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Celecoxib

Sounds like 'SEL-e-KOX-ib'

Key points about celecoxib

Celecoxib is an anti-inflammatory used to treat pain and inflammation.
Celecoxib is also called Celebrex.
Find out how to take it safely and the possible side effects.

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Celecoxib is one of a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs). Celecoxib is used to treat different types of pain such as pain from osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and painful periods. Read more about pain.

In New Zealand celecoxib is available as capsules (100 mg and 200 mg).

(RheumInfo, Canada, 2019)
Note: this video is from Canada so may have information that differs from New Zealand recommendations.

The usual dose of celecoxib is 200 mg once a day or 100 mg twice a day.
Some people may need a higher dose of 200 mg twice a day.
Always take your celecoxib exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

Take celecoxib with a full glass of water. Swallow the capsules whole. Don't crush or chew them. If celecoxib causes stomach upset, take it with food.
Avoid or limit alcohol while you are taking celecoxib. Alcohol can increase the risk of side effects such as stomach upset.
Missed dose: If you forget to take a dose, take it when you next need pain relief and then continue as before. Don't take 2 doses together to make up for a forgotten dose.

Here are some things to know when you're taking celecoxib. Other things may be important as well, so ask your healthcare provider what you should know about.

For most people taking celecoxib is safe but extra care is needed in some situations, for example if:

you are pregnant or are planning a pregnancy
have high blood pressure
you have heart or kidney problems or asthma
you're aged 65 years or older
you smoke.

It can also be harmful to take celecoxib when you are dehydrated or have been sick with diarrhoea (runny poos) or vomiting (being sick). Read more about the risks of NSAIDs.

When you should NOT take celecoxib
Celecoxib should NOT be used in some situations as it can be harmful. For example, if you: have current or previous stomach problems such as ulcers or bleeding are pregnant have heart failure or chest pain (angina) have had a stroke or heart attack have chronic kidney disease have had an allergic reaction (such as hives or trouble breathing) to ibuprofen, aspirin, or other similar medications (discuss with your healthcare provider) are taking medicines to reduce blood clots (anticoagulants) such as warfarin, dabigatran and rivaroxaban are also taking other anti-inflammatory medicines, eg, diclofenac (Voltaren®), ibuprofen (Brufen) or naproxen (Naprosyn®, Naprogesic®) are taking some blood pressure medicines such as ACE inhibitors, ARBs, diuretics. Always check with your healthcare provider before taking NSAIDs. Read more about the risks associated with NSAIDs.

When you should NOT take celecoxib

Celecoxib should NOT be used in some situations as it can be harmful. For example, if you:

have current or previous stomach problems such as ulcers or bleeding
are pregnant
have heart failure or chest pain (angina)
have had a stroke or heart attack
have chronic kidney disease
have had an allergic reaction (such as hives or trouble breathing) to ibuprofen, aspirin, or other similar medications (discuss with your healthcare provider)
are taking medicines to reduce blood clots (anticoagulants) such as warfarin, dabigatran and rivaroxaban
are also taking other anti-inflammatory medicines, eg, diclofenac (Voltaren®), ibuprofen (Brufen) or naproxen (Naprosyn®, Naprogesic®)
are taking some blood pressure medicines such as ACE inhibitors, ARBs, diuretics. Always check with your healthcare provider before taking NSAIDs.

Read more about the risks associated with NSAIDs.

Don't take other anti-inflammatory medicines such as diclofenac, ibuprofen or naproxen while taking celecoxib. This can increase your risk of side effects.

It's safe to take celecoxib with paracetamol because they work differently.

Celecoxib interacts with some medicines, especially those used for high blood pressure, so check with your doctor or pharmacist before you start taking it.

Image credit: University of Otago, NZ

Taking NSAIDs together with blood pressure medicines can be harmful to your kidneys. This is called the ‘triple whammy’. If you are taking blood pressure medicines (ACE inhibitors or ARBs and diuretics) tell your doctor or pharmacist before starting celecoxib.

Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
Examples of ARBs are candesartan, irbesartan and losartan.
Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide, spironolactone, eplerenone and metolazone.

Read more about the triple whammy.(external link)

Like all medicines, celecoxib can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects	What should I do?
Heartburn Indigestion Stomach discomfort Runny poo (diarrhoea)	These are common and should settle within a few days. Take celecoxib with food. Talk to your doctor if they're ongoing.
Serious stomach problems such as really bad stomach pain, blood in the stool or black stools, cough or vomit up blood or dark coloured vomit.	Stop taking celecoxib. Tell your doctor immediately or ring Healthline on 0800 611 116.
Chest pain Shortness of breath or trouble breathing Weakness in one part or side of the body Slurred speech	Stop taking celecoxib. Tell your doctor immediately or ring Healthline on 0800 611 116.
Swollen ankles, blood in your pee or not peeing at all – these can be signs of a kidney problem.	Stop taking celecoxib. Tell your doctor immediately or ring Healthline on 0800 611 116.
Signs of an allergic reaction such as skin rash, itching, swelling of your lips, face and mouth or difficulty breathing	Stop taking celecoxib. Tell your doctor immediately or ring Healthline on 0800 611 116.
Read more about medicines and side effects and reporting a reaction you think might be a side effect.

Medicine labels
Non-steroidal anti-inflammatories (NSAIDs)
Osteoarthritis | Pona ngoikore
Rheumatoid arthritis | Mate rumatiki
Ankylosing spondylitis
Painful periods

The following links provide further information about celecoxib. Be aware that websites from other countries may have information that differs from Aotearoa New Zealand recommendations.

Celecoxib Patient Information(external link) NZ Formulary, NZ
Celecoxib(external link) Rheuminfo, US
Celecoxib capsules for pain and inflammation(external link) Patient info, UK