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Celecoxib

Celecoxib Capsule 

Celecoxib is a selective NSAID targeting the COX-2 enzyme, reducing inflammation, pain, and fever. It is used for various conditions, including arthritis, acute pain, ankylosing spondylitis, and menstrual cramps. Available in capsules ranging from 100 to 400 mg, it can be taken with or without a meal. While effective for pain management, Celecoxib may cause side effects such as stomach issues and dizziness, with more severe risks including heart attacks and gastrointestinal bleeding. Proper adherence to dosing schedules is crucial, and in cases of overdose, immediate medical intervention is necessary. Store Celecoxib at room temperature and consult healthcare providers for safe use.

Product Overview

Celecoxib Capsule, popularly marketed under the brand name Celebrex, is a nonsteroidal anti-inflammatory drug (NSAID) specifically targeting the cyclooxygenase-2 (COX-2) enzyme. This selective action helps reduce the production of prostaglandins, which are chemicals that lead to inflammation, pain & fever. Celecoxib is primarily used to relieve symptoms of several conditions like arthritis (including juvenile rheumatoid arthritis, osteoarthritis, and rheumatoid arthritis), acute pain, ankylosing spondylitis, and manage menstrual cramps. Its ability to decrease inflammation and pain makes it a vital treatment option for those suffering from chronic inflammatory conditions.

Celecoxib is available in various strengths, typically 100 mg to 400 mg, allowing for dosage customization based on individual patient needs and specific conditions. The medication is usually administered in capsule form and can be taken with or without food. Designed for adults and, in certain cases, for children (particularly those with juvenile rheumatoid arthritis), Celecoxib must be prescribed by a healthcare specialist who will determine the right dosage and treatment regimen.

While Celecoxib effectively manages pain and inflammation, it can also pose side effects. Common issues might include digestive distress, headache, and dizziness, while serious side effects could involve heart attack, stroke, severe gastrointestinal bleeding, and liver problems. It’s essential for patients to follow their medical professional’s instructions regarding missed doses and to avoid double dosing. In the situation of an overdose, seeking immediate medical attention is necessary. Celecoxib should be stored at a normal temperature, protected from moisture and heat, and out of reach of children. Patients are advised to discuss potential interactions with other medications and heed warnings, especially about heart health and gastrointestinal risks.

Uses of Celecoxib 

  • Juvenile rheumatoid arthritis (JRA)
  • Sudden pain
  • Osteoarthritis (OA)
  • Ankylosing spondylitis (AS)
  • Rheumatoid arthritis (RA)
  • Menstrual cramps

How to Use Celecoxib?

Dosage

Celecoxib comes in the following oral capsule strengths:

  • 50 milligrams (mg)
  • 100 mg
  • 200 mg
  • 400 mg

Recommended Dosage for Different Patients

Osteoarthritis:

  • Take 200 mg once daily or split into two doses of 100 mg each.

Rheumatoid Arthritis:

  • 100 mg to 200 mg taken twice a day.

Acute Pain or Menstrual Pain:

  • If necessary, take 400 mg initially on the first day, followed by an additional dose of 200 mg.
  • Maintenance dosage: 200 mg twice a day as needed.

Ankylosing Spondylitis:

  • Take 200 mg daily, either as a single dose or divided into two doses of 100 mg each. In some cases, patients may require 400 mg daily.

Dosage Adjustments

  • Patients with Liver Impairment: Lower doses may be required, especially for those with moderate liver impairment. Celecoxib should be used cautiously, and regular liver function monitoring is advised.
  • Elderly Patients: While no specific adjustments are typically necessary, caution is advised due to the increased risk of kidney, gastrointestinal, and cardiovascular side effects.
  • Children: A pediatrician or specialist should determine the use and dosage in pediatric patients based on the specific condition and patient characteristics.

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll prescribe your dosage accordingly.]

How to Take It?

  • Always take Celecoxib exactly as your doctor has prescribed. Do not change the dosage or frequency without first consulting your doctor.
  • Celecoxib is typically available in capsule form. Swallow the capsules whole with a glass of water.
  • You can take Celecoxib with or without food, but taking it with food may help to reduce stomach upset.
  • Try to take your doses simultaneously each day to maintain an even level of the medication in your body.
  • Use Celecoxib for the shortest duration necessary to manage your symptoms, as directed by your doctor.
  • Keep routine appointments with your doctor to monitor the medication’s effectiveness and discuss potential side effects or concerns.

[Note: Your doctor will decide the suitable dosage strength and timing for you based on your condition, following guidelines & studies on the drug. 

How Does Celecoxib Capsule Work?

Celecoxib, marketed as Celebrex, belongs to the class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It specifically targets and inhibits the enzyme cyclooxygenase-2 (COX-2). This enzyme plays a vital role in the production of prostaglandins, which are chemicals in the body that promote inflammation, pain, and fever. By blocking COX-2, Celecoxib effectively reduces the levels of prostaglandins, leading to reduced inflammation and pain. This selective inhibition helps reduce the gastrointestinal side effects typically associated with other NSAIDs, which also affect cyclooxygenase-1 (COX-1), an enzyme that protects the stomach lining.

Important Safety Information

Side Effects

Common Side Effects

  • Sore throat
  • Diarrhea
  • Trouble sleeping
  • Headache
  • Rash
  • Back pain
  • Muscle or joint pain
  • Fever
  • Belly pain
  • Passing gas
  • Upper respiratory infection
  • Stuffy or runny nose
  • Congestion
  • Nausea
  • Vomiting
  • Dry mouth
  • Swelling in the arms and legs
  • Dizziness
  • Indigestion
  • Cough
  • Ringing in the ear

Serious Side Effects

  • Heart attack: Chest pain or tightness, trouble breathing
  • Heart failure: Swelling in your body, sudden weight gain, tiredness, trouble breathing
  • Stroke: Difficulty speaking, blurred vision, weakness on one side of the body, difficulty walking
  • Stomach or gut bleeds: Pain in your stomach that doesn’t go away, blood in your vomit, stool that looks like black coffee grounds
  • Severe asthma attack: Difficulty breathing, wheezing, chest pain, cough
  • Serious allergic or skin reaction: Fever, body aches, rash, painful blisters all over your body, swelling of the face, trouble breathing, cough, peeling skin

[Note: This list may not encompass all possible side effects of this medication. It’s best to always consult with your healthcare giver for medical advice about side effects.]

Warnings

  • Heart Risks: Celebrex capsules can increase the risk of heart attacks and strokes, particularly if you have existing heart problems or have undergone recent heart surgery. Avoid Celebrex immediately before or after heart bypass surgery. Call emergency services if you see signs of chest pain, trouble breathing, or symptoms of a stroke, such as weakness or difficulty speaking.
  • Gastrointestinal Risks: This medication can lead to serious gastrointestinal issues, including bleeding and ulcers, especially if taken over long periods. The risk is higher among older adults, those with a history of stomach issues, and when combined with alcohol, smoking, or other medications that increase bleeding risk. Seek immediate medical attention right away if you notice severe stomach pain, black stools, or blood in your urine.
  • Liver Damage: Although rare, Celebrex can cause liver problems, potentially leading to liver failure. Use the lowest dosage of this medication for the shortest duration to minimize risk. Stop taking Celebrex and contact your healthcare provider if you develop symptoms like fever, nausea, stomach pain on the right, yellowing of the skin or eyes, or dark urine.
  • Cardiovascular and Renal Effects: Celebrex may increase blood pressure and contribute to heart failure by causing fluid retention. Notify your healthcare provider if you have heart conditions or are on blood pressure medications. Regular monitoring of blood pressure is recommended. Symptoms like swelling, sudden weight gain, or difficulty breathing should be reported immediately.
  • Severe Allergic Reactions: Be cautious if you have a sulfa allergy, as Celebrex contains sulfa. Severe reactions like anaphylaxis are possible. Discontinue taking Celebrex and seek emergency medical help if you develop symptoms like hives, swelling on any body part, or difficulty breathing.
  • Severe Skin Reactions: Rarely, Celebrex can cause serious skin reactions such as peeling, blisters, or rashes, accompanied by fever and swelling. Discontinue use and get medical help immediately if these symptoms occur.
  • Asthma and Respiratory Risks: Celebrex can trigger severe asthma attacks, especially in individuals who have a history of asthmatic episodes exacerbated by NSAIDs. Reach out for immediate medical assistance if you experience a tightening of the throat or difficulty breathing.
  • Pregnancy Risks: Taking Celebrex during the later stages of pregnancy (beyond 20 weeks) can harm the unborn baby, causing heart or kidney issues. Discuss potential risks and safer alternatives with your respective doctor if you are pregnant or are planning to conceive.

Precautions

Allergies

  • Inform your medical expert if you have allergies to Celecoxib, aspirin, or other NSAIDs (like ibuprofen or naproxen) or if you have any other allergies.
  • Celecoxib may contain inactive ingredients that could cause allergic reactions or other problems.

Medical History

  • Disclose your complete medical history, especially if you have:
    • Asthma or worsening breathing after taking aspirin or other NSAIDs.
    • Blood disorders (e.g., anemia, bleeding/clotting issues).
    • Nasal polyps.
    • Liver disease.
    • Stomach, intestine, or esophagus problems (e.g., bleeding, ulcers, recurrent heartburn).
    • Heart disease (e.g., history of heart attack).
    • High blood pressure.
    • History of stroke.
    • Swelling or fluid retention.

Kidney Health

  • Kidney issues can occur with NSAIDs, including Celecoxib, especially if you are dehydrated, have heart or any type of kidney disease, are an older adult, or take certain medications.
  • Stay hydrated; follow your doctor’s advice on fluid intake.
  • Report any unusual changes in urine volume immediately.

Stomach Bleeding Risk

  • The use of alcohol and tobacco can increase the risk of stomach bleeding, especially when combined with this medication.
  • Limit alcohol and stop smoking; discuss with your doctor the safe amount of alcohol consumption.

Surgical Considerations

  • Before you schedule undergoing any surgery, inform your doctor or dentist about all the medicinal products you use, including prescription medications & over-the-counter drugs, as well as herbal products.

Increased Risk in Older Adults

  • Older adults may face a much higher risk of stomach/intestinal bleeding, kidney problems & stroke.

Women of Childbearing Age

  • Discuss the risks of taking Celecoxib with your doctor if you are of childbearing age.
  • Avoid using this medication from 20 weeks until delivery due to potential risks to the unborn baby.
  • If usage is essential between 20 and 30 weeks of pregnancy, administer the minimum effective dose for the briefest possible duration. 
  • Do not use after 30 weeks of pregnancy.

Breastfeeding

  • Celecoxib passes into breast milk, but no harm to nursing infants has been reported.
  • Consult your doctor before breastfeeding to discuss potential risks.

Contraindications 

Contraindications refer to situations or medical conditions where taking a specific medication could be harmful. If you have any of the following conditions, inform your healthcare provider as Celebrex (Celecoxib) may not be safe for you:

  • Allergic reactions to Celebrex (Celecoxib) or any other NSAIDs.
  • Allergies to sulfa drugs.
  • Recent coronary artery bypass surgery.

Missed Dose

If you miss a dose of your medication, take it as soon as you remember. However, skip the missed dose if it’s nearly time for your next scheduled dose. Do not double up on doses.

[Note: If you have missed a dosage of Celecoxib and are unsure regarding the next dosage, immediately consult your doctor or pharmacist.]

Overdose 

In the event of an overdose where someone exhibits severe symptoms like passing out or difficulty breathing, immediately call 911. For other symptoms of overdose, contact a poison control center without delay. Common signs of an overdose can include severe stomach pain, slow or shallow breathing, and loss of consciousness.

[Note: If you have consumed more than the prescribed dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

  • Keep Celecoxib in a closed container at a normal temperature ranging from 68°F to 77°F (20°C to 25°C).
  • You may also refrigerate Celecoxib if desired.
  • Keep Celecoxib away from direct heat, light, and humidity.
  • Do not store it in the bathroom.
  • A Celecoxib capsule that has been blended with applesauce can be refrigerated and must be used within 6 hours.
  • Avoid storing the oral liquid bottle and reusing the remaining medicine.

[Note: Discuss with your healthcare expert regarding the proper disposal of unused medication and any questions you may have regarding the proper storage.]

Celecoxib Interactions

  • Anticoagulants and Antiplatelet Drugs: Celecoxib can heighten the risk of bleeding when taken in combination with drugs like warfarin (Coumadin), clopidogrel (Plavix), and aspirin. Close monitoring by a healthcare provider is necessary.
  • Angiotensin-converting enzyme (ACE) Inhibitors and Angiotensin II Receptor Blockers (ARBs): When Celecoxib is used with ACE inhibitors (e.g., lisinopril) or ARBs (e.g., losartan), it can reduce their ability to lower blood pressure levels and increase the risk of kidney damage.
  • Diuretics: Taking Celecoxib with diuretics (e.g., furosemide, hydrochlorothiazide) can reduce the diuretic effect and increase the risk of kidney problems.
  • Lithium: Celecoxib can increase the plasma levels of lithium, potentially leading to increased side effects. Monitoring lithium blood levels is recommended when these medications are used together.
  • Methotrexate: Celecoxib may increase the toxicity of methotrexate, used for treating certain types of cancers and autoimmune diseases, by affecting renal clearance. Monitoring blood levels and renal function is advised.
  • Cyclosporine: Using Celecoxib can increase the nephrotoxic effects of cyclosporine, an immunosuppressant. Renal function should be closely monitored.
  • Other NSAIDs: Combining Celecoxib with other NSAIDs (e.g., ibuprofen, naproxen) increases the risk of gastrointestinal bleeding and does not provide additional therapeutic benefits.
  • Selective Serotonin Reuptake Inhibitors (SSRIs): Taking Celecoxib with SSRIs (e.g., fluoxetine, sertraline) may increase the risk of gastrointestinal bleeding.
  • CYP2C9 Inhibitors: Drugs that inhibit the CYP2C9 enzyme (e.g., fluconazole) can increase Celecoxib blood levels, leading to more pronounced effects and potential toxicity. Dose adjustments may be necessary.

[Note: This is not a complete list, and there could be other drugs that interact with Celecoxib Capsule. Make sure to inform your doctor about any prescription, over-the-counter medicines & herbal products you’re taking.]

Celecoxib Alternatives

  • Adderall (amphetamine/dextroamphetamine)
  • Ambien (zolpidem)
  • Ativan (lorazepam)
  • Cymbalta (duloxetine)
  • Lyrica (pregabalin)
  • Seroquel (quetiapine)
  • Xanax (alprazolam)
  • Zoloft (sertraline)
  • Neurontin (gabapentin)
  • Nexium (esomeprazole)
  • Protonix (pantoprazole)
  • Topamax (topiramate)
  • Valium (diazepam)
  • Zofran (ondansetron)
  • Vitamin B12 (cyanocobalamin)
  • Vitamin D3 (cholecalciferol)
  • Fish Oil (omega-3 polyunsaturated fatty acids)
  • Flexeril (cyclobenzaprine)
  • Flonase (fluticasone nasal)
  • Klonopin (clonazepam)
  • Tylenol (acetaminophen)

[Note: Your doctor will choose the most suitable for you. Don’t use any of these alternative medications without consulting your medical expert. Taking them by yourself may result in serious side effects.] 

Frequently Asked Questions

Has Celecoxib been banned?

Celecoxib has not been banned or discontinued. Other drugs in its class, such as Vioxx (rofecoxib) and Bextra (valdecoxib), were pulled from the market due to ongoing concerns over an increased risk of heart attacks and strokes. However, Celebrex did not exhibit the same risks in large clinical trials, showing a comparable risk of heart events to those who used prescription-strength ibuprofen or naproxen. It’s important to note that all NSAIDs have issued warnings about the potential increased risk of heart complications. This medication should be consumed at the lowest effective dose and for the shortest period necessary to manage pain.

Is Celecoxib Capsule classified as a narcotic painkiller?

No, Celecoxib is not a narcotic painkiller. Narcotics generally refer to opioids, which are a class of pain-relieving medications that act on the brain. Celebrex belongs to a different class known as nonsteroidal anti-inflammatory drugs (NSAIDs). It works by blocking specific proteins that play a role in inflammation and pain, unlike opioids, which primarily affect the perception of pain in the brain.

Is Celecoxib Capsule the same as Celebrex?

Yes, Celecoxib is the lower-cost generic formulation of the brand-name Celebrex. They’re both available by prescription from your provider only. Don’t take Celecoxib and Celebrex simultaneously since it can lead to an accidental overdose, which may cause stomach side effects, drowsiness, tiredness, confusion, and rare but serious stomach damage.

Is it safe to take ibuprofen with Celecoxib?

It is not recommended to take ibuprofen (Advil) alongside Celecoxib as both are nonsteroidal anti-inflammatory drugs (NSAIDs) and work similarly. Using them together elevates the risk of serious side effects, such as abdominal ulcers and bleeding. If you find that neither Celebrex nor ibuprofen alone is sufficiently managing your pain, you should seek help from your doctor to explore alternative treatment options.

Can taking Celecoxib lead to weight gain?

Weight gain is not normally reported as a side effect of Celecoxib, although some individuals have experienced it while on the medication. If you notice an increased weight during your treatment with Celebrex, it’s important to consult with your healthcare provider. They can help determine if the weight add-on is related to the medication or other underlying causes. Additionally, rapid weight gain can indicate fluid retention, which might be a sign of heart failure. You should also immediately report any symptoms to your provider, such as increased swelling, fatigue, or breathing difficulties.

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