Celebrex (celecoxib) is a prescription nonsteroidal anti-inflammatory drug (NSAID) specifically formulated as a selective cyclooxygenase-2 (COX-2) inhibitor. It is indicated for the management of osteoarthritis (OA), rheumatoid arthritis (RA), ankylosing spondylitis, and acute pain in adults. Unlike traditional NSAIDs, which non-selectively inhibit both COX-1 and COX-2 enzymes, Celebrex provides anti-inflammatory and analgesic effects while offering a potentially improved gastrointestinal tolerability profile. It is available in capsule form and should be used at the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Features

• Active ingredient: Celecoxib
• Drug class: Selective COX-2 inhibitor NSAID
• Available in 50 mg, 100 mg, 200 mg, and 400 mg capsules
• Prescription-only medication
• Once-daily or twice-daily dosing depending on indication
• Not available in generic form in some markets

Benefits

• Provides effective relief from pain and inflammation associated with chronic arthritic conditions
• Reduces joint stiffness and improves physical function, enhancing quality of life
• Selective COX-2 inhibition may result in fewer gastrointestinal side effects compared to non-selective NSAIDs
• Flexible dosing allows for tailored treatment regimens based on specific indications and patient needs
• Demonstrated efficacy in managing acute pain and primary dysmenorrhea
• Long-term management option for chronic inflammatory conditions when appropriate

Common use

Celebrex is commonly prescribed for the management of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It is also used for the treatment of acute pain in adults, including that associated with musculoskeletal injuries, and for the management of primary dysmenorrhea. The medication works by reducing substances in the body that cause pain and inflammation, making it particularly effective for conditions characterized by chronic inflammation and pain.

Dosage and direction

For osteoarthritis: 200 mg per day administered as a single dose or as 100 mg twice daily.

For rheumatoid arthritis: 100 mg to 200 mg twice daily.

For ankylosing spondylitis: 200 mg once daily or 100 mg twice daily. If no effect is observed after 6 weeks, a trial of 400 mg daily (either as 200 mg twice daily or 400 mg once daily) may be considered.

For acute pain and primary dysmenorrhea: 400 mg initially, followed by an additional 200 mg dose if needed on the first day. On subsequent days, the recommended dose is 200 mg twice daily as needed.

Should be taken with a full glass of water, with or without food. For patients who experience esophageal irritation, administration with food or milk is recommended.

Precautions

Patients should be monitored for signs and symptoms of gastrointestinal ulceration and bleeding. Cardiovascular risk should be assessed before initiating treatment and periodically during therapy. Celebrex may lead to new hypertension or worsening of pre-existing hypertension. Use with caution in patients with fluid retention, heart failure, or renal impairment. Periodic monitoring of hemoglobin and hematocrit is recommended in patients on long-term therapy. Serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, have been reported with NSAID use.

Contraindications

Known hypersensitivity to celecoxib or any components of the formulation. History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Should not be used in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs.

Possible side effect

Common: Dyspepsia (8.8%), diarrhea (5.6%), nausea (4.5%), abdominal pain (4.2%), headache (3.5%), sinusitis (2.9%), upper respiratory tract infection (2.2%), rash (2.2%).

Serious: Gastrointestinal bleeding, ulceration, and perforation; myocardial infarction; stroke; heart failure; hypertension; renal impairment and kidney failure; hepatotoxicity; anaphylactic reactions; serious skin reactions; hematological toxicity (anemia, leukopenia, thrombocytopenia).

Drug interaction

Increased risk of gastrointestinal bleeding with warfarin (monitor INR closely). Concomitant use with aspirin may increase GI toxicity. Celebrex may decrease the antihypertensive effect of ACE inhibitors, angiotensin II receptor antagonists, and beta-blockers. Diuretics may enhance the risk of renal impairment. Concomitant use with other NSAIDs should be avoided. May increase lithium plasma levels (monitor lithium levels). CYP2C9 inhibitors (fluconazole) may increase celecoxib concentrations.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next dose, the missed dose should be skipped and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended.

Overdose

Symptoms may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, hypertension, acute renal failure, respiratory depression, coma, and anaphylactoid reactions. There is no specific antidote for celecoxib overdose. Management should be supportive and symptomatic. Gastric lavage and administration of activated charcoal may be considered if presented soon after ingestion. Hemodialysis is not effective due to high protein binding.

Storage

Store at room temperature between 15°C to 30°C (59°F to 86°F). Keep in the original container, tightly closed, and protect from moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Celebrex is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Patients should consult their physician for proper diagnosis and treatment recommendations. Individual results may vary, and not all patients will experience the same benefits or side effects. The safety and efficacy of Celebrex in pediatric patients have not been established.

Reviews

“After struggling with osteoarthritis pain for years, Celebrex has significantly improved my mobility and reduced my discomfort. I appreciate that I can take it once daily, and I’ve experienced minimal gastrointestinal side effects compared to previous NSAIDs I’ve tried.” - Margaret T., 68

“As a rheumatologist, I find Celebrex to be a valuable option for patients who require NSAID therapy but are concerned about gastrointestinal side effects. The COX-2 selectivity provides an important therapeutic advantage for appropriate patients, though cardiovascular risk assessment remains crucial.” - Dr. Evans, Rheumatology

“I was prescribed Celebrex for rheumatoid arthritis flare-ups. While it effectively manages my inflammation, I did experience some mild edema that required dosage adjustment. Regular monitoring with my physician has been essential for optimal management.” - Robert K., 54