Celebrex is a medication that belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs), specifically selective COX-2 inhibitors. It is a prescription medication used to treat the signs and symptoms of arthritis, acute pain (mild or moderate), and inflammation.¹
Celebrex inhibits the enzyme that produces prostaglandins, which cause pain in high concentrations. By lowering prostaglandin levels, inflammation and pain decrease.
Celebrex has US Food and Drug Administration (FDA) boxed warnings. Taking NSAIDs increases your risk of serious gastrointestinal problems, including bleeding, ulceration, and perforation. In some cases, gastrointestinal problems triggered by NSAID use occur without warning signs and can be fatal. The risk of serious outcomes is highest among older adults and people with a history of peptic ulcer disease or gastrointestinal bleeding.²
NSAIDs also increase the risk of severe (and potentially fatal) cardiovascular thrombotic events, including heart attack and stroke.
Finally, Celebrex is contraindicated in the setting of coronary artery bypass graft (CABG) surgery due to evidence of increased heart attack and stroke risk.
Celecoxib is the generic name of Celebrex. It is available in capsule form in 50mg, 100mg, 200mg, and 400mg strengths.
Celebrex is indicated for the treatment of:²
Juvenile rheumatoid arthritis in patients two years and older
Primary dysmenorrhea (menstrual cramps)
Off-label uses (uses for which FDA approval has not yet been granted) include:
Familial adenomatous polyposis³
Celebrex is taken orally. Usually, the lowest effective dose should be given for the shortest period possible. Typical dosage recommendations are as follows:²
For osteoarthritis: 100mg twice daily or 200mg once a day
For rheumatoid arthritis: 100–200mg twice daily
For ankylosing spondylitis: 200mg daily taken as one dose or divided (maximum 400mg per day)
For juvenile rheumatoid arthritis: Celebrex is only intended for children two and older, and the dose depends on their weight
For children 12–25kg, the recommended dose is 50mg twice daily
For children over 25kg, the dose can be as high as 100mg twice daily
For acute pain or menstrual cramps: 400mg once on the first day with an additional 200mg if needed, then 200mg twice the next day, if required
Your doctor will prescribe the lowest dose that effectively manages your condition. You can take Celebrex with or without food. However, doses higher than 400mg twice daily should be taken with food to enhance absorption.
People who struggle with swallowing pills can break open the capsules and mix the contents into a tablespoon of applesauce. The mixture should be consumed right away along with water.⁵
Celebrex significantly improves pain and inflammation in arthritis, but it doesn’t stop the disease from progressing. Celebrex has been shown to improve function in patients with osteoarthritis, but it only provides pain relief when used to treat rheumatoid arthritis.⁶ ⁷
Clinical studies assessing the effectiveness of Celebrex produced the following results:²
Patients with osteoarthritis saw significant reductions in pain within 24 to 48 hours when taking Celebrex during a flare
Patients with osteoarthritis, rheumatoid arthritis, juvenile arthritis, and ankylosing spondylosis saw benefits when assessed at predetermined points during the study period (12 weeks or 24 weeks after initiating treatment)
Patients with acute pain related to oral surgery, orthopedic surgery, and primary dysmenorrhea reported pain relief from a single dose of Celebrex within 60 minutes
It may take some time to see the results of Celebrex. Continue taking the medication as prescribed, even if it doesn’t seem to be helping with your symptoms. If you’ve been taking Celebrex for a couple of weeks and are concerned about a lack of apparent benefit, discuss your concerns with your doctor.
Celebrex is associated with side effects that range from common and mild to rare and fatal.²
Common side effects of Celebrex are typically mild and include
Elevated blood pressure³
Upper respiratory tract infections
Indigestion or gas
Nausea and vomiting
Back, body, and joint pain
As well as other gastrointestinal, nervous system, psychiatric, respiratory, and whole-body issues.
Less common side effects may be mild or severe and include the following:
Gastrointestinal issues, including constipation, difficulty swallowing, vomiting, and gastritis, esophagitis, or gastroesophageal reflux
Cardiovascular issues, including high blood pressure, cardiac chest pain, heart attack, and coronary artery disease
Infectious issues, including bacterial, viral, and fungal infections, as well as herpes simplex and zoster infections
Nervous system issues, such as loss of sensation, migraine, and nerve pain
Musculoskeletal effects, such as leg cramps, muscle aches, and joint pain
Reproductive concerns, including painful periods and other menstrual disorders, fibrocystic breasts, vaginitis, and prostate issues
Ear and hearing troubles, including ringing in the ears, earaches, and deafness
Heart rate and rhythm irregularities, such as fast heart rate and palpitations
Liver and biliary abnormalities, including abnormal function and increased liver enzymes
Skin-related problems, such as rash, hair loss, and increased sweating
Blood-related problems, including platelet irregularities and anemia
And various other metabolic, musculoskeletal, respiratory, skin, urinary tract, and eye health concerns.
Rare and severe adverse effects associated with Celebrex include the following:
Angioedema (allergic swelling of the face, throat, or tongue)
Anaphylaxis (whole-body allergic reaction)
Hepatitis or liver failure
Ulcers and bleeding (sometimes fatal) requiring hospitalization
Congestive heart failure
Intestinal obstruction or perforation
Ataxia (loss of balance)
Suicidal thoughts or behaviors
Acute kidney failure
And a range of other severe and life-threatening conditions related to the cardiovascular, gastrointestinal, hepatic, metabolic, nervous, and renal systems.
Seek emergency medical attention if you experience any of the following:
Signs of an allergic reaction: hives, a blistering or peeling rash, swelling of your face, tongue, or throat, difficulty breathing, fever, or burning eyes
Signs of a heart attack or stroke: chest pain spreading to your shoulder or jaw, shortness of breath, sudden numbness or weakness on one side of the body, difficulty speaking, or leg swelling
Signs of gastrointestinal bleeding or perforation: nausea, abdominal pain, vomit that contains blood or looks like coffee grounds, black or tarry stool, fast heart rate, fever, or low blood pressure
Celebrex is a commonly-prescribed drug, but it’s not suitable for everyone.²
People with any history of the following conditions should use Celebrex cautiously and only if their doctor decides the benefits outweigh the risks:
Heart attack or heart failure
Peptic ulcer disease or gastrointestinal bleeding
Blood platelet issues
Celebrex is contraindicated in people with the following conditions:
Hypersensitivity to celecoxib
Allergic reactions to sulfonamides
Asthma or allergic reactions after taking aspirin or other NSAIDs
Those undergoing CABG surgery
Additionally, people taking certain drugs should be aware of possible interactions with Celebrex. Drug interactions are detailed in the section Interactions with other drugs below.
Celecoxib oral capsules may be used for short- or long-term treatment, depending on the condition being treated. It can raise the risk of heart attacks and strokes for older people and those with heart conditions. Your doctor will advise you if you can safely use it long-term.
If you miss a dose, take it as soon as you remember. However, if it’s nearly time for your next dose, skip the missed one and resume your normal schedule. Don’t double your dose to make up for a missed one.
Before taking any over-the-counter medications for pain, fever, swelling, or cold and flu symptoms while on Celebrex, see your doctor or pharmacist to be sure it’s safe and learn the appropriate dose for you.
Aspirin, ibuprofen, and other anti-inflammatory drugs are similar to celecoxib and belong to the same family, so taking two or more of these medications together could result in an overdose. Overdose signs and symptoms may include any of the following:
Ringing in the ears
Severe stomach pain
A change in your urine volume
High blood pressure
Agitation and incoherence
Slow or shallow breathing
Loss of consciousness or coma
A Celebrex overdose is a medical emergency. If you suspect you (or someone in your care) have taken too much Celebrex, call the National Poison Control helpline and seek immediate emergency care.
Tell your doctor if you are allergic to celecoxib, aspirin, other NSAIDs (such as ibuprofen), other COX-2 inhibitors, or anything else (drugs or otherwise). This product might include inactive ingredients that could trigger an allergic reaction.
Tell your doctor or pharmacist about any medical conditions you have, including:
High blood pressure
Gastrointestinal bleeding or ulcer disease
If your child takes Celebrex for systemic-onset juvenile rheumatoid arthritis, they may be at an elevated risk of life-threatening bleeding or clotting problems. Speak with your doctor about steps you can take to minimize the risk and remain vigilant for signs of complications.²
Stop taking Celebrex if your doctor recommends it. Your doctor may instruct you to taper off the medication for a few days before stopping it entirely.
Stop using Celebrex and contact your doctor immediately if you have:
Any sign of a skin rash, even if it’s mild
A reaction affecting many parts of your body, including a widespread skin rash, swollen glands, fever, severe muscle aches or weakness, unusual bruising, or yellowing skin or eyes
Signs of internal bleeding, including tarry or bloody stools, vomit that looks like coffee grounds, or coughing up blood
Signs of heart problems, such as swelling, shortness of breath, or rapid weight gain
Signs of kidney dysfunction, including little to no urination, shortness of breath, fatigue, or swelling in your feet or ankles
Signs of liver problems, such as abdominal pain (upper right side), nausea, itching, dark urine, tiredness, or yellowing skin or eyes
Signs of anemia, including pale skin, cold hands and feet, unusual tiredness, lightheadedness, or shortness of breath
You must speak with your doctor before taking NSAIDs, including Celebrex, during pregnancy. The US FDA warns against taking NSAIDs from the 20th week of gestation.⁸
During the initial approval phase, Celebrex was designated a pregnancy category C drug up to 30 weeks gestation by the FDA. Category C means animal studies have shown harm to the fetus, but there have not been enough good-quality human studies to determine its risk in humans. Based on its pregnancy category, doctors would only recommend Celebrex during this stage of pregnancy if the benefits outweighed the potential risks.
The FDA subsequently designated Celebrex a category D drug from 30 weeks gestation and beyond. Category D means that studies in pregnant women at this stage have demonstrated risks to the fetus. Researchers concluded that taking NSAIDs during the third trimester increases the risk of a severe cardiovascular problem called premature closure of the fetal ductus arteriosus.² ³
The current guidance reflects an update provided by the FDA in 2020. Through a review of relevant literature and reports filed through the FDA Adverse Event Reporting System (FAERS) database, the organization identified cases of severely low amniotic fluid levels and kidney problems in the fetus when the mother had taken NSAIDs after 20 weeks.
Thus, the FDA advises against taking any form of NSAIDs, including Celebrex, from the 20th week of gestation in an effort to prevent these fetal adverse effects. Ask your doctor for guidance if you are pregnant or trying to conceive.
Celebrex is excreted in breast milk, but there is limited data on its implications for the baby. Speak with your doctor about the risk of adverse effects to you and your baby before taking Celebrex if you’re breastfeeding or planning to breastfeed.
A variety of drugs are known to interact with Celebrex. A drug interaction can have severe (sometimes fatal) consequences when one or both drugs involved act differently than intended.
Other NSAIDs (such as ibuprofen and naproxen) and salicylates (including aspirin) may interact with Celebrex. This interaction increases the risk of stomach and intestinal ulcers, perforation, and bleeding. Thus, it is important to avoid over-the-counter NSAIDs such as Aleve, Motrin, Advil, Bufferin, and Excedrin and instead, let your doctor know that you need another type of medicine for your pain.
You should avoid consuming alcohol while taking any NSAIDs, as this increases the risk of stomach ulcers, bleeding, and perforation, which could be fatal.
NSAIDs may diminish the effects of blood pressure-lowering medications, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and beta-blockers, as prostaglandins have a role in blood pressure regulation.
Those taking blood thinners (such as warfarin) and anti-platelet drugs (including aspirin) are at risk of severe bleeding events while also on Celebrex. Therefore, doctors will closely monitor them for signs of bleeding. Doctors may also recommend blood testing, especially in the first few days of starting the medication or with any dose changes.
Similarly, people taking drugs that influence serotonin reuptake may face a higher risk of bleeding and require monitoring.
NSAIDs may reduce the effectiveness of both loop (Lasix, Bumex) and thiazide (Zaroxolyn, Microzide, Diuril) diuretics. Doctors will monitor people taking these drugs alongside Celebrex for signs of worsening kidney function and diuretic inefficacy.
Celebrex increases digoxin (Lanoxin) levels in the blood and prolongs its half-life, meaning more of the drug stays in the body for longer, so a dosage adjustment may be required. The drugs may be used concurrently with routine monitoring of digoxin serum concentration.
Taking NSAIDs, including Celebrex, alongside methotrexate may increase the risk of methotrexate toxicity. Doctors will monitor methotrexate levels in patients taking both medications.
Kidney toxicity is among the known severe side effects associated with cyclosporine use. Taking Celebrex increases the risk, and patients taking both drugs must undergo routine monitoring for signs of deteriorating kidney function.
Celebrex raises the level of lithium in the blood, which could cause lithium toxicity in those taking lithium concurrently.
Taking Celebrex alongside pemetrexed (Alimta) increases the risk of severe side effects associated with pemetrexed, including bone marrow suppression and toxicity within the kidney and gastrointestinal systems.
Using Celebrex and corticosteroids concurrently may increase the risk of gastrointestinal ulcers and bleeding. Therefore, patients taking both drugs must remain vigilant in monitoring for signs of adverse reactions within the gastrointestinal system.
Medications that inhibit CYP2C9, including the antifungal fluconazole, may increase the risk of Celebrex toxicity. In contrast, medications that induce CYP2C9, such as rifampin, may impair Celebrex’s effectiveness.
Celebrex inhibits the enzyme CYP2D6 and may affect concentrations of drugs metabolized by the enzyme, including atomoxetine (Strattera).
Celebrex rarely causes a serious allergic reaction. But if you detect any signs of a severe allergic response, seek medical treatment immediately.
Signs of a drug allergy may include:
Swelling (particularly of the face, tongue, and throat)
Loss of consciousness
1998: The US FDA approves Celebrex for treating the symptoms of rheumatoid arthritis and osteoarthritis⁹
1999: The US FDA approves Celebrex for polyp reduction in familial adenomatous polyposis¹⁰
2006: The US FDA approves Celebrex for treating the symptoms of juvenile rheumatoid arthritis in patients two years and older¹¹
2012: The US FDA withdraws approval of Celebrex for polyp reduction in familial adenomatous polyposis because a postmarketing study on effectiveness required as part of the drug’s approval was not completed (the withdrawal was not linked to any new data indicating lack of effectiveness or safety)¹²
2014: The US FDA approves the first generic versions of celecoxib¹³
The following tips can help you stay safe while taking Celebrex:
Do not give Celebrex to a child unless a doctor has prescribed it.
Store Celebrex at room temperature and out of the reach of children.
Use UV-protective clothing and broad-spectrum SPF 30+ sunscreen if you have to be in the sun, as Celebrex may make your skin more sensitive to sun exposure.¹⁴
Monitor for signs of weight gain as unexplained weight increases may be linked to fluid retention, which might point to other health concerns.
Celecoxib | MedlinePlus
Celecoxib (Rx) | Medscape
Label: Celebrex- celecoxib capsule | NIH: DailyMed
FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid | U.S. Food & Drug Administration
FDA approves celecoxib celebrex | Johns Hopkins Arthritis Center
Celebrex is approved for polyp reduction in FAP patients | Cancer Network
Celebrex approved for juvenile rheumatoid arthritis | Patient Care Online
First generic versions of Pfizer's Celebrex approved by the FDA | Pharmaceutical Online
The sun and your medicine | U.S. Food & Drug Administration
Here at HealthMatch, we’ve done our best to ensure that the information provided in this article is helpful, up to date, and, most importantly, accurate.
However, we can’t replace the one-to-one advice of a qualified medical practitioner or outline all of the possible risks associated with this particular drug and your circumstances.
It is therefore important for you to note that the information contained in this article does not constitute professional medical or healthcare advice, diagnosis or recommendation of treatment and is not intended to, nor should be used to, replace professional medical advice. This article may not always be up to date and is not exhaustive of all of the risks and considerations relevant to this particular drug. In no circumstances should this article be relied upon without independent consideration and confirmation by a qualified medical practitioner.
Your doctor will be able to explain all possible uses, dosages, precautions, interactions with other drugs, and other potential adverse effects, and you should always talk to them about any kind of medication you are taking, thinking about taking or wanting to stop taking.
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