From the Guidelines
Celecoxib is not recommended for aborting acute headaches due to its slower onset of action and primary use in chronic conditions like arthritis. While celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that can help with pain, it is not specifically designed or commonly used as an abortive treatment for headaches 1. For acute headache abortion, medications like triptans (sumatriptan, rizatriptan), certain NSAIDs (ibuprofen, naproxen), or combination analgesics are generally more effective. Some key points to consider when treating acute headaches include:
- Using first-line therapies such as aspirin, ibuprofen, naproxen sodium, tolfenamic acid, and the combination agent acetaminophen plus aspirin plus caffeine 1
- Considering migraine-specific agents (triptans, DHE) in patients whose migraine attack has not responded to NSAIDs 1
- Selecting a nonoral route of administration for patients whose migraines present early with nausea or vomiting as a significant component of the symptom complex 1
- Evaluating patients for use of preventive therapy, especially if they experience two or more attacks per month that produce disability lasting 3 or more days per month 1
- Using recommended first-line agents for the prevention of migraine headache, such as propranolol, timolol, amitriptyline, divalproex sodium, and sodium valproate 1 It's essential to consult with a healthcare provider to determine the best course of treatment for acute headaches, as they can recommend appropriate medications and provide guidance on proper dosing and frequency tailored to the individual's specific headache type and medical history.
From the FDA Drug Label
Central, Peripheral Nervous system Dizziness Headache 2.0% 15.8% Nervous System 17 11 21 Headache NOS131016
The FDA drug label does not provide information that celecoxib aborts headaches. Headache is listed as an adverse event, but there is no indication that celecoxib is used to treat or abort headaches. 2
From the Research
Celecoxib and Headache Treatment
- Celecoxib is a cyclo-oxygenase (COX)-2 selective inhibitor that has been used for symptomatic relief in the treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis 3.
- The use of celecoxib for the acute treatment of migraine has been studied, with results showing that it can be effective in relieving pain and reducing the incidence of gastric pain compared to other NSAIDs 4, 5.
Efficacy of Celecoxib in Abortive Treatment of Migraine
- A randomized, open-label, controlled trial found that celecoxib 400 mg was equally effective as naproxen sodium 550 mg in relieving pain in acute migraine, with a significant improvement in visual analogue score (VAS) at one and two hours after treatment 4.
- A randomized, placebo-controlled clinical trial found that celecoxib oral solution was superior to placebo in achieving pain freedom and freedom from the most bothersome symptom at 2 hours post-dose, with a low incidence of treatment-emergent adverse events 5.
Safety of Celecoxib in Acute Treatment of Migraine
- A narrative review found that low-dose formulations of NSAIDs, such as celecoxib oral solution, provide acute migraine analgesia with similar or fewer associated cardiovascular and gastrointestinal events than previous formulations 6.
- The review also discussed the mechanisms of action of nonselective NSAIDs vs. COX-2 inhibitors and how these mechanisms underlie the adverse events associated with these treatments 6.