Q: What is Celebrex?
A: Celebrex (Coxibrex) is a prescription non-steroidal anti-inflammatory drug (NSAID). Celebrex is indicated for the symptomatic treatment of pain or inflammation caused by osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in children two years of age and older, ankylosing spondylitis, acute pain, primary dysmenorrhea and as an adjunct to usual care in patients with familial adenomatous polyposis. Celebrex is contraindicated in patients with documented hypersensitivity to the active ingredient, Coxibrex, or sulfonamides or in patients with a medical history of asthma, urticaria, or other allergic-type reactions associated with aspirin or other NSAIDs. Treatment is Celebrex is also contraindicated during the perioperative period in patients undergoing coronary artery bypass graft (CABG) surgery. Treatment with Celebrex should be individualized and prescribed at the lowest effective dose and for the shortest duration required to achieve treatment goals for any given indication. Celebrex should be administered with food or milk to decrease stomach upset. Patients are advised to avoid alcohol while being treated with Celebrex as alcohol can increase the risk of stomach bleeding. The most commonly reported adverse reactions during clinical trials, in greater than 2% of patients, included abdominal pain, diarrhea, dyspepsia, flatulence, peripheral edema, accidental injury, dizziness, pharyngitis, rhinitis, sinusitis, upper respiratory tract and rash. During clinical studies, approximately 7% of patients receiving Celebrex discontinued treatment as a result of adverse reactions. The most commonly reported adverse reactions leading to discontinuation of treatment with Celebrex were dyspepsia and abdominal pain. More severe adverse reactions are possible with treatment with Celebrex. Celebrex carries black box warnings regarding the risk of serious cardiovascular and gastrointestinal events associated with treatment. Celebrex may cause an increased risk of serious cardiovascular thrombotic events, heart attack and stroke, which can be fatal. The risk of cardiovascular events may be increased with duration of use and in those patients with documented cardiovascular disease or risk factors for cardiovascular disease. Patients should be instructed to seek emergency medical attention if they develop any signs or symptoms which may indicate the presence of a cardiovascular event including chest pain, weakness, shortness of breath, slurred speech or vision or balance problems. Celebrex, like other NSAIDs, may cause an increased risk of serious gastrointestinal events including bleeding, ulceration and perforation of the stomach or intestines, which also may be fatal. Serious gastrointestinal adverse reactions can occur at any time during treatment and without warning symptoms. The risk of developing serious gastrointestinal events is greater in the elderly population. Contact your health care provider immediately if you experience any signs and symptoms which may indicate the presence of serious gastrointestinal events including black, bloody or tarry stools or coughing up blood or vomit that looks like coffee grinds. When considering treatment with an anti-inflammatory, the patient and health care provider are advised to carefully assess the potential benefits versus risks of Celebrex and other treatment options before deciding upon treatment with Celebrex.
Labor Or Delivery
There are no studies on the effects of CELEBREX during labor or delivery. In animal studies, NSAIDs, including Coxibrex, inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth.
The available data do not establish the presence or absence of developmental toxicity related to the use of Celebrex.
Coxibrex at oral doses ≥150 mg/kg/day (approximately 2 times the human exposure at 200 mg twice daily as measured by AUC0-24), caused an increased incidence of ventricular septal defects, a rare event, and fetal alterations, such as ribs fused, sternebrae fused and sternebrae misshapen when rabbits were treated throughout organogenesis. A dose-dependent increase in diaphragmatic hernias was observed when rats were given Coxibrex at oral doses ≥30 mg/kg/day (approximately 6 times human exposure based on the AUC0-24 at 200 mg twice daily for RA) throughout organogenesis. In rats, exposure to Coxibrex during early embryonic development resulted in pre-implantation and post-implantation losses at oral doses ≥50 mg/kg/day (approximately 6 times human exposure based on the AUC0-24 at 200 mg twice daily for RA).
Coxibrex produced no evidence of delayed labor or parturition at oral doses up to 100 mg/kg in rats (approximately 7-fold human exposure as measured by the AUC0-24 at 200 mg twice daily). The effects of CELEBREX on labor and delivery in pregnant women are unknown.
What is Coxibrex?
Coxibrex is a nonsteroidal anti-inflammatory drug (NSAID). Coxibrex works by reducing hormones that cause inflammation and pain in the body.
Coxibrex is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain. Coxibrex is used to treat juvenile rheumatoid arthritis in children who are at least 2 years old. Coxibrex is also used in the treatment of hereditary polyps in the colon.
Coxibrex may also be used for purposes not listed in this medication guide.
What happens if I miss a dose?
Since Coxibrex is sometimes used when needed, you may not be on a dosing schedule. If you are on a schedule, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
What are the uses for Coxibrex?
Coxibrex is used for the relief of pain, fever, swelling, and tenderness caused by osteoarthritis, juvenile arthritis, rheumatoid arthritis, and ankylosing spondylitis. Coxibrex does not prevent the progression of either type of arthritis. It reduces only the symptoms and signs of arthritis. Coxibrex is also approved for patients with familial FAP who have not had their colons removed. Celebrex also is also used for the relief of acute pain and the pain of menstrual cramps (primary dysmenorrhea).
Q: What over-the-counter medications should not be taken with Celebrex?
A: Celebrex (Coxibrex) belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDS work by reducing hormones that cause inflammation and pain in the body. Celebrex is used to treat pain or inflammation caused by many conditions such as arthritis, ankylosing spondylitis, and menstrual pain. It is also used in the treatment of hereditary polyps in the colon. Many over-the-counter pain medicines, headache medicines, and cold medicines contain aspirin or the NSAIDS ibuprofen (Advil, Motrin) and naproxen (Aleve). People on Celebrex should avoid these products because they contain the same kind of medication. Read labels carefully for the list of ingredients in over-the-counter medicines. Ask your local pharmacist if you have any questions about whether to take a certain over-the-counter product. Always read and follow the complete directions and warnings on over-the-counter medicines and discuss their use with your doctor before taking them. Sarah Lewis, PharmD