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COX-2 Inhibitor Advantage — MFDS Part 1 MCQ

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ModeratePharmacologyCOX-2 Inhibitor AdvantageMFDS Part 1

Compared with a conventional non-selective NSAID, what is the principal intended advantage of the selective COX-2 inhibitor celecoxib?

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Correct answer: A — Lower risk of gastroduodenal ulceration while retaining anti-inflammatory efficacy

Celecoxib selectively inhibits COX-2, which contributes to prostaglandin-mediated pain and inflammation, while largely sparing COX-1 at therapeutic doses. Its intended advantage is therefore retained anti-inflammatory activity with a lower risk of gastroduodenal ulceration than some non-selective NSAIDs. This is a relative reduction, not elimination of gastrointestinal harm. Celecoxib is not inherently more analgesically potent. It also retains cardiovascular and thrombotic risk and has no clinically useful antiplatelet effect. Renal COX-2 is not spared: renal toxicity, fluid retention, oedema and hypertension may occur. Clinically important interactions also remain, including increased bleeding risk and the need for INR monitoring with warfarin.

Reference: Electronic Medicines Compendium. Celecoxib 100 mg Capsules, Summary of Product Characteristics, sections 4.4, 4.5 and 5.1. Revised 13 May 2026. https://www.medicines.org.uk/emc/product/2117/smpc