title="Prostaglandin EP4 receptor"><abbr title="Prostaglandin EP4 receptor">EP<sub>4</sub></abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin EP4 receptor</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Lubiprostone" title="Lubiprostone">Lubiprostone</a></li> <li><a href="/wiki/Misoprostol" title="Misoprostol">Misoprostol</a></li> <li><a href="/wiki/Prostaglandin_E1" title="Prostaglandin E1">Prostaglandin E<sub>1</sub> (alprostadil)</a></li> <li><a href="/wiki/Prostaglandin_E2" title="Prostaglandin E2">Prostaglandin E<sub>2</sub> (dinoprostone)</a></li> <li><a href="/w/index.php?title=TCS-2510&action=edit&redlink=1" class="new" title="TCS-2510 (page does not exist)">TCS-2510</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/wiki/Grapiprant" title="Grapiprant">Grapiprant</a></li> <li><a href="/w/index.php?title=GW-627368&action=edit&redlink=1" class="new" title="GW-627368 (page does not exist)">GW-627368</a></li> <li><a href="/w/index.php?title=L-161982&action=edit&redlink=1" class="new" title="L-161982 (page does not exist)">L-161982</a></li> <li><a href="/w/index.php?title=ONO-AE3-208&action=edit&redlink=1" class="new" title="ONO-AE3-208 (page does not exist)">ONO-AE3-208</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;">Unsorted</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/w/index.php?title=16,16-Dimethyl_Prostaglandin_E2&action=edit&redlink=1" class="new" title="16,16-Dimethyl Prostaglandin E2 (page does not exist)">16,16-Dimethyl Prostaglandin E<sub>2</sub></a></li> <li><a href="/w/index.php?title=Aganepag&action=edit&redlink=1" class="new" title="Aganepag (page does not exist)">Aganepag</a></li> <li><a href="/wiki/Carboprost" title="Carboprost">Carboprost</a></li> <li><a href="/w/index.php?title=Evatanepag&action=edit&redlink=1" class="new" title="Evatanepag (page does not exist)">Evatanepag</a></li> <li><a href="/wiki/Gemeprost" title="Gemeprost">Gemeprost</a></li> <li><a href="/w/index.php?title=Nocloprost&action=edit&redlink=1" class="new" title="Nocloprost (page does not exist)">Nocloprost</a></li> <li><a href="/wiki/Omidenepag" title="Omidenepag">Omidenepag</a></li> <li><a href="/wiki/Prostaglandin_F2%CE%B1" class="mw-redirect" title="Prostaglandin F2α">Prostaglandin F<sub>2α</sub> (dinoprost)</a></li> <li><a href="/w/index.php?title=Simenepag&action=edit&redlink=1" class="new" title="Simenepag (page does not exist)">Simenepag</a></li> <li><a href="/w/index.php?title=Taprenepag&action=edit&redlink=1" class="new" title="Taprenepag (page does not exist)">Taprenepag</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_F_receptor" title="Prostaglandin F receptor"><abbr title="Prostaglandin F receptor">FP (F<sub>2α</sub>)</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin F receptor</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/wiki/Alfaprostol" title="Alfaprostol">Alfaprostol</a></li> <li><a href="/wiki/Bimatoprost" title="Bimatoprost">Bimatoprost</a></li> <li><a href="/wiki/Carboprost" title="Carboprost">Carboprost</a></li> <li><a href="/wiki/Cloprostenol" title="Cloprostenol">Cloprostenol</a></li> <li><a href="/wiki/Enprostil" title="Enprostil">Enprostil</a></li> <li><a href="/w/index.php?title=Fluprostenol&action=edit&redlink=1" class="new" title="Fluprostenol (page does not exist)">Fluprostenol</a></li> <li><a href="/wiki/Latanoprost" title="Latanoprost">Latanoprost</a></li> <li><a href="/wiki/Prostaglandin_D2" title="Prostaglandin D2">Prostaglandin D<sub>2</sub></a></li> <li><a href="/wiki/Prostaglandin_F2%CE%B1" class="mw-redirect" title="Prostaglandin F2α">Prostaglandin F<sub>2α</sub> (dinoprost)</a></li> <li><a href="/w/index.php?title=Sulotroban&action=edit&redlink=1" class="new" title="Sulotroban (page does not exist)">Sulotroban</a></li> <li><a href="/wiki/Tafluprost" title="Tafluprost">Tafluprost</a></li> <li><a href="/wiki/Travoprost" title="Travoprost">Travoprost</a></li> <li><a href="/wiki/Unoprostone" title="Unoprostone">Unoprostone</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostacyclin_receptor" title="Prostacyclin receptor"><abbr title="Prostacyclin receptor">IP (I<sub>2</sub>)</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostacyclin receptor</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/w/index.php?title=ACT-333679&action=edit&redlink=1" class="new" title="ACT-333679 (page does not exist)">ACT-333679</a></li> <li><a href="/w/index.php?title=AFP-07&action=edit&redlink=1" class="new" title="AFP-07 (page does not exist)">AFP-07</a></li> <li><a href="/wiki/Beraprost" title="Beraprost">Beraprost</a></li> <li><a href="/w/index.php?title=BMY-45778&action=edit&redlink=1" class="new" title="BMY-45778 (page does not exist)">BMY-45778</a></li> <li><a href="/w/index.php?title=Carbacyclin&action=edit&redlink=1" class="new" title="Carbacyclin (page does not exist)">Carbacyclin</a></li> <li><a href="/w/index.php?title=Cicaprost&action=edit&redlink=1" class="new" title="Cicaprost (page does not exist)">Cicaprost</a></li> <li><a href="/wiki/Iloprost" title="Iloprost">Iloprost (ciloprost)</a></li> <li><a href="/w/index.php?title=Isocarbacyclin&action=edit&redlink=1" class="new" title="Isocarbacyclin (page does not exist)">Isocarbacyclin</a></li> <li><a href="/w/index.php?title=MRE-269&action=edit&redlink=1" class="new" title="MRE-269 (page does not exist)">MRE-269</a></li> <li><a href="/w/index.php?title=NS-304&action=edit&redlink=1" class="new" title="NS-304 (page does not exist)">NS-304</a></li> <li><a href="/wiki/Prostacyclin" title="Prostacyclin">Prostacyclin (prostaglandin I<sub>2</sub>, epoprostenol)</a></li> <li><a href="/wiki/Prostaglandin_E1" title="Prostaglandin E1">Prostaglandin E<sub>1</sub> (alprostadil)</a></li> <li><a href="/w/index.php?title=Ralinepag&action=edit&redlink=1" class="new" title="Ralinepag (page does not exist)">Ralinepag</a></li> <li><a href="/wiki/Selexipag" title="Selexipag">Selexipag</a></li> <li><a href="/w/index.php?title=Taprostene&action=edit&redlink=1" class="new" title="Taprostene (page does not exist)">Taprostene</a></li> <li><a href="/w/index.php?title=TRA-418&action=edit&redlink=1" class="new" title="TRA-418 (page does not exist)">TRA-418</a></li> <li><a href="/wiki/Treprostinil" title="Treprostinil">Treprostinil</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/w/index.php?title=RO1138452&action=edit&redlink=1" class="new" title="RO1138452 (page does not exist)">RO1138452</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Thromboxane_receptor" title="Thromboxane receptor"><abbr title="Thromboxane receptor">TP (TX<sub>A2</sub>)</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Thromboxane receptor</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><b>Agonists:</b> <a href="/w/index.php?title=Carbocyclic_thromboxane_A2&action=edit&redlink=1" class="new" title="Carbocyclic thromboxane A2 (page does not exist)">Carbocyclic thromboxane A<sub>2</sub></a></li> <li><a href="/w/index.php?title=I-BOP&action=edit&redlink=1" class="new" title="I-BOP (page does not exist)">I-BOP</a></li> <li><a href="/wiki/Thromboxane_A2" title="Thromboxane A2">Thromboxane A<sub>2</sub></a></li> <li><a href="/wiki/U-46619" class="mw-redirect" title="U-46619">U-46619</a></li> <li><a href="/w/index.php?title=Vapiprost&action=edit&redlink=1" class="new" title="Vapiprost (page does not exist)">Vapiprost</a></li></ul> <ul><li><b>Antagonists:</b> <a href="/wiki/12-Hydroxyeicosatetraenoic_acid" title="12-Hydroxyeicosatetraenoic acid">12-HETE</a></li> <li><a href="/w/index.php?title=13-APA&action=edit&redlink=1" class="new" title="13-APA (page does not exist)">13-APA</a></li> <li><a href="/w/index.php?title=AA-2414&action=edit&redlink=1" class="new" title="AA-2414 (page does not exist)">AA-2414</a></li> <li><a href="/wiki/Argatroban" title="Argatroban">Argatroban</a></li> <li><a href="/w/index.php?title=Bay_U3405&action=edit&redlink=1" class="new" title="Bay U3405 (page does not exist)">Bay U3405</a></li> <li><a href="/w/index.php?title=BMS-180,291&action=edit&redlink=1" class="new" title="BMS-180,291 (page does not exist)">BMS-180,291</a></li> <li><a href="/w/index.php?title=Daltroban&action=edit&redlink=1" class="new" title="Daltroban (page does not exist)">Daltroban</a></li> <li><a href="/w/index.php?title=Domitroban&action=edit&redlink=1" class="new" title="Domitroban (page does not exist)">Domitroban</a></li> <li><a href="/w/index.php?title=EP-045&action=edit&redlink=1" class="new" title="EP-045 (page does not exist)">EP-045</a></li> <li><a href="/w/index.php?title=GR-32191&action=edit&redlink=1" class="new" title="GR-32191 (page does not exist)">GR-32191</a></li> <li><a href="/w/index.php?title=ICI-185282&action=edit&redlink=1" class="new" title="ICI-185282 (page does not exist)">ICI-185282</a></li> <li><a href="/w/index.php?title=ICI-192605&action=edit&redlink=1" class="new" title="ICI-192605 (page does not exist)">ICI-192605</a></li> <li><a href="/wiki/Ifetroban" title="Ifetroban">Ifetroban</a></li> <li><a href="/w/index.php?title=Imitrodast&action=edit&redlink=1" class="new" title="Imitrodast (page does not exist)">Imitrodast</a></li> <li><a href="/w/index.php?title=L-655240&action=edit&redlink=1" class="new" title="L-655240 (page does not exist)">L-655240</a></li> <li><a href="/w/index.php?title=L-670596&action=edit&redlink=1" class="new" title="L-670596 (page does not exist)">L-670596</a></li> <li><a href="/w/index.php?title=Linotroban&action=edit&redlink=1" class="new" title="Linotroban (page does not exist)">Linotroban</a></li> <li><a href="/w/index.php?title=Mipitroban&action=edit&redlink=1" class="new" title="Mipitroban (page does not exist)">Mipitroban</a></li> <li><a href="/w/index.php?title=ONO-3708&action=edit&redlink=1" class="new" title="ONO-3708 (page does not exist)">ONO-3708</a></li> <li><a href="/w/index.php?title=ONO-11120&action=edit&redlink=1" class="new" title="ONO-11120 (page does not exist)">ONO-11120</a></li> <li><a href="/wiki/Picotamide" title="Picotamide">Picotamide</a></li> <li><a href="/w/index.php?title=Pinane_thromboxane_A2&action=edit&redlink=1" class="new" title="Pinane thromboxane A2 (page does not exist)">Pinane thromboxane A<sub>2</sub></a></li> <li><a href="/wiki/Ramatroban" title="Ramatroban">Ramatroban</a></li> <li><a href="/w/index.php?title=Ridogrel&action=edit&redlink=1" class="new" title="Ridogrel (page does not exist)">Ridogrel</a></li> <li><a href="/w/index.php?title=S-145&action=edit&redlink=1" class="new" title="S-145 (page does not exist)">S-145</a></li> <li><a href="/w/index.php?title=Samixogrel&action=edit&redlink=1" class="new" title="Samixogrel (page does not exist)">Samixogrel</a></li> <li><a href="/wiki/Seratrodast" title="Seratrodast">Seratrodast</a></li> <li><a href="/w/index.php?title=SQ-28,668&action=edit&redlink=1" class="new" title="SQ-28,668 (page does not exist)">SQ-28,668</a></li> <li><a href="/w/index.php?title=SQ-29,548&action=edit&redlink=1" class="new" title="SQ-29,548 (page does not exist)">SQ-29,548</a></li> <li><a href="/w/index.php?title=Sulotroban&action=edit&redlink=1" class="new" title="Sulotroban (page does not exist)">Sulotroban</a></li> <li><a href="/wiki/Terbogrel" title="Terbogrel">Terbogrel</a></li> <li><a href="/wiki/Terutroban" title="Terutroban">Terutroban</a></li> <li><a href="/w/index.php?title=TRA-418&action=edit&redlink=1" class="new" title="TRA-418 (page does not exist)">TRA-418</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;">Unsorted</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/w/index.php?title=Arbaprostil&action=edit&redlink=1" class="new" title="Arbaprostil (page does not exist)">Arbaprostil</a></li> <li><a href="/w/index.php?title=Ataprost&action=edit&redlink=1" class="new" title="Ataprost (page does not exist)">Ataprost</a></li> <li><a href="/w/index.php?title=Ciprostene&action=edit&redlink=1" class="new" title="Ciprostene (page does not exist)">Ciprostene</a></li> <li><a href="/w/index.php?title=Clinprost&action=edit&redlink=1" class="new" title="Clinprost (page does not exist)">Clinprost</a></li> <li><a href="/w/index.php?title=Cobiprostone&action=edit&redlink=1" class="new" title="Cobiprostone (page does not exist)">Cobiprostone</a></li> <li><a href="/w/index.php?title=Delprostenate&action=edit&redlink=1" class="new" title="Delprostenate (page does not exist)">Delprostenate</a></li> <li><a href="/w/index.php?title=Deprostil&action=edit&redlink=1" class="new" title="Deprostil (page does not exist)">Deprostil</a></li> <li><a href="/w/index.php?title=Dimoxaprost&action=edit&redlink=1" class="new" title="Dimoxaprost (page does not exist)">Dimoxaprost</a></li> <li><a href="/w/index.php?title=Doxaprost&action=edit&redlink=1" class="new" title="Doxaprost (page does not exist)">Doxaprost</a></li> <li><a href="/w/index.php?title=Ecraprost&action=edit&redlink=1" class="new" title="Ecraprost (page does not exist)">Ecraprost</a></li> <li><a href="/w/index.php?title=Eganoprost&action=edit&redlink=1" class="new" title="Eganoprost (page does not exist)">Eganoprost</a></li> <li><a href="/w/index.php?title=Enisoprost&action=edit&redlink=1" class="new" title="Enisoprost (page does not exist)">Enisoprost</a></li> <li><a href="/w/index.php?title=Eptaloprost&action=edit&redlink=1" class="new" title="Eptaloprost (page does not exist)">Eptaloprost</a></li> <li><a href="/w/index.php?title=Esuberaprost&action=edit&redlink=1" class="new" title="Esuberaprost (page does not exist)">Esuberaprost</a></li> <li><a href="/w/index.php?title=Etiproston&action=edit&redlink=1" class="new" title="Etiproston (page does not exist)">Etiproston</a></li> <li><a href="/w/index.php?title=Fenprostalene&action=edit&redlink=1" class="new" title="Fenprostalene (page does not exist)">Fenprostalene</a></li> <li><a href="/w/index.php?title=Flunoprost&action=edit&redlink=1" class="new" title="Flunoprost (page does not exist)">Flunoprost</a></li> <li><a href="/w/index.php?title=Froxiprost&action=edit&redlink=1" class="new" title="Froxiprost (page does not exist)">Froxiprost</a></li> <li><a href="/w/index.php?title=Lanproston&action=edit&redlink=1" class="new" title="Lanproston (page does not exist)">Lanproston</a></li> <li><a href="/w/index.php?title=Limaprost&action=edit&redlink=1" class="new" title="Limaprost (page does not exist)">Limaprost</a></li> <li><a href="/w/index.php?title=Luprostiol&action=edit&redlink=1" class="new" title="Luprostiol (page does not exist)">Luprostiol</a></li> <li><a href="/w/index.php?title=Meteneprost&action=edit&redlink=1" class="new" title="Meteneprost (page does not exist)">Meteneprost</a></li> <li><a href="/w/index.php?title=Mexiprostil&action=edit&redlink=1" class="new" title="Mexiprostil (page does not exist)">Mexiprostil</a></li> <li><a href="/w/index.php?title=Naxaprostene&action=edit&redlink=1" class="new" title="Naxaprostene (page does not exist)">Naxaprostene</a></li> <li><a href="/w/index.php?title=Nileprost&action=edit&redlink=1" class="new" title="Nileprost (page does not exist)">Nileprost</a></li> <li><a href="/w/index.php?title=Nocloprost&action=edit&redlink=1" class="new" title="Nocloprost (page does not exist)">Nocloprost</a></li> <li><a href="/w/index.php?title=Ornoprostil&action=edit&redlink=1" class="new" title="Ornoprostil (page does not exist)">Ornoprostil</a></li> <li><a href="/w/index.php?title=Oxoprostol&action=edit&redlink=1" class="new" title="Oxoprostol (page does not exist)">Oxoprostol</a></li> <li><a href="/w/index.php?title=Penprostene&action=edit&redlink=1" class="new" title="Penprostene (page does not exist)">Penprostene</a></li> <li><a href="/w/index.php?title=Pimilprost&action=edit&redlink=1" class="new" title="Pimilprost (page does not exist)">Pimilprost</a></li> <li><a href="/w/index.php?title=Piriprost&action=edit&redlink=1" class="new" title="Piriprost (page does not exist)">Piriprost</a></li> <li><a href="/w/index.php?title=Posaraprost&action=edit&redlink=1" class="new" title="Posaraprost (page does not exist)">Posaraprost</a></li> <li><a href="/w/index.php?title=Prostalene&action=edit&redlink=1" class="new" title="Prostalene (page does not exist)">Prostalene</a></li> <li><a href="/w/index.php?title=Rioprostil&action=edit&redlink=1" class="new" title="Rioprostil (page does not exist)">Rioprostil</a></li> <li><a href="/w/index.php?title=Rivenprost&action=edit&redlink=1" class="new" title="Rivenprost (page does not exist)">Rivenprost</a></li> <li><a href="/w/index.php?title=Rosaprostol&action=edit&redlink=1" class="new" title="Rosaprostol (page does not exist)">Rosaprostol</a></li> <li><a href="/w/index.php?title=Spiriprostil&action=edit&redlink=1" class="new" title="Spiriprostil (page does not exist)">Spiriprostil</a></li> <li><a href="/w/index.php?title=Tiaprost&action=edit&redlink=1" class="new" title="Tiaprost (page does not exist)">Tiaprost</a></li> <li><a href="/w/index.php?title=Tilsuprost&action=edit&redlink=1" class="new" title="Tilsuprost (page does not exist)">Tilsuprost</a></li> <li><a href="/w/index.php?title=Tiprostanide&action=edit&redlink=1" class="new" title="Tiprostanide (page does not exist)">Tiprostanide</a></li> <li><a href="/w/index.php?title=Trimoprostil&action=edit&redlink=1" class="new" title="Trimoprostil (page does not exist)">Trimoprostil</a></li> <li><a href="/w/index.php?title=Viprostol&action=edit&redlink=1" class="new" title="Viprostol (page does not exist)">Viprostol</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;"><a href="/wiki/Enzyme" title="Enzyme">Enzyme</a><br /><small>(<a href="/wiki/Enzyme_inhibitor" title="Enzyme inhibitor">inhibitors</a>)</small></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Cyclooxygenase" title="Cyclooxygenase"><abbr title="Cyclooxygenase">COX</abbr><br />(<abbr title="prostaglandin G/H synthase">PTGS</abbr>)</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><i>Salicylic acids:</i> <a href="/wiki/Aloxiprin" title="Aloxiprin">Aloxiprin</a></li> <li><a href="/wiki/Aspirin" title="Aspirin">Aspirin (acetylsalicylic acid)</a></li> <li><a href="/wiki/Benorilate" title="Benorilate">Benorilate (benorylate)</a></li> <li><a href="/wiki/Carbasalate_calcium" title="Carbasalate calcium">Carbasalate calcium</a></li> <li><a href="/wiki/Diflunisal" title="Diflunisal">Diflunisal</a></li> <li><a href="/wiki/Dipyrocetyl" title="Dipyrocetyl">Dipyrocetyl</a></li> <li><a href="/wiki/Ethenzamide" title="Ethenzamide">Ethenzamide</a></li> <li><a href="/wiki/Guacetisal" title="Guacetisal">Guacetisal</a></li> <li><a href="/wiki/Magnesium_salicylate" title="Magnesium salicylate">Magnesium salicylate</a></li> <li><a href="/wiki/Mesalazine" title="Mesalazine">Mesalazine (5-aminosalicylic acid)</a></li> <li><a href="/wiki/Methyl_salicylate" title="Methyl salicylate">Methyl salicylate</a></li> <li><a href="/w/index.php?title=Salacetamide&action=edit&redlink=1" class="new" title="Salacetamide (page does not exist)">Salacetamide</a></li> <li><a href="/wiki/Salicin" title="Salicin">Salicin</a></li> <li><a href="/wiki/Salicylamide" title="Salicylamide">Salicylamide</a></li> <li><a href="/wiki/Salicylate" class="mw-redirect" title="Salicylate">Salicylate (salicylic acid)</a></li> <li><a href="/wiki/Salsalate" title="Salsalate">Salsalate</a></li> <li><a href="/wiki/Sodium_salicylate" title="Sodium salicylate">Sodium salicylate</a></li> <li><a href="/wiki/Triflusal" title="Triflusal">Triflusal</a>; <i>Acetic acids:</i> <a href="/wiki/Aceclofenac" title="Aceclofenac">Aceclofenac</a></li> <li><a href="/wiki/Acemetacin" title="Acemetacin">Acemetacin</a></li> <li><a href="/w/index.php?title=Aclofenac&action=edit&redlink=1" class="new" title="Aclofenac (page does not exist)">Aclofenac</a></li> <li><a href="/wiki/Amfenac" title="Amfenac">Amfenac</a></li> <li><a href="/wiki/Alclofenac" title="Alclofenac">Alclofenac</a></li> <li><a href="/wiki/Bendazac" title="Bendazac">Bendazac</a></li> <li><a href="/wiki/Bromfenac" title="Bromfenac">Bromfenac</a></li> <li><a href="/wiki/Bufexamac" title="Bufexamac">Bufexamac</a></li> <li><a href="/wiki/Bumadizone" title="Bumadizone">Bumadizone</a></li> <li><a href="/w/index.php?title=Cinmetacin&action=edit&redlink=1" class="new" title="Cinmetacin (page does not exist)">Cinmetacin</a></li> <li><a href="/w/index.php?title=Clometacin&action=edit&redlink=1" class="new" title="Clometacin (page does not exist)">Clometacin</a></li> <li><a href="/wiki/Diclofenac" title="Diclofenac">Diclofenac</a></li> <li><a href="/wiki/Difenpiramide" title="Difenpiramide">Difenpiramide</a></li> <li><a href="/wiki/Etodolac" title="Etodolac">Etodolac</a></li> <li><a href="/wiki/Felbinac" title="Felbinac">Felbinac</a></li> <li><a href="/wiki/Fenclofenac" title="Fenclofenac">Fenclofenac</a></li> <li><a href="/wiki/Fentiazac" title="Fentiazac">Fentiazac</a></li> <li><a href="/wiki/Glucametacin" title="Glucametacin">Glucametacin</a></li> <li><a href="/wiki/Indometacin" title="Indometacin">Indometacin (indomethacin)</a></li> <li><a href="/wiki/Indometacin_farnesil" title="Indometacin farnesil">Indometacin farnesil</a></li> <li><a href="/wiki/Ketorolac" title="Ketorolac">Ketorolac</a></li> <li><a href="/wiki/Lonazolac" title="Lonazolac">Lonazolac</a></li> <li><a href="/wiki/Mofezolac" title="Mofezolac">Mofezolac</a></li> <li><a href="/wiki/Nabumetone" title="Nabumetone">Nabumetone</a></li> <li><a href="/wiki/Oxametacin" title="Oxametacin">Oxametacin</a></li> <li><a href="/w/index.php?title=Oxindanac&action=edit&redlink=1" class="new" title="Oxindanac (page does not exist)">Oxindanac</a></li> <li><a href="/wiki/Proglumetacin" title="Proglumetacin">Proglumetacin</a></li> <li><a href="/wiki/Sulindac" title="Sulindac">Sulindac</a></li> <li><a href="/w/index.php?title=Sulindac_sulfide&action=edit&redlink=1" class="new" title="Sulindac sulfide (page does not exist)">Sulindac sulfide</a></li> <li><a href="/wiki/Tolmetin" title="Tolmetin">Tolmetin</a></li> <li><a href="/w/index.php?title=Zidometacin&action=edit&redlink=1" class="new" title="Zidometacin (page does not exist)">Zidometacin</a></li> <li><a href="/wiki/Zomepirac" title="Zomepirac">Zomepirac</a>; <i>Propionic acids:</i> <a href="/wiki/Alminoprofen" title="Alminoprofen">Alminoprofen</a></li> <li><a href="/wiki/Benoxaprofen" title="Benoxaprofen">Benoxaprofen</a></li> <li><a href="/w/index.php?title=Bucloxic_acid&action=edit&redlink=1" class="new" title="Bucloxic acid (page does not exist)">Bucloxic acid (blucloxate)</a></li> <li><a href="/w/index.php?title=Butibufen&action=edit&redlink=1" class="new" title="Butibufen (page does not exist)">Butibufen</a></li> <li><a href="/wiki/Carprofen" title="Carprofen">Carprofen</a></li> <li><a href="/wiki/Dexibuprofen" title="Dexibuprofen">Dexibuprofen</a></li> <li><a href="/w/index.php?title=Dexindoprofen&action=edit&redlink=1" class="new" title="Dexindoprofen (page does not exist)">Dexindoprofen</a></li> <li><a href="/wiki/Dexketoprofen" title="Dexketoprofen">Dexketoprofen</a></li> <li><a href="/wiki/Fenbufen" title="Fenbufen">Fenbufen</a></li> <li><a href="/wiki/Fenoprofen" title="Fenoprofen">Fenoprofen</a></li> <li><a href="/wiki/Flunoxaprofen" title="Flunoxaprofen">Flunoxaprofen</a></li> <li><a href="/wiki/Flurbiprofen" title="Flurbiprofen">Flurbiprofen</a></li> <li><a href="/wiki/Ibuprofen" title="Ibuprofen">Ibuprofen</a></li> <li><a href="/wiki/Ibuproxam" title="Ibuproxam">Ibuproxam</a></li> <li><a href="/wiki/Indoprofen" title="Indoprofen">Indoprofen</a></li> <li><a href="/wiki/Ketoprofen" title="Ketoprofen">Ketoprofen</a></li> <li><a href="/wiki/Loxoprofen" title="Loxoprofen">Loxoprofen</a></li> <li><a href="/wiki/Miroprofen" title="Miroprofen">Miroprofen</a></li> <li><a href="/wiki/Naproxen" title="Naproxen">Naproxen</a></li> <li><a href="/wiki/Naproxcinod" title="Naproxcinod">Naproxcinod</a></li> <li><a href="/wiki/Oxaprozin" title="Oxaprozin">Oxaprozin</a></li> <li><a href="/wiki/Pirprofen" title="Pirprofen">Pirprofen</a></li> <li><a href="/wiki/Pranoprofen" title="Pranoprofen">Pranoprofen</a></li> <li><a href="/wiki/Suprofen" title="Suprofen">Suprofen</a></li> <li><a href="/wiki/Tarenflurbil" title="Tarenflurbil">Tarenflurbil</a></li> <li><a href="/wiki/Tepoxalin" title="Tepoxalin">Tepoxalin</a></li> <li><a href="/wiki/Tiaprofenic_acid" title="Tiaprofenic acid">Tiaprofenic acid (tiaprofenate)</a></li> <li><a href="/wiki/Vedaprofen" title="Vedaprofen">Vedaprofen</a>; <i>Anthranilic acids (fenamic acids):</i> <a href="/wiki/Etofenamate" title="Etofenamate">Etofenamic acid (etofenamate)</a></li> <li><a href="/w/index.php?title=Floctafenic_acid&action=edit&redlink=1" class="new" title="Floctafenic acid (page does not exist)">Floctafenic acid (floctafenate)</a></li> <li><a href="/wiki/Flufenamic_acid" title="Flufenamic acid">Flufenamic acid (flufenamate)</a></li> <li><a href="/wiki/Meclofenamic_acid" title="Meclofenamic acid">Meclofenamic acid (meclofenamate)</a></li> <li><a href="/wiki/Mefenamic_acid" title="Mefenamic acid">Mefenamic acid (mefenamate)</a></li> <li><a href="/wiki/Morniflumate" title="Morniflumate">Morniflumic acid (morniflumate)</a></li> <li><a href="/wiki/Niflumic_acid" title="Niflumic acid">Niflumic acid (niflumate)</a></li> <li><a href="/w/index.php?title=Talinflumic_acid&action=edit&redlink=1" class="new" title="Talinflumic acid (page does not exist)">Talinflumic acid (talinflumate)</a></li> <li><a href="/wiki/Tolfenamic_acid" title="Tolfenamic acid">Tolfenamic acid (tolfenamate)</a>; <i>Pyrazolones:</i> <a href="/wiki/Azapropazone" title="Azapropazone">Azapropazone</a></li> <li><a href="/wiki/Dipyrone" class="mw-redirect" title="Dipyrone">Dipyrone</a></li> <li><a href="/wiki/Isopyrin" class="mw-redirect" title="Isopyrin">Isopyrin</a></li> <li><a href="/wiki/Oxyphenbutazone" title="Oxyphenbutazone">Oxyphenbutazone</a></li> <li><a href="/wiki/Phenylbutazone" title="Phenylbutazone">Phenylbutazone</a>; <i>Enolic acids (oxicams):</i> <a href="/wiki/Ampiroxicam" title="Ampiroxicam">Ampiroxicam</a></li> <li><a href="/wiki/Droxicam" title="Droxicam">Droxicam</a></li> <li><a href="/w/index.php?title=Enolicam&action=edit&redlink=1" class="new" title="Enolicam (page does not exist)">Enolicam</a></li> <li><a href="/wiki/Isoxicam" title="Isoxicam">Isoxicam</a></li> <li><a href="/wiki/Lornoxicam" title="Lornoxicam">Lornoxicam</a></li> <li><a href="/wiki/Meloxicam" title="Meloxicam">Meloxicam</a></li> <li><a href="/wiki/Piroxicam" title="Piroxicam">Piroxicam</a></li> <li><a href="/wiki/Tenoxicam" title="Tenoxicam">Tenoxicam</a>; <i>4-Aminoquinolines:</i> <a href="/wiki/Antrafenine" title="Antrafenine">Antrafenine</a></li> <li><a href="/wiki/Floctafenine" title="Floctafenine">Floctafenine</a></li> <li><a href="/wiki/Glafenine" title="Glafenine">Glafenine</a>; <i>Quinazolines:</i> <a href="/wiki/Fluproquazone" title="Fluproquazone">Fluproquazone</a></li> <li><a href="/wiki/Proquazone" title="Proquazone">Proquazone</a>; <i>Aminonicotinic acids:</i> <a href="/w/index.php?title=Clonixeril&action=edit&redlink=1" class="new" title="Clonixeril (page does not exist)">Clonixeril</a></li> <li><a href="/wiki/Clonixin" title="Clonixin">Clonixin</a></li> <li><a href="/wiki/Flunixin" title="Flunixin">Flunixin</a>; <i>Sulfonanilides:</i> <a href="/w/index.php?title=Flosulide&action=edit&redlink=1" class="new" title="Flosulide (page does not exist)">Flosulide</a></li> <li><a href="/wiki/Nimesulide" title="Nimesulide">Nimesulide</a>; <i>Aminophenols (anilines):</i> <a href="/wiki/Acetanilide" title="Acetanilide">Acetanilide</a></li> <li><a href="/wiki/AM404" title="AM404">AM-404 (N-arachidonoylaminophenol)</a></li> <li><a href="/wiki/Bucetin" title="Bucetin">Bucetin</a></li> <li><a href="/wiki/Paracetamol" title="Paracetamol">Paracetamol (acetaminophen)</a></li> <li><a href="/w/index.php?title=Parapropamol&action=edit&redlink=1" class="new" title="Parapropamol (page does not exist)">Parapropamol</a></li> <li><a href="/wiki/Phenacetin" title="Phenacetin">Phenacetin</a></li> <li><a href="/wiki/Propacetamol" title="Propacetamol">Propacetamol</a>; <i>Selective COX-2 inhibitors (coxibs):</i> <a href="/wiki/Apricoxib" title="Apricoxib">Apricoxib</a></li> <li><a href="/wiki/Celecoxib" title="Celecoxib">Celecoxib</a></li> <li><a href="/wiki/Cimicoxib" title="Cimicoxib">Cimicoxib</a></li> <li><a href="/wiki/Deracoxib" title="Deracoxib">Deracoxib</a></li> <li><a href="/wiki/Etoricoxib" title="Etoricoxib">Etoricoxib</a></li> <li><a href="/wiki/Firocoxib" title="Firocoxib">Firocoxib</a></li> <li><a href="/wiki/Lumiracoxib" title="Lumiracoxib">Lumiracoxib</a></li> <li><a href="/wiki/Mavacoxib" title="Mavacoxib">Mavacoxib</a></li> <li><a href="/wiki/Parecoxib" title="Parecoxib">Parecoxib</a></li> <li><a href="/wiki/Polmacoxib" title="Polmacoxib">Polmacoxib</a></li> <li><a href="/wiki/Robenacoxib" title="Robenacoxib">Robenacoxib</a></li> <li><a href="/wiki/Rofecoxib" title="Rofecoxib">Rofecoxib</a></li> <li><a href="/wiki/Tilmacoxib" title="Tilmacoxib">Tilmacoxib</a></li> <li><a href="/wiki/Valdecoxib" title="Valdecoxib">Valdecoxib</a>; <i>Others/unsorted:</i> <a href="/wiki/Anitrazafen" title="Anitrazafen">Anitrazafen</a></li> <li><a href="/w/index.php?title=Clobuzarit&action=edit&redlink=1" class="new" title="Clobuzarit (page does not exist)">Clobuzarit</a></li> <li><a href="/wiki/Curcumin" title="Curcumin">Curcumin</a></li> <li><a href="/w/index.php?title=DuP-697&action=edit&redlink=1" class="new" title="DuP-697 (page does not exist)">DuP-697</a></li> <li><a href="/w/index.php?title=FK-3311&action=edit&redlink=1" class="new" title="FK-3311 (page does not exist)">FK-3311</a></li> <li><a href="/wiki/Flumizole" title="Flumizole">Flumizole</a></li> <li><a href="/w/index.php?title=FR-122047&action=edit&redlink=1" class="new" title="FR-122047 (page does not exist)">FR-122047</a></li> <li><a href="/wiki/Glimepiride" title="Glimepiride">Glimepiride</a></li> <li><a href="/wiki/Hyperforin" title="Hyperforin">Hyperforin</a></li> <li><a href="/w/index.php?title=Itazigrel&action=edit&redlink=1" class="new" title="Itazigrel (page does not exist)">Itazigrel</a></li> <li><a href="/w/index.php?title=L-655240&action=edit&redlink=1" class="new" title="L-655240 (page does not exist)">L-655240</a></li> <li><a href="/w/index.php?title=L-670596&action=edit&redlink=1" class="new" title="L-670596 (page does not exist)">L-670596</a></li> <li><a href="/wiki/Licofelone" title="Licofelone">Licofelone</a></li> <li><a href="/wiki/Menatetrenone" title="Menatetrenone">Menatetrenone (vitamin K<sub>2</sub>)</a></li> <li><a href="/w/index.php?title=NCX-466&action=edit&redlink=1" class="new" title="NCX-466 (page does not exist)">NCX-466</a></li> <li><a href="/w/index.php?title=NCX-4040&action=edit&redlink=1" class="new" title="NCX-4040 (page does not exist)">NCX-4040</a></li> <li><a href="/wiki/NS-398" title="NS-398">NS-398</a></li> <li><a href="/wiki/Pamicogrel" title="Pamicogrel">Pamicogrel</a></li> <li><a href="/wiki/Resveratrol" title="Resveratrol">Resveratrol</a></li> <li><a href="/w/index.php?title=Romazarit&action=edit&redlink=1" class="new" title="Romazarit (page does not exist)">Romazarit</a></li> <li><a href="/wiki/Rosmarinic_acid" title="Rosmarinic acid">Rosmarinic acid</a></li> <li><a href="/wiki/Rutecarpine" title="Rutecarpine">Rutecarpine</a></li> <li><a href="/w/index.php?title=Satigrel&action=edit&redlink=1" class="new" title="Satigrel (page does not exist)">Satigrel</a></li> <li><a href="/w/index.php?title=SC-236&action=edit&redlink=1" class="new" title="SC-236 (page does not exist)">SC-236</a></li> <li><a href="/w/index.php?title=SC-560&action=edit&redlink=1" class="new" title="SC-560 (page does not exist)">SC-560</a></li> <li><a href="/w/index.php?title=SC-58125&action=edit&redlink=1" class="new" title="SC-58125 (page does not exist)">SC-58125</a></li> <li><a href="/wiki/Tenidap" title="Tenidap">Tenidap</a></li> <li><a href="/w/index.php?title=Tiflamizole&action=edit&redlink=1" class="new" title="Tiflamizole (page does not exist)">Tiflamizole</a></li> <li><a href="/w/index.php?title=Timegadine&action=edit&redlink=1" class="new" title="Timegadine (page does not exist)">Timegadine</a></li> <li><a href="/w/index.php?title=Trifenagrel&action=edit&redlink=1" class="new" title="Trifenagrel (page does not exist)">Trifenagrel</a></li> <li><a href="/w/index.php?title=Tropesin&action=edit&redlink=1" class="new" title="Tropesin (page does not exist)">Tropesin</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_D_synthase" class="mw-redirect" title="Prostaglandin D synthase"><abbr title="Prostaglandin D synthase">PGD<sub>2</sub>S</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin D synthase</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Retinoid" title="Retinoid">Retinoids</a></li> <li><a href="/wiki/Selenium" title="Selenium">Selenium</a> (<a href="/wiki/Selenium_tetrachloride" title="Selenium tetrachloride">selenium tetrachloride</a>, <a href="/wiki/Sodium_selenite" title="Sodium selenite">sodium selenite</a>, <a href="/wiki/Selenium_disulfide" title="Selenium disulfide">selenium disulfide</a>)</li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_E_synthase" title="Prostaglandin E synthase"><abbr title="Prostaglandin E synthase">PGES</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin E synthase</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"><a href="/w/index.php?title=HQL-79&action=edit&redlink=1" class="new" title="HQL-79 (page does not exist)">HQL-79</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostaglandin_F_synthase" title="Prostaglandin F synthase"><abbr title="Prostaglandin F synthase">PGFS</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostaglandin F synthase</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"><a href="/wiki/Bimatoprost" title="Bimatoprost">Bimatoprost</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Prostacyclin_synthase" title="Prostacyclin synthase"><abbr title="Prostacyclin synthase">PGI<sub>2</sub>S</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Prostacyclin synthase</span></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"><a href="/wiki/Tranylcypromine" title="Tranylcypromine">Tranylcypromine</a></div></td></tr><tr><th scope="row" class="navbox-group" style="width:5em;;text-align:center;"><a href="/wiki/Thromboxane_A_synthase" class="mw-redirect" title="Thromboxane A synthase"><abbr title="Thromboxane A synthase">TXAS</abbr></a><span class="sr-only" style="border: 0; clip: rect(0, 0, 0, 0); clip-path: polygon(0px 0px, 0px 0px, 0px 0px); height: 1px; margin: -1px; overflow: hidden; padding: 0; position: absolute; width: 1px; white-space: nowrap;">Tooltip Thromboxane A synthase</span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/w/index.php?title=Camonagrel&action=edit&redlink=1" class="new" title="Camonagrel (page does not exist)">Camonagrel</a></li> <li><a href="/w/index.php?title=Dazmegrel&action=edit&redlink=1" class="new" title="Dazmegrel (page does not exist)">Dazmegrel</a></li> <li><a href="/wiki/Dazoxiben" title="Dazoxiben">Dazoxiben</a></li> <li><a href="/wiki/Furegrelate" title="Furegrelate">Furegrelate</a></li> <li><a href="/w/index.php?title=Isbogrel&action=edit&redlink=1" class="new" title="Isbogrel (page does not exist)">Isbogrel</a></li> <li><a href="/w/index.php?title=Midazogrel&action=edit&redlink=1" class="new" title="Midazogrel (page does not exist)">Midazogrel</a></li> <li><a href="/w/index.php?title=Nafagrel&action=edit&redlink=1" class="new" title="Nafagrel (page does not exist)">Nafagrel</a></li> <li><a href="/w/index.php?title=Nicogrelate&action=edit&redlink=1" class="new" title="Nicogrelate (page does not exist)">Nicogrelate</a></li> <li><a href="/wiki/Ozagrel" title="Ozagrel">Ozagrel</a></li> <li><a href="/wiki/Picotamide" title="Picotamide">Picotamide</a></li> <li><a href="/w/index.php?title=Pirmagrel&action=edit&redlink=1" class="new" title="Pirmagrel (page does not exist)">Pirmagrel</a></li> <li><a href="/w/index.php?title=Ridogrel&action=edit&redlink=1" class="new" title="Ridogrel (page does not exist)">Ridogrel</a></li> <li><a href="/w/index.php?title=Rolafagrel&action=edit&redlink=1" class="new" title="Rolafagrel (page does not exist)">Rolafagrel</a></li> <li><a href="/w/index.php?title=Samixogrel&action=edit&redlink=1" class="new" title="Samixogrel (page does not exist)">Samixogrel</a></li> <li><a href="/wiki/Terbogrel" title="Terbogrel">Terbogrel</a></li> <li><a href="/w/index.php?title=U63557A&action=edit&redlink=1" class="new" title="U63557A (page does not exist)">U63557A</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;text-align:center;">Others</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><b>Precursors:</b> <a href="/wiki/Linoleic_acid" title="Linoleic acid">Linoleic acid</a></li> <li><a href="/wiki/Gamma-Linolenic_acid" class="mw-redirect" title="Gamma-Linolenic acid">γ-Linolenic acid (gamolenic acid)</a></li> <li><a href="/wiki/Dihomo-%CE%B3-linolenic_acid" title="Dihomo-γ-linolenic acid">Dihomo-γ-linolenic acid</a></li> <li><a href="/wiki/Diglyceride" title="Diglyceride">Diacylglycerol</a></li> <li><a href="/wiki/Arachidonic_acid" title="Arachidonic acid">Arachidonic acid</a></li> <li><a href="/wiki/Prostaglandin_G2" title="Prostaglandin G2">Prostaglandin G<sub>2</sub></a></li> <li><a href="/wiki/Prostaglandin_H2" title="Prostaglandin H2">Prostaglandin H<sub>2</sub></a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <dl><dt>See also</dt> <dd><i><a href="/wiki/Template:Receptor_modulators" title="Template:Receptor modulators">Receptor/signaling modulators</a></i></dd> <dd><i><a href="/wiki/Template:Leukotriene_signaling_modulators" title="Template:Leukotriene signaling modulators">Leukotriene signaling modulators</a></i></dd></dl> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style></div><div role="navigation" class="navbox authority-control" aria-label="Navbox" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" 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