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- What is celecoxib, and how does it work (mechanism of action)?
- What are the uses for celecoxib?
- What are the side effects of celecoxib?
- What is the dosage for celecoxib?
- Which drugs or supplements interact with celecoxib?
- Is celecoxib safe to take if I'm pregnant or breastfeeding?
- What else should I know about celecoxib?
What is celecoxib, and how does it work (mechanism of action)?
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat arthritis, pain, menstrual cramps, and colonic polyps. Prostaglandins are chemicals that are important contributors to the inflammation of arthritis that causes pain, fever, swelling and tenderness. Celecoxib blocks the enzyme that makes prostaglandins (cyclooxygenase 2), resulting in lower concentrations of prostaglandins. As a consequence, inflammation and its accompanying pain, fever, swelling and tenderness are reduced. Celecoxib differs from other NSAIDs in that it causes less inflammation and ulceration of the stomach and intestine (at least with short-term use) and does not interfere with the clotting of blood.
NSAIDs have been found to prevent the formation and reduce the size of polyps in patients with the genetic disease, familial adenomatous polyposis (FAP). In FAP, patients develop large numbers of polyps in their colons, and the polyps invariably become malignant. The only cure of FAP is removal of the entire colon. Celecoxib is approved as an adjunctive (secondary) treatment among patients with FAP. The cramping and pain during menstrual periods is due to prostaglandins, and blocking the production of prostaglandins with celecoxib reduces the cramps and pain. The FDA approved celecoxib in December 1998.
What are the uses for celecoxib?
Celecoxib is used for the relief of pain, fever, swelling, and tenderness caused by osteoarthritis, juvenile arthritis, rheumatoid arthritis, and ankylosing spondylitis. Celecoxib does not prevent the progression of either type of arthritis. It reduces only the symptoms and signs of arthritis. Celecoxib is also approved for patients with familial FAP who have not had their colons removed. Celebrex also is also used for the relief of acute pain and the pain of menstrual cramps (primary dysmenorrhea).
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What are the side effects of celecoxib?
The most common adverse effects are:
Other side effects include:
- kidney failure,
- heart failure,
- aggravation of hypertension,
- chest pain,
- ringing in the ears,
- stomach and intestinal ulcers,
- blurred vision,
- weight gain,
- water retention,
- flu-like symptoms,
- drowsiness and
Celecoxib, like other NSAIDs may cause serious stomach and intestinal ulcers that may occur at any time during treatment. Celecoxib does not interfere with the function of the blood platelets and, as a result, does not reduce clotting and lead to increased bleeding time like other NSAIDs.
Allergic reactions can occur with celecoxib. Individuals who have developed allergic reactions (rash, itching, difficulty breathing) from sulfonamides (for example, sulfamethoxazole and trimethoprim [Bactrim]), aspirin or other NSAIDs may experience an allergic reaction to celecoxib and should not take celecoxib.
NSAIDs (except for low-dose aspirin) may increase the risk of heart attacks, stroke, and related conditions, which can be fatal. This risk may increase with duration of use and in patients who have underlying risk factors for heart and blood vessel conditions. NSAIDs should not be used for the treatment of pain resulting from coronary artery bypass graft (CABG) surgery.
NSAIDs cause an increased risk of serious, even fatal, stomach and intestinal adverse reactions such as bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these types of reactions.
What is the dosage for celecoxib?
The lowest effective dose should be used for each patient.
- For the management of osteoarthritis, the dose usually is 100 mg twice daily or 200 mg as a single dose.
- For rheumatoid arthritis, the dose usually is 200 mg twice daily.
- For acute pain or menstrual cramps, the dose is 400 mg as a single dose on the first day followed by an additional 200 mg if needed, then 200 mg twice daily as needed.
- For FAP, the recommended dose is 400 mg twice daily.
Which drugs or supplements interact with celecoxib?
Fluconazole (Diflucan) increases the concentration of celecoxib in the body by preventing the elimination of celecoxib in the liver. Therefore, treatment with celecoxib should be initiated at the lowest recommended doses in patients who are taking fluconazole.
Celecoxib increases the concentration of lithium (Eskalith, Lithobid) in the blood by 17% and may promote lithium toxicity. Therefore, lithium therapy should be closely monitored during and after therapy with celecoxib.
Persons taking the anticoagulant (blood thinner) warfarin (Coumadin) should have their blood tested when initiating or changing celecoxib treatment, particularly in the first few days, for any changes in the effects of the anticoagulant.
Persons who drink more than three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs, and this also may be true with celecoxib.
Is celecoxib safe to take if I'm pregnant or breastfeeding?
Celecoxib has not been studied in pregnant women. In animal studies, doses that were twice the maximally recommended dose were harmful to the fetus. It should not be used in late pregnancy because there is a risk of heart defects in the newborn. Celecoxib should only be used in pregnant women when the benefits outweigh the potential risk to the fetus.
What else should I know about celecoxib?
- Celecoxib is available as capsules: 50, 100, 200, and 400 mg. Capsules should be stored between 15 C and 30 C (59 F and 86 F).
- Celecoxib is available in generic form. You need a prescription to obtain this drug.
- The brand name for celecoxib available in the US is Celebrex.
Celecoxib (Celebrex - Discontinued Brand) is a NSAID (nonsteroidal antiinflammatory drug) that is used to treat pain, arthritis pain, menstrual cramps, and colonic polyps. Celebrex is also used relief of pain, fever, swelling, and tenderness caused by osteoarthritis, juvenile arthritis, rheumatoid arthritis, and ankylosing spondylitis. There are important drug interactions to review when taking Celebrex. Side effects should also be reviewed.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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Calcific BursitisCalcific bursitis is the calcification of the bursa caused by chronic inflammation of the bursa. Calcific bursitis most commonly occurs in the shoulder. Calcific bursitis treatment includes medication for inflammation, ice, immobilization, cortisone injections, and occasionally surgical removal of the inflamed bursa.
Elbow PainElbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Hip BursitisBursitis of the hip results when the fluid-filled sac (bursa) near the hip becomes inflamed due to localized soft tissue trauma or strain. Symptoms include stiffness and pain around the hip joint. If the hip bursa is not infected, hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications.
Juvenile ArthritisJuvenile idiopathic arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are six types of JIA. Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Knee BursitisBursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
Knee Pain FactsAcute injuries, medical conditions, and chronic use conditions are causes of knee pain. Symptoms and signs that accompany knee pain include redness, swelling, difficulty walking, and locking of the knee. To diagnose knee pain, a physician will perform a physical exam and also may order X-rays, arthrocentesis, blood tests, or a CT scan or MRI. Treatment of knee pain depends upon the cause of the pain.
Low Back PainThere are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
Nonsteroidal Anti-inflammatory Drugs and UlcersNonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
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