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Celebrex

Celebrex (Celecoxib) is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve the pain, tenderness, inflammation (swelling), stiffness caused by arthritis, menstrual cramps, and colonic polyps.

Medications and Prescriptions

Generic name: Celecoxib
Product Brand Name: Celebrex ®

1. Description: 
Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve the pain, tenderness, inflammation (swelling), stiffness caused by arthritis, menstrual cramps, and colonic polyps. Celebrex was approved by the U.S. Food and Drug Administration for use in 1998.

2. Celebrex is Prescribed for: 
Celebrex is used for the relief of pain, fever, swelling, and tenderness caused by osteoarthritis and rheumatoid arthritis . Celebrex does not prevent the progression of either type of arthritis. It reduces only the symptoms and signs of arthritis. Celebrex has been approved for patients with familial FAP who have not had their colons removed. Celebrex also is approved for the relief of acute pain and the pain of menstrual cramps (primary dysmenorrhea).
Celebrex as a nonsteroidal anti-inflammatory drugs (NSAIDs) is commonly prescribed medication for the inflammation of arthritis and other body tissues, such as in tendinitis and bursitis.
Celebrex differs from other NSAIDs in that it causes less inflammation and ulceration of the stomach and intestine (at least with short-term treatment) and does not interfere with the clotting of blood. NSAIDs have been found to prevent the formation and reduce the size of polyps in patients with the genetic disease, familial adenomatous polyposis (FAP).

3. Drug Mechanism: 
Celebrex is a COX-2 inhibitor that works specifically on an enzyme called COX-2. COX-2 inhibitors are newly developed drugs for inflammation that selectively block the COX-2 enzyme. Blocking this enzyme impedes the production of the chemical messengers (prostaglandins) that cause the pain and swelling of arthritis inflammation. Cox-2 inhibitors are a new class of nonsteroidal anti-inflammatory drugs (NSAIDs). Because they selectively block the COX-2 enzyme and not the COX-1 enzyme, these drugs are uniquely different from traditional NSAIDs.

4. Dosage Form: 
The lowest effective dose should be used for each patient. For the management of osteoarthritis, the dose usually is 100 mg twice daily or 200 mg as a single dose. For rheumatoid arthritis, the dose usually is 100 or 200 mg twice daily. For acute pain or menstrual cramps, the dose is 400 mg as a single dose on the first day followed by an additional 200 mg if needed, then 200mg twice daily as needed. For FAP, the recommended dose is 400 mg twice daily.

5. Drug Interactions: 
Concomitant use of Celebrex with aspirin or other NSAIDs (e.g., ibuprofen, naproxen, etc.) may increase the occurrence of stomach and intestinal ulcers.
Fluconazole (Diflucan) increases the concentration of celecoxib in the body by inhibiting the breakdown of celecoxib in the liver. Therefore, treatment with Celebrex should be initiated at the lowest recommended doses in patients who are taking fluconazole.
Celebrex increases the concentration of lithium (Eskalith) in the blood by 17%. Therefore, lithium therapy should be closely monitored during and after therapy with celecoxib.
Persons taking the anticoagulant (blood thinner) warfarin (Coumadin) should have their blood tested when initiating or changing celecoxib treatment, particularly in the first few days, for any changes in the effects of the anticoagulant.

6. Pregnancy: 
Celebrex has not been studied in pregnant women. However, there is a chance that this medicine may cause unwanted effects on the heart or blood flow of the fetus or newborn baby if it is taken regularly during the last few months of pregnancy In animal studies, doses that were twice the maximally recommended dose were harmful to the fetus. Celebrex should only be used in pregnant women when the benefits outweigh the potential risk to the fetus.

Studies in animals have shown that Celebrex has caused birth defects of the ribs and sternebrae. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

7. Nursing Mothers: 
The use of Celebrex in nursing mothers has not been evaluated.
It is not known whether Celebrex passes into breast milk. However, Celebrex may cause unwanted effects in nursing babies. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

8. Dietary and Alcohol Considerations: 
Celebrex may be taken with or without food. If Celebrex causes an upset stomach, take it with food.
Persons who drink more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking NSAIDs, and this also may be true with Celebrex.

9. Possible Side Effects: 
Some 10%-50% of patients are unable to tolerate NSAID treatment. Although stomach and intestinal ulcers occur with the use of Celebrex, their incidence is less than with other NSAIDs in short-term studies.
Celebrex does not interfere with the function of the blood platelets and, as a result, does not reduce clotting and lead to increased bleeding like other NSAIDs.
The most common adverse effects are headache, abdominal pain, dyspepsia, diarrhea, nausea, flatulence and insomnia. Other side effects include fainting, kidney failure, heart failure, aggravation of hypertension, chest pain, ringing in the ears, deafness, stomach and intestinal ulcers, bleeding, blurred vision, anxiety, photosensitivity, weight gain, water retention, flu-like symptoms, drowsiness and weakness.
Allergic reactions can occur with Celebrex. Individuals who have developed allergic reactions (rash, itching, difficulty breathing) from sulfonamides, aspirin or other NSAIDs may experience an allergic reaction to Celebrex and should not take Celebrex. If you notice other effects not listed above, contact your doctor or pharmacist.

10. Storage: 
Keep this medication in the container it came in, tightly closed, and out of reach of children. Capsules should be stored at room temperature (77°F (25°C)) and away from excess heat and moisture (not in the bathroom). It is okay for brief periods in temperatures between 59-86°F (15-30°C). Throw away any medication that is outdated or no longer needed.

11. Package Size and Type: 
Capsules: 100 mg (white with a blue band), 200 mg (white with a gold band), 400 mg (white with a green band).

12. Where can I get more information on acarbose?
a) U.S. National Library of Medicine and National Institutes of Health
b) WebMD Corporation

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.