Celebrex (celecoxib) belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by reducing hormones that cause inflammation and pain in the body.
Celebrex is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain. It is also used in the treatment of hereditary polyps in the colon.
Celebrex may also be used for purposes not listed in this medication guide.
Celecoxib is licensed for use in osteoarthritis, rheumatoid arthritis, acute pain, painful menstruation and menstrual symptoms, ankylosing spondylitis and to reduce the number of colon and rectal polyps in patients with familial adenomatous polyposis. It was originally intended to relieve pain while minimizing the gastrointestinal adverse effects usually seen with conventional NSAIDs. In practice, its primary indication is in patients who need regular and long term pain relief: there is probably no advantage to using celecoxib for short term or acute pain relief over conventional NSAIDs, except in the situation where non-selective NSAIDs or aspirin cause cutaneous reactions (urticaria or “hives”).
Pregnancy: You must not use Celebrex (Celecoxib) during pregnancy or if you are trying to become pregnant due to possible harm to the unborn baby and interference with normal labor/delivery.
Breast-feeding: Tell your doctor before using Celebrex (Celecoxib) if you are breast-feeding. It is not known whether using Celebrex (Celecoxib) during breastfeeding is dangerous. Limited data show celecoxib is excreted into human milk in small amounts. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Celebrex may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use Celebrex just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.
Celebrex may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Celebrex, especially in older adults.
Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.
Avoid drinking alcohol while taking Celebrex. It may increase your risk of stomach bleeding. Ask a doctor or pharmacist before using any other cold, allergy, or pain medicine. Medicines similar to celecoxib are contained in many combination medicines. Check the label to see if a medicine contains an NSAID (non-steroidal anti-inflammatory drug) such as aspirin, ibuprofen, ketoprofen, or naproxen.
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects (see below) and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
abdominal pain
diarrhea
dizziness
drowsiness
gas
headache
heartburn
increased sensitivity to sunlight
nausea
ringing in the ears
runny nose
sinus pain
skin rash
sore throat
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
fast heartbeat
fatigue
hearing changes
increased blood pressure
signs of bleeding (e.g., unusual bruising or bleeding, bloody nose, blood in urine, coughing blood, cuts that won't stop bleeding)
signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
swelling of the legs or feet
symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
Stop taking the medication and seek immediate medical attention if any of the following occur:
bladder symptoms such as bladder pain, difficulty or pain passing urine, urinary frequency, or blood in the urine
blurred vision or other vision changes
signs of a heart attack (e.g., pain or discomfort in the chest, neck, jaw, back, or stomach; shortness of breath; sweating; nausea; or lightheadedness)
symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; or swelling of the lips, throat, or tongue)
symptoms of a severe skin reaction (e.g., high fever; rash, sores, or painful blisters on the skin, mouth, or eyes; or skin peeling off)
symptoms of a stroke (e.g., sudden confusion, trouble speaking, or understanding speech; sudden weakness or numbness, especially in one side of the body; sudden vision problems in one or both eyes; sudden loss of balance or coordination; or sudden severe headache without a known cause)
symptoms of bleeding in the stomach or intestines (e.g., dark and tarry stools, blood coming from rectum, vomiting blood or material that looks like coffee grounds, fast heartbeat, weakness or fainting)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Avoid drinking alcohol. It may increase your risk of stomach bleeding.
Avoid taking Celebrex together with other NSAIDs such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn, Naprelan, Treximet), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), or piroxicam (Feldene).
Ask a doctor or pharmacist before using any other cold, allergy, or pain medicine. Medicines similar to celecoxib are contained in many combination medicines. Taking certain products together can cause you to get too much of a certain type of drug. Check the label to see if a medicine contains an NSAID (non-steroidal anti-inflammatory drug) such as aspirin, ibuprofen, ketoprofen, or naproxen.
Avoid exposure to sunlight or tanning beds. Celebrex can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergy: Some people who are allergic to sulfonamide medications such as certain antibiotics also experience allergic reactions to celecoxib. Before you take celecoxib, inform your doctor about any previous adverse reactions you have had to medications, especially sulfonamides and anti-inflammatories. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.
Anemia: Celecoxib may cause or worsen anemia. People with anemia should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Drowsiness/reduced alertness: Celecoxib may cause drowsiness or dizziness. Avoid driving, operating machinery, or engaging in other activities that require alertness and coordination if you find that celecoxib affects you in this way.
Fluid retention: Celecoxib may cause fluid retention and swelling, possibly worsening high blood pressure, congestive heart failure, or decreased heart function. People with these conditions should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you develop shortness of breath; fatigue; excessive weight gain; chest pain; or swelling of the legs, feet, or ankles while taking this medication, consult your doctor immediately.
Heart attack and stroke: The use of selective COX-2 inhibitor NSAIDs, including celecoxib, is associated with an increased risk of cardiovascular events such as heart attack and stroke, similar to the risk associated with most traditional NSAIDs (e.g., ibuprofen, diclofenac, naproxen). The risk is increased with higher total daily doses and when taking the medication over long periods of time. Due to this increased risk, people with the following conditions or risk factors should be closely monitored by their doctor if they use celecoxib:
congestive heart failure
diabetes
heart attack
heart disease
high blood pressure
high cholesterol
impaired kidney function
poor circulation
smoking
stroke
Kidney disease: Like other NSAIDs, celecoxib is not recommended for people with advanced kidney disease. People with kidney disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver disease: Celecoxib may worsen liver disease. People with liver disease or severely impaired liver function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Potassium levels: Celecoxib may increase the risk of high potassium levels in the blood - especially for seniors, people who have conditions such as diabetes or kidney failure, or those taking certain other types of medications. Your doctor may order blood tests periodically during long-term treatment to monitor the amount of potassium in your blood. People who have been diagnosed with having high potassium levels in their blood should not take this medication.
Stomach problems: Celecoxib may cause stomach problems such as ulcers or bleeding. People with stomach problems should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Call your doctor immediately if you notice signs such as stomach or abdominal pain, black tarry stools, or vomiting blood. Using acetylsalicylic acid (ASA) at the same time as celecoxib increases the risk of stomach ulcers and bleeding.
Children: The safety and effectiveness of using this medication have not been established for children and adolescents under 18 years old.
There may be an interaction between celecoxib and any of the following:
ACE inhibitors (e.g., enalapril, ramipril)
acetylsalicylic acid (ASA) and other salicylate medications
alcohol
aluminum- and magnesium-containing antacids
angiotensin II antagonists (e.g., losartan, irbesartan)
cholestyramine
colestipol
clopidogrel
cyclosporine
digoxin
feverfew
fluconazole
fluouracil
furosemide
garlic
ginger
glucocorticoids (e.g., dexamethasone, hydrocortisone, prednisone)
green tea
ketoconazole
lithium
methotrexate
other NSAID medications (e.g., ibuprofen, ketorolac, naproxen)
selective serotonin reuptake inhibitors (SSRIs, e.g., citalopram, fluoxetine, paroxetine, sertraline)
sulfisoxazole
tacrolimus
thiazide diuretics (e.g., hydrochlorothiazide)
thioridazine
ticlopidine
tolbutamine
warfarin
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, etc., can affect the action of many medications, you should let your prescriber know if you use them.
This medication is a nonsteroidal anti-inflammatory drug (NSAID), specifically a COX-2 inhibitor, which relieves pain and swelling (inflammation). It is used to treat arthritis, acute pain, and menstrual pain and discomfort. The pain and swelling relief provided by this medication helps you perform more of your normal daily activities. This drug works by blocking the enzyme in your body that makes prostaglandins. Decreasing prostaglandins helps to reduce pain and swelling.
In comparison to the older NSAIDs, Celebrex relieves arthritis pain and inflammation for a longer period of time – up to 24 hours after taking 200 mg dose.
CELEBREX can be taken with or without food, so you don't have to plan your day around it.
Clinical studies proved a lower percentage of gastrointestinal adverse reactions (indigestion, abdominal pain, nausea, etc.) due to the treatment with Celebrex than with the other painkillers. The reason for that is that Celebrex is a selective NSAID inhibiting only COX-2 enzyme and not interfering with the work of COX-1, which protects stomach lining.
Celebrex does not thin blood; therefore, it can sometimes be used with low-dose aspirin, unlike the other prescription NSAIDs.
Even low doses of Celebrex relieve pain effectively and quickly in many people.
In clinical studies with OA patients, CELEBREX is proven to improve daily physical function, so moving is easier. In fact, CELEBREX improves pain, stiffness, and physical function.
In clinical studies, for patients with RA, CELEBREX demonstrated significant reduction in joint tenderness/pain and joint swelling.
In clinical studies with patients experiencing acute pain, single doses of CELEBREX provided relief within 60 minutes.
CELEBREX doesn't interfere with aspirin. If you're taking low-dose aspirin for your heart and need an NSAID pain reliever, CELEBREX can be used because it doesn't interfere with aspirin's antiplatelet effect. However, taking low-dose aspirin may not reduce the cardiovascular risk associated with NSAID use. With any NSAID, including CELEBREX, patients also taking aspirin are at an increased risk for stomach bleeding and ulcers. CELEBREX is not a substitute for aspirin in preventing heart attack or stroke.
ScienceDaily (May 15, 2008) — Celecoxib, the anti-inflammatory medication also known by the trade name Celebrex, has proven to be safe and reduces a specific proliferation measurement of precancerous lesions in the lung, according to a study from The University of Texas M. D. Anderson Cancer Center. This finding demonstrates the significance of COX-2 inhibition toward preventing lung cancer in individuals at higher risk of developing the disease.
The study is the first large randomized trial of Celebrex in lung cancer prevention; the findings will be presented at the American Society for Clinical Oncology's (ASCO) upcoming annual meeting as an oral presentation.
“With this study, in principal, we've been able to demonstrate the importance of COX-2 and the implications on inflammation pathway in lung cancer development,” said Edward Kim, M.D., assistant professor in M. D. Anderson's Department of Thoracic Head and Neck Medical Oncology. “We've also been able to demonstrate that this drug class is safe and tolerable for this patient population. As we move forward in lung cancer chemoprevention, the importance of this class of drugs cannot be ignored.”
From November 2001 to September 2006, the M. D. Anderson study enrolled 212 individuals, all of whom were current or former smokers with at least a 20-pack-year smoking habit. Most participants did not have any history of cancer; however, patients with a history of cancer who had been disease-free for six months could participate. The median age of participants was 53. The study examined levels of KI-67, a biomarker associated with precancerous lung lesions.
Participants underwent a baseline broncoscopy in which six predetermined biopsies were performed. They then were randomized to receive Celebrex at either 200 milligrams (low dose) or 400 milligrams (high dose) twice a day or placebo. After three months, participants received a second broncoscopy, the primary endpoint of the trial. Patients had the option to continue on the trial for three more months per their prior randomized arm; for those participants, a third and final broncoscopy was conducted at six months.
“In patients who had high risk features such as smoking, especially in the current smokers, we were able to see that a higher dose of Celebrex could decrease the proliferation marker KI-67 in these patients, as seen through their bronchial epithelium,” said Kim. “We are encouraged that we have a drug like Celebrex that decreases the expression of this proliferation marker.”
These findings are also significant in that the study shows that serial broncoscopies are feasible, explained Kim. “Although CT scanning and other imaging techniques are important, for lung cancer, it may be vital to examine actual tissue to see what the markers are doing in the actual epithelium of the lung so as to best understand if an individual has a higher or lower risk of developing lung cancer.”
Celebrex is in a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin or ibuprofen, which work by blocking chemical enzymes that cause inflammation. The COX-2 enzyme inside cancer cells is thought to control the synthesis of prostaglandins, which are substances believed to trigger cancer cell growth. Researchers believe that prostaglandins promote the growth of new blood vessels to feed tumors, and also protect new cancers from destruction by the body's immune system. Blocking the COX-2 enzyme may reduce the amount of prostaglandin available to cancer cells and thus repress tumor growth, says Kim.
In December 2004, M. D. Anderson voluntarily suspended the trial at the request of Pfizer and the National Cancer Institute, the funding source for the study, until further data on the drug's risk for cardiac toxicities, specifically heart attacks and strokes, could be investigated. Months later, advisors to the FDA recommended that Celebrex continue to be studied in the treatment and prevention of cancer, and the NCI supported the continuation of the trials, encouraging investigators to weigh the risks and benefits of the drug for their specific clinical setting.
After adding stringent guidelines to further reduce the cardiac risk to patients, the M. D. Anderson investigators then reapplied to the institution's Institutional Review Board to reactivate the trial. The study reopened in May 2005.
Kim noted that there were no adverse cardiac events in the M. D. Anderson trial. Three patients experienced grade three toxicities on the higher dose of the drug which were not cardiac related.
Lung cancer is the leading cause of cancer death in the United States, according to the American Cancer Society. In 2008, approximately 215,000 people will be diagnosed with lung cancer and approximately 114,000 people will die from the disease.
M. D. Anderson has been a leader in chemoprevention since the early 1990s, when Hong (Waun Ki Hong, M.D., head of the Division of Cancer Medicine) was the first to demonstrate that retinoids can reverse oral leukoplakia, a premalignant condition that often leads to cancer, and that 13-cis retinoic acid can prevent secondary primary tumors among patients with head and neck cancers.
“Lung cancer remains a lethal and stubborn disease with tobacco as the leading culprit for this killer,” said Hong. “The Celebrex findings are exciting for the entire field of lung cancer chemoprevention.”
Celebrex is part of a class of nonsteroidal anti-inflammatory drugs ( NSAIDs) called COX-2 inhibitors. It works by blocking a particular enzyme (COX-2) that plays a role in pain and inflammation. Unlike other NSAIDs (such as ibuprofen and naproxen) that target both the COX-1 and the COX-2 enzymes, Celebrex only targets the COX-2 enzyme. The COX-1 enzyme plays an important role in protecting the lining of the stomach.
Celebrex® (celecoxib) is a prescription medication that has been licensed to treat several conditions related to pain and inflammation. These approved uses for Celebrex include:
Acute pain relief, such as for pain following a procedure or straining a muscle.
Treatment of arthritis symptoms, including pain, stiffness, and swelling. Celebrex can be used to treat several different types of arthritis, such as osteoarthritis, rheumatoid arthritis (including juvenile rheumatoid arthritis), and ankylosing spondylitis. The medication is not an arthritis cure, however.
Treatment of painful menstrual periods.
Celebrex was previously approved to decrease the number of colon and rectal polyps in people with familial adenomatous polyposis (FAP), a hereditary condition that can cause hundreds of growths (called polyps) in the colon and rectum. People with FAP usually develop colon cancer and/or rectal cancer by their late 30s. However, Celebrex is no longer approved for this use.
Celebrex is approved for the treatment of juvenile rheumatoid arthritis in children as young as two years old. It is not approved for other uses in children. Talk to your child's healthcare provider about the benefits and risks of using Celebrex in children.
On occasion, your healthcare provider may recommend Celebrex for something other than the conditions listed in this article. This is called an “off-label” use. For example, research scientists are currently exploring the use of Celebrex for the treatment of certain types of cancer, including melanoma and lung cancer.
Review by jenjen22: User Rating: 9.0
Celebrex (celecoxib) for Pain: After my two total hip replacements I still have chronic pain due to having avascular necrosis. I rely on Celebrex to literally allow me to be able to walk. I received some samples in 2006 following my second surgery. My doctor at that time had enough samples so that I was taking them on a regular basis. Only after a short period without them did we realize to what extent they were helping me. I sincerely believe that I could not live a normal life without the Celebrex. It scares me to think that one day I may not be able to get it due to not being able to afford it. ... I tell anyone I can what Celebrex has done for me, with absolutely no side effects.
Review by 32yrold woman: User Rating: 9.0
Celebrex (celecoxib) for Rheumatoid Arthritis: About a year ago I started having symptoms of RA (seronegative). I started on prednisone 20mg which helped somewhat but I was having flare ups in the ankles and hands. Finally got switched to Celebrex because the pain and swelling were not going away. 200mg daily - all I can say is it's been like night and day since I started taking it - less pain, less swelling, better days!
Review by ktl682: User Rating: 7.0
Celebrex (celecoxib) for Rheumatoid Arthritis: I've been taking it for 2 months, 200 mg daily. The first 2 weeks were great, all pain was gone. The pain gradually came back and I had so many flare ups even when I was taking it. My doctor just gave me Prednisone 20 mg daily to combine with Celebrex. I started yesterday and most of the pain has gone, however, my doctor advised not to take Prednisone for more than one week in order to prevent having the serious side effects, such as bone problems.
Review by Krisite: User Rating: 9.0
Celebrex (celecoxib) for Pain: I have been taking Celebrex now for a little over 30 days. I am 30 years old and have suffered from chronic arthritis pain for over 10 years. I have had two ankle surgeries leaving me with what feels like no relief. My last surgery was over 2 years ago and did provide SOME relief but not completely. ... I went from 2-3 days a week of pain and discomfort to virtually none.
Review by Deltenney: User Rating: 9.0
Celebrex (celecoxib) for Osteoarthritis: I have flare-ups of arthritis in my knees. I am an 80 year old female. I take Celebrex only as needed, at about 3 month intervals. When I have a problem walking, I take Celebrex 1 table a day for three days - it is like a miracle drug. It does away with the knee pain and I am back to walking as I need to. I have had NO side effects so far. I think it is a [very good] drug. Not everyone has had the same good fortune but this works for me and I keep it on hand for this limited use.
Review by smoore002: User Rating: 9.0
Celebrex (celecoxib) for Rheumatoid Arthritis: I have had chronic pain and tried many medicines including narcotics to help. Celebrex has helped me so much. I am able to do so many things that I couldn't before. My doctor has me taking it with Tylenol w/Codeine #3 and Carisoprodol.
Review by Callianne: User Rating: 1.0
Celebrex (celecoxib) for Osteoarthritis: ... I need both knees replaced for osteoarthritis, and I also have pain in my back, neck, elbows, hips and wrists. I've been on Celebrex for 6 or 7 years. When I first used it, it used to make me very dizzy. But it NEVER ever relieved any pain for me! I always had to pop multiple Tylenol, Motrin or Advil to supplement, in order to get even minimum relief. My doctor put me on Arthrotec today, and I am really hoping for success. If that doesn't work, he's going to try me on Tylenol-3 (codeine-based).
Review by Anonymous: User Rating: 8.0
Celebrex (celecoxib) for Pain: On 400 mg a day and it works great in regards to my synovitis pain in all my joints that my lupus causes. No side effects after taking it for two months. I prefer taking this over prednisone any day.
Review by Anonymous: User Rating: 8.0
Celebrex (celecoxib) for Pain: I've had two bad knee surgeries and was left option-less by my orthopedist so I left and went to a pain doctor. I was prescribed Celebrex after trying nearly all the other NSAIDs and have taken it for 6 months. I'm not painless, but it has worked [very good] from where I was, and I know when I've forgotten to take it.
Review by Anonymous: User Rating: 9.0
Celebrex (celecoxib) for Osteoarthritis: I need a new knee and get Synvisc shots every 6 months. Not so much pain, but often uncomfortable and the knee is very useless after about 4 months. Found Celebrex and took it. As package said, it took a couple of weeks to do much, but then woke up pain free one morning. Amazing. I have a very stressful job though and seem to have developed a heart condition. Did Celebrex contribute? I do not know, but have discontinued its use.
Review by ...J: User Rating: 10
Celebrex (celecoxib) for Osteoarthritis: I have severe osteoarthritis of the right knee and was facing a certain total knee replacement. As a "last resort" for pain relief, I tried Celebrex 200 mg. For about two months, there was no impact on pain or improved knee function. Then (...), the constant pain went away and my knee function returned to just about normal. I now have the ability to exercise and move like the whole thing never happened! I'm certainly glad I stuck with the medication, as it's been "almost a miracle". Now, I have to decide whether to proceed with knee replacement, or will Celebrex buy me a few more years.
Review by Doug in Thailand: User Rating: 10
Celebrex (celecoxib): I take Celebrex for tendinitis (in my elbows and ankles). Pain and swelling stopped within one day of taking 400mg, and I have been free of pain for several months. I now take a 200 mg capsule only when needed (and that isn't often).