Celebrex is the brand name for celecoxib, a prescription medication that belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is primarily used to relieve pain, reduce inflammation, and manage symptoms of conditions such as:
- Osteoarthritis: a degenerative joint disease.
- Rheumatoid arthritis: an autoimmune disorder causing joint inflammation.
- Ankylosing spondylitis: arthritis of the spine.
- Menstrual pain (dysmenorrhea).
- Acute pain in adults.
Celebrex works by inhibiting the enzyme COX-2 (cyclooxygenase-2), which plays a role in producing inflammatory chemicals (prostaglandins) in the body. By blocking COX-2, Celebrex helps reduce pain and swelling without the gastrointestinal side effects often associated with older NSAIDs that inhibit both COX-1 and COX-2 enzymes.
Warnings of Taking Celebrex
Celebrex may cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. You should not take this medicine if you already have bleeding in your stomach or intestines.
Celecoxib can increase your risk of fatal heart attack or stroke, even if you don’t have any risk factors. Do not use Celebrex just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
How Should I Take Celebrex?
Take Celebrex exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.
You may take Celebrex with or without food.
If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of applesauce. Swallow the mixture with water. You may save this applesauce mixture for later use in a refrigerator for up to 6 hours.
Store at room temperature away from moisture and heat.
Dosing Information of Taking Celebrex
The dosing of Celebrex (celecoxib) varies depending on the condition being treated. Below is general dosing information, but it’s important to follow your healthcare provider’s recommendations.
1. Osteoarthritis
- Usual dose: 200 mg once daily or 100 mg twice daily.
2. Rheumatoid Arthritis
- Usual dose: 100 mg to 200 mg twice daily.
3. Ankylosing Spondylitis
- Usual dose: 200 mg once daily or 100 mg twice daily.
- If no effect is observed after 6 weeks, the dose may be increased to 400 mg once daily or 200 mg twice daily.
4. Acute Pain (e.g., post-surgical or dental pain) and Primary Dysmenorrhea (menstrual pain)
- Initial dose: 400 mg on the first day, followed by an additional 200 mg if needed.
- Subsequent dose: 200 mg twice daily as needed.
5. Familial Adenomatous Polyposis (FAP)
- Usual dose: 400 mg twice daily.
Important Notes:
- With food: While Celebrex can be taken with or without food, patients with difficulty tolerating NSAIDs may prefer to take it with food to reduce gastrointestinal side effects.
- Duration: Use the lowest effective dose for the shortest duration consistent with treatment goals to minimize side effects.
Adjustments:
- Elderly patients: Start at the lowest recommended dose due to a higher risk of side effects, especially gastrointestinal and cardiovascular.
- Kidney or liver impairment: Dose adjustments may be necessary; consult a healthcare provider.
The Side Effects of Celebrex
Like all medications, Celebrex (celecoxib) can cause side effects. These side effects may range from mild to serious, and not everyone will experience them. Below are the most common, less common, and serious side effects of Celebrex.
Common Side Effects:
- Stomach pain or discomfort
- Diarrhea
- Indigestion
- Gas
- Nausea
- Headache
- Dizziness
- Swelling of the hands, feet, or ankles (edema)
Less Common Side Effects:
- Insomnia (difficulty sleeping)
- Flu-like symptoms
- Upper respiratory tract infection
- Rash or skin reactions
- Cough
- Sinusitis
- Back pain
Serious Side Effects:
Celebrex can lead to more severe and potentially life-threatening side effects, particularly at higher doses or with long-term use. These include:
1. Cardiovascular Risks:
- Increased risk of heart attack and stroke, especially in people with pre-existing heart conditions or who use the drug long-term.
- Chest pain, shortness of breath, weakness on one side of the body, or slurred speech may be signs of serious cardiovascular issues and require immediate medical attention.
2. Gastrointestinal Risks:
- Stomach ulcers, bleeding, and perforation of the stomach or intestines, which can occur without warning and may be fatal.
- Symptoms may include bloody or black, tarry stools, vomiting blood, or severe stomach pain.
3. Kidney Problems:
- Celebrex may cause kidney damage or worsen pre-existing kidney conditions, particularly in people who are dehydrated, elderly, or have other kidney risk factors.
- Decreased urine output, swelling, and fatigue may signal kidney issues.
4. Liver Problems:
- Liver damage may occur, with symptoms like yellowing of the skin or eyes (jaundice), fatigue, nausea, and dark urine.
5. Allergic Reactions:
- Celebrex may cause severe allergic reactions, including anaphylaxis. Symptoms include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.
6. Skin Reactions:
- Rare but serious skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. These can be life-threatening, with symptoms including blisters, peeling skin, and severe rash.
Other Serious Side Effects:
- Anemia (low red blood cell count)
- High blood pressure (hypertension)
- Vision changes
- Tinnitus (ringing in the ears)
Who Is at Higher Risk for Side Effects:
- People with heart disease, high blood pressure, or diabetes
- Those with a history of stomach ulcers or bleeding
- Elderly patients or those with kidney/liver disease
What to Do if You Experience Side Effects:
- Mild side effects may improve over time. If they persist or worsen, consult your healthcare provider.
- For serious side effects, stop taking Celebrex and seek immediate medical attention.
Always report any side effects to your doctor and follow their guidance.
What Happens if I Miss a Dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
What Happens if I Overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What Other Drugs Will Affect Celebrex?
Several drugs can interact with Celebrex (celecoxib), potentially altering its effectiveness or increasing the risk of side effects. It’s important to inform your healthcare provider of all medications you are taking, including prescription drugs, over-the-counter medications, and supplements. Below are the most common drug interactions with Celebrex.
1. Other NSAIDs or COX-2 Inhibitors
Taking Celebrex with other NSAIDs (nonsteroidal anti-inflammatory drugs) such as:
This combination can increase the risk of gastrointestinal bleeding, stomach ulcers, and kidney damage.
2. Blood Thinners (Anticoagulants and Antiplatelets)
Combining Celebrex with blood thinners can raise the risk of bleeding:
- Warfarin (Coumadin)
- Clopidogrel (Plavix)
- Apixaban (Eliquis)
- Dabigatran (Pradaxa)
- Heparin
- Aspirin (when used as a blood thinner)
3. ACE Inhibitors, ARBs, and Diuretics (for Blood Pressure)
Celebrex may reduce the effectiveness of medications used to control high blood pressure, and combining them may increase the risk of kidney problems:
- ACE inhibitors: such as Lisinopril or Enalapril
- ARBs (Angiotensin II receptor blockers): such as Losartan or Valsartan
- Diuretics: such as Furosemide (Lasix) or Hydrochlorothiazide (HCTZ)
4. Corticosteroids
Using corticosteroids like:
- Prednisone
- Dexamethasone
Together with Celebrex can increase the risk of gastrointestinal bleeding or ulcers.
5. SSRIs and SNRIs (Antidepressants)
Certain antidepressants can increase the risk of bleeding when taken with Celebrex:
- SSRIs: such as Fluoxetine (Prozac), Sertraline (Zoloft), or Escitalopram (Lexapro)
- SNRIs: such as Duloxetine (Cymbalta) or Venlafaxine (Effexor)
6. Methotrexate
Combining Celebrex with Methotrexate (a drug used for rheumatoid arthritis and cancer) may increase methotrexate toxicity, which can harm the liver, kidneys, and blood cells.
7. Lithium
Celebrex can increase the level of lithium in the blood, leading to lithium toxicity, which can cause nausea, hand tremors, and confusion.
8. Fluconazole and Other CYP2C9 Inhibitors
Fluconazole (an antifungal) and other drugs that inhibit the enzyme CYP2C9 can increase Celebrex levels, potentially increasing the risk of side effects.
- Other CYP2C9 inhibitors include Amiodarone and Sulfamethoxazole.
9. CYP2D6 Substrates
Celebrex may increase the blood levels of medications that are metabolized by the CYP2D6 enzyme, such as:
10. Alcohol
Drinking alcohol while taking Celebrex increases the risk of stomach ulcers and gastrointestinal bleeding.