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All about: Celebrex

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Generic name: Celecoxib
Brand names: Celebrex

Why is Celebrex prescribed?

Celebrex is prescribed for acute pain, menstrual cramps, and the pain and inflammation of osteoarthritis and rheumatoid arthritis. It is a member of a new class of nonsteroidal anti-inflammatory drugs (NSAIDs) called COX-2 inhibitors. Like older NSAIDs such as Motrin and Naprosyn, Celebrex is believed to fight pain and inflammation by inhibiting the effect of a natural enzyme called COX-2. Unlike the older medications, however, it does not interfere with a similar substance, called COX-1, which exerts a protective effect on the lining of the stomach. Therefore, Celebrex may be less likely to cause the bleeding and ulcers that sometimes accompany sustained use of the older NSAIDs.

Celebrex has also been found to reduce the number of colorectal polyps (growths in the wall of the lower intestine and rectum) in people who suffer from the condition called familial adenomatous polyposis (FAP), an inherited tendency to develop large numbers of colorectal polyps that eventually become cancerous.

Most important fact about Celebrex

Like other NSAID medication, Celebrex could increase the chance of having a heart attack or stroke, possibly resulting in death. The risk is greater if you have heart disease or use NSAIDs for a long time. It's important to discuss the risks and benefits of using Celebrex with your doctor and to use the lowest effective dose for the shortest amount of time possible.

Although Celebrex is easy on the stomach, it still poses some degree of risk—especially if you've had a stomach ulcer or gastrointestinal bleeding in the past. All NSAIDs, including Celebrex, can cause serious—and even life-threatening—ulcers and bleeding in the stomach and intestines. These side effects can happen without symptoms and may occur at any time during treatment. If you've ever had ulcers or stomach bleeding, make sure the doctor is aware of it. And be sure to alert the doctor if you develop any digestive problems or notice a change in your bowel movement (such as blood in the stool or black, sticky stools).

How should you take Celebrex?

Take Celebrex exactly as prescribed. You can take it with or without food.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Do not take 2 doses at the same time.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Celebrex.

  • More common side effects may include:
    Abdominal pain, diarrhea, headache, indigestion, nausea, respiratory infection, sinus inflammation

Why should Celebrex not be prescribed?

Do not take Celebrex right before or after heart bypass surgery (also called coronary artery bypass graft, or CABG).

In addition, you should not use Celebrex if you are allergic to sulfonamide drugs such as sulfadiazine, sulfisoxazole, Gantanol, and Thiosulfil. Also avoid the drug if you've ever suffered an asthma attack, face and throat swelling, or skin eruptions after taking aspirin or other NSAIDs. If you find that you are allergic to Celebrex, you will not be able to use it.

Special warnings about Celebrex

Remember to tell your doctor about any stomach ulcers or bleeding you've had in the past. Also alert your doctor if you develop any digestive problems, swelling, or rash. The chance of developing a stomach ulcer or bleeding while taking Celebrex increases if you also take steroid drugs or blood thinners, smoke, drink alcohol, or use Celebrex or other NSAID medications for a long time. The risk is also greater if you're older or in poor health. Be sure the doctor is aware of your full medical history.

If you have asthma, use Celebrex with caution. It could trigger an attack, especially if you are also sensitive to aspirin.

If you are taking a steroid medication for your arthritis, do not discontinue it abruptly when you begin therapy with Celebrex. Celebrex is not a substitute for such drugs.

Celebrex has been known to cause kidney or liver problems, particularly in people with an existing condition. If you have such a disorder, take Celebrex with caution. If you develop symptoms of liver poisoning, stop taking the drug and see your doctor immediately. Warning signs include nausea, fatigue, itching, yellowish skin, pain in the right side of the stomach, and flu-like symptoms.

If you are prone to anemia (loss of red blood cells), make sure the doctor knows about it. Celebrex occasionally fosters this problem.

Celebrex sometimes causes water retention, which can aggravate swelling, high blood pressure, and heart failure. Use Celebrex with caution if you have any of these conditions.

There is no proof that Celebrex reduces the odds of cancer in people who take the drug for FAP. Although Celebrex can reduce the number of growths, you'll still need the other treatments and frequent checkups that this condition requires.

The safety and effectiveness of Celebrex have not been tested in children under 18.

Possible food and drug interactions when taking Celebrex

If Celebrex is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Celebrex with the following:

ACE-inhibitors (a type of blood pressure and heart medication, including such drugs as Capoten, Vasotec, and Prinivil)
Blood thinning agents such as Coumadin
Fluconazole (Diflucan)
Furosemide (Lasix)
Lithium (Eskalith, Lithobid)
Thiazide diuretics (water pills) such as hydrochlorothiazide and Dyazide

If you take low-dose aspirin to protect against heart attack, you can continue taking it with Celebrex. Using aspirin increases your risk of stomach ulcers or bleeding, but Celebrex does not have aspirin's protective effect on the heart.

Special information if you are pregnant or breastfeeding

Celebrex can harm a developing baby if taken during the third trimester, and its safety earlier in pregnancy has not been confirmed. Take it during pregnancy only if you feel the risk is justified.

It's possible that Celebrex makes its way into breast milk (limited data from one subject indicated that the drug was excreted in human milk), and it could cause serious reactions in a nursing infant. If Celebrex is essential to your health, your doctor may advise you to discontinue breastfeeding.

Recommended dosage

The following dosages are typically cut in half for people with moderate liver problems.

ADULTS

Osteoarthritis

The recommended daily dose is 200 milligrams, taken as a single dose or in 100-milligram doses twice a day.

Rheumatoid Arthritis

The recommended dose is 100 to 200 milligrams twice a day.

Acute Pain and Menstrual Cramps

The recommended starting dose is 400 milligrams, followed by an additional 200 milligrams if needed on the first day. On subsequent days, the recommended dosage is 200 milligrams twice a day.

Familial Adenomatous Polyposis

The recommended dose is 400 milligrams twice a day with food.

Overdosage

Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.

  • Symptoms of Celebrex overdose may include:
    Breathing difficulties, coma, drowsiness, gastrointestinal bleeding, high blood pressure, kidney failure, nausea, sluggishness, stomach pain, vomiting

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