Celebrex (Celecoxib) is a medication used to treat different types of pain and arthritis. Celebrex belongs to a class of drugs known as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Celebrex blocks an enzyme in the body that is involved with inflammation and pain called cyclooxygenase-2 (COX-2).
NSAIDs are very helpful in relieving joint pain and swelling associated with the most common type of arthritis: osteoarthritis. They are widely used to treat other types of arthritis as well.
Celebrex is available in 100 mg and 200 mg oral capsules that are taken either once or twice a day. A doctor will recommend the right dose.
Celebrex can start to work quickly, often after the first dose. In other people and other conditions it can take a little longer. If there is no improvement from Celebrex after 2-3 weeks then it is not likely to work.
Important Tests and Risks
Celebrex shouldn’t be taken at the same time as other NSAIDs such as ibuprofen (Advil), naproxen, and many others. This can increase the risk of stomach problems.
Patients should consult with a doctor before taking Celebrex with a blood thinner like warfarin (Coumadin).
If someone is allergic to aspirin (ASA) or any NSAID, then they are also likely to be allergic to Celebrex. Patients with these allergies shouldn’t take Celebrex.
How Celebrex Works
Celebrex blocks an enzyme in the body that is involved with inflammation and pain called cyclooxygenase-2 (COX-2).
Celebrex belongs to a family of medicines called COX-2 inhibitors that all block the COX-2 enzyme. Celebrex also belongs to broader class of drugs known as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) because it is not a steroid (non-steroidal) and it reduces inflammation (anti-inflammatory).
Why Block COX-2?
COX-2 converts arachidonic acid (AA) in the body to a prostaglandin called prostaglandin endoperoxide H2. Some of the prostaglandin made by COX-2 can in turn become prostacyclin.
Prostacyclin is a powerful vasodilator (a substance that opens (dilates) blood vessels) that also influences blood platelets and clotting. Prostacyclin plays a direct role in inflammation (pain and swelling).
By blocking COX-2, Celebrex disrupts the body’s process of producing prostaglandin/prostacyclin. Lowering the quantity of these substances in the body will reduce inflammation.
Risks of blocking COX-2
Some prostaglandins have other functions in the body that are not directly related to inflammation. COX-2 inhibitors can block the production of those as well. Also, for some situations outside of arthritis, the body’s inflammatory response can be beneficial. These and other factors can sometimes lead to side effects.
Though most COX-2 inhibitors including Celebrex are considered safe and effective at reducing inflammation, they can also increase the risk of side-effects that impact the gastrointestinal (stomach and digestive) and cardiovascular (heart) systems. Doctors will help patients consider the benefits and risks, and decide if COX-2 inhibitors are a good treatment for them.
Side Effects of Celebrex
It is important for people taking Celebrex to make sure their doctor knows about any heart, high blood pressure, kidney, stomach, esophagus, or intestinal problems so that the doctor can properly assess the risks and benefits of prescribing this medication and can follow their patients accordingly.
The risk of serious side effects to patients taking Celebrex is relatively low, especially in patients that do not also have other risk factors. Though incidents are rare, Celebrex can increase the risk of fatal heart attack or stroke. It can also increase the risk of stomach or intestinal bleeding and other gastrointestinal issues.
We have put together a special guide to help patients learn more about the relative risks of taking NSAIDs like Celebrex compared to common lifestyle risk factors like smoking: NSAIDs & Osteoarthritis: Putting Risks Into Perspective.
Possible side-effects of Celebrex include:
- Kidney – Patients with kidney problems should be careful when taking Celebrex
- Blood pressure – Celebrex can cause an increase in blood pressure. Doctors will monitor this. Patients should tell their doctor if they have high blood pressure.
- Leg swelling – Celebrex can cause swelling of the legs. It can also worsen a condition called congestive heart failure (CHF). Patients should tell their doctor if they have CHF or if they develop leg swelling.
- Heart attack & stroke – Patients who have had a recent heart attack or stroke or experienced serious chest pain from heart disease should not take Celebrex.
- Headache – Celebrex can rarely cause a headache or dizziness.
- Skin rash – Celebrex can rarely cause an allergic rash. Stop the medicine and let your doctor know if you develop a rash, hives, or blisters.
- Pregnancy & breastfeeding – Celebrex has not been studied in pregnancy. Let your doctor know if you are planning to get pregnant or if you are breastfeeding.
Patients should talk to their doctor if they are concerned about any side effects. It is safe to simply stop taking Celebrex; patients do not need to wean off the medication. Patients should always advise their doctor any time they stop taking a medication or change the dosage on their own.
Who Should NOT Take Celebrex
Patients who should NOT be taking Celebrex include:
- Patients with serious heart or other cardiovascular problems
- Patients with certain stomach or intestinal (gastrointestinal) problems
- Patients who have had a recent heart attack or stroke or experienced serious chest pain from heart disease
- Anyone with allergies to Celebrex, aspirin, any other NSAIDs (such as ibuprofen), or any other COX-2 inhibitors should tell their doctor because Celebrex may not be right for them.
Anyone who becomes pregnant while taking Celebrex should notify their doctor immediately.
When to Call a Doctor
Patients should call their doctor if they feel sick and want to stop, or they you are concerned about any side effects.
Other reasons to call a doctor while taking Celebrex include:
- Severe leg swelling
- Shortness of breath or chest pain
- Allergic reaction
- Stomach pain, nausea, vomiting, black or bloody stools
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Celebrex.