Celebrex (generic name celecoxib) is a one of many pain medications in the nonsteroidal anti-inflammatory drug, or NSAID, class. This medication has analgesic, or pain relieving, as well as anti-inflammatory properties. The FDA approved Celebrex in 1998 for the treatment of several types of arthritis, acute pain (as from sports injuries or surgeries), menstrual pain and several other medical conditions involving pain and inflammation. Celebrex is protected by patents until 2014, after which time a generic formulation may become available.
How NSAIDs Work
When your body is injured, cells begin to produce prostaglandins using COX-2 enzymes. Prostaglandins are chemicals that help heal your injuries by attracting extra blood and nutrients to the injured area. This extra blood flow causes painful swelling of the injured area. NSAIDs block the production of prostaglandins, which reduces inflammation and swelling and eases pain.
Prostaglandins, however, are used for more than just helping heal injuries. Your body also requires the prostaglandins produced by COX-1 enzymes to protect your stomach lining from caustic digestive acids.
Most NSAIDS, like aspirin, ibuprofen and naproxen, block both COX-1 and COX-2 enzymes. That means they work to reduce pain and inflammation by blocking COX-2 enzymes but can cause stomach ulcers if the protective action of the COX-1 prostaglandins are also blocked. Celebrex is a more specific form of NSAID; it only blocks the COX-2 enzyme, so there is less risk of stomach ulcers forming.
Risks
The FDA warns that Celebrex may still cause stomach ulcers, and the risk of ulcers forming increases with higher doses and longer durations of therapy. The FDA also warns patients and physicians about other risks associated with NSAID use. NSAIDS, including Celebrex, reduce the flow of blood to the kidneys. This can lead to fluid retention, which raises blood pressure, or to permanent kidney damage. People with kidney damage should not take NSAIDS.
Other COX-2 inhibitors, like Vioxx, were removed from the market because they were associated with increased risk of heart disease. Celebrex and other NSAID medications may increase your risk of heart attacks and strokes. A black-box warning is the strongest warning the FDA can give about a medication. Celebrex has black-box warnings in its package labeling that notify patients and physicians about the risk of ulcers and heart disease associated with NSAIDs.
Side Effects
The manufacturer of Celebrex lists the most common side effects of Celebrex as dyspepsia or indigestion, and abdominal pain. Possible rare but serious adverse reactions to Celebrex include increased blood pressure, heart attacks, strokes, kidney or liver damage, stomach ulcers, exacerbations of heart failure, allergic reactions that can be fatal, or asthma attacks. Celebrex should not be taken in the third trimester of pregnancy.
Dosing
Celebrex is manufactured in 50mg, 100mg, 200mg and 400mg capsule strengths. The medication can be taken once or twice daily, usually with a meal. The maximum daily dose is 400mg when used for pain. According to the manufacturer, Celebrex capsules can be opened and the contents sprinkled on applesauce if it is ingested immediately. Celebrex should be taken at the lowest effective dose for the shortest possible time to reduce the risk of serious adverse events.
Contraindications
According to the manufacturer, to reduce the risk of harm, do not take Celebrex if you are allergic to Celebrex, aspirin or any other NSAID. Celebrex contains a sulfonamide moiety, and should not be taken by people with sulfa-drug allergies. This medication may exacerbate asthma attacks and if you have ever had an asthma or allergic-type reaction while taking Celebrex, you should not take it again. Finally, because of the risk of heart attacks and strokes, patients who have just had coronary artery bypass graft (CABG) surgery should not take this medication.
