From the Guidelines
Celebrex (celecoxib) should be used with caution, particularly in patients with a history of cardiovascular disease, and the lowest effective dose should be prescribed for the shortest duration necessary, as it may increase the risk of cardiovascular events, especially at higher doses or with prolonged use 1. When considering the use of Celebrex, it's essential to weigh the benefits against the risks, taking into account the patient's individual risk profile, including gastrointestinal and cardiovascular risks.
- The typical dosage of Celebrex ranges from 100-200 mg once or twice daily, depending on the condition being treated.
- Patients should take Celebrex with food if stomach upset occurs.
- Unlike some other NSAIDs, Celebrex may have a lower risk of stomach ulcers and bleeding, though it still carries cardiovascular risks.
- People with heart disease, history of stroke, or certain allergies should use caution with this medication.
- Common side effects include headache, indigestion, upper respiratory tract infection, and diarrhea.
- Patients should avoid taking Celebrex with other NSAIDs and should inform their doctor about all medications they're taking to prevent potential interactions. According to the most recent guidelines, for patients with normal gastrointestinal function, non-selective oral NSAIDs, preferably in combination with a proton pump inhibitor (PPI), or selective cyclooxygenase 2 (COX2) inhibitors, such as celecoxib, are recommended 1. In patients with an increased risk of cardiovascular events, the use of COX-2 inhibitors, including celecoxib, should be limited to 30 days, and non-selective NSAIDs should be limited to 7 days 1. It's also important to consider the patient's age, as it is a major risk factor for cardiovascular, cerebrovascular, and gastrointestinal adverse outcomes, and the use of oral NSAIDs should be avoided in persons aged 65 years and above, or used with caution in those aged 75 years and above, and instead, topical NSAIDs may be preferred 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Overview of Celebrex
- Celebrex, also known as celecoxib, is a cyclo-oxygenase (COX) 2-selective inhibitor used for the relief of signs and symptoms of osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) 2.
- It is also used for the management of acute pain in adults, treatment of primary dysmenorrhoea, and reduction of adenomatous colorectal polyps in familial adenomatous polyposis 2.
Efficacy and Safety
- Celecoxib has been shown to be effective in improving signs and symptoms of OA, RA, and AS, with a similar efficacy to nonselective NSAIDs 3, 4.
- It has a lower incidence of upper gastrointestinal ulceration and complications compared to nonselective NSAIDs 3, 4, 5.
- The risk of cardiovascular events with celecoxib is increased with higher doses, but is comparable to nonselective NSAIDs 6.
- Celecoxib should be used at the lowest effective dose for the shortest possible duration, weighing the potential benefits against the risks of gastrointestinal, cardiovascular, and renal adverse events 2, 3, 6.
Patient Selection
- Celecoxib is a useful option for patients at high risk of NSAID-induced gastrointestinal toxicity, or those who are unresponsive to or intolerant of other NSAIDs 2, 3.
- It is also a rational choice for patients at low cardiovascular risk who require NSAID therapy 2.
- Prescribers should make informed decisions based on the available evidence and discuss the potential risks and benefits with patients 6.