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The analgesic and anti-inflammatory properties acts by inhibiting two recognized isoenzymes of prostaglandin cycl-oxygenase (COX), which are subgroups COX 1 and COX 2.The pharmacodynamic action of these drugs is mostly base on the inhibition of COX2, while the adverse reactions are largely due to COX1 inhibition

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In particular, in comparison with those who have a low proportion of MMA (III + V) in urine, those who have a higher proportion have been observed to be at higher risks for heart disease, atherosclerosis, peripheral vascular disease, hypertension, and bladder, lung, and skin cancer (reviewed in Steinmaus et al