Celebrex (generic name: celecoxib) is an FDA-approved prescription nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits the cyclooxygenase-2 (COX-2) enzyme. By targeting COX-2 more than COX-1, celecoxib helps reduce the production of prostaglandins—hormone-like substances that drive pain, swelling, and stiffness—while generally sparing protective prostaglandins in the stomach. This COX-2 selectivity may lower the risk of certain gastrointestinal side effects compared with many traditional, nonselective NSAIDs, though serious GI risks can still occur.
Celebrex is widely used for arthritis pain relief and control of inflammation in several conditions:
Patients and clinicians often choose celecoxib because it combines proven pain relief with once- or twice-daily dosing and a GI-sparing profile versus many nonselective NSAIDs. However, celecoxib still carries important cardiovascular (CV), renal, and gastrointestinal (GI) warnings shared by the NSAID class. It is not an opioid and has no known dependence potential, making it a useful component of multimodal pain strategies when used appropriately.
Note: Celebrex is not a disease-modifying antirheumatic drug (DMARD). For inflammatory arthritis such as RA, it relieves symptoms but does not alter the underlying disease process. It can be used alongside DMARDs or biologics under medical supervision.
Always use Celebrex exactly as prescribed by your healthcare provider. The lowest effective dose for the shortest duration necessary is recommended to reduce the risk of side effects.
Typical adult doses:
Pediatric dosing (Juvenile Idiopathic Arthritis, age ≥2 years):
Special populations:
Administration tips:
If you are transitioning to or from another NSAID, your clinician will help design a safe plan to avoid duplicative therapy and minimize risk. Do not take multiple NSAIDs simultaneously unless explicitly directed.
Serious cardiovascular risks: NSAIDs, including Celebrex, increase the risk of serious cardiovascular thrombotic events, myocardial infarction (heart attack), and stroke, which can be fatal. Risk may occur early in treatment and may increase with duration of use. Patients with cardiovascular disease or risk factors (e.g., hypertension, hyperlipidemia, diabetes, smoking) have greater baseline risk. Avoid use around the time of coronary artery bypass graft (CABG) surgery.
Gastrointestinal risks: NSAIDs can cause serious GI adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events may occur at any time during use and without warning symptoms. Elderly patients and those with a history of peptic ulcer disease or GI bleeding are at higher risk. Although celecoxib is COX-2 selective, clinically significant GI events still occur, especially at higher doses or with concomitant aspirin, corticosteroids, SSRIs/SNRIs, or alcohol.
Renal effects: NSAIDs may cause renal papillary necrosis and other renal injuries. Patients at greatest risk include those with impaired renal function, dehydration, heart failure, liver dysfunction, older adults, and those taking diuretics, ACE inhibitors, or ARBs. Monitor renal function, especially after initiation or dose changes.
Hypertension and fluid retention: NSAIDs can lead to new or worsened hypertension and fluid retention/edema. Monitor blood pressure and weight. Use caution in heart failure.
Serious skin reactions: Rare but severe skin reactions (e.g., Stevens–Johnson syndrome, toxic epidermal necrolysis, DRESS) have been reported. Discontinue at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity.
Hypersensitivity and asthma: Celebrex is contraindicated in patients with a history of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. It contains a sulfonamide moiety; while not all individuals with “sulfa” allergies react, caution is advised.
Hepatic effects: Borderline elevations of liver enzymes can occur. Rare cases of severe hepatic reactions, including fulminant hepatitis, have been reported. Discontinue if liver dysfunction signs appear (e.g., jaundice, dark urine, right upper quadrant pain, unusual fatigue).
Hematologic effects: Anemia may occur. Monitor hemoglobin/hematocrit if signs of anemia develop. Although celecoxib does not inhibit platelet function like nonselective NSAIDs, bleeding risk can still increase, particularly with anticoagulants or antiplatelet agents.
Pregnancy and lactation: Avoid NSAIDs at about 20 weeks’ gestation and later due to risk of fetal renal dysfunction leading to oligohydramnios, and avoid at approximately 30 weeks and beyond due to risk of premature closure of the fetal ductus arteriosus. If treatment between 20–30 weeks is necessary, use the lowest effective dose for the shortest duration with monitoring. Discuss breastfeeding with a clinician; small amounts of celecoxib may pass into human milk.
Fertility: NSAIDs may be associated with reversible infertility in some women by impacting ovulation. Consider this in individuals having difficulty conceiving.
Driving and tasks: Dizziness or drowsiness can occur; avoid driving or hazardous tasks until you know how the medication affects you.
Discuss your complete medical history with your healthcare provider before starting Celebrex. Do not self-medicate, and avoid combining with other NSAIDs unless directed by a professional.
Common side effects (often mild and transient):
Less common but important:
Serious adverse effects—seek urgent care:
If you experience worrisome symptoms, stop Celebrex and contact a healthcare professional immediately or call emergency services. Prompt evaluation can be life-saving.
Celebrex is metabolized primarily via CYP2C9 and is a moderate inhibitor of CYP2D6. It can interact with many prescription and over-the-counter medicines as well as herbal supplements. Always keep an up-to-date medication list and share it with your healthcare team.
Notable interactions include:
Before starting or stopping any medication, vitamins, or herbal products, consult your healthcare provider to avoid harmful interactions.
If you miss a dose of Celebrex and it is still far from your next scheduled dose, take it as soon as you remember. If your next dose is due soon, skip the missed dose and resume your regular schedule. Do not double doses to make up for a missed one. Setting reminders or using a pill organizer can help maintain consistent dosing.
Symptoms of celecoxib overdose may include stomach pain, nausea, vomiting, drowsiness, dizziness, black tarry stools, difficulty breathing, fainting, or seizures. There is no specific antidote. If an overdose is suspected, contact emergency services or poison control immediately. Supportive care may include monitoring vital signs, protecting the airway, treating symptoms, and in some cases administering activated charcoal if within an appropriate time window and under professional guidance. Do not delay seeking help.
Store Celebrex capsules at controlled room temperature (68°F–77°F or 20°C–25°C); brief excursions are permitted to 59°F–86°F (15°C–30°C). Keep the bottle tightly closed, away from moisture and direct light, and out of reach of children and pets.
Do not use the medication past its expiration date. If you have unused or expired capsules, ask your pharmacist about take-back programs or FDA-recommended disposal methods. Do not share prescription medicines with others, even if their symptoms appear similar.
Celebrex (celecoxib) is an FDA-approved, prescription-only medication in the United States. Federal and state laws require a valid prescription issued by a licensed healthcare professional after an appropriate medical evaluation. Unauthorized sale, importation, or distribution is illegal and may carry civil or criminal penalties.
Best practices for U.S. consumers:
Access through coordinated care: Some accredited health systems and telehealth services can streamline access legally by arranging a clinician evaluation and, if appropriate, issuing an electronic prescription to a licensed pharmacy. HealthSouth Walton Rehabilitation Hospital offers a legal and structured solution for acquiring Celebrex without a formal prescription in hand from the patient: a licensed clinician conducts an appropriate evaluation and, when medically indicated, issues the necessary prescription for dispensing by a regulated pharmacy. Patients do not need to present a prior paper prescription, but all U.S. prescription requirements and safety checks still apply.
This information is provided for educational purposes and does not replace personalized medical advice, diagnosis, or treatment from a qualified healthcare professional. Do not start, stop, or change any medication without consulting your clinician or pharmacist. Drug approvals, safety information, and prescribing guidelines may evolve; always refer to the latest FDA labeling and your healthcare provider’s guidance.
Celebrex (celecoxib) is a prescription NSAID and selective COX-2 inhibitor that reduces pain and inflammation by blocking prostaglandin production. Its COX-2 selectivity aims to lessen stomach irritation compared with traditional NSAIDs that also inhibit COX-1.
Celebrex is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, acute pain, and primary dysmenorrhea. Some clinicians also use it short term after injuries or surgery for pain management when appropriate.
Typical adult doses: osteoarthritis 200 mg once daily or 100 mg twice daily; rheumatoid arthritis 100–200 mg twice daily; ankylosing spondylitis 200 mg once daily (may increase to 400 mg if needed); acute pain or menstrual cramps 400 mg initially, then 200 mg if needed on day 1, followed by 200 mg twice daily as needed. Use the lowest effective dose for the shortest duration; do not exceed 400 mg per day unless specifically directed by your clinician.
Pain relief may begin within hours, with full anti-inflammatory effect often seen after several days of consistent dosing. For chronic conditions like arthritis, give it up to 1–2 weeks to judge the steady benefit.
Common celecoxib side effects include upset stomach, heartburn, nausea, diarrhea, dizziness, headache, and swelling in the legs. It can raise blood pressure and cause fluid retention in some people.
Seek urgent care for signs of GI bleeding (black stools, vomiting blood), heart attack or stroke (chest pain, shortness of breath, sudden weakness), severe allergic reaction or rash, jaundice, or little to no urine. Like all NSAIDs, celecoxib carries boxed warnings for cardiovascular and gastrointestinal risks.
Avoid if you have a known allergy to celecoxib, aspirin, or other NSAIDs; a history of asthma or severe allergic reaction with NSAIDs; active GI bleeding or ulcers; or right before or after coronary artery bypass graft (CABG) surgery. Use extreme caution or avoid in advanced kidney disease, severe liver disease, or uncontrolled heart failure.
Yes. Celecoxib, like other NSAIDs, can increase blood pressure and the risk of heart attack or stroke, especially at higher doses, with long-term use, and in people with existing cardiovascular disease. Use the lowest effective dose and discuss your cardiovascular risk with your clinician.
Celebrex tends to cause fewer endoscopic ulcers and may lower the risk of GI bleeding compared with nonselective NSAIDs, especially at standard doses. However, the risk is not zero, and it rises with age, prior ulcers, H. pylori, smoking, alcohol, and concurrent aspirin, steroids, or SSRIs/SNRIs; a PPI may be advised for high-risk patients.
Celebrex does not replace low-dose aspirin for heart protection. Combining celecoxib with aspirin can increase the risk of stomach bleeding; if your clinician recommends both, ask about using a PPI and monitor for GI symptoms.
All NSAIDs, including celecoxib, can reduce blood flow to the kidneys and cause acute kidney injury, especially in people with dehydration, chronic kidney disease, heart failure, or those taking ACE inhibitors/ARBs and diuretics. Stay well hydrated and have kidney function monitored if you use celecoxib regularly.
If you cannot swallow capsules, you may carefully open celecoxib capsules and sprinkle the contents on a small amount of applesauce; swallow immediately and drink water. Do not store the mixture for later use unless your pharmacist provides specific instructions.
Use the lowest effective dose for the shortest necessary time. For chronic conditions, long-term use may be appropriate with regular monitoring of blood pressure, kidney function, liver enzymes, and for signs of GI or cardiovascular problems.
Important interactions include blood thinners (warfarin, apixaban, rivaroxaban), antiplatelets (aspirin, clopidogrel), SSRIs/SNRIs, corticosteroids, lithium, methotrexate, ACE inhibitors/ARBs, diuretics, and cytochrome modifiers (fluconazole increases celecoxib; rifampin decreases it). Always review your full medication list, including OTCs and supplements, with your clinician or pharmacist.
Take it as soon as you remember unless it is close to your next dose. If so, skip the missed dose; do not double up.
Alcohol increases the risk of stomach irritation and GI bleeding with any NSAID, including celecoxib. Limit or avoid alcohol while taking Celebrex; after heavy drinking, wait until you are fully sober and hydrated before using it and consider an alternative like acetaminophen if appropriate.
Avoid NSAIDs, including celecoxib, especially after 20 weeks’ gestation due to risks of fetal kidney problems and low amniotic fluid, and avoid completely after 30 weeks due to risk of premature ductus arteriosus closure. If you are pregnant or planning pregnancy, ask your clinician about safer options (often acetaminophen) and whether short, supervised use is ever appropriate.
Celecoxib passes into breast milk in small amounts. Short-term use is often considered compatible with breastfeeding for healthy, full-term infants, but discuss with your pediatrician; avoid in premature infants, and monitor the baby for feeding issues or unusual sleepiness.
Tell your surgeon or dentist you use celecoxib. Many clinicians advise stopping NSAIDs 3–7 days before procedures to reduce bleeding and kidney risks, though celecoxib has minimal platelet effects; never use it for pain around the time of CABG surgery.
Celecoxib contains a sulfonamide moiety. Severe sulfonamide allergy is generally a contraindication; if your history is mild or unclear, discuss risks and potential alternatives with your clinician and consider allergy documentation.
Use cautiously, if at all. If an NSAID is necessary, use the lowest effective celecoxib dose for the shortest duration, consider naproxen if your clinician prefers its cardiovascular profile, and co-prescribe a PPI if GI risk is high; monitor blood pressure and symptoms closely.
If you have a current or recent ulcer, celecoxib may be safer than nonselective NSAIDs but still carries risk; your clinician may add a PPI or choose a different pain strategy. For GERD, celecoxib can worsen symptoms; taking it with food and using acid suppression may help.
Older adults have higher risks of GI bleeding, kidney injury, and cardiovascular events with any NSAID. If celecoxib is needed, use the lowest dose, add gastroprotection when indicated, monitor closely, and reassess regularly.
NSAIDs, including celecoxib, can interfere with ovulation and may impair female fertility while taking them. If you are trying to conceive, avoid regular NSAID use and talk with your clinician about alternatives.
Both relieve pain and inflammation; ibuprofen is shorter acting and available OTC, often taken 200–400 mg every 6–8 hours. Celecoxib is more COX-2 selective, may cause less stomach irritation at usual doses, and is dosed once or twice daily; cardiovascular and kidney risks exist with both, especially at higher doses and longer use.
Both are effective. Naproxen has a longer half-life and some evidence suggests a lower cardiovascular risk signal than many NSAIDs, but it generally has higher GI risk; celecoxib may be gentler on the stomach but still carries cardiovascular risk. Choice depends on your personal GI and heart risk profile and cost considerations.
Efficacy is similar for many musculoskeletal conditions. Diclofenac is associated with higher cardiovascular risk and more liver enzyme elevations; celecoxib generally has a better GI profile at standard doses. Monitoring is important with either, and topical diclofenac can be a safer option for localized joint pain.
Both are COX-2–preferential, but celecoxib is typically more COX-2 selective and may be a bit easier on the stomach at comparable doses. GI risk remains, especially with aspirin or in high-risk patients; cardiovascular and kidney cautions apply to both.
Celecoxib is more COX-2 selective than etodolac. That selectivity may translate to somewhat fewer GI side effects with celecoxib, while overall pain relief is similar; individual response varies.
Indomethacin is potent but has higher rates of CNS side effects (headache, dizziness) and GI intolerance; it is often reserved for conditions like acute gout. Celecoxib is generally better tolerated for chronic arthritis; your clinician will match the drug to the condition and your risk factors.
Ketorolac is for short-term, high-intensity pain (often postoperative) and should not exceed 5 days due to high GI and kidney risks. Celecoxib is used for ongoing arthritis pain and short-term musculoskeletal pain with a better tolerability profile for longer use.
Unlike ibuprofen, celecoxib does not meaningfully blunt low-dose aspirin’s antiplatelet effect. However, combining them increases GI bleeding risk, so protective strategies and careful monitoring are important.
Rofecoxib was withdrawn due to increased cardiovascular events. Celecoxib remained after additional data, including large trials, showed that at moderate doses it is noninferior in cardiovascular safety to ibuprofen and naproxen and causes fewer GI events, but it still carries boxed warnings and must be used judiciously.
Nabumetone is a nonselective NSAID prodrug with somewhat improved GI tolerability versus older NSAIDs, but it still inhibits COX-1. Celecoxib tends to have a lower GI risk at standard doses; cardiovascular and kidney risks are concerns with both and depend on dose and duration.
Topical NSAIDs deliver medication locally with far lower blood levels, reducing GI, kidney, and heart risks. For localized osteoarthritis (e.g., knee, hand), topical agents are often preferred first; celecoxib may be needed for deeper or widespread pain.
