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Celebrex (celecoxib) is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat both chronic and acute pain while reducing swelling and inflammation caused by osteoarthritis (OA) and rheumatoid arthritis (RA). While Celebrex does not cure arthritis, this medication effectively alleviates the symptoms. 

Celebrex is in the same drug class as some other commonly known over-the-counter NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve); however, Celebrex is a more potent NSAIDs, requiring a prescription from a healthcare professional.  

Celebrex is generally well-tolerated by most people, when used exactly as instructed. However, like most medications, it can cause some unwanted adverse effects, some of which can be serious, requiring emergency medical care. In addition, Celebrex can interact with other drugs and cause health complications. Please continue reading to learn about the side effects and drug interactions of Celebrex.

What type of drug is Celebrex?

Celebrex is a brand name product for the generic medication celecoxib. It is a prescription pain medication. Celebrex belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Specifically, Celebrex is a  cyclooxygenase-2 (COX-2) selective NSAID, also referred to as COX-2 inhibitor. 

To understand how Celebrex (celecoxib) works, let's look at the enzymes that Celebrex targets.

Our body makes two cyclooxygenase (COX) enzymes, COX-1 and COX-2, which produce prostaglandins, chemicals responsible for pain, inflammation, and fever.

One key fact to remember is that COX-1 enzymes produce prostaglandins that play different roles in regulating essential body functions, such as platelet aggregation, to stop bleeding and protect the lining of the gastrointestinal tract.

On the other hand, COX-2 enzymes make prostaglandins that are primarily involved with inflammation.

Celebrex (celecoxib) is a COX-2 inhibitor because it mainly blocks the actions of COX-2 enzymes, with much less effect on COX-1. Therefore, Celebrex is also referred to as a "selective NSAID." By selectively targeting COX-2, Celebrex (celecoxib) doesn't affect your stomach lining and the blood clotting.

On the contrary, commonly known NSAIDs like ibuprofen (Motrin, Advil) and naproxen (Aleve) block both COX-1 and COX-2; therefore, they're classified as "non-selective NSAIDs." As a result, non-selective NSAIDs are effective at reducing pain and inflammation. Still, they come with gastrointestinal side effects such as stomach ulcers and stomach bleeding. 

What is Celebrex used to treat?

Celebrex (celecoxib) is used to treat symptoms caused by osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, and ankylosing spondylitis, such as joint pain, swelling, inflammation, and stiffness. It can also be used for menstrual pain. In addition, Celebrex can be used to treat pain caused by injuries, surgery, dental procedures, or medical conditions.

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Is Celebrex a strong painkiller?

Celebrex (celecoxib) is effective in treating mild to moderate pain. However, there are stronger painkillers, such as opioid (narcotic) painkillers, available to treat moderate to severe pain.

Is Celebrex stronger than ibuprofen?

Both Celebrex (celecoxib) and ibuprofen (Advil, Motrin) are nonsteroidal anti-inflammatory drugs. They are used to treat many of the same types of pain and are equally effective. However, as mentioned above, Celebrex may be better tolerated because it only blocks COX-2 enzymes. One study in people with knee osteoarthritis found that patient satisfaction scores were higher and side effects were fewer in the Celebrex group compared to the ibuprofen group.

Learn more: Is Osteoarthritis Genetic?

How to take Celebrex?

Celebrex (celecoxib) comes in the form of 50 milligrams (mg), 100 mg, 200 mg, and 400 mg capsules to take by mouth. The usual dose ranges between 200 mg and 400 mg per day, taken in divided doses. Doses of up to 200 mg can be taken with or without food. Doses higher than 200 mg should be taken with food.

Read the prescription label carefully and take Celebrex exactly as prescribed. Do not change the dose, dosage frequency, or treatment duration without talking to your healthcare provider.

If you miss a dose of Celebrex, take it as soon as you remember. But if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose or extra medicine to make up for a missed dose.

In case of an overdose of Celebrex, call your doctor or the National Poison Control Center at 1-800-222-1222 immediately. Call 911 if someone has collapsed, cannot breathe, is unresponsive, or has had a seizure.

What is the main side effect of Celebrex?

Common side effects of Celebrex (celecoxib) include dizziness, gas or bloating, constipation, cold symptoms, sore throat, and an unpleasant taste in the mouth. Tell your doctor if these adverse effects are severe or persist after a few days.

What are the serious side effects of Celebrex?

In a small number of people, Celebrex (celecoxib) can cause a more serious drug reaction. Call your doctor or seek medical treatment immediately if you develop the following warning symptoms:

• Shortness of breath or difficulty breathing

• Unexplained weight gain (rapid weight gain or sudden weight gain)

• Swelling of the abdomen, lower legs, ankles, or feet

• Stomach pain in the right upper part of the abdomen, nausea, diarrhea

• Loss of appetite

• Itching

• Yellowing of the skin or eyes

• Severe weakness, unusual tiredness, lack of energy

• Unusual bleeding or bruising

• Stomach pain, heartburn, vomiting that looks like coffee grounds, black tarry stools

• Muscle aches, fever, flu-like symptoms

• Severe skin reaction (skin pain, skin rash, hives, itching, blisters)

• Swelling of the face, eyes, lips, tongue, throat, or hands

• Hoarseness

• Difficulty swallowing

• Fast heartbeat

• Chest pain spreading to the shoulder

• Sudden numbness or weakness 

• Pale skin

• Back pain

• Discolored, cloudy, or bloody urine

• Pain with urination, difficulty with urination, little or no urination

• Frequent urination, especially at night

What medications should not be taken with Celebrex?

Certain medications can interact with Celebrex (celecoxib) and cause serious side effects or health complications. Your doctor may change your dose, switch you to another medication, or monitor you carefully for side effects if there are known interactions between Celebrex and your other medications. Celebrex can have drug-drug interactions with the following medicines:

• Blood pressure medications including:

  • Angiotensin-converting enzyme (ACE) inhibitors, for example, captopril, benazepril (Lotensin, in Lotrel), enalapril (Vasotec, Epaned, in Vaseretic), lisinopril (Qbrelis, in Zestoretic), fosinopril, moexipril (Univasc), quinapril (Accupril, in Quinaretic), perindopril (Aceon, in Prestalia), trandolapril (in Tarka), and ramipril (Altace).

  • Angiotensin receptor blockers (ARBs), for example, valsartan (Diovan, in Entresto, in Exforge HCT), losartan (Cozaar, in Hyzaar), candesartan (Atacand, in Atacand HCT), irbesartan (Avapro, in Avalide), eprosartan, telmisartan (Micardis, in Micardis HCT, in Twynsta), and olmesartan (Benicar, in Benicar HCT, in Azor, in Tribenzor).

  • Beta-blockers, for example, atenolol (Tenormin, in Tenoretic), propranolol (Inderal, Hemangeol, Innopran), metoprolol (Kapspargo Sprinkle, Toprol XL, Lopressor, in Dutoprol), labetalol (Trandate), and nadolol (Corgard, in Corzide)

• ADHD (attention-deficit/hyperactivity disorder) medications such as atomoxetine (Strattera)

• Immunosuppressants such as cyclosporine (Neoral, Gengraf, Sandimmune)

• Heart medications such as digoxin (Lanoxin)

• Diuretics or water pills

• Antifungal agents such as fluconazole (Diflucan)

• Psychiatric medications such as lithium (Lithobid)

• Methotrexate (Otrexup, Rasuvo, Reditrex, Trexall), a medication used to treat rheumatoid arthritis and psoriasis 

• Cancer drugs such as pemetrexed (Alimta, Pemfexy)

• Other NSAIDs, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn)

• Anticoagulants or blood thinners used to prevent blood clots, for example, warfarin (Coumadin, Jantoven)

• Oral steroids such as methylprednisolone (Medrol), dexamethasone, and prednisone (Rayos)

• Antidepressants including selective serotonin reuptake inhibitors (SSRIs), for example, citalopram (Celexa), fluvoxamine (Luvox), sertraline (Zoloft), fluoxetine (Prozac, Sarafem, in Symbyax), paroxetine (Paxil, Brisdelle, Pexeva), and serotonin-norepinephrine reuptake inhibitors (SNRIs), for example, duloxetine (Cymbalta), desvenlafaxine (Pristiq), and venlafaxine (Effexor XR)

What are the risks of taking Celebrex?

Severe allergic reaction

Serious skin reactions and anaphylaxis (allergic reaction causing throat closing, wheezing, and shortness of breath) caused by Celebrex are rare. However, you should seek emergency medical help immediately if these symptoms appear.

Cardiovascular thrombotic events

Nonsteroidal anti-inflammatory drugs (NSAIDs), including Celebrex, are associated with an increased risk of serious cardiovascular thrombotic events (stroke and myocardial infarction or heart attack). These potentially fatal events are more likely to occur after long-term Celebrex use, but they can also occur soon after starting treatment. 

People who are scheduled to undergo or have recently undergone a coronary artery bypass graft (CABG) (heart bypass surgery) should not take Celebrex. 

Gastrointestinal bleeding

Taking Celebrex and other NSAIDs is a risk factor for serious stomach bleeding, ulceration, and perforation in the gastrointestinal tract, which can be life-threatening. These complications can occur at any time during Celebrex use. Risk factors include a history of stomach ulcer and/or stomach bleeding, elderly patients, people who drink alcohol excessively, long-term use of Celebrex, and poor health status. You should avoid drinking alcohol while on Celebrex.

Disseminated Intravascular Coagulation (DIC)

Celebrex can be prescribed to children 2 years of age and older to treat juvenile rheumatoid arthritis. This medication can cause a serious blood clotting disorder called disseminated intravascular coagulation (DIC) in children. Tell your child’s doctor without delay if you notice any unusual bruising or bleeding.

Who should not take Celebrex?

Celebrex may not be safe for people with heart disease, heart failure, recent heart attack, stroke, high blood pressure, high cholesterol, diabetes, stomach ulcers, stomach bleeding, anemia (low red blood cells), asthma, frequent nasal congestion or runny nose, nasal polyps, swelling in the limbs, liver disease, kidney disease or kidney problems, and an allergy to sulfa drugs. 

If you are pregnant or breastfeeding, ask your doctor before taking Celebrex. This medicine can cause harm to an unborn baby, especially if it is taken after 20 weeks of pregnancy.

Why was Celebrex taken off the market?

Celebrex was not taken off the market. Other COX-2 inhibitors, such as rofecoxib (Vioxx) and valdecoxib (Bextra) were taken off the market due to concerns about the increased risk of serious cardiovascular thrombotic events such as heart attack or stroke. It is worth noting that all NSAIDs increase the risk of heart attack or stroke. 

A post-market study conducted by Pfizer called PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen or Naproxen) compared Celebrex (celecoxib) to other NSAIDs like naproxen and ibuprofen. The study included 24,000 patients with arthritis and either established cardiovascular disease or risk factors for it. Cardiovascular side effects were the lowest with celecoxib (2.3%) compared to naproxen (2.5%) and ibuprofen (2.7%). However, critics say there were many problems with the PRECISION study. 

Nonetheless, the U.S. Food and Drug Administration (FDA) allowed Celebrex (celecoxib) to remain on the market, making it the only COX-2 inhibitor or selective NSAIDs available in the U.S. However, the wording on the label was changed to indicate that it is linked to an increased risk of heart attack and stroke.