In February 2007, the American Heart Association warned that with respect to "patients with a prior history of or at high risk for cardiovascular disease... use of COX-2 inhibitors for pain relief should be limited to patients for whom there are no appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary. "In 2005, a study published in the Annals of Internal Medicine found that cardiovascular effects of COX-2 inhibitors differ, depending on the drug. Other COX-2-selective inhibitors, such as rofecoxib, have significantly higher myocardial infarction rates than celecoxib. In April 2005, after an extensive review of data, the FDA concluded it was likely "that there is a class effect for increased CV risk for all NSAIDs". In a 2006 meta-analysis of randomized control studies, the cerebrovascular events associated with COX-2 inhibitors were examined, but no significant risks were found when compared to nonselective NSAIDs or placebos. Drug interactions
Celecoxib is predominantly metabolized by cytochrome P450 2C9. Caution must be exercised with concomitant use of 2C9 inhibitors, such as fluconazole, which can greatly elevate celecoxib serum levels. If used concomitantly with lithium, celecoxib increases lithium plasma levels. If used concomitantly with warfarin, celecoxib may result in increased risk of bleeding complications. The risk of bleeding and gastric ulcers also increase further when SSRIs are used in combination with celecoxib. The drug may increase the risk of kidney failure with angiotensin-converting enzyme-inhibitors, such as lisinopril, and diuretics, such as hydrochlorothiazide.
Lipocortins can inhibit the common precursor of inflammation mediators, arachidonic acid. Interactions
Common medications causing a minor negative drug interaction include: Insulin and Metformin. Common medications checked in combination, but that are not known to create a negative drug interaction, include: Aspirin, Cymbalta (duloxetine), Fish Oil, Acetaminophen, Vitamin B12, Vitamin C, Vitamin D3, and Zyrtec. History
Desonide was first introduced in the United States under the trade name Tridesilon by Dome Laboratories in 1972. Since the discovery in the United States, several other countries have introduced different brand names of desonide, including Italy, Spain, United Kingdom, and Germany. The FDA first approved Connetics Corporation’s Verdeso Foam®
on September 16, 2006. Just shortly after, the FDA approved SkinMedica Inc.’s
Desonate® hydrogel delivery vehicle on October 20, 2006.Desonate® gel is currently manufactured by Bayer HealthCare
Pharmaceuticals Inc. in Whippany, NJ. DesOwen® creams, ointments, and lotions
are currently manufactured by DPT Laboratories, Ltd. in San Antonio Texas and
is marketed by Galderma Laboratories. Other suppliers for the generic desonide
include Rebel Distributors Corp and Perrigo New York Inc.

Research and clinical trials
Desonate was approved by the FDA following two major clinical trials in 2006. Each randomized, double-blind, placebo-controlled study enrolled 582 pediatric patients (between the ages of 3 months and 18 years). The patient was topically administered the drug or placebo two times a day for four weeks. Using the Investigator’s Global Severity Score (IGSS), the treatment was considered successful if at Week 4 there was at least a two (2) point decrease from the patient’s baseline IGSS.