Severe bronchospasm after parenteral parecoxib: cyclooxygenase-2 inhibitors: not the answer yet.

IN a subset of patients with asthma, nonsteroidal antiinflammatory drugs (NSAIDs) that inhibit both cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2) can precipitate dangerous asthmatic attacks. It has been proposed that in these patients, the attacks are triggered by inhibition of COX-1 and not COX-2, and that the use of highly selective COX-2 inhibitors may be safe in asthmatic patients, even those with sensitivity to NSAIDs. We describe two cases of acute, life-threatening bronchospasm after administration of parecoxib, a parenteral COX-2 inhibitor, in patients with a history of asthma but no previous history of aspirin or other NSAID sensitivity.