Celebrex is a medication of the nonsteroidal anti-inflammatory class, which are also known as NSAIDs. Celebrex has most commonly been prescribed for the treatment of chronic painful conditions, such as arthritis, but can be used for anything that involves inflammation, including muscle aches. Celebrex specifically inhibits an enzyme known as cyclooxygenase-2, or COX 2, and as a result of this specific action it has been surmised to cause less damaging effects to the stomach lining which tends to be a side effect of other NSAID drugs. However celebrex carries its own side effect profile which must be weighed by the user before beginning therapy.
Gastrointestinal Side Effects
Despite the effects on the COX 2 enzyme, celebrex can still exert toxic effects on the gastrointestinal system, but is less common than with other NSAID class drugs. Common complications can include ulcer formation, diarrhea, upset stomach, abdominal pain, constipation, and less commonly bleeding or bowel obstruction.
Anaphylaxis
Patients on celebrex, like any other medication, can suffer from anaphylactic reactions. Anaphylaxis is a term that describes a severe allergic reaction. These can vary in duration and/or seriousness and can include hives, swelling of the face or neck, shortness of breath, or even collapse of the cardiovascular system. If any of these symptoms are suspected, immediate medical consultation is advised.
Kidney Toxicity
Celebrex, like other NSAIDs, tends to be toxic to the kidneys. Inflammation of the kidney tissue, known as interstitial nephritis, can result which can ultimately result in kidney failure. These effects are especially prominent in chronic users. A patient who uses celebrex continuously for three months or more is considered a chronic user. Patients should be monitored for early signs such as blood or protein in the urine, decreased urine output, or pain while urinating.
Dermatologic Effects
The most common dermatologic effect that celebrex can cause is a generalized rash that is accompanied with itching. More serious dermatologic effects can include Steven-Johnson syndrome, and erythema multiforme; all of which can be life threatening in nature. Steven-Johnson syndrome and erythema multiforme are related diseases that involve a rash on the skin and membranes, such as the inside of the mouth, and lesions on the skin that resemble a bullseye. It is advised to discontinue the medication at the first sign of a skin rash.
Headache
Headache is a common reported effect among celebrex users. It tends to be described as a “rebound headache” which usually occurs when the drug is being taken at higher doses with development of tolerance. Features of the rebound headache include morning onset, end of dosing onset, and headache improvement with discontinuation of medication.
Cardiovascular Effects
Celebrex can also cause increased risk of cardiovascular events which can be life threatening. These include the formation of blood clots, heart attack, heart arrhythmias, and stroke. This risk increases with duration of use, and in patients with risk factors for cardiovascular disease or preexisting diseases. This risk applies to all medications of the NSAID class.
References
- “The Archives of Internal Medicine”; The effects of cyclooxygenase-2 inhibitors and nonsteroidal anti-inflammatory therapy on 24-hour blood pressure in patients with hypertension, osteoarthritis, and type 2 diabetes mellitus; Sowers, JR et al; Volume 165
- Celebrex (celecoxib) package insert. New York, NY: Pfizer, Inc.; 2008 Dec.
- “Journal of the American Medical Association”; Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis; Silverstein, FE et al; Volume 284
