BMA Concise Guide to Medicine & Drugs

Celecoxib

Brand name Celebrex

Used in the following combined preparations None

QUICK REFERENCE

Drug group Analgesic and non-steroidal anti-inflammatory drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Celecoxib is a type of NSAID called a cyclo-oxygenase-2 (COX-2) inhibitor; these drugs were originally thought to have a lower risk of causing irritation to the upper gastrointestinal tract than other NSAIDs but this is now disputed.

Celecoxib reduces pain, stiffness, and inflammation and is used to relieve the symptoms of both rheumatoid arthritis and osteoarthritis.

Elderly patients may be more sensitive to the drug’s effects, and for this reason they are usually prescribed a low dose to begin with.

Celecoxib is not prescribed to anyone who has had a heart attack or stroke, because it slightly increases the risk of recurrence, nor is it prescribed to people with peripheral artery disease (poor circulation). It is prescribed with caution to anyone at risk of any of these conditions.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Capsules.

Frequency and timing of doses 1–2 x daily.

Adult dosage range 200–400mg daily.

Onset of effect 1 hour.

Duration of action 8 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children.

Missed dose Take as soon as you remember. If your next dose is due within 4 hours, take a single dose now and skip the next.

Stopping the drug If being used short term, the drug can safely be stopped as soon as you no longer need it. If prescribed for long-term use, you should not stop taking the drug without consulting your doctor.

Exceeding the dose An occasional unintentional extra dose is unlikely to cause problems. Large overdoses may cause stomach and intestinal pain and damage. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Gastrointestinal, nervous, and respiratory symptoms are the most likely adverse effects. If indigestion, abdominal pain, diarrhoea, flatulence, nausea, dizziness, or insomnia are severe, consult your doctor. In all cases, consult your doctor if a rash or swollen ankles develop, and call your doctor immediately if palpitations occur. If you experience wheezing, breathlessness, pain in the chest, groin, or leg, black or bloody vomit or faeces, or loss of consciousness, stop taking the drug and contact your doctor immediately.

INTERACTIONS

General note Celecoxib interacts with a wide range of drugs, including ACE inhibitors, SSRI antidepressants, antihypertensives, diuretics, and drugs that increase the risk of bleeding and/or peptic ulcers (e.g. aspirin and other NSAIDs).

Lithium Levels and effects of this drug are increased when taken with celecoxib.

Carbamazepine, fluconazole, rifampicin, and barbiturates reduce the effects of celecoxib.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have liver or kidney problems.

· You have epilepsy.

· You have asthma.

· You are allergic to aspirin or any other NSAID.

· You are allergic to sulphonamides.

· You have a history of peptic ulcers.

· You have high blood pressure.

· You have ankle swelling.

· You have heart problems.

· You have had a heart attack or stroke.

· You have inflammatory bowel disease.

· You are taking other medicines.

Pregnancy Not prescribed.

Breast-feeding Not prescribed.

Infants and children Not recommended.

Over 60 Elderly people may be more sensitive to the drug’s effects. Lower doses may be necessary.

Driving and hazardous work Avoid until you know how the drug affects you. It can cause dizziness, vertigo, and sleepiness.

Alcohol Avoid. Alcohol may increase drowsiness and the risk of stomach irritation.

PROLONGED USE

Long-term use increases the risk of a stroke or heart attack, so the lowest effective dose is given for the shortest duration.

Monitoring Periodic tests of kidney function may be performed.