Polmacoxib (trade name Acelex) is a nonsteroidal anti-inflammatory drug (NSAID) used to treat osteoarthritis. Polmacoxib is a novel NSAID that, due to its postulated dual inhibition of cyclooxygenase enzymes and Carbonic anhydrase -I/II, might limit the propensity for NSAID-induced hypertension and thereby attenuate associated cardiovascular risks. Polmacoxib did not elevate blood pressure in healthy volunteers or OA subjects in any of the previous clinical studies, including 4 Phase I and 1 Phase II trials. In Phase III clinical trials Polmacoxib was relatively well tolerated and demonstrated efficacy superior to placebo and noninferior to celecoxib after 6 weeks of treatment in patients with osteoarthritis. The results obtained during the 18-week trial extension with Polmacoxib were consistent with those observed during the 6-week treatment period, indicating that Polmacoxib can be considered safe for long-term use based on this relatively small scale of study in a Korean population. Polmacoxib approved for use in South Korea in February 2015.