What are the common and rare side effects of Celebrex oral. How severe are they. What conditions are contraindicated with Celebrex?

Celebrex: Exploring the Common and Rare Side Effects

Celebrex, a nonsteroidal anti-inflammatory drug (NSAID), is a widely prescribed medication for the treatment of various conditions such as arthritis, menstrual cramps, and acute pain. While Celebrex can provide effective relief, it is essential to be aware of its potential side effects, both common and rare.

Common Side Effects of Celebrex

According to the information provided, the common side effects of Celebrex oral tend to have a Severe or Less Severe expression. Severe common side effects include:

• Abnormal liver function tests
• Accidental injury
• High alanine transaminase level
• High aspartate transaminase level

Less Severe common side effects include:

• Throat irritation
• Common cold
• Stuffy and runny nose
• Indigestion
• Dizziness
• Skin rash
• Gas
• Diarrhea
• Intense abdominal pain

Infrequent Side Effects of Celebrex

The information provided does not have any data available for the Severe infrequent side effects of Celebrex. However, the Less Severe infrequent side effects include:

• Inflammation of the tissue lining the sinuses
• Backache
• Inflammation of the elbow and surrounding tissue
• Difficulty sleeping
• Headache
• Nausea

Rare Side Effects of Celebrex

Celebrex can also cause a wide range of rare side effects, which can be further divided into Severe and Less Severe expressions. Severe rare side effects include:

• Meningitis not due to an infection
• Low blood sugar
• High cholesterol
• Increased sodium level in the blood
• Low amount of sodium in the blood
• High levels of potassium in the blood
• Low amount of potassium in the blood
• Pancytopenia (a type of blood disorder with a decrease in all types of blood cells)
• Bone marrow failure leading to low blood counts
• Anemia
• Decreased blood platelets
• Very low levels of granulocytes (a type of white blood cell)
• Low levels of white blood cells
• Increase in the number of platelets in the blood
• Hemorrhage from the conjunctiva of the eye
• High blood pressure
• Heart attack
• Angina (a type of chest pain)
• Coronary artery disease
• Sinus bradycardia
• Heart failure
• Left ventricular hypertrophy
• Bleeding within the skull
• Stroke
• Inflammation of the blood vessels
• Thrombophlebitis (an inflamed vein due to a blood clot)
• Blood clot in a deep vein of the extremities
• Bleeding
• Pneumonia
• Bronchospasm
• Inflammation of the esophagus
• Puncture, tear, or hole in the esophagus
• Gastroesophageal reflux disease (GERD)
• Stomach or intestinal ulcer
• Hiatal hernia
• Blockage of the stomach or intestine
• Diverticulitis
• Liver tissue death
• Liver failure
• Inflammation of the liver called hepatitis
• Gallstones
• Blood in the bowel movement
• Bleeding of the stomach or intestines
• Interstitial nephritis (a type of kidney inflammation)
• Damage to the kidneys
• Renal papillary necrosis
• Kidney stones
• Inflammation of the bladder
• Bloody urine
• Erythema multiforme (a type of allergic skin reaction)
• Toxic epidermal necrolysis (a skin disorder with blistering and peeling skin)
• Stevens-Johnson syndrome (a skin disorder with blistering and peeling skin)
• Skin rash with sloughing
• Rupture of a tendon
• Fainting
• Sensation of spinning or whirling
• Visible water retention
• Puffy face from water retention
• High blood sugar
• Elevation of proteins in the urine
• Anaphylaxis (a significant type of allergic reaction)
• Angioedema (a type of allergic reaction)
• Rupture in the wall of the stomach or intestine
• Jaundice (a yellowing of the eyes or skin from buildup of bilirubin)
• Pancreatitis
• Cellulitis
• Acute generalized exanthematous pustulosis (a type of skin disorder)
• Sepsis
• DRESS syndrome (a type of significant allergic skin reaction)

The Less Severe rare side effects of Celebrex include:

• Migraine headache
• Ringing in the ears
• Hearing loss
• Hemorrhoids
• Bruising under the skin
• Laryngitis
• Bronchitis
• Dry mouth
• Stomatitis (a condition with painful swelling and sores inside the mouth)
• Gastritis (a type of stomach irritation)
• Inflammation of the lining of the stomach and intestines
• Constipation
• Increased sensitivity of the skin to the sun
• Contact dermatitis (a type of skin rash that occurs from contact with an offending substance)
• Inflammation of the skin due to an allergy
• Itching
• Dry skin
• Hives
• Joint pain
• Abnormal increase in muscle tone
• Muscle pain
• Drowsiness
• Fever
• Low energy
• Flu-like symptoms
• Excessive sweating
• Pain
• Taste impairment
• Loss of muscle coordination
• Numbness
• Temporary redness of face and neck
• Decreased appetite
• Weight gain
• Increased hunger
• Trouble breathing
• Cough
• Vomiting
• Difficulty swallowing
• Burping
• Ineffective painful straining of stool or urine
• Difficult or painful urination
• Increased need to urinate often
• Nervousness
• Feeling of pins and needles on skin
• Inflammation of the lining of a joint
• Generalized weakness
• Maculopapular rash (a type of bumpy skin rash)
• Loss of taste
• No sense of smell
• Anxious feelings
• Fast heartbeat

Contraindicated Conditions with Celebrex

According to the information provided, the following conditions are contraindicated with Celebrex:

• Systemic mastocytosis
• Dehydration
• Anemia
• Increased risk of bleeding
• Alcoholism
• High blood pressure
• Heart attack
• Chronic heart failure

It is important to consult with a healthcare professional before taking Celebrex if you have any of these contraindicated conditions, as the medication may not be suitable or may require special precautions.

Conclusion

In conclusion, Celebrex can have a wide range of potential side effects, from common to rare and from less severe to severe. It is crucial for patients taking Celebrex to be aware of these side effects and to report any concerning symptoms to their healthcare provider immediately. Additionally, individuals with certain medical conditions should avoid Celebrex or use it with caution, as it may not be suitable for their specific health needs.

Common and Rare Side Effects for Celebrex oral

COMMON side effects

If experienced, these tend to have a Severe expression i

• abnormal liver function tests
• an accidental injury
• a high alanine transaminase level
• a high aspartate transaminase level

If experienced, these tend to have a Less Severe expression i

• throat irritation
• a common cold
• a stuffy and runny nose
• indigestion
• dizziness
• a skin rash
• gas
• diarrhea
• intense abdominal pain

INFREQUENT side effects

If experienced, these tend to have a Severe expression i

Sorry, we have no data available. Please contact your doctor or pharmacist.

If experienced, these tend to have a Less Severe expression i

• inflammation of the tissue lining the sinuses
• backache
• inflammation of the elbow and surrounding tissue
• difficulty sleeping
• headache
• nausea

RARE side effects

If experienced, these tend to have a Severe expression i

• meningitis not due to an infection
• low blood sugar
• high cholesterol
• an increased sodium level in the blood
• low amount of sodium in the blood
• high levels of potassium in the blood
• low amount of potassium in the blood
• a type of blood disorder with a decrease in all types of blood cells called pancytopenia
• low blood counts due to bone marrow failure
• anemia
• decreased blood platelets
• very low levels of granulocytes, a type of white blood cell
• low levels of white blood cells
• increase in the number of platelets in the blood
• hemorrhage from the conjunctiva of the eye
• high blood pressure
• a heart attack
• angina, a type of chest pain
• coronary artery disease
• sinus bradycardia
• heart failure
• left ventricular hypertrophy
• bleeding within the skull
• a stroke
• inflammation of the blood vessels
• thrombophlebitis, an inflamed vein due to a blood clot
• blood clot in a deep vein of the extremities
• bleeding
• pneumonia
• bronchospasm
• inflammation of the esophagus
• a puncture, tear or hole in the esophagus
• gastroesophageal reflux disease
• stomach or intestinal ulcer
• hiatal hernia
• blockage of the stomach or intestine
• diverticulitis
• liver tissue death
• liver failure
• inflammation of the liver called hepatitis
• gallstones
• blood in the bowel movement
• bleeding of the stomach or intestines
• a type of kidney inflammation called interstitial nephritis
• damage to the kidneys
• renal papillary necrosis
• kidney stones
• inflammation of the bladder
• bloody urine
• erythema multiforme, a type of allergic skin reaction
• a skin disorder with blistering and peeling skin called toxic epidermal necrolysis
• a skin disorder with blistering and peeling skin called Stevens-Johnson syndrome
• skin rash with sloughing
• rupture of a tendon
• fainting
• sensation of spinning or whirling
• visible water retention
• puffy face from water retention
• high blood sugar
• elevation of proteins in the urine
• a significant type of allergic reaction called anaphylaxis
• a type of allergic reaction called angioedema
• a rupture in the wall of the stomach or intestine
• a yellowing of the eyes or skin from buildup of bilirubin called jaundice
• pancreatitis
• cellulitis
• a type of skin disorder called acute generalized exanthematous pustulosis
• sepsis
• a type of significant allergic skin reaction called DRESS syndrome

If experienced, these tend to have a Less Severe expression i

• a migraine headache
• ringing in the ears
• hearing loss
• hemorrhoids
• bruising under the skin
• laryngitis
• bronchitis
• dry mouth
• stomatitis, a condition with painful swelling and sores inside the mouth
• a type of stomach irritation called gastritis
• inflammation of the lining of the stomach and intestines
• constipation
• increased sensitivity of the skin to the sun
• contact dermatitis, a type of skin rash that occurs from contact with an offending substance
• inflammation of the skin due to an allergy
• itching
• dry skin
• hives
• joint pain
• an abnormal increase in muscle tone
• muscle pain
• drowsiness
• fever
• low energy
• flu-like symptoms
• excessive sweating
• pain
• taste impairment
• loss of muscle coordination
• numbness
• temporary redness of face and neck
• decreased appetite
• weight gain
• increased hunger
• trouble breathing
• cough
• vomiting
• difficulty swallowing
• burping
• ineffective painful straining of stool or urine
• difficult or painful urination
• an increased need to urinate often
• nervousness
• a feeling of pins and needles on skin
• inflammation of the lining of a joint
• generalized weakness
• a type of bumpy skin rash called a maculopapular rash
• a loss of taste
• no sense of smell
• anxious feelings
• fast heartbeat

Common and Rare Side Effects for Celebrex oral

The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

Conditions:

• systemic mastocytosis
• dehydration
• anemia
• an increased risk of bleeding
• alcoholism
• high blood pressure
• a heart attack
• chronic heart failure
• abnormal bleeding in the brain resulting in damage to brain tissue, called a hemorrhagic stroke
• a blood clot
• asthma
• an ulcer from too much stomach acid
• stomach or intestinal ulcer
• liver problems
• bleeding of the stomach or intestines
• kidney transplant
• visible water retention
• abnormal liver function tests
• pregnancy
• a rupture in the wall of the stomach or intestine
• tobacco smoking
• increased cardiovascular event risk
• time immediately after coronary bypass surgery
• CYP2C9 poor metabolizer
• chronic kidney disease stage 4 (severe)
• chronic kidney disease stage 5 (failure)
• kidney disease with likely reduction in kidney function
• aspirin exacerbated respiratory disease
• history of gastric bypass surgery
• history of kidney donation

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Differences, similarities, and which is better for you

Drug overview and main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Arthritis is known to cause aches and pains. There are so many medications out there for arthritis pain that it can be confusing which one to take. Two common medications in the NSAID (nonsteroidal anti-inflammatory drug) category are Celebrex (celecoxib) and ibuprofen.

NSAIDs can be effective in treating osteoarthritis and rheumatoid arthritis, as well as a variety of other conditions. Both Celebrex and ibuprofen are available in generic form. While Celebrex is only available by prescription, you can buy lower doses of ibuprofen over-the-counter. Higher doses of ibuprofen are available by prescription. Because Celebrex and ibuprofen are in the same class of drugs, they are similar, but they also do have some notable differences.

What are the main differences between Lexapro vs. Zoloft?

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Conditions treated by Celebrex and Ibuprofen

Celebrex, a nonsteroidal anti-inflammatory drug (NSAID), is indicated for the following conditions: osteoarthritis, rheumatoid arthritis,   juvenile rheumatoid arthritis in patients two years and older, ankylosing spondylitis, acute pain, primary dysmenorrhea, and familial adenomatous polyposis as an adjunct to usual care.

Ibuprofen is also an NSAID and is indicated for relief of the signs and symptoms of osteoarthritis and rheumatoid arthritis, mild to moderate pain, and primary dysmenorrhea.

NSAID drugs work by blocking prostaglandins (prostaglandins cause pain and inflammation) from being made. Prostaglandin is made by two enzymes, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2).

Is Celebrex or Ibuprofen more effective?

Celebrex is known as a selective COX-2 inhibitor. While it is still an NSAID like ibuprofen, Celebrex only blocks COX-2, as opposed to ibuprofen, which blocks both COX-1 and COX-2. What does this mean? A COX-2 inhibitor can be easier on the stomach, with a lower risk of causing stomach ulcers.

In clinical studies for efficacy, Celebrex demonstrated:

• Reduced joint pain in osteoarthritis patients
• Reduced joint pain and swelling in rheumatoid arthritis patients
• Improvement in patients with juvenile rheumatoid arthritis
• Improvement in patients with ankylosing spondylitis (in pain intensity, disease activity, and functional impairment)
• Relief of moderate to severe pain caused by surgical pain or dysmenorrhea

In clinical studies for efficacy, ibuprofen demonstrated:

• A similar effect to aspirin in patients with osteoarthritis and rheumatoid arthritis for pain and inflammation
• Relief of pain from episiotomy, dental procedures, and dysmenorrhea

Which medication is more effective? It is difficult to say. In one study, Celebrex was shown to be “as effective as” ibuprofen for patients with osteoarthritis of the knee. Some studies show ibuprofen to be more effective, while others conclude Celebrex may be more effective.

In terms of safety, clinical trials of Celebrex, as well as non-selective NSAIDs (such as ibuprofen) of up to three years have shown an increased risk of serious cardiovascular events, myocardial infarction, and stroke, which can be fatal. Therefore, all NSAIDs (including both Celebrex and ibuprofen) may be potentially associated with this risk. Also, all NSAIDs, including Celebrex and ibuprofen, have an increased risk of GI events, such as bleeding and ulcers.

The best drug for you can only be determined by your healthcare provider, who can take into account the whole picture of your medical condition(s), risk factors, health history, and other medications you are taking.

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Coverage and cost comparison of Celebrex vs.

Ibuprofen

Celebrex is typically covered by insurance and Medicare Part D in its generic form of celecoxib. A typical prescription would be for 30 capsules of 200 mg celecoxib. The out-of-pocket price is approximately $217.49 but you can get celecoxib for $105-145 at participating pharmacies with a SingleCare coupon.

Ibuprofen is typically covered by insurance and Medicare Part D, in prescription strengths of 400 mg, 600 mg, and 800 mg. Doctor’s prescriptions vary. For example, the retail price for 30 tablets of 800 mg ibuprofen costs anywhere from $6-30. With a SingleCare coupon, the cost for ibuprofen is $4-8.

Side effects of Celebrex vs.

Ibuprofen

The most common adverse events of Celebrex and ibuprofen include abdominal pain, diarrhea, indigestion, and headaches. See warning section for more information about cardiovascular risk and risk of GI bleeding.

*Frequency of adverse effects of ibuprofen is not provided with drug information; only that these effects occurred in 3-9% of patients.

Source: DailyMed (Celebrex), DailyMed (ibuprofen)

This is not a complete list; other side effects may occur. Consult with your healthcare provider for details.

Drug interactions of Celebrex and Ibuprofen

Celebrex and ibuprofen have many of the same interactions with other prescription drugs. Both medications interact with blood thinners such as Coumadin (warfarin), certain blood pressure medications (ACE inhibitors, ARBs, and beta blockers), antidepressants, and diuretics such as hydrochlorothiazide and methotrexate. Consult your healthcare provider for guidance.

Alcohol should be avoided when taking Celebrex or ibuprofen. Using either of these medications with alcohol can increase the risk of GI (stomach) bleeding or inflammation. The combination could also cause kidney damage or kidney failure.

This is a partial list of drug interactions. Contact your healthcare provider for more information.

Warnings of Celebrex and Ibuprofen

Celebrex should be avoided in patients who are allergic to NSAIDs, as well as patients who are allergic to sulfa. Ibuprofen should be avoided in patients who are allergic to NSAIDs.

Because both drugs are NSAIDs, Celebrex and ibuprofen have the same warnings. They have a boxed warning (the strongest warning as required by the Food and Drug Administration, or FDA). Celebrex or ibuprofen may increase the risk of serious cardiovascular events, MI (myocardial infarction, or heart attack), and stroke, all of which could be fatal. All NSAIDs have a similar risk, which increases the longer you use it. Patients with heart disease or who have cardiovascular risk factors are at greater risk. Celebrex or ibuprofen should not be used for pain during coronary artery bypass graft (CABG) surgery.

Also in the boxed warning is the risk of serious GI, or gastrointestinal events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Any of these events could occur at any time, and without warning symptoms. Elderly patients and those with a history of ulcers or GI bleed are at higher risk for serious GI events.

Other Celebrex and ibuprofen warnings include:

• Risk of elevated liver enzymes and, rarely, severe hepatic reactions.
• New cases or worsening of hypertension (high blood pressure). Use with caution in hypertension patients; monitor blood pressure closely during treatment.
• Fluid retention and edema. Use with caution in patients with fluid retention or heart failure
• Renal papillary necrosis/other renal injury with long term use. Use with caution in the elderly, patients with impaired renal function, heart failure, liver dysfunction, and patients who take diuretics, ACE inhibitors, or angiotensin II blockers.
• Anaphylactoid reactions. Do not use it for patients with Samter’s triad.
• Serious skin reactions can occur such as exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal and occur without warning. Discontinue Celebrex and seek immediate medical treatment if rash or skin reaction occurs.

There is limited data on NSAIDs use in pregnancy. The use of all NSAIDs, including both Celebrex and ibuprofen, during the third trimester of pregnancy, increases the risk of premature closure of the fetal ductus arteriosus. Therefore, NSAIDs should not be used after 30 weeks of gestation.

Consult your healthcare provider regarding Celebrex or ibuprofen use in pregnancy. If you are already taking Celebrex or ibuprofen and find out that you are pregnant, contact your healthcare provider for guidance.

There is limited data on Celebrex and ibuprofen with breastfeeding; consult your doctor for guidance.

Frequently asked questions about Celebrex vs. Ibuprofen

What is Celebrex?

Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the following conditions: osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in patients two years and older, ankylosing spondylitis, acute pain, primary dysmenorrhea, and familial adenomatous polyposis as an adjunct to usual care.

What is Ibuprofen?

Ibuprofen is an NSAID and used to treat signs and symptoms of osteoarthritis, rheumatoid arthritis, mild to moderate pain, and primary dysmenorrhea.

Are Celebrex and Ibuprofen the same?

Because both drugs are NSAIDs, they are similar and have similar side effects and warnings. They differ in indications and price. See above to find out more about the similarities and differences.

Is Celebrex or Ibuprofen better?

Both drugs can be very effective in treating arthritis as well as other conditions. Depending on what condition(s) you are treating, and taking into account any other medical conditions and risk factors you have, as well as other medications you are taking, your doctor can help recommend the appropriate medication for you.

Can I use Celebrex or Ibuprofen while pregnant?

If you find out you are pregnant and using Celebrex or ibuprofen contact your healthcare provider for recommendations.

Pregnant women should not use these NSAIDs after 30 weeks of pregnancy. Using Celebrex and ibuprofen during the third trimester of pregnancy can increase the risk of premature closure of the fetal ductus arteriosus.

Can I use Celebrex or Ibuprofen with alcohol?

No. Using either of these medications with alcohol can increase the risk of GI (stomach) bleeding or stomach inflammation. The combination could also cause kidney damage or kidney failure.

Is Celebrex more effective than ibuprofen?

Both drugs can be very effective in treating arthritis pain as well as other conditions. Consult with your healthcare provider to learn which medication is best for you given your condition(s), health history, and other medications you might be taking.

Why did they take Celebrex off the market?

Celebrex is still on the market as of today. Vioxx (rofecoxib), a similar drug to Celebrex, was removed from the market by its manufacturer, Merck, in 2004, due to increased risk of cardiovascular events with chronic use. In 2005, another similar drug, Bextra (valdecoxib), was pulled off the market by manufacturer Pfizer for the same reasons.

Is Celebrex a painkiller?

Celebrex is an NSAID (nonsteroidal anti-inflammatory) drug that helps with symptoms of pain and inflammation from a variety of conditions (see above). Because it only works on COX-2 enzymes, it may be safer for the stomach, although there is still a GI risk.

Aleve (naproxen) vs. Celebrex (celecoxib) Effectiveness

Migraine vs. Headache: Differences and Similarities

Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine.
Symptoms of migraine that usually aren’t experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain.
Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure.
Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don’t know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the “worst headache of your life,” seek medical care immediately.

Celecoxib tablets and celecoxib side effects at Pateint

About celecoxib

Anti-inflammatory painkillers like celecoxib are sometimes called non-steroidal anti-inflammatory drugs (NSAIDs), or just ‘anti-inflammatories’. Celecoxib is used to treat painful rheumatic conditions such as osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. It eases pain and reduces inflammation.

Celecoxib is also known as a cyclo-oxygenase-2 inhibitor. This is because it works to relieve pain and inflammation by blocking an enzyme in the body called cyclo-oxygenase-2 (COX-2). COX-2 is involved in the production of irritant substances in the body in response to disease. By blocking the action of COX-2, celecoxib reduces the symptoms of pain and inflammation in arthritis.

Before taking celecoxib

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking celecoxib, it is important that your doctor knows:

• If you have asthma or any other allergic disorder.
• If you have had a stomach or duodenal ulcer, or if you have an inflammatory bowel disorder such as Crohn’s disease or ulcerative colitis.
• If you are pregnant, trying for a baby, or breastfeeding.
• If you are under 18 or over 65 years of age.
• If you have liver or kidney problems.
• If you have a heart condition, or a problem with your blood vessels or circulation.
• If you have high blood pressure.
• If you have ever had blood clotting problems.
• If you have a connective tissue disorder, such as systemic lupus erythematosus (an inflammatory condition also called lupus, or SLE).
• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
• If you have ever had an allergic reaction to a medicine. It is particularly important that you tell your doctor if you have ever had a bad reaction to any other NSAID (such as aspirin, naproxen, diclofenac, and indometacin), or if you are allergic to a sulfonamide medicine (used to treat infection).

How to take celecoxib

• Before you start taking celecoxib, read the manufacturer’s printed information leaflet from inside the pack. The manufacturer’s leaflet will give you more information about celecoxib and provide a full list of side-effects which you may experience from taking it.
• Take celecoxib exactly as your doctor tells you to. The usual dose is one capsule, taken once or twice daily. There are two strengths of capsule available, 100 mg and 200 mg – your doctor will tell you which is right for you. Try to take your doses at the same times of day each day, as this will help you to remember to take the capsules regularly.
• Swallow the capsules whole with a drink of water. If you have difficulty swallowing the capsules they can be opened and the entire contents sprinkled on to a spoonful of soft food such as apple sauce, yoghurt or mashed banana. Swallow the mixture straightaway, followed by drinking a large glass of water.
• It is not important whether you take your doses before or after meals.
• If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a missed dose.

Getting the most from your treatment

• Your doctor will try to prescribe you the lowest dose for the shortest time to reduce the risk of side-effects. If you need to take celecoxib for a long time, your doctor may want to prescribe another medicine along with it to protect your stomach from irritation.
• Try to keep any regular appointments with your doctor. This is so your doctor can check on your progress. Your doctor will want to check your blood pressure from time to time while you are taking celecoxib.
• You should find that your pain is eased within a few days of starting to take the capsules. If after two weeks you find your pain is no better despite taking celecoxib, you should discuss this with your doctor, as an alternative painkiller may be more suitable for you.
• If you have asthma, symptoms such as wheeze or breathlessness can be made worse by anti-inflammatories such as celecoxib. If this happens to you, you should stop taking celecoxib and see your doctor as soon as possible.
• If you buy any medicines, check with a pharmacist that they are safe to take with an anti-inflammatory like celecoxib. This is because you should not take celecoxib with any other anti-inflammatory painkiller, some of which are available in cold and flu remedies which can be bought over the counter.
• If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

Can celecoxib cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with celecoxib. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Important: if you experience any of the following less common but more serious symptoms, stop taking celecoxib and contact your doctor for advice straightaway:

• If you have any breathing difficulties such as wheeze or breathlessness.
• If you have any signs of an allergic reaction such as swelling around your mouth or face, or a severe itchy skin rash.
• If you pass blood or black stools, bring up (vomit) blood, or have abdominal pains.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store celecoxib

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light. 

Important information about all medicines

About Celebrex (Celecoxib), a COX-2 Inhibitor

Celecoxib is a prescription nonsteroidal anti-inflammatory drug (NSAID) commonly prescribed for many types of joint pain and inflammation.

See NSAIDs: Non-Steroidal Anti-Inflammatory Drugs

The medication is sold under the brand name Celebrex, or in generic form. Celecoxib is a type of medication known as a COX-2 inhibitor because of the way it works in the body.

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Conditions Treated with Celecoxib

Common conditions that Celebrex may treat include:

• Osteoarthritis. Joint stiffness, pain, and swelling—especially following inactivity—are frequent symptoms of osteoarthritis that may be relieved by celecoxib. By easing these symptoms, the medication allows an individual to exercise more, which is critical to keep osteoarthritis from progressing. Some medical research has also found celecoxib helpful in slowing joint damage in osteoarthritis.¹

See Osteoarthritis of the Spine

• Rheumatoid arthritis. The swelling and inflammation of joints that characterize rheumatoid arthritis can often be alleviated with celecoxib. Unlike disease-modifying anti-rheumatic drugs (DMARDs) used for rheumatoid arthritis, celecoxib does not address the disease itself. Alleviating these symptoms enables people to be more physically active, which has been shown to improve range of motion and reduce disability.

See Rheumatoid Arthritis in the Spine

• Juvenile rheumatoid arthritis. Inflammation, stiffness, tenderness, swelling, and pain in the joints, as well as rashes and fever, are often experienced with juvenile rheumatoid arthritis. Celecoxib or another NSAID are often the only medications needed for this disease. Celecoxib can relieve all but the rash symptoms. It can be taken by children age 2 and older. As when celecoxib is used for arthritis in adults, the relief of symptoms allows greater participation in physical activities, which can improve daily functioning.
• Ankylosing spondylitis. Early morning stiffness, sacroiliac pain and inflammation, and pain in the lower back, hip, or buttock are typical with this type of arthritis. Celecoxib treats the pain, inflammation, and stiffness.

See Ankylosing Spondylitis

• Acute pain in the back, neck, and elsewhere. Celecoxib’s ability to reduce pain and inflammation makes it helpful in treating strains, sprains, headaches, menstrual pain, and aches and pains caused by overexertion. It also treats the aches and pains of the flu and other illnesses.

Watch Video: What is Acute Neck Pain?

• Post-surgical pain. Celecoxib can be helpful when taken by itself or in combination with other medications to relieve pain following surgery, including joint replacement surgery.

See Getting Adequate Pain Control After Back Surgery

• Chronic low back pain. Symptoms of this common condition include inflammation as well as pain. Both can be relieved with celecoxib.

See Types of Back Pain: Acute Pain, Chronic Pain, and Neuropathic Pain

• Gout. Celecoxib is commonly prescribed “off-label” to treat acute gout. Off-label use means the medication is not specifically approved by the U.S. Food and Drug Administration for the condition or symptoms. An off-label medication is typically prescribed if the doctor thinks it will be more helpful than other options for an individual.

Taking celecoxib 30 minutes before physical activity is advised for those with osteoarthritis, rheumatoid arthritis, or juvenile rheumatoid arthritis. People with arthritis may need to take the medication for up to two weeks to get the maximum benefit.

See Osteoarthritis Medications

Those taking celecoxib on an as-needed basis, rather than on a schedule, usually get the best pain relief by taking the medication at the first sign of pain.

In This Article:

How Celecoxib Works

As a COX-2 inhibitor, celecoxib blocks an inflammation-promoting enzyme called COX-2. Medications known as COX-2 inhibitors were developed to work as well as traditional NSAIDs but with fewer stomach problems.

See Safe Use of COX-2 Inhibitors and Other NSAIDs

However, many reports of heart attacks and stroke prompted the FDA to re-evaluate the risks and benefits of the COX-2s. Two drugs in this class were taken off the U.S. market following reports of heart attacks in people who took them.

See Understanding COX-2 Inhibitor Side Effects

Celebrex is still available, but with strong warnings, as are required for all NSAID medications. The risk of serious cardiovascular thrombotic events, including myocardial infarction (MI) and stroke, are black box warnings—the strictest issued by the FDA—and outlined in black on the medication label. This risk may occur early in the treatment and may increase with duration of use.

See Potential Risks and Complications of NSAIDs

The FDA also advises that celecoxib be prescribed at the lowest possible dose for the shortest time possible.

The decreased risk for gastrointestinal problems is a significant selling point for celecoxib because many people are unable to take NSAIDs such as ibuprofen due to the risk of gastrointestinal bleeding.

See Types of NSAIDs

One medical study showed a significantly lower incidence of gastric ulcers in people with rheumatoid arthritis or osteoarthritis who were prescribed celecoxib rather than diclofenac, another NSAID.² (Diclofenac has a black box warning citing the risk of fatal gastrointestinal bleeding, ulceration, and perforation of the stomach and intestines.)

Another benefit of the COX-2 inhibitor celecoxib is that—unlike other NSAIDs—it does not hamper blood clotting. This can make celecoxib an option for some people on blood-thinning medications such as warfarin (brand name Coumadin).

How Celecoxib Is Taken

Celecoxib is available in 50 mg, 100 mg, 200 mg, and 400 mg capsules, and should be taken with food or milk to avoid an upset stomach. Typical doses range from 200 to 400 mg daily, but the dose for acute gout is up to 800 mg once, followed by 400 mg on the first day, then 400 mg twice daily for a week. Taking the lowest effective dose is recommended.

People who have trouble swallowing a capsule—a condition called dysphagia—may empty the contents of the capsule onto a teaspoon of cool or room-temperature applesauce and administer immediately with water. Patients are advised to avoid lying down for 30 minutes after taking celecoxib.

See Treatments for Dysphagia

References

• 1.Cho H, Walker A, Williams J, Hasty KA. Study of osteoarthritis treatment with anti-inflammatory drugs: cyclooxygenase-2 inhibitor and steroids. Biomed Res Int. 2015;2015:595273.
• 2.Cheung R, Cheng TT, Dong Y, et al. Incidence of gastroduodenal ulcers during treatment with celecoxib or diclofenac: pooled results from three 12-week trials in Chinese patients with osteoarthritis or rheumatoid arthritis. Int J Rheum Dis. 2010;13(2):151-7.

Anti-inflammatory medications and the risk for cardiovascular disease: A new study, a new perspective

Follow me on Twitter  @RobShmerling

News last week about celecoxib shows how challenging it can be to understand the risks and benefits of newly developed drugs. This is particularly true when the findings of one study contradict those of past studies. And that’s exactly what has happened with celecoxib.

Anti-inflammatory medications: pros and cons

The FDA approved celecoxib (Celebrex) in 1999. This anti-inflammatory medication can be a highly effective treatment for arthritis and other painful conditions. It was developed with the hope that it would be at least as effective as other anti-inflammatory medications (such as ibuprofen or naproxen) but cause less stomach irritation. Developing a safer anti-inflammatory medication is a worthy goal, since stomach irritation can not only cause annoying pain or nausea, but it can also lead to ulcers, bleeding, or perforation. These medications can also increase blood pressure and cause kidney problems.

Celecoxib is known as a COX-2 inhibitor — that’s because it targets an enzyme (COX-2) involved in inflammation. Ibuprofen and naproxen (and many other anti-inflammatories) target COX-1 and COX-2. They’re called “non-selective” anti-inflammatory drugs. Because of where these enzymes are found in the body, the COX-2 selective medications seemed capable of dampening down inflammation while going easier on the stomach.

And that was true. Celecoxib — and other COX-2 inhibitors, such as rofecoxib (Vioxx) — did cause less stomach trouble. But soon after its approval, studies suggested other concerns: an increased risk of heart attack and stroke. Rofecoxib was removed from the market in 2004. And while the FDA allowed celecoxib to remain on the market, it required the manufacturer to issue additional warnings to patients. It also required additional study. And that’s why celecoxib is back in the news this week. The results of the PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety versus Ibuprofen or Naproxen) trial were released. And the news is good for celecoxib.

Results suggests lower cardiovascular disease risk — and fewer side effects — than expected

The PRECISION trial is a carefully designed and powerful study that analyzed the impact of celecoxib on cardiovascular disease. The study spanned 926 medical centers in 13 countries and enrolled more than 24,000 patients with two of the most common types of arthritis (osteoarthritis and rheumatoid arthritis). Each study subject had a higher than average risk for cardiovascular disease due to a history of high blood pressure or high cholesterol.

Study subjects were divided into three groups who took anti-inflammatory medications every day: one group took celecoxib, one group took ibuprofen, and the last group took naproxen.

Study subjects taking celecoxib in moderate doses were

• no more likely than those taking ibuprofen or naproxen to have a fatal or non-fatal heart attack or stroke
• less likely than those taking ibuprofen or naproxen to have significant gastrointestinal problems, such as serious bleeding
• less likely than those taking ibuprofen to have kidney problems or hospital admission for high blood pressure.

What does this mean for you?

It’s rare that a single study provides a definitive answer or changes practice overnight. But this was a large, well-designed, and expensive study that is unlikely to be repeated any time soon. And, another study of lower-risk people came to a similar conclusion just last year.

Still, questions may yet come up regarding:

• The lack of a placebo group. As suggested by some prior research, it is possible that all three of the drugs used in this study increase the risk of cardiovascular problems; without a control group, it’s impossible to say.
• Dosing. Study subjects were allowed to take up to 400 mg/day of celecoxib if they had rheumatoid arthritis but only 200 mg/day if they had osteoarthritis. In real life doctors may prescribe a wider range of doses.
• Reason for treatment. This study only included people with rheumatoid arthritis or osteoarthritis. The results might be different if people with other conditions had been included.
• Other medical problems. The risks and benefits of celecoxib in people with other medical problems (such as significant kidney disease) are uncertain because this study excluded them.
• Other medical treatments. All patients in this study took a medication to protect the stomach; outside of studies, that’s not always the case.

While these issues are valid, I think this study does provide a significant measure of reassurance regarding the cardiovascular risks of celecoxib. And it may encourage doctors who thought the drug was too risky to prescribe it more often.

This new research shows in a dramatic way why “more research is needed” is not just a tagline at the end of so many medical news stories. And in the case of celecoxib, the result of the additional research is good news indeed.

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“Tactics of choosing drugs of the group of non-steroidal anti-inflammatory drugs (NSAIDs)”

On July 20, 2016 at the OJSC “Clinical and diagnostic center” Euromedservice “a medical conference was held on the topic:” The tactics of choosing drugs of the group of non-steroidal anti-inflammatory drugs (NSAIDs) “

Speaker: traumatologist-orthopedist Kuzmina Yu.O.

Summary of the report: in modern practice almost every doctor can meet with diseases accompanied by edematous-painful and inflammatory syndromes.For the treatment of these conditions all over the world, drugs of the group of non-steroidal anti-inflammatory drugs (NSAIDs) are most widely used. This group includes numerous drugs, combined according to the principle of the generality of the effects observed from their use.

Main effects of drugs in this group:

• anti-inflammatory;
• analgesic;
• antipyretic;
• antiaggregatory;
• immunosuppressive.

For different drugs, these effects can have different degrees of severity.

NSAIDs with a pronounced anti-inflammatory effect:
Indomethacin, diclofenac (ortofen, voltaren, naklofen), meloxicam (movalis, amelotex), phenylbutazone (butadione), piroxicam, aspirin, ibuprofen (nurofen, brufen, ibalgin, next, mig).

Less pronounced anti-inflammatory effect of drugs:
Celecoxib (celebrex), nimesulide (nise, nimesil), paracetamol.

NSAIDs with the most pronounced analgesic effect:
Diclofenac, lornoxicam (xefocam), ketorolac (ketorol), ketoprofen (ketonal), metamizole (analgin), ibuprofen, naproxen.

NSAIDs with the most pronounced antipyretic effect:
Paracetamol, ibuprofen, naproxen, aspirin.

All NSAIDs have antiaggregatory effects to varying degrees, but aspirin is the most.

It should be remembered that all drugs of the NSAID group to one degree or another have an immunosuppressive effect, but the most pronounced are indomethacin, phenylbutazone, naproxen, ibuprofen.

The main indications for the use of drugs of the NSAID group:

1. Rheumatic diseases: rheumatism (rheumatic fever), rheumatoid arthritis, gouty and psoriatic arthritis, ankylosing spondylitis (ankylosing spondylitis), Reiter’s syndrome. With large collagenoses (SLE, scleroderma and others) NSAIDs are often ineffective.
2. Non-rheumatic diseases of the musculoskeletal system: osteoarthritis, myositis, tendovaginitis, trauma. Topical forms of NSAIDs are used more often.
3. Neurological diseases: neuralgia, sciatica, sciatica, lumbago.
4. Renal, hepatic colic.
5. Pain syndrome of various etiologies, including headache and toothache, postoperative pain.
6. Fever (usually at a body temperature above 38.5 ° C).
7. Prevention of arterial thrombosis.
8. Dysmenorrhea – to relieve pain associated with an increase in uterine tone due to hyperproduction of PG-F2a.In addition to the analgesic effect, NSAIDs reduce the amount of blood loss.

The drugs in this group have certain and often quite pronounced side effects.

1. Gastroduodenopathy.
2. Nephrotoxicity. Risk factors: age over 65 years, cirrhosis of the liver, previous renal pathology, decreased circulating blood volume, prolonged use of NSAIDs, concomitant use of diuretics.
3. Hematotoxicity. (Most often – metamizole, phenylbutazone).
4. Coagulopathy.
5. Hepatotoxicity. (Most often – metamizole, phenylbutazone).
6. Hypersensitivity reactions (allergies). (Most often – metamizole, phenylbutazone).
7. Bronchospasm. (Most often, aspirin.)
8. Prolongation of pregnancy and delay in labor. If you need to take drugs of the NSAID group, the safest (but not before childbirth!) Are small doses of aspirin.

Drugs of the NSAID group, when taken simultaneously with drugs of other groups, can interact.The most famous and frequent of these interactions are:

1. Strengthening the action of indirect anticoagulants.
2. Strengthening the action of oral hypoglycemic agents.
3. Weakening the effect of antihypertensive drugs and diuretics.
4. Increased toxicity of aminoglycoside antibiotics.
5. Increased toxicity of digoxin.
6. Aluminum-containing antacids (almagel, maalox and others) weaken absorption

NSAID.Intervals of at least 4 hours are required.

1. Glucocorticoids and “slow-acting” (basic) anti-inflammatory drugs (gold preparations, aminoquinolines) enhance the anti-inflammatory effect of NSAIDs.
2. Narcotic analgesics and sedatives enhance the analgesic effect of NSAIDs.
3. Phenylbutazone (butadione) – increased excretion of uric acid.

Thus, drugs of the NSAID group are used to treat a variety of diseases accompanied by pain, fever, and inflammation.When prescribing drugs in this group, it is worth focusing on the most expected effect (anti-inflammatory, analgesic, etc.). It is worth considering possible contraindications in the appointment of drugs in this group.
Depending on the tasks and the nature of the disease, the doctor can prescribe drugs of this group in the form of various dosage forms – tablets, soluble tablets or granules, capsules, injections, gel, ointment, syrup, etc.

OJSC “Clinical and Diagnostic Center“ Euromedservice ”attaches great importance to drawing up an individual treatment plan for each patient.Preparations of the NSAID group are recommended to be used only by a doctor’s prescription. When prescribing drugs, doctors explain the need for taking them, the expected effects, and possible side effects. The patient is explained the form of application of the drug (tablet, gel or other.), The frequency of use (how many times a day) and the duration of use (for example, 3 consecutive days or once a week). Following these recommendations, improvement of well-being and recovery becomes possible in the shortest possible time.

Correct use of NSAIDs

The abbreviation for NSAIDs – does this tell you anything? If not, then we propose to broaden your horizons a little and find out what these mysterious four letters mean.Read the article and everything will become absolutely clear. We hope that it will be not only informative, but also interesting!

NSAIDs stand for non-steroidal anti-inflammatory drugs – drugs in our time are very popular and in demand, since they are able to simultaneously eliminate pain and relieve inflammation in various organs of our body.

If, until now, you have never needed to take NSAIDs, this can be considered almost a miracle. You are one of the rare lucky ones, really, your health can be envied! NSAIDs are, we are ahead of the next question and immediately talk about the decoding of the word “non-steroidal”, which means that these drugs are non-hormonal, i.e.That is, they do not contain any hormones. And this is very good, because everyone knows how unpredictable and dangerous hormonal drugs can be.

Most popular NSAIDs

If you think NSAIDs are drugs whose names are rarely pronounced in everyday life, then you are wrong.

Many people do not even realize how often we have to use non-steroidal anti-inflammatory drugs to cure various ailments that have accompanied the human race since the expulsion of Adam and Eve from the heavenly booths.

Read the list of such remedies, for sure some of them are in your home medicine cabinet. So, NSAIDs include drugs such as: “Aspirin”, “Amidopyrin”, “Analgin”, “Piroxicam”, “Bystrumgel”, “Diclofenac”, “Ketoprofen”, “Indomethacin”, “Ketorol”, “Naproxen”, “Ketorolac”, “Flurbiprofen”, “Voltarengel”, “Nimesil”, “Diclofenac”, “Ibuprofen”, “Indopan”, “Ipren”, “Upsarin UPSA”, “Ketanov”, “Mesulid”, “Movalis”, ” Nise, Nurofen, Ortofen, Trombo ASS, Ultrafen, Fastum, Finalgel.

Yes, these are all NSAID drugs. The list turned out, although large, but, of course, far from complete. And yet it gives an idea of ​​the variety of modern non-steroidal anti-inflammatory drugs.

Some historical facts

The first primitive NSAID drugs were known to people in ancient times. For example, in ancient Egypt, willow bark was widely used to relieve heat and pain – a natural source of salicylates and one of the first non-steroidal anti-inflammatory drugs.And even in those distant times, healers treated their patients suffering from joint pain and fever with decoctions of myrtle and lemon balm – they also contain salicylic acid.

In the middle of the 19th century, chemistry began to develop rapidly, which gave impetus to the development of pharmacology. At the same time, the first studies of the compositions of medicinal substances obtained from plant materials began to be carried out. Pure salicin from willow bark was synthesized in 1828 – this was the first step towards the creation of the familiar “Aspirin”.

But it will take many more years of scientific research before this drug is born. The grandiose event took place in 1899. Physicians and their patients quickly appreciated the benefits of the new drug. In 1925, when a terrible flu epidemic hit Europe, Aspirin became a savior for a huge number of people.

And in 1950, this non-steroidal anti-inflammatory drug hit the Guinness Book of Records as the most-sold pain reliever.Later, other non-steroidal anti-inflammatory drugs (NSAIDs) were created by pharmacists.

For what diseases are anti-inflammatory nonsteroidal drugs used?

The range of use of NSAIDs is very wide. They are very effective in the treatment of both acute and chronic diseases, accompanied by pain and inflammation.

Nowadays, studies are in full swing to study the effectiveness of these drugs in the treatment of diseases of the heart and blood vessels.And today almost everyone knows that they can be used for pain in the spine (NSAIDs for osteochondrosis are a real salvation).

Here is a list of painful conditions, in the event of which the use of various non-steroidal anti-inflammatory drugs is indicated: Fever. Headaches, migraines. Renal colic. Rheumatoid arthritis. Gout. Arthrosis. Osteoarthritis. Dysmenorrhea. Inflammatory arthropathies (psoriatic arthritis, ankylosing spondylitis, Reiter’s syndrome).Postoperative pain syndrome. Pain syndrome from mild to moderate severity with injuries and various inflammatory changes.

Classification of NSAIDs by their chemical structure

By reading this article, you have already had the opportunity to see that there are a lot of non-steroidal anti-inflammatory drugs. To navigate among them at least a little better, let’s start classifying these tools.

First of all, they can be divided as follows: a group – acids and a group of NSAIDs – non-acidic derivatives.

The first include: – Salicylates (you can immediately remember about “Aspirin”). – Derivatives of phenylacetic acid (Aceclofenac, Diclofenac, etc. ). – Pyrazolidines (sodium metamizole, known to most of us as “Analgin”, “Phenylbutazone, etc.). – Oxycams (” Tenoxicam “,” Meloxicam “,” Piroxicam “,” Tenoxicam “) – Indoleacetic acid derivatives (” Sulindac ” , “Indomethacin”, etc.). – Propionic acid derivatives (“Ibuprofen”, etc.).

The second group is: – Sulfonamide derivatives (Celecoxib, Nimesulide, Rofecoxib).- Alcanones (“Nabumeton”).

Classification of non-steroidal anti-inflammatory drugs according to their effectiveness

The use of NSAIDs for osteochondrosis and in the treatment of other joint diseases can literally work wonders. But, unfortunately, not all drugs are the same in their effectiveness. The undisputed leaders among them are: “Diclofenac”, “Ketoprofen”, “Indomethacin”, “Flurbiprofen”, “Ibuprofen” and some other drugs.

The listed medicines can be called basic; T.That is, on their basis, new NSAIDs can be developed and supplied to the pharmacy chain, but under a different changed name and often at a higher price. To avoid wasting your money, study the next chapter well.

The information contained in it will help you make the right choice. What you need to pay attention to when choosing a medicine NSAIDs are, for the most part, excellent modern drugs, but when coming to the pharmacy, it is better to be aware of some of the nuances. Which ones? But read it! For example, you are faced with a choice of what is better to buy: “Diclofenac”, “Ortofen” or “Voltaren”.And you are trying to ask the pharmacist which of these drugs is better. Most likely, you will be advised the one that is more expensive. But the fact is that the composition of the listed drugs is almost identical. And the difference in the names is due to the fact that they are produced by different companies, which is why the trade marks differ from each other.

The same can be said, for example, about “Metindol” and “Indomethacin” or “Ibuprofen” and “Brufen”, etc. To understand the confusion, always carefully look at the packaging, because the main active ingredient of the medicinal product must be indicated there. funds.Only it will be written, most likely, in small letters.

But that is not all. Rather, not everything is so simple! Taking an NSAID analogue of a drug you are familiar with can unexpectedly cause an allergic reaction or side effects that you have never seen before. What’s the matter here? The reason may lie in additional additives, about which, of course, nothing was written on the packaging. This means that you also need to study the instructions.

Another possible reason for the different results of analog drugs is the difference in dosage.Ignorant people often do not pay any attention to this, but in vain. After all, small tablets may contain a “horse” dose of the active substance. Conversely, oversized pills or capsules happen to be as much as 90 percent fillers. Sometimes drugs are also produced in retarded form, that is, as drugs of long-term (prolonged) action. An important feature of such drugs is the ability to be absorbed gradually, due to which their effect can last a whole day. Such a drug does not need to be drunk 3 or 4 times a day, a single dose will be enough. This feature of the medicine should be indicated on the package or right in the name. For example, “Voltaren” in prolonged form is called “Voltaren-retard”.

List of analogues of known drugs

We are publishing this little cheat sheet in the hope that it will help you better navigate the many beautiful pharmacy packages. Let’s say you immediately need an effective NSAID for arthrosis to relieve excruciating pain.Take out your cheat sheet and read the following list:

• Analogs of “Diclofenac”, in addition to the already mentioned “Voltaren” and “Ortofen”, are also “Diclofen”, “Dicloran”, “Diclonac”, “Rapten”, “Diklobene”, “Artrozan”, “Naklofen”.
• “Indomethacin” is sold under such brands as “Indomin”, “Indotard”, “Metindol”, “Rheumatine”, “Indobene”, “Inteban”.
• Analogs of “Piroxicam”: “Erazon”, “Pirox”, “Roxicam”, “Pirokam”.
• Analogs of “Ketoprofen”: “Flexen”, “Profenid”, “Ketonal”, “Artrosilen”, “Knavon”.
• The popular and inexpensive “Ibuprofen” is included in such medicines as “Nurofen”, “Reumafen”, “Brufen”, “Bolinet”.

Rules for taking NSAIDs

Taking NSAIDs can be accompanied by a number of side effects, so it is recommended to follow these rules when taking them:

1. Reading the instructions and following the recommendations contained in it are mandatory!
2. Take capsules or tablets by mouth with a glass of water to protect your stomach.This rule must be adhered to, even if you are drinking the most modern drugs (which are considered safer), because extra precaution never hurts;
3. Do not lie down after taking the drug for about half an hour. The fact is that the force of gravity will facilitate better passage of the capsule down the esophagus;
4. It is better to refuse alcoholic beverages, since NSAIDs and alcohol linked together are an explosive mixture that can cause various diseases of the stomach.
5. Do not take two different non-steroidal drugs on the same day – this will not increase the positive result, but, most likely, summarize the side effects.
6. If the medication does not work, check with your doctor, it may be that you have been prescribed a dose that is too low.

Side effects and non-steroidal gastropathy

Now you have to learn what NSAID gastropathy is. Unfortunately, all NSAIDs have significant side effects.They have a particularly negative effect on the gastrointestinal tract. Patients may be disturbed by manifestations such as Nausea (sometimes very severe). Heartburn. Vomit. Dyspepsia. Gastrointestinal bleeding. Diarrhea. Ulcer of the duodenum and stomach.

All of the above troubles are NSAID gastropathy. Therefore, doctors so often try to prescribe to their patients the lowest possible dose of classic non-steroidal anti-inflammatory drugs. To minimize the harmful effects on the stomach and intestines, it is recommended never to take such drugs on an empty stomach, but only after a large meal.

But problems with the digestive system are not all the side effects that some of the NSAIDs can produce. Certain drugs can be bad for the heart as well as the kidneys. Sometimes taking them can be accompanied by headache and dizziness.

Another serious nuisance is that they have a destructive effect on the intra-articular cartilage (of course, only with prolonged use). Fortunately, today there are new generation NSAIDs commercially available, which are largely freed from these disadvantages.

New generation non-steroidal anti-inflammatory drugs

In the past two decades, several pharmaceutical companies have simultaneously been intensively developing new modern NSAIDs, which, along with effective elimination of pain and inflammation, would have as few side effects as possible.

The efforts of pharmacists were crowned with success – a whole group of new generation drugs, called selective, was developed. Imagine – these drugs under the supervision of a doctor can be drunk for very long courses.Moreover, the terms can be measured not only in weeks and months, but even in years.

Medicines from this group do not have a destructive effect on the articular cartilage, side effects are much less common and practically do not cause complications. New generation NSAIDs are drugs such as: “Movalis”. “Nise” (aka “Nimulid”). “Arcoxia”. Celebrex.

We will tell you about some of their advantages using Movalis as an example. It is available both in traditional tablets (7.5 and 15 mg each), and in 15 mg suppositories, and in glass ampoules for intramuscular administration (also 15 mg).This medicine works very mildly, but at the same time it is extremely effective: just one tablet is enough for the whole day. When a patient is shown long-term treatment for severe arthrosis of the hip or knee joints, “Movalis” is simply irreplaceable.

Different forms in which NSAIDs are produced

Most of the popular non-steroidal anti-inflammatory drugs can be purchased and used not only in the form of tablets and capsules for oral administration, but also in ointments, gels, suppositories and in injection solutions.And this, of course, is very good, since such a variety makes it possible in some cases to avoid harm during treatment while obtaining a faster therapeutic effect.

So, new generation NSAIDs, used in the form of injections for arthrosis, have much less effect on the gastrointestinal tract. But there is also a downside to this coin: when administered intramuscularly, almost all non-steroidal drugs are capable of giving a complication – muscle tissue necrosis. That is why NSAID injections are never practiced for a long time.

Basically, injections are prescribed for exacerbation of inflammatory and degenerative-dystrophic diseases of the joints and spine, accompanied by severe intolerable pain. After the patient’s condition improves, it becomes possible to switch to tablets and external agents in the form of ointments.

Usually doctors combine different dosage forms, deciding what and when can bring the greatest benefit to the patient. The conclusion suggests itself: if you do not want to harm yourself by self-treatment of such common ailments as osteochondrosis or arthrosis, contact a medical institution for help, it is there that they will be able to help you.

Can NSAIDs be used during pregnancy

Doctors strongly discourage pregnant women from taking NSAIDs (especially this prohibition applies to the third trimester), as well as mothers who are breastfeeding. It is believed that drugs in this group can adversely affect the bearing of the fetus and cause various malformations in it.

According to some reports, such a harmless medicine, in the opinion of many as Aspirin, can increase the risk of early miscarriage.But sometimes doctors, according to indications, prescribe this drug to women (in a limited course and in minimal doses). In each case, the decision must be made by a medical professional.

During pregnancy, women often have back pain and there is a need to solve this problem with the help of non-steroidal anti-inflammatory drugs as the most effective and fast-acting. In this case, the use of “Voltaren gel” is permissible. But – again – its independent use is possible only in the first and second trimester, in late pregnancy, the use of this strong drug is allowed only under the supervision of a doctor.

Conclusion

We told you what we knew ourselves about NSAIDs. Deciphering the abbreviation, the classification of medicines, the rules for taking them, information about side effects – this can come in handy in life. But we want our readers to have a need for medicines as seldom as possible. Therefore, at parting, we wish you good health!

Celebrex :: Instruction :: Price :: Description of the drug

Celebrex
Celebrex 100 (200) mg.
Active substance: Celecoxib 100 (200) mg.
Additional substances: lactose monohydrate, Na lauryl sulfate, Mg stearate, povidone, croscarmellose Na.
The mechanism of action of celecoxib consists in the predominant suppression of COX2 activity and in the minimal suppression of COX1. COX2 activation occurs in response to the release of biologically active substances due to inflammation.
Celebrex has analgesic, antipyretic and anti-inflammatory effects. In experiments conducted on animals, it has been shown to be effective in reducing the incidence of colon cancer.
Due to the minimal effect on COX1, the drug does not disrupt the natural processes caused by E1 class prostaglandins in platelets, intestines and stomach.
When using Celebrex, the incidence of gastroduodenal ulcers and complications associated with them is significantly lower than when using other NSAIDs, such as acetylsalicylic acid, naproxen, ibuprofen, which is confirmed by the results of endoscopic studies. The difference in ulcer development is statistically significant.
In studies on healthy volunteers, it has been proven that when using celecoxib at a dose of 1.2 g per day, the drug has no effect on platelet function and clotting indicators.

In studies, celecoxib caused an increase in the risk of sudden cardiovascular death and thrombosis, including in vital organs, compared with placebo, but this difference was not statistically significant. Compared to NSAIDs that affect both COX1 and COX2, celecoxib increases the risk of nonfatal heart attack, reduces the risk of nonfatal stroke, and does not affect cardiovascular mortality.When aspirin was added to the therapy, these results did not change.
The drug is well absorbed from the digestive tract, reaching a maximum concentration in 2-3 hours. Eating food, especially fatty ones, delays the absorption of Celebrex, while the maximum concentration can be reached after 6-7 hours, which is 4 hours longer than taking on an empty stomach.
As a result of the biotransformation of celecoxib (with the participation of cytochrome P450 2C9), three metabolites are formed that are inactive with respect to COX1.Celebrex is excreted mainly through the liver (by 99%) .There is evidence of the possibility of penetration of the drug through the BBB.
In patients with low body weight, the concentration of celecoxib in the blood is higher, and higher concentrations are noted in women compared to men, therefore women with a small body weight (up to 50 kg) should start treatment with the minimum therapeutic doses, especially for patients old age.

An increase in concentration is also noted in persons of the Negroid race, therefore, they need to start treatment with the minimum therapeutic dosages.
In case of mild liver dysfunction, dose adjustment is not required, in case of moderate dysfunction, a dosage reduction of 50% is required.
In case of impaired renal function, dosage adjustment is not required, since only about 1% of the drug is excreted in the urine.
In studies, a temporary decrease in sodium excretion and, accordingly, fluid retention, with the development of peripheral edema, was recorded. However, there was no increase in the incidence of arterial hypertension, and the edema resolved without treatment.
In studies, no embryotoxic and teratogenic effects of the drug were found. In rats, celecoxib increases the risk of developing diaphragmatic hernias, and in rabbits, the risk of developing pathology of the cardiovascular system.

As symptomatic therapy for:
– arthritis (rheumatoid arthritis, osteoarthritis), spondylitis;
– algodismenorrhea;
– acute pain.
As part of complex therapy for patients with familial adenomatous polyposis to reduce the number and size of adenomatous colorectal polyps.
It is recommended to take Celebrex at a dose of 200 mg twice a day.
Considering that complications from the cardiovascular system depend on the dose of the drug, the drug should be used in the minimum effective dosages, in courses of short duration.

Application for osteoarthritis:
The recommended daily dose is 200 mg, it is possible to take both 200 mg once a day and 100 mg twice a day. If necessary, the dose can be increased to 800 mg per day (400 mg twice a day), without increasing the risk of side effects.

Application for rheumatoid arthritis:
The recommended daily dose is 200 – 400 mg per day, for 2 doses. If necessary, the dose can be increased to 800 mg per day (400 mg twice a day), without increasing the risk of side effects.

Application for ankylosing spondylitis:
The recommended daily dose is 200 mg, it is possible to take both 200 mg once a day and 100 mg twice a day. If necessary, it can be used in a dose of 400 mg per day.

Application for acute pain:
Initial dose 400 – 600 mg per day, then 200 mg twice a day.

Application for familial adenomatous polyposis:
Celebrex is prescribed as an adjunct to standard therapy. The recommended dose is 400 mg twice a day.
For elderly patients, dose adjustment is not required, except when their body weight does not exceed 50 kg.
When using Celebrex in patients with a moderate decrease in liver function, it is recommended to reduce the daily dosage by 2 times. There is no experience of using the drug in patients with severe hepatic impairment.
In case of mild and moderate renal insufficiency, dose reduction is not required. There is no experience of using Celebrex in patients with severe renal failure.

For short-term use (up to 12 weeks) at a dose of 100-800 mg.

Frequent (prevalence ≥1% to ≤10%):
Allergic reactions (pruritus, rash), dyspepsia, flatulence, peripheral edema, insomnia, upper respiratory tract infections, cough, rhinitis, urinary tract infections, flu-like reactions.
Uncommon (prevalence ≥0.1 to ≤1%):
Anxiety, tinnitus, anemia, thrombocytopenia, hot flashes, arterial hypertension, arrhythmias, visual disturbances, tinnitus, alopecia, urticaria.
Individual (prevalence from 0.01% to ≤0.1%):
Angioedema, CHF, ulceration in the digestive tract, development of pancreatitis, increased transaminase activity, skin bullae, confusion.
With long-term use (up to 3 years) at a dose of 400-800 mg.
Very common (prevalence up to 10%):
arterial hypertension, stool disorders.
Frequent (prevalence ≥1% to ≤10%):
Ear infections, non-systemic fungal infections, coronary artery disease (angina pectoris, myocardial infarction), IBS, nausea, dysphagia, kidney stones, prostatitis, increased creatinine.

Uncommon (prevalence ≥0.1 to ≤1%):
angina pectoris, arrhythmia, left ventricular hypertrophy, ischemic stroke, sleep disorders, conjunctival hemorrhage, coronary atherosclerosis, deep vein thrombosis, oral ulcers, hemorrhoidal bleeding, vaginal bleeding, dysmenorrhea, menopause symptoms, dysphonia, nocturia, increased K and Na levels, increased hemoglobin, decreased hematocrit.

Intolerance to any of the components of the drug or sulfonamides. Allergic reactions when taking acetylsalicylic acid or other NSAIDs.
It is contraindicated to take Celebrex as an analgesic after coronary artery bypass grafting.
There is no data on the safety of use during pregnancy, so it should be used only under strict indications, given the possible risk of side effects in the fetus.
Do not use in the last trimester of pregnancy, as due to the suppression of the synthesis of prostaglandins, the contractile activity of the uterus may be disrupted, and premature contamination of the oval window may also occur.
Celebrex is biotransformed with the participation of cytochrome P450 2C9, therefore, its interaction with some drugs is possible.
As a result of the simultaneous use with warfarin, the risk of bleeding, up to fatal, may increase.
When administered simultaneously with fluconazole and ketonazole, the concentration of celecoxib in the blood can double.
With the appointment of an ACE inhibitor or angiotensin 2 blockers with NSAIDs, their antihypertensive effect may decrease.
When combined with lithium preparations, an increase in the level of lithium in the blood occurs, by about 17%, therefore, with such a combination, careful monitoring of analyzes and the patient’s condition is necessary.
The appointment of Celebrex and other NSAIDs is unacceptable.
In case of an overdose of celecoxib, elimination measures and symptomatic therapy are required.
Capsules 100 mg in blisters No. 10.
Capsules 100 mg in blisters No. 20.
Capsules 200 mg in blisters No. 10.
Capsules 200 mg in blisters No. 20.
Store in a dry place at room temperature (16-25 degrees Celsius).
Ranselex, Phlogoxib-Health, Revmoxib.
When taking Celebrex, the risk of thrombosis may increase, including in vital organs (heart and brain), therefore, if possible, therapy should be carried out with the lowest effective doses for a short period of time.
Celebrex does not replace acetylsalicylic acid, since it does not have antiplatelet properties, therefore, it is inappropriate to cancel it.
Ulcers of the stomach and duodenum more often occur in elderly patients, in patients with a history of peptic ulcers, in debilitated patients, while taking it with acetylsalicylic acid.
It is necessary to strictly monitor blood pressure during the entire course of treatment, since the drug can contribute to the development of hypertension.
Prescribe cautiously to patients with CHF, due to the possibility of fluid retention and the formation of peripheral edema.
The drug can have a nephrotoxic effect, therefore, during the entire course of therapy, careful monitoring of renal function is necessary.
If a rash occurs on the skin, the drug should be canceled, since cases of the development of Stevens-Johnson syndrome have been described.
Do not use the drug in children, as there is no evidence of the safety of its use in children.
The drug passes into breast milk and can be potentially dangerous to the baby, therefore, during treatment, you should stop breastfeeding the baby.

The manual was compiled by a team of authors and editors of the Piluli website. The list of authors of the reference book of medicines is presented on the page of the site editorial office: Site editorial board.

Links to used sources of information.

Description of the preparation “ Celebrex ” on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and familiarize yourself with the annotation approved by the manufacturer.
Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the doses and methods of its use.

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