Celebrex: 7 things you should know
Medically reviewed by Carmen Fookes, BPharm. Last updated on Jan 24, 2020.
1. How it works
- Celebrex is a brand (trade) name of the drug celecoxib. Celecoxib helps relieve pain and inflammation by inhibiting prostaglandin synthesis, primarily by blocking the effects of the cyclooxygenase-2 (COX-2) enzyme.
- Celecoxib does not block the effects of COX-1.
- Celecoxib belongs to the class of drugs called nonsteroidal anti-inflammatory drugs (NSAID). It is also a sulfonamide.
- Effective for the relief of pain and inflammation associated with arthritis, Ankylosing Spondylitis, menstruation, and for the relief of acute pain.
- NSAIDs (including Celebrex) are considered first-line options for mild-to-moderate acute pain because at correct dosages they are effective, do not cause dependence and are readily available.
- Celebrex relieves pain, decreases inflammation, and lowers temperature.
- Celebrex is less likely to cause stomach ulcers at higher dosages than other NSAIDs. Advantages are negated when Celebrex is given with aspirin.
- Celebrex is available as a generic under the name celecoxib.
If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:
- Abdominal pain, diarrhea, dyspepsia, flatulence, and nausea. Other stomach-related adverse effects include bleeding, ulceration, or perforation, which occasionally may be fatal. Older patients or those taking other medicines that affect the stomach may be more at risk. May occur at any time and without warning.
- May also cause a headache, rash, tinnitus (ringing in the ears), hematological effects, fluid retention, and edema. May mask symptoms of infections.
- Like other NSAIDs, Celebrex is associated with an increased risk of heart attack and stroke. The risk increases the longer Celebrex is taken for and is higher in people with pre-existing heart disease.
- May also increase blood pressure leading to the onset of new high blood pressure or aggravate pre-existing high blood pressure. Monitor for signs and symptoms of abnormal clotting or bleeding.
- May decrease kidney function and precipitate reversible kidney failure. Patients at risk include those with pre-existing impaired kidney function, heart failure, liver dysfunction, taking certain medications (such as diuretics, heart medicines), and the elderly.
- Use with caution in people with asthma or with aspirin-sensitive asthma as bronchospasm may occur and cross-reactivity between aspirin and other NSAIDs (such as Celebrex) has been reported.
- Rarely, life-threatening hypersensitivity reactions may trigger allergy-like asthma.
- Not suitable for use in certain people (such as those with severe liver disease; poor metabolizers of CYPD2C9 substrates; allergic to sulfonamides, aspirin, or other NSAIDs; active gastrointestinal bleeding) or after certain procedures, such as following coronary artery bypass graft (CABG) surgery.
- Do not use at the same time as other non-aspirin NSAIDs. May interact with several other drugs including warfarin, lithium, fluconazole and ACE inhibitors.
- Should not be used during the last trimester of pregnancy as can promote premature closure of the ductus arteriosus.
- Expensive compared to most other NSAIDs.
Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects
- Celebrex may be given with or without food, although dosages above 400mg twice daily should be administered with food to improve absorption.
- Seek immediate medical advice if you develop any chest pain, shortness of breath, weakness, slurring of speech, dyspepsia, or blood in your stool.
- Also seek urgent medical attention if you develop unexplained nausea, fatigue, itching, skin yellowing, right upper abdominal pain tenderness or flu-like symptoms.
- If you have asthma and your asthma worsens after taking Celebrex, seek urgent medical advice.
- Use the lowest effective dose for the shortest duration of time.
- Celebrex is a sulfonamide and can cause serious skin effects. Stop Celebrex immediately if any type of rash develops and contact your doctor as soon as possible.
- Report any unexplained weight gain or fluid retention to your doctor.
- Twice daily dosing is recommended; more frequent dosing does not necessarily improve response.
- Response to different NSAIDs can vary so switching types (for example, from Celebrex to naproxen) may improve response.
6. Response and Effectiveness
- Celebrex takes approximately 3 hours after oral administration to reach peak concentrations. The pain-relieving effects of Celebrex last for approximately 12 hours.
Medicines that interact with Celebrex may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Celebrex. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.
Common medications that may interact with Celebrex include:
- anticoagulants (blood thinners) such as apixaban, dabigatran, fondaparinux, heparin, or warfarin
- corticosteroids, such as dexamethasone
- diuretics, such as furosemide
- medications that lower blood pressure, such as ACE inhibitors (eg, benazepril, captopril), ARBs (such as candesartan, irbesartan), or beta-blockers (eg, atenolol, sotalol)
- methotrexate and other drugs used to treat rheumatoid arthritis
- nonsteroidal anti-inflammatories (NSAIDs), such as diclofenac, etodolac, ibuprofen, meloxicam, nabumetone, or naproxen
- other medications that inhibit or induce cytochrome enzymes CYP2D6, such as fluoxetine, bupropion, duloxetine)
Alcohol can increase the likelihood of gastrointestinal side effects with Celebrex, and possibly liver and kidney damage.
Note that this list is not all-inclusive and includes only common medications that may interact with Celebrex. You should refer to the prescribing information for Celebrex for a complete list of interactions.
Celebrex (celecoxib) [Package Insert]. Revised: 05/2019. G.D. Searle LLC Division of Pfizer Inc. https://www.drugs.com/pro/celebrex.html
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Celebrex only for the indication prescribed.
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Other brands: Elyxyb