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Celecoxib (Oral route)

Pronunciation:

sel-e-KOX-ib

Brand Names:

  • Celebrex

Dosage Forms:

  • Capsule

Warnings:

Oral route(Capsule)

Celecoxib may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may be increased in patients with cardiovascular disease or risk factors for cardiovascular disease. Celecoxib is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery. Celecoxib can also cause an increased risk of serious gastrointestinal adverse events especially in the elderly, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal .

Classifications:

Therapeutic—

Analgesic

Pharmacologic—

Cyclooxygenase-2 Inhibitor

Uses of This Medicine:

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and help relieve symptoms of arthritis (e.g., osteoarthritis, rheumatoid arthritis, or juvenile rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain. However, this medicine does not cure arthritis and will help you only as long as you continue to take it.

Celecoxib is also used to treat ankylosing spondylitis, which is a type of arthritis that affects the joints in the spine. This medicine may also be used to treat acute pain and menstrual cramps.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of celecoxib in children 2 years of age and older. However, safety and efficacy have not been established in children younger than 2 years of age.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of celecoxib in the elderly. However, elderly patients are more likely to have age-related kidney or stomach problems, which may require caution.

Pregnancy—

Pregnancy CategoryExplanation
1st TrimesterCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
2nd TrimesterCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.
3rd TrimesterDStudies in pregnant women have demonstrated a risk to the fetus. However, the benefits of therapy in a life threatening situation or a serious disease, may outweigh the potential risk.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Ketorolac

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abciximab
  • Apixaban
  • Ardeparin
  • Argatroban
  • Beta Glucan
  • Bivalirudin
  • Certoparin
  • Cilostazol
  • Citalopram
  • Clopidogrel
  • Clovoxamine
  • Cyclosporine
  • Dabigatran Etexilate
  • Dabrafenib
  • Dalteparin
  • Danaparoid
  • Desirudin
  • Dipyridamole
  • Duloxetine
  • Enoxaparin
  • Eptifibatide
  • Erlotinib
  • Escitalopram
  • Femoxetine
  • Feverfew
  • Flesinoxan
  • Fluoxetine
  • Fondaparinux
  • Ginkgo
  • Gossypol
  • Heparin
  • Lepirudin
  • Levomilnacipran
  • Meadowsweet
  • Methotrexate
  • Milnacipran
  • Nadroparin
  • Nefazodone
  • Parnaparin
  • Paroxetine
  • Pemetrexed
  • Pentosan Polysulfate Sodium
  • Pentoxifylline
  • Pralatrexate
  • Prasugrel
  • Protein C
  • Reviparin
  • Rivaroxaban
  • Sibutramine
  • Tacrolimus
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Warfarin
  • Zimeldine

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Acetohexamide
  • Alacepril
  • Alprenolol
  • Amiloride
  • Amlodipine
  • Arotinolol
  • Aspirin
  • Atenolol
  • Azilsartan Medoxomil
  • Azosemide
  • Befunolol
  • Bemetizide
  • Benazepril
  • Bendroflumethiazide
  • Benzthiazide
  • Bepridil
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bopindolol
  • Bucindolol
  • Bumetanide
  • Bupranolol
  • Buthiazide
  • Candesartan Cilexetil
  • Canrenoate
  • Captopril
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Chlorothiazide
  • Chlorpropamide
  • Chlorthalidone
  • Cilazapril
  • Clopamide
  • Cyclopenthiazide
  • Delapril
  • Desvenlafaxine
  • Dilevalol
  • Diltiazem
  • Enalaprilat
  • Enalapril Maleate
  • Eprosartan
  • Esmolol
  • Ethacrynic Acid
  • Felodipine
  • Fluconazole
  • Flunarizine
  • Fosinopril
  • Furosemide
  • Gallopamil
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Hydrochlorothiazide
  • Hydroflumethiazide
  • Imidapril
  • Indapamide
  • Irbesartan
  • Isradipine
  • Labetalol
  • Lacidipine
  • Landiolol
  • Levobetaxolol
  • Levobunolol
  • Lidoflazine
  • Lisinopril
  • Lithium
  • Losartan
  • Manidipine
  • Mepindolol
  • Methyclothiazide
  • Metipranolol
  • Metolazone
  • Metoprolol
  • Moexipril
  • Nadolol
  • Nebivolol
  • Nicardipine
  • Nifedipine
  • Nilvadipine
  • Nimodipine
  • Nipradilol
  • Nisoldipine
  • Nitrendipine
  • Olmesartan Medoxomil
  • Oxprenolol
  • Penbutolol
  • Pentopril
  • Perindopril
  • Pindolol
  • Piretanide
  • Polythiazide
  • Pranidipine
  • Propranolol
  • Quinapril
  • Ramipril
  • Sotalol
  • Spirapril
  • Spironolactone
  • Talinolol
  • Tasosartan
  • Telmisartan
  • Temocapril
  • Tertatolol
  • Timolol
  • Tolazamide
  • Tolbutamide
  • Torsemide
  • Trandolapril
  • Triamterene
  • Trichlormethiazide
  • Valsartan
  • Verapamil
  • Xipamide
  • Zofenopril

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia or
  • Congestive heart failure or
  • Edema (fluid retention or body swelling) or
  • Heart attack, history of or
  • Heart disease or
  • Hypertension (high blood pressure) or
  • Kidney disease, mild to moderate or
  • Stomach ulcers or bleeding, history of or
  • Stroke, history of—Use with caution. May make these conditions worse.
  • Aspirin-sensitive asthma, history of or
  • Aspirin sensitivity, history of or
  • Kidney impairment, severe or
  • Liver impairment, severe or
  • Sulfa or sulfonamide allergy (e.g., sulfamethoxazole, Bactrim®, or Septra®)—Should not be used in patients with these conditions.
  • Heart surgery (e.g., coronary artery bypass graft [CABG] surgery)—This medicine should not be used to relieve pain right before or after the surgery.
  • Certain genetic conditions (poor CYP2C9 (a liver enzyme) metabolizers) or
  • Liver disease, mild or moderate—Use with caution. You may need a reduced dose of this medicine.

Proper Use of This Medicine:

For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Taking too much of this medicine may increase the chance of unwanted effects.

This medicine should come with a Medication Guide. It is very important that you read and understand this information. Be sure to ask your doctor about anything you do not understand.

You may take this medicine with or without food.

If you cannot swallow the capsule, you may open it and pour the medicine to a teaspoon of cool or room temperature applesauce. This mixture must be swallowed right away without chewing and followed with a glass of water to make sure all of the mixture is swallowed.

Any medicine that has been mixed with applesauce may be stored in a refrigerator and used within 6 hours.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (capsules):
    • For acute pain or pain during menstruation:
      • Adults—At first, 400 milligrams (mg). A second dose of 200 mg can be taken if needed on the first day. Then, 200 mg two times a day as needed.
      • Children—Use and dose must be determined by your doctor.
    • For ankylosing spondylitis or osteoarthritis:
      • Adults—200 milligrams (mg) once a day or 100 mg two times a day. Your doctor may increase your dose if needed.
      • Children—Use and dose must be determined by your doctor.
    • For rheumatoid arthritis or juvenile rheumatoid arthritis:
      • Adults—100 to 200 milligrams (mg) two times a day.
      • Children 2 years of age and older and weighing more than 25 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The dose is usually 100 milligrams (mg) two times a day.
      • Children 2 years of age and older and weighing less than 25 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The dose is usually 50 milligrams (mg) two times a day.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

It is very important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

This medicine may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk.

This medicine may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely if you or your child have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are over 60 years of age, are in poor health, or using certain other medicines (such as steroids or a blood thinner).

Using this medication in certain patients under the age of 18 for the treatment of juvenile rheumatoid arthritis may increase the risk of disseminated intravascular coagulation (bleeding problem). Talk with your doctor if you have concerns about this .

Serious skin reactions can occur with this medicine. Stop using this medicine and check with your doctor right away if you or your child have any of the following symptoms while taking this medicine: blistering, peeling, or loosening of the skin; chills; cough; diarrhea; fever; itching; joint or muscle pain; red skin lesions; sore throat; sores, ulcers, white spots in the mouth or on the lips; or unusual tiredness or weakness.

Taking two or more of the nonsteroidal anti-inflammatory drugs (NSAIDs) together on a regular basis may increase the chance of unwanted effects. Also, taking acetaminophen, aspirin or other salicylates, or ketorolac (e.g., Toradol) regularly while you are taking a nonsteroidal anti-inflammatory drug may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your doctor tells you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take acetaminophen or aspirin or other salicylates together with this medicine for more than a few days, and do not take any ketorolac (e.g., Toradol) while you are taking this medicine, unless your doctor has directed you to do so and is following your progress.

Some possible warning signs of serious side effects that can occur during treatment with this medicine may include black, tarry stools; decreased urination; severe stomach pain; skin rash; swelling of the face, fingers, feet, or lower legs; unusual bleeding or bruising; unusual weight gain; vomiting of blood or material that looks like coffee grounds; or yellow eyes and skin. Also, signs of serious heart problems could occur such as chest pain, tightness in the chest, fast or irregular heartbeat, or unusual flushing or warmth of the skin. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.

Celecoxib may cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur more often in patients who are allergic to aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs), or sulfonamide-type drugs. Anaphylaxis can be life-threatening and requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swellings of the eyelids or around the eyes. If these effects occur, get emergency help at once. Ask someone to drive you to the nearest hospital emergency room. If this is not possible, do not try to drive yourself. Call an ambulance, lie down, cover yourself to keep warm, and prop your feet higher than your head. Stay in that position until help arrives.

Using this medicine during the later part of pregnancy can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

Tell your doctor if you or your child have unexplained weight gain or edema (fluid retention or body swelling) with this medicine.

Before having any kind of surgery or medical tests, tell your doctor that you are taking this medicine. It may be necessary for you to stop treatment for a while, or to change to a different nonsteroidal anti-inflammatory drug before your procedure.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
Cough
fever
skin rash
sneezing
sore throat
swelling of the face, fingers, feet, or lower legs
Less common or rare
Abnormal growth in the breast
arm, back, or jaw pain
bloody or black, tarry stools
blurred vision
burning feeling in the chest or stomach
burning or stinging of the skin
burning, tingling, numbness, or pain in the hands, arms, feet, or legs
chest pain or discomfort
chest tightness or heaviness
chills
confusion
congestion in the chest
cramps
diarrhea
dry mouth
earache
fast or irregular heartbeat
heartburn
heavy bleeding
heavy non-menstrual vaginal bleeding
high blood pressure
increased hunger
increased thirst
increased urination
loss of appetite
loss of consciousness
muscle aches and pains
nausea
nerve pain
painful blisters on the trunk of body
painful cold sores or blisters on the lips, nose, eyes, or genitals
pale skin
redness or swelling in the ear
sensation of pins and needles
soreness or redness around the fingernails and toenails
stabbing pain
stiff neck
stomachache
stomach pain (severe)
sweating
tenderness in the stomach area
troubled breathing with exertion
unexplained weight loss
unusual bleeding or bruising
unusual tiredness or weakness
unusual weight gain
vomiting
vomiting of blood or material that looks like coffee grounds
weakness
wheezing
Incidence not known
Area rash
changes in skin color
clay-colored stools
dilated neck veins
light-colored stools
pale or a bluish color skin of the fingers or toes
seizures
slurred speech
sores, welting, or blisters
sudden and severe inability to speak
unpleasant breath odor
weakness in the arm or leg on one side of the body
yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Continuing thirst
dizziness
drowsiness
headache, severe or continuing
shortness of breath
sudden decrease in the amount of urine
troubled breathing
weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Back pain
gas
headache
heartburn
inability to sleep
pain or burning in the throat
stuffy or runny nose
Less common
Anxiety
bleeding after defecation
bloody or cloudy urine
breast pain
bone deformity
buzzing or ringing noise in the ears
change in sense of taste
constipation
decrease in height
decreased appetite
depression
difficult, burning, or painful urination
difficulty with moving or walking
difficulty with swallowing
excessive muscle tone, muscle tension, or tightness
excessive tearing
feeling of pressure
hair loss
hives
hoarseness
increased sweating
infection
inflammation
itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at site
itching of the vagina or genital area
joint or muscle pain or stiffness
large, flat, blue, or purplish patches in the skin
loss of energy or weakness
loss of hearing
muscle pain increased
muscle stiffness
nervousness
numbness or tingling in the fingers or toes
pain during sexual intercourse
pain in the back, ribs, arms, or legs
pounding heartbeat
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness or swelling in the arms or legs
sensitivity of the skin to sunlight
severe sunburn
sleepiness
straining while passing stool
sudden sweating and feelings of warmth
swelling
swelling or inflammation of the mouth
tenderness
thick, white vaginal discharge with no odor or with a mild odor
thinning of the hair
trouble with swallowing
troubled breathing
uncomfortable swelling around anus
unexplained weight loss
voice changes
warmth on the skin
weakness or heaviness of the legs
Incidence not known
Bleeding gums
blistering, peeling, or loosening of the skin
bloating
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
loss of sense of smell
pain
pinpoint red spots on the skin
red or irritated eyes
red skin lesions, often with a purple center
shakiness and unsteady walk
sores, ulcers, or white spots in the mouth or on the lips
stomach cramps
swelling of the neck
tenderness
trembling, or other problems with muscle control or coordination
unsteadiness
watery or bloody diarrhea

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 4/4/2014

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