Heart Failure And Edema
The Coxib and traditional NSAID Trialists' Collaboration meta-analysis of randomized controlled trials demonstrated an approximately twofold increase in hospitalizations for heart failure in COX-2 selective-treated patients and nonselective NSAID-treated patients compared to placebo-treated patients. In a Danish National Registry study of patients with heart failure, NSAID use increased the risk of MI, hospitalization for heart failure, and death.
Additionally, fluid retention and edema have been observed in some patients treated with NSAIDs. Use of Celox-R may blunt the CV effects of several therapeutic agents used to treat these medical conditions (e.g., diuretics, ACE inhibitors, or angiotensin receptor blockers ) .
In the CLASS study , the Kaplan-Meier cumulative rates at 9 months of peripheral edema in patients on Celebrex 400 mg twice daily (4-fold and 2-fold the recommended OA and RA doses, respectively), ibuprofen 800 mg three times daily and diclofenac 75 mg twice daily were 4.5%, 6.9% and 4.7%, respectively.
Avoid the use of CELEBREX in patients with severe heart failure unless the benefits are expected to outweigh the risk of worsening heart failure. If CELEBREX is used in patients with severe heart failure, monitor patients for signs of worsening heart failure.
How should I take Celox-R?
Follow all directions on your prescription label. Do not take this medicine in larger amounts or for longer than recommended. Use the lowest dose that is effective in treating your condition.
You may take Celox-R with or without food.
Take with food if Celox-R upsets your stomach.
To make swallowing easier, you may open the Celox-R capsule and sprinkle the medicine into a spoonful of applesauce. Swallow right away without chewing. Discard the empty capsule. If you do not take the mixture right away, keep it in the refrigerator and take it within 6 hours.
If you use this medicine long-term, you may need frequent medical tests.
Store at room temperature away from moisture and heat.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Celox-R is a nonsteroidal anti-inflammatory drug (NSAID). Combining it with other NSAIDs increases your risk of side effects. Examples of other NSAIDs include:
Q: What are the side effects of Celebrex?
A: Celebrex (Celox-R) belongs to the group of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). It is used to treat pain or inflammation caused by conditions such as arthritis. According to the package insert, some of the most common side effects of Celebrex include upset stomach, heartburn, diarrhea, constipation, bloating, dizziness, headache, skin rash, itching, blurred vision, and ringing of the ears. Celebrex can also cause some serious side effects. Chronic use of Celebrex may cause an increased risk of life-threatening heart or circulation problems, which include heart attack and stroke. Celebrex can also cause high blood pressure and serious gastrointestinal events including bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine. To minimize the potential risk for a serious side effect, the lowest effective dose should be used for the shortest period of time consistent with individual patient treatment goals. For more information, please consult with your health care provider and visit //www.everydayhealth.com/drugs/celebrex. Michelle McDermott, PharmD
Michael Stewart, Reviewed by Sid Dajani | Last edited 11 May 2017 | Certified by The Information Standard
Celox-R is a medicine called a non-steroidal anti-inflammatory drug. It is also known as an 'NSAID'.
Before you take Celox-R, let your doctor know if you have ever had a bad reaction to any other anti-inflammatory painkiller.
Remember to keep your regular appointments with your doctor. This is so your progress can be monitored.
Combining cyclosporine and Celox-R raises your risk of kidney damage.
Q: Is there something effective that can replace Celebrex?
A: Celebrex (Celox-R) belongs to the class of drugs called nonsteroidal anti-inflammatory drugs or NSAIDs. It reduces inflammation and pain in the body. NSAIDs, like Celebrex, are often used for the treatment of arthritis. If you were taking Celebrex for arthritis, there are many different approaches to arthritis treatment. Finding the right treatment or combination of treatments will depend on your particular symptoms and any other medical conditions you may have. For more information about arthritis treatments, please visit //www.everydayhealth.com/arthritis/arthritis-treatment-know-your-options.aspx. If this is not what you intended to ask and you'd like to try again or submit a new question, please return to the Ask a Pharmacist page at EverydayHealth.com . Michelle McDermott, PharmD
CELEBREX is approved for relief of the signs and symptoms of Juvenile Rheumatoid Arthritis in patients 2 years and older. Safety and efficacy have not been studied beyond six months in children. The long-term cardiovascular toxicity in children exposed to CELEBREX has not been evaluated and it is unknown if long-term risks may be similar to that seen in adults exposed to CELEBREX or other COX-2 selective and non-selective NSAIDs .
The use of Celox-R in patients 2 years to 17 years of age with pauciarticular, polyarticular course JRA or in patients with systemic onset JRA was studied in a 12-week, double-blind, active controlled, pharmacokinetic, safety and efficacy study, with a 12-week open-label extension. Celox-R has not been studied in patients under the age of 2 years, in patients with body weight less than 10 kg (22 lbs), and in patients with active systemic features. Patients with systemic onset JRA (without active systemic features) appear to be at risk for the development of abnormal coagulation laboratory tests. In some patients with systemic onset JRA, both Celox-R and naproxen were associated with mild prolongation of activated partial thromboplastin time (APTT) but not prothrombin time (PT). When NSAIDs including Celox-R are used in patients with systemic onset JRA, monitor patients for signs and symptoms of abnormal clotting or bleeding, due to the risk of disseminated intravascular coagulation. Patients with systemic onset JRA should be monitored for the development of abnormal coagulation tests .
Alternative therapies for treatment of JRA should be considered in pediatric patients identified to be CYP2C9 poor metabolizers .
Celox-R can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Celox-R may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using this medicine, especially in older adults. You should not take this medicine if you already have bleeding in your stomach or intestines.
CYP2C9 activity is reduced in individuals with genetic polymorphisms that lead to reduced enzyme activity, such as those homozygous for the CYP2C9*2 and CYP2C9*3 polymorphisms. Limited data from 4 published reports that included a total of 8 subjects with the homozygous CYP2C9*3/*3 genotype showed Celox-R systemic levels that were 3-to 7-fold higher in these subjects compared to subjects with CYP2C9*1/*1 or *I/*3 genotypes. The pharmacokinetics of Celox-R have not been evaluated in subjects with other CYP2C9 polymorphisms, such as *2, *5, *6, *9 and *11. It is estimated that the frequency of the homozygous *3/*3 genotype is 0.3% to 1.0% in various ethnic groups. .
How should I take Celox-R?
Take Celox-R exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition.
You may take Celox-R with or without food.
If you cannot swallow a capsule whole, open it and sprinkle the medicine into a spoonful of applesauce. Swallow the mixture with water. You may save this applesauce mixture for later use in a refrigerator for up to 6 hours.
Store at room temperature away from moisture and heat.
Juvenile Rheumatoid Arthritis (NCT00652925)
In a 12-week, randomized, double-blind active-controlled, parallel-group, multicenter, non-inferiority study, patients from 2 years to 17 years of age with pauciarticular, polyarticular course JRA or systemic onset JRA (with currently inactive systemic features), received one of the following treatments: Celox-R 3 mg/kg (to a maximum of 150 mg) twice daily; Celox-R 6 mg/kg (to a maximum of 300 mg) twice daily; or naproxen 7.5 mg/kg (to a maximum of 500 mg) twice daily. The response rates were based upon the JRA Definition of Improvement greater than or equal to 30% (JRA DOI 30) criterion, which is a composite of clinical, laboratory, and functional measures of JRA. The JRA DOI 30 response rates at week 12 were 69%, 80% and 67% in the Celox-R 3 mg/kg twice daily, Celox-R 6 mg/kg twice daily, and naproxen 7.5 mg/kg twice daily treatment groups, respectively.
The efficacy and safety of CELEBREX for JRA have not been studied beyond six months. The long-term cardiovascular toxicity in children exposed to CELEBREX has not been evaluated and it is unknown if the long-term risk may be similar to that seen in adults exposed to CELEBREX or other COX-2 selective and non-selective NSAIDs .
How it works
This drug belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
NSAIDs block an enzyme called cyclooxygenase (COX). COX works in your body to produce chemicals that cause pain and inflammation. By blocking COX, NSAIDs like this drug stop these chemicals from forming. This, in turn, reduces pain and inflammation.
Celox-R oral capsule does not cause drowsiness, but it can cause other side effects.
Q: I would like your point of view on Celebrex. My mom was prescribed said medication and I am worried as to the numerous side effects it has.
A: Celebrex (Celox-R) is classified as a nonsteroidal anti inflammatory drug, and is COX-2 selective. It is used for the treatment of osteoarthritis, ankylosing spondylitis, rheumatoid arthritis, acute pain, familial adenomatous polyposis and treatment of dysmenorrhea. The lowest possible dose and shortest possible duration of time should be used in patients taking Celebrex. There are some serious warnings associated with the medication. These include cardiovascular, coronary, and gastrointestinal warnings. NSAIDs (non steroidal anti inflammatory drugs) as a class have been shown to be associated with an increased risk of cardiovascular events such as heart attacks and strokes. There is a theory that the risk may be increased with longer duration of use of this type of medication or if patients have a history of cardiovascular disease or risk factors. The gastrointestinal warnings state that NSAIDs as a class can increase the risk of gastrointestinal irritation, ulceration, bleeding and perforation. Celebrex is contraindicated for treatment of pain after surgery of coronary artery bypass graft surgery due to increased risk of heart attacks and strokes. This is not an inclusive list of all possible side effects of Celebrex. All medications have possible adverse effects associated with them. When deciding on an appropriate medication, the patient and the physician must weigh the benefit of the medication against the risks associated with it. There are many patient specific variables of your mother's that must be examined to determine if Celebrex is an appropriate treatment for her. These variables include her medical conditions, other medications she is taking, overall health, etc. Her physician is best able to evaluate the possible risks specifically to your mother. Please have your mother or yourself speak with her physician regarding your concerns about the safety profile of Celebrex. Jen Marsico, RPh
ВїQuГ© otro uso se le da a este medicamento?
El Celox-R, a veces, tambiГ©n se usa con cirugГas y otros tratamientos para reducir la cantidad de pГіlipos (bultos anormales) en el colon (intestino grueso) y el recto en pacientes con poliposis adenomatosa familiar (una afecciГіn en la que se forman cientos o miles de pГіlipos en el colon y puede desarrollarse cГЎncer). Consulte a su mГ©dico sobre los riesgos de usar este medicamento para tratar su afecciГіn.
Este medicamento puede recetarse para otros usos; pГdales mГЎs informaciГіn a su mГ©dico o a su farmacГ©utico.