From the Guidelines
No, Celebrex is not considered a sulfa drug in the context of cross-reactivity with sulfonamide antimicrobials. According to the most recent and highest quality study, a 2022 practice parameter update on drug allergy published in the Journal of Allergy and Clinical Immunology 1, Celecoxib, the active ingredient in Celebrex, is listed as a COX-2 inhibitor with no or weak evidence of cross-reactivity in patients with a history of sulfonamide antimicrobial adverse reactions.
This classification is crucial for patients with known sulfa allergies, as it suggests that the risk of cross-reactivity with Celebrex is minimal. The study highlights that sulfonamide antimicrobials are structurally different from nonantimicrobial sulfonamides, such as Celecoxib, due to the presence of an aromatic amine group at the N4 position.
Key points to consider:
- Celecoxib is a COX-2 selective nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation.
- It is classified as a sulfonamide non-antimicrobial, which has a different structure than sulfonamide antimicrobials.
- The risk of allergic reaction in patients with sulfa antibiotic allergies taking Celebrex appears to be lower than with sulfonamide antibiotics, as indicated by the lack of cross-reactivity evidence 1.
- Patients with known sulfa allergies should still inform their healthcare provider before taking Celebrex, but the current evidence suggests that Celebrex is not a sulfa drug in the context of cross-reactivity with sulfonamide antimicrobials.
From the FDA Drug Label
Celecoxib capsules are a sulfonamide and both NSAIDs and sulfonamides may cause allergic type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people
- Yes, Celebrex is a sulfonamide, which is related to sulfa drugs.
- The chemical name of celecoxib is 4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl] benzenesulfonamide, which contains a sulfonamide moiety 2.
From the Research
Definition of a Sulfa Drug
A sulfa drug is defined as any compound with an SO2NH2 moiety 3.
Celebrex and Sulfa Allergy
Celecoxib, the active ingredient in Celebrex, is a diaryl-substituted pyrazole derivative containing a sulfonamide substituent, which may lead to concerns about cross-reactivity in patients with a sulfa allergy 3. However, studies have shown that the potential for cross-reactivity between celecoxib and sulfonamide antimicrobials appears to be low 4.
Key Differences Between Sulfonamide Antimicrobials and Other Sulfonamide-Containing Medications
The major difference between sulfonamide antimicrobials and other sulfonamide-containing medications, such as celecoxib, is the presence of an aromatic amine group at the N4 position in sulfonamide antimicrobials 3. This difference is critical in determining the potential for adverse reactions, such as hypersensitivity syndrome reactions and toxic epidermal necrolysis.
Studies on Celebrex and Sulfa Allergy
- A pilot study found that 28 patients with a history of sulfonamide antimicrobial allergy tolerated celecoxib without any adverse reactions 4.
- Another study reviewed the use of celecoxib in the management of arthritis and acute pain, but did not specifically address the issue of sulfa allergy 5.
- Other studies have compared the safety of celecoxib with other nonsteroidal anti-inflammatory drugs (NSAIDs), but did not focus on the issue of sulfa allergy 6, 7.
Conclusion on Celebrex Being a Sulfa Drug
Based on the available evidence, Celebrex (celecoxib) is a sulfonamide-containing medication, but the potential for cross-reactivity with sulfonamide antimicrobials is low due to key differences in their chemical structure 3, 4.