A newer type of NSAID available is known as the COX-2 inhibitor. COX-2 inhibitors provide the anti-inflammatory effects of blocking the COX-2 enzyme, but do not affect the COX-1 enzyme, reducing the risk of stomach or intestinal damage. COX-2 inhibitors are ideal for patients who are considered to be at an elevated risk for developing stomach or intestinal problems; however, COX-2 inhibitors can increase the risk for damage to the heart, and thus, are not ideal for patients with problems with circulation or other types of heart conditions.
NSAIDS have antipyretic activity and can be used to treat fever.   Fever is caused by elevated levels of prostaglandin E2 , which alters the firing rate of neurons within the hypothalamus that control thermoregulation.   Antipyretics work by inhibiting the enzyme COX, which causes the general inhibition of prostanoid biosynthesis ( PGE2 ) within the hypothalamus .   PGE2 signals to the hypothalamus to increase the body's thermal set point.   Ibuprofen has been shown more effective as an antipyretic than paracetamol (acetaminophen).   Arachidonic acid is the precursor substrate for cyclooxygenase leading to the production of prostaglandins F, D & E.