Rofecoxib, one member of the class of pain and arthritis drugs known as COX-2 inhibitors (coxibs), appears to increase the risk of heart attack and stroke after long-term use and has been withdrawn from the market. The potential for similar adverse effects with other coxibs is currently being studied. Because one recent study has shown a 2.5-fold increase in cardiovascular problems with another coxib, celecoxib, current FDA recommendations are to limit use of any coxib to people at high risk of gastrointestinal bleeding, who have a history of intolerance to other NSAIDs, or who are not doing well on other NSAIDs. Caution should be taken with use of coxibs for long periods or by people with risk factors for heart attack and stroke.