Celebrex (celecoxib)

How does it work?

Celebrex capsules contain the active ingredient celecoxib, which is a type of medicine known as a non-steroidal anti-inflammatory drug (NSAID). NSAIDs work by blocking the action of a substance in the body called cyclo-oxygenase. Cyclo-oxygenase is involved in producing prostaglandins, in response to injury or certain diseases. These prostaglandins cause pain, swelling and inflammation. Because NSAIDs block the production of these prostaglandins, they are effective at relieving pain and inflammation. Cyclo-oxygenase does not only produce prostaglandins that cause inflammation. It also produces prostaglandins that have useful roles in the body. There are two different forms of cyclo-oxygenase, COX-1 and COX-2. COX-2 is the form that (among other things) produces prostaglandins that cause inflammation. COX-1 does not produce inflammatory prostaglandins, but does produce others that have useful effects, including some that are involved in maintaining a healthy stomach and intestinal lining. Traditional NSAIDs, such as ibuprofen or diclofenac, block the action of both COX-1 and COX-2, and this is why they can sometimes cause side effects such as stomach irritation and peptic ulcers. Celecoxib belongs to a new generation of NSAIDs that selectively block the action of COX-2. This means that it stops the production of inflammatory prostaglandins, without stopping the production of prostaglandins that protect the stomach and intestines. It therefore reduces pain and inflammation, but is less likely than traditional NSAIDs to cause side effects on the stomach and intestines (although such side effects are still possible).

What is it used for?

Rheumatoid arthritis.

Osteoarthritis.

A form of arthritis affecting the joints of the spine (ankylosing spondylitis).

Warning!

This medicine may cause dizziness or sleepiness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

NSAIDs can occasionally cause serious side effects on the gut, such as ulceration, bleeding or perforation of the stomach or intestinal lining. This type of side effect is more likely to occur in elderly people and in people taking high doses of the medicine. The risk can also be increased by taking certain other medicines (see below). It is important that these people, as well as people with a history of disorders affecting the stomach or intestines, are closely monitored by a doctor while taking this medicine. All people taking this medicine should stop treatment and consult their doctor immediately if they experience any sign of bleeding from the stomach or intestine during treatment, for example vomiting blood and/or passing black/tarry/bloodstained stools.

COX-2 inhibitors may carry an increased risk of heart attacks and stroke when compared to placebo (no treatment). If you have risk factors for heart disease or stroke, such as diabetes, high cholesterol or smoking, your doctor will need to assess the overall benefits and risks before deciding if this medicine is suitable for you. In general, if this medicine is suitable, your doctor will prescribe the lowest effective dose for as short a time as possible to control your symptoms, because the risks may increase with higher doses and the longer the medicine is taken. Do not exceed the prescribed dose. Tell your doctor if you experience shortness of breath, chest pains or ankle swelling while taking the medicine. Ask your doctor or pharmacist for further information.

This medicine may hide fever, which is a sign of infection. This may make you think mistakenly that an infection is getting better when it isn't, or that an infection is less serious than it is. For this reason you should tell your doctor if you get an infection while you are taking this medicine.

People with impaired kidney, liver or heart function should have their kidney function monitored while taking this medicine.

Very rarely, NSAIDS may cause serious blistering or peeling skin reactions (eg Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis). For this reason, you should stop taking this medicine and consult your doctor if you get a skin rash or sores inside your mouth while taking this medicine. This side effect is very rare, but if it occurs, is most likely to happen in the first month of treatment.

Use with caution in

Elderly people.

Decreased liver function.

Decreased kidney function.

Decreased volume of fluid in the body, eg due to dehydration, high doses of diuretics, severe vomiting or diarrhoea.

History of heart failure.

Swelling due to excess fluid retention (oedema).

History of disorders affecting the stomach or intestines, such as ulceration or bleeding.

High blood pressure.

Raised levels of fats such as cholesterol in the blood (hyperlipidaemia).

Diabetes.

Smokers.

Not to be used in

Children.

Allergy to medicines from the sulphonamide group, eg the antibiotic sulfamethoxazole.

People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal polyps, nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema).

Active peptic ulcer or bleeding from the gut.

Inflammatory bowel disease such as Crohn's disease or ulcerative colitis.

Severe liver disease.

Moderate to severely decreased kidney function.

Heart failure.

Heart disease caused by inadequate blood flow to the heart (ischaemic heart disease), eg angina or history of heart attack.

Disease of the blood vessels in and around the brain (cerebrovascular disease), eg history of stroke.

Poor circulation in the arteries of the legs or feet (peripheral arterial disease).

Pregnancy.

Breastfeeding.

Rare hereditary problems of galactose intolerance, the Lapp lactose deficiency or glucose-galactose malabsorption (Celebrex capsules contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used during pregnancy, particularly during the third trimester, as it may be harmful to the unborn baby. Women who could get pregnant should use effective contraception to avoid pregnancy while taking this medicine. If you do fall pregnant, stop taking this medicine and consult your doctor immediately. Seek medical advice from your doctor.

It is not known whether this medicine passes into breast milk. Mothers who need to take this medicine should not breastfeed. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Difficulty in sleeping (insomnia).

Inflammation of the sinuses (sinusitis).

Dizziness.

Inflammation of the throat (pharyngitis).

Inflammation of the lining of the nose (rhinitis) causing a blocked or runny nose.

Disturbances of the gut such as indigestion, diarrhoea, constipation, nausea, vomiting, flatulence or abdominal pain.

Retention of water in the body tissues (fluid retention)causing swelling, particularly of the legs and ankles (peripheral oedema).

Skin reactions such as rash.

Blurred vision.

Tiredness.

Anxiety.

Depression.

Increased potassium level in the blood (hyperkalaemia).

Pins and needles (paraesthesia).

Sensation of ringing or other noise in the ears (tinnitus).

Shortness of breath.

High blood pressure (hypertension).

Heart attack or stroke.

Ulceration or bleeding of the stomach or intestines.

Liver, kidney or blood disorders.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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