Celecoxib, Oral Capsule

Highlights for celecoxib

1. Celecoxib oral capsule is available as a generic drug and a brand-name drug. Brand name: Celebrex.
2. Celecoxib only comes as a capsule you take by mouth.
3. This drug is used to treat various forms of arthritis, short-term pain, and menstrual cramping and pain.

What is celecoxib?

Celecoxib is a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that celecoxib is based on is called Celebrex.

Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand-name version.

Celecoxib only comes as a capsule you take by mouth.

Why it’s used

Celecoxib is used to treat the following conditions in adults:

• rheumatoid arthritis
• osteoarthritis
• ankylosing spondylitis
• acute (short-term) pain
• menstrual cramping and pain

Celecoxib is also used to treat juvenile rheumatoid arthritis in children ages 2 years and older.

How it works

Celecoxib belongs to a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). 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 such as celecoxib stop the formation of these chemicals. This helps to reduce pain and inflammation.

Is celecoxib a strong painkiller? Is it a narcotic?

Celecoxib is an NSAID and not a narcotic drug. The term ”narcotic“ usually refers to opioid drugs. Opioids are also prescribed for pain, but they’re often used for severe, long-term pain. Celecoxib is used for some kinds of short-term pain.

Opioid drugs are considered to be “stronger” or more powerful than NSAIDs such as celecoxib. Opioids can cause severe side effects, and have a risk of misuse and addiction. But each person’s experience with pain relief medications can be different. How strong celecoxib is also depends on the dose your doctor prescribes you.

If you have questions about how strong celecoxib is, or how it compares with other types of narcotic or nonnarcotic pain medications, be sure to talk with your doctor or pharmacist.

Celecoxib side effects

Celecoxib oral capsule does not cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with celecoxib oral capsule include:

• stomach pain
• constipation
• diarrhea
• gas
• heartburn
• nausea
• vomiting
• dizziness
• headache
• upper respiratory tract infection

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 (or your local emergency number) if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Chest pain, which may or may not be a symptom of a heart attack. Symptoms may include:
  • pressure or tightness in the chest
  • pain in your back, arm, or jaw
  • pain with exertion
• Heart attack,* Symptoms may include:
  • shortness of breath or difficulty breathing
  • pain in your neck, shoulder, or arm
  • dizziness or lightheadedness
  • sweating
  • nausea
• Bleeding and ulcers in your stomach and intestines,* Symptoms may include:
  • blood in your urine
  • vomiting
  • bloody stools
  • black and sticky stools
• Stroke,* Symptoms may include:
  • sudden weakness in one part or side of your body
  • slurred speech
  • drooping on one side of your face
  • blurred vision
  • sudden dizziness or difficulty walking
  • very severe headache with no other cause
• High blood pressure. This may not cause noticeable symptoms.
• Edema (swelling due to a buildup of excess fluid). Symptoms may include:
  • swelling in your arms and legs, hands and feet
  • unusual weight gain
• Serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. Symptoms may include:
  • a rash and blisters
  • fever
  • red or irritated eyes
  • body aches
• Liver problems. Symptoms may include yellowing of the skin or whites of the eyes.
• Asthma attacks. Symptoms may include:
  • sudden difficulty breathing
  • chest tightness
  • wheezing or coughing
• Allergic reaction. Symptoms may include:
  • itching and hives
  • swelling of your face or throat
  • rash

* Celecoxib has a boxed warning for this side effect. This is the most serious warning from the FDA. To learn more, see “Boxed warnings” at the beginning of this article.

Celecoxib may interact with other medications

Taking a medication with certain vaccines, foods, and other drugs can affect how the medication works. These effects are called interactions.

Celecoxib oral capsule may interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Examples of drugs that can cause interactions with celecoxib are listed below.

Anticoagulant (blood thinner)

Combining warfarin (Jantoven) and celecoxib raises your risk of bleeding.

Mental health drug

Celecoxib may increase the levels of lithium (Lithobid) in your body. Signs of lithium toxicity include slurred speech and tremors.

Blood pressure drugs

Celecoxib may reduce the blood pressure-lowering effects of certain blood pressure drugs. Examples of these drugs include:

• angiotensin converting enzyme inhibitors
• angiotensin II receptor blockers
• diuretics

Transplant drug

Combining cyclosporine (Gengraf, Neoral, Sandimmune) and celecoxib raises your risk of kidney damage.

Cancer drugs

Taking celecoxib with certain drugs used to treat cancer raises the risk of side effects from those drugs. These side effects include kidney damage and a decrease in cells that help you fight infection. Examples of these drugs include:

• methotrexate
• pemetrexed (Pemfexy, Almita)

Other NSAIDs

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). Combining it with other NSAIDs increases your risk of side effects. Examples of other NSAIDs include:

• ibuprofen (Advil, Motrin)
• naproxen (Naprosyn)
• aspirin

Corticosteroids

Combining celecoxib with corticosteroids such as prednisone (Rayos) raises your risk of stomach bleeding.

Digoxin

If you take celecoxib with digoxin (Lanoxin), the levels of digoxin in your body may increase. If you take these drugs together, your doctor may monitor your digoxin levels.

Certain antidepressants

Combining celecoxib with selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) increases your risk of stomach bleeding. Examples of SSRIs and SNRIs include:

• citalopram (Celexa)
• paroxetine (Paxil)
• sertraline (Zoloft)
• venlafaxine (Effexor XR)
• duloxetine (Cymbalta)

Celecoxib warnings

Celecoxib comes with several warnings.

High blood pressure warning

This drug may cause you to develop high blood pressure or may worsen high blood pressure. Take this medication with caution if you have high blood pressure. Check your blood pressure before and while taking this drug.

Asthma warning

Take celecoxib with caution if you have asthma. It may cause narrowing in your airways, which can be life threatening. If your asthma worsens while you take this drug, get immediate medical attention.

Allergy warning

Celecoxib can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 (or your local emergency number) or go to the nearest emergency room. Your doctor won’t prescribe celecoxib again if you’ve ever had an allergic reaction to it.Taking it again could be life threatening.

Alcohol interaction warning

Combining alcohol with celecoxib raises your risk of stomach bleeding. If you drink alcohol, talk with your doctor about how much (if any) is safe for you to have while you’re taking celecoxib.

Smoking warning

Smoking while taking celecoxib raises your risk of stomach bleeding. If you smoke and you’d like to quit, talk with your doctor about this.

Warnings for people with certain health conditions

For people with cardiovascular disease: If you have a history of cardiovascular disease or are at risk for heart disease, your doctor won’t prescribe celecoxib. The drug raises your risk of blood clots, heart attack, and stroke.

For people with stomach problems: If you have a history of stomach bleeding or ulcers, you’re at greater risk of having another ulcer or bleeding event, which may be life threatening.

For people with sulfonamide “sulfa” allergy: If you’re allergic to medications that contain sulfonamide, your doctor won’t prescribe celecoxib. This drug contains sulfonamide. You may have serious skin reactions. Be sure to report any skin rashes to your doctor right away.

Warnings for other groups

For pregnant people: Tell your doctor if you’re pregnant or if you plan to become pregnant. Celecoxib should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Call your doctor right away if you become pregnant while taking this drug.

For people who are breastfeeding: Celecoxib has been shown to pass into breast milk. But more information is needed to determine whether there may be any effects on a child who is breastfed or on milk production.

You and your doctor can weigh the risks and benefits of breastfeeding while you’re taking celecoxib. Your doctor can recommend other ways to feed your child, if necessary.

For older adults: This drug has been studied in a small number of people older than 65 years. If you’re 65 years or older, you may have an increased risk of stomach problems and kidney failure that may be fatal. Your doctor can discuss these risks with you and determine if celecoxib is safe for you to take.

For children: This drug hasn’t been studied in children younger than 2 years.

How to take celecoxib

This dosage information is for celecoxib oral capsule. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• how severe your condition is
• other medical conditions you have
• how your body reacts to the first dose

Forms and strengths

Generic: Celecoxib

• Form: oral capsule
• Strengths: 50 milligrams (mg), 100 mg, 200 mg, and 400 mg

Brand: Celebrex

• Form: oral capsule
• Strengths: 50 mg, 100 mg, 200 mg, and 400 mg

Dosage for osteoarthritis

Adult dosage (ages 18 years and older)

The typical dosage is 200 mg taken once per day, or 100 mg taken twice per day in evenly spaced doses.

Dosage for rheumatoid arthritis

Adult dosage (ages 18 years and older)

The typical dosage is 100 to 200 mg taken twice per day in evenly spaced doses.

Child dosage (ages 2 to 17 years), for juvenile rheumatoid arthritis

• For children who weigh 10 to 25 kg (22 to 55 pounds [lb]), the typical dosage is 50 mg, taken twice per day in evenly spaced doses.
• For children who weigh more than 25 kg (55 pounds [lb]), the typical dosage is 100 mg taken twice per day in evenly spaced doses.

Dosage for ankylosing spondylitis

Adult dosage (ages 18 years and older)

• The typical dosage is 200 mg taken once per day or 100 mg taken twice per day in evenly spaced doses.
• If celecoxib isn’t working after 6 weeks, your doctor may increase your dose to 400 mg per day (in single or divided doses).

Dosage for short-term pain

Adult dosage (ages 18 years and older)

• The typical dosage is 400 mg for the first dose, followed by a 200-mg dose about 8 to 12 hours later if needed.
• On the following days, the typical dosage is 200 mg taken twice per day as needed.

Dosage for menstrual cramping and pain

Adult dosage (ages 18 years and older)

• The typical dosage is 400 mg for the first dose followed by a 200-mg dose about 8 to 12 hours later if needed.
• On following days, the typical dosage is 200 mg taken twice per day as needed.

Special considerations

People with liver disease: Having liver disease may reduce your ability to clear celecoxib from your body, which could lead to more side effects. If you have moderate liver disease, your doctor might reduce your daily dose of celecoxib by half. If you have severe liver disease, your doctor won’t prescribe celecoxib.

Celecoxib cost and coupons

Whether you have health insurance or not, cost may be a factor when you’re considering celecoxib. What you’ll pay for celecoxib may depend on several things, such as your treatment plan and the pharmacy you use.

Cost information and savings coupons

You can visit Optum Perks to get price estimates of what you’d pay for celecoxib when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also check out this celecoxib cost article. And you can refer to this article to learn more about saving money on prescriptions.

Take as directed

Celecoxib oral capsule may be used for short-term or long-term treatment, depending on your condition. This drug has risks if you don’t take it as prescribed by your doctor.

If you stop or miss doses: If you stop taking this drug, miss doses, or don’t take it on schedule, you may experience more pain caused by your condition.

If you take too much: Taking too much increases your risk of experiencing side effects.

What to do if you miss a dose: If you miss your dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You may be able to tell celecoxib is working if you experience less pain.

Important considerations for taking this drug

Keep these considerations in mind if your doctor prescribes celecoxib oral capsule for you.

General

• Whether you should take this drug with food depends on your dosage. If you take 400 mg of celecoxib twice per day, you should take it with food for better drug absorption. If you take up to 200 mg of celecoxib twice per day, you can take it with or without food.
• If you have difficulty swallowing the capsule, you can open it and sprinkle the contents onto a level teaspoon of cool or room-temperature applesauce. Eat the applesauce immediately and then drink some water to make sure you’ve swallowed your entire dose.

Storage

• Store at room temperature between 68°F and 77°F (20°C and 25°C). If needed, you can store it temporarily at temperatures between 59°F and 86°F (15°C and 30°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled packaging with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will check your blood pressure before and during treatment with celecoxib. Your doctor may also do blood tests to check how well your liver and kidneys are functioning during treatment.

Sun sensitivity

You may be more sensitive to sunlight if you take celecoxib. Protect yourself from the sun:

• Wear sun-protective clothing.
• Use sunscreen that’s SPF 15 or higher.
• Limit your time in direct sunlight.
• Avoid tanning beds.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription. You can refer to this celecoxib cost article for details.