Celecoxib

Generic Name: celecoxib (oral) (SEL e KOX ib)
Brand Names: Celebrex

What is celecoxib?

Celecoxib is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Celecoxib works by reducing hormones that cause inflammation and pain in the body.

Celecoxib is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain. Celecoxib is also used in the treatment of hereditary polyps in the colon

Celecoxib may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about celecoxib?

This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use celecoxib. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking celecoxib. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not drink alcohol while taking celecoxib. Alcohol can increase the risk of stomach bleeding caused by celecoxib. Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many pain medicines available over the counter contain aspirin or other medicines similar to celecoxib. If you take certain products together you may accidentally take too much of this type of medication.

What should I discuss with my healthcare provider before taking celecoxib?

Taking an NSAID can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use an NSAID. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

NSAIDs can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking an NSAID. Older adults may have an even greater risk of these serious gastrointestinal side effects.

You should not use this medication if you are allergic to celecoxib, or if you have a history of allergic reaction to aspirin, sulfa drugs, or other NSAIDs.

Before taking celecoxib tell your doctor if you are allergic to any drugs, or if you have:

• a history of heart attack, stroke, or blood clot;

• heart disease, congestive heart failure, high blood pressure;

• a history of stomach ulcers or bleeding;

• liver or kidney disease,

• a seizure disorder such as epilepsy;

• asthma;

• polyps in your nose; or

• a bleeding or blood clotting disorder.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take celecoxib.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Taking celecoxib during the last 3 months of pregnancy may harm the unborn baby. Do not take celecoxib during pregnancy unless your doctor has told you to. Celecoxib passes into breast milk and may affect a nursing baby. Do not take celecoxib without first talking to your doctor if you are breast-feeding a baby. Do not give this medicine to a child younger than 2 years old without the advice of a doctor.

How should I take celecoxib?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Take celecoxib with food or milk to lessen stomach upset.

You may open the celecoxib capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Discard the empty capsule. Swallow the medicine and applesauce mixture with water and avoid chewing. If you do not take the mixture right away, keep it in the refrigerator and take it within 6 hours.

If you take celecoxib for a long period of time, your doctor may want to check you on a regular basis to make sure this medication is not causing harmful effects. Do not miss any scheduled appointments.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you are using celecoxib.

Store celecoxib at room temperature away from moisture and heat.

What happens if I miss a dose?

Since celecoxib is sometimes taken only as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include nausea, vomiting, stomach pain, drowsiness, black or bloody stools, coughing up blood, shallow breathing, fainting, or coma.

What should I avoid while taking celecoxib?

Avoid taking celecoxib together with other NSAIDs such as ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), diclofenac (Cataflam, Voltaren), diflunisal (Dolobid), etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), or piroxicam (Feldene).

Do not drink alcohol while taking celecoxib. Alcohol can increase the risk of stomach bleeding caused by celecoxib. Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many pain medicines available over the counter contain aspirin or other medicines similar to celecoxib. If you take certain products together you may accidentally take too much of this type of medication. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). Celecoxib can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun.

Celecoxib side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop taking celecoxib and seek medical attention or call your doctor at once if you have any of these serious side effects:

• chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;

• black, bloody, or tarry stools;

• coughing up blood or vomit that looks like coffee grounds;

• swelling or rapid weight gain;

• urinating less than usual or not at all;

• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

• bruising, severe tingling, numbness, pain, muscle weakness.

Less serious side effects may include:

• upset stomach, mild heartburn, diarrhea, constipation;

• bloating, gas;

• dizziness, nervousness, headache;

• skin rash, itching;

• blurred vision; or

• ringing in your ears.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Celecoxib Dosing Information

Usual Adult Dose for Pain:

Acute pain: 400 mg initially, followed by 200 mg if needed on the first day. Then, 200 mg twice daily as needed.

Usual Adult Dose for Dysmenorrhea:

400 mg initially, followed by 200 mg if needed on the first day. Then, 200 mg twice daily as needed.

Usual Adult Dose for Osteoarthritis:

200 mg orally once daily or 100 mg orally twice daily.

Usual Adult Dose for Rheumatoid Arthritis:

100 to 200 mg orally twice daily.

Usual Adult Dose for Familial Adenomatous Polyposis:

400 mg orally twice daily with food.

Usual Adult Dose for Ankylosing Spondylitis:

200 mg orally once daily or 100 mg orally twice daily. If after 6 weeks of therapy no results are observed, a trial dose of 400 mg orally daily may be worthwhile. If no response is seen after 6 weeks, consideration should be given to alternate treatment options.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis:

2 years or older:

10 to less than or equal to 25 kg: 50 mg orally twice daily

Greater than 25 kg: 100 mg orally twice daily

What other drugs will affect celecoxib?

Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with celecoxib may cause you to bruise or bleed easily.

Before taking celecoxib, tell your doctor if you are taking any of the following drugs:

• a blood thinner such as warfarin (Coumadin);

• diuretics (water pills) such as furosemide (Lasix);

• fluconazole (Diflucan);

• lithium (Eskalith, Lithobid);

• a heart or blood pressure medication such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro, Avalide), losartan (Cozaar, Hyzaar), valsartan (Diovan), telmisartan (Micardis), or olmesartan (Benicar); or

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik).

This is not a complete list and there may be other drugs that can interact with celecoxib. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about celecoxib.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Where can I buy celecoxib?

You can buy celecoxib by any brand name such as Celebrex at any reputable online pharmacy.