Celecoxib
Risk Factor: CM*
Class: CENTRAL NERVOUS SYSTEM DRUGS
/ Nonsteroidal Anti-inflammatory Drugs
Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
References
Questions and Answers
Fetal Risk Summary
Celecoxib is a second-generation nonsteroidal antiinflammatory agent (NSAID) that inhibits prostaglandin synthesis via the inhibition of cyclooxygenase-2 (COX-2). It is in the same NSAID subclass (COX-2 inhibitors) as rofecoxib. At therapeutic concentrations, it does not inhibit, as do first-generation NSAIDs, the cyclooxygenase-1 (COX-1) isoenzyme. Celecoxib is indicated for the relief of the signs and symptoms of osteoarthritis and rheumatoid arthritis (1).
Celecoxib was not mutagenic or clastogenic in Chinese hamster ovary cells or clastogenic in an in vivo micronucleus test in rat bone marrow (1). Administration to female rats of oral doses (50 mg/kg/day (about 6 times the maximum recommended human dose [MRHD] based on AUC at 200 mg twice a day) resulted in pre-implantation and post-implantation losses and reduced embryo/fetal survival, a natural consequence of its inhibition of prostaglandin synthesis (1).
Teratogenicity studies have been conducted in rats and rabbits (1). In pregnant rats, a dose-related increase in diaphragmatic hernias was observed in one of two studies at doses of (30 mg/kg/day) (about 6 times the MRHD). No teratogenic effects occurred in pregnant rabbits dosed at 60 mg/kg/day (equal to the MRHD), but at (150 mg/kg/day (approximately 2 times the MRHD), an increased incidence of fetal alterations (fused ribs and fused, misshapen sternebrae) was observed (1). No evidence of delayed labor or parturition at doses up to 100 mg/kg (approximately 7 times the MRHD) was observed in rats (1).
No reports describing the placental transfer of celecoxib have been located. The molecular weight (about 381), however, is low enough that passage to the fetus should be expected. Celecoxib metabolism is mediated by the cytochrome P450 2C9 enzyme, resulting in at least three inactive metabolites (1). Women in whom metabolism by this enzyme is known or suspected to be deficient may have abnormally high plasma levels of celecoxib and, thus, more of the drug will be available for placental transfer.
A combined 2001 population-based observational cohort study and a case-control study estimated the risk of adverse pregnancy outcome from the use of NSAIDs (2). The use of NSAIDs during pregnancy was not associated with congenital malformations, preterm delivery, or low birth weight, but a positive association was discovered with spontaneous abortions (SABs) (see Ibuprofen for details).
The use of first-generation NSAIDs during the latter half of pregnancy has been associated with oligohydramnios and premature closure of the ductus arteriosus (e.g., see Indomethacin) (3). Persistent pulmonary hypertension of the newborn may occur if NSAIDs are used in the 3rd trimester close to delivery (3). These drugs also have been shown to inhibit labor and prolong pregnancy, both in humans (4) and in animals (5). Similar effects should be expected if celecoxib is used during the 3rd trimester or close to delivery. Women attempting to conceive should not used any prostaglandin synthesis inhibitor, including celecoxib, because of the findings in a variety of animal models that indicate these agents block blastocyst implantation (6,7). Moreover, as noted above, NSAIDs have been associated with SABs.
[*Risk Factor D if used in 3rd trimester or near delivery.]
Breast Feeding Summary
No reports describing the use of celecoxib during human lactation have been located. The drug is excreted in the milk of lactating rats in concentrations similar to those measured in plasma (1). Although several first-generation NSAIDs are considered low-risk during nursing (e.g., see Diclofenac, Fenoprofen, Flurbiprofen, Ibuprofen, Ketoprofen, Ketorolac, and Tolmetin), the relatively long adult serum half-life of celecoxib (11.2 hours) and the absence of clinical pharmacologic data in infants suggest that this agent should be avoided during nursing.
References
- Product information. Celebrex. G.D. Searle, 1999.
- Nielsen GL, Sorensen HT, Larsen H, Pedersen L. Risk of adverse birth outcome and miscarriage in pregnant users of non-steroidal antiinflammatory drugs: population based observational study and case-control study. Br Med J 2001;322:26670.
- Levin DL. Effects of inhibition of prostaglandin synthesis on fetal development, oxygenation, and the fetal circulation. Semin Perinatol 1980;4:3544.
- Fuchs F. Prevention of prematurity. Am J Obstet Gynecol 1976;126:80920.
- Powell JG, Cochrane RL. The effects of a number of non-steroidal antiinflammatory compounds on parturition in the rat. Prostaglandins 1982;23:46988.
- Matt DW, Borzelleca JF. Toxic effects on the female reproductive system during pregnancy, parturition, and lactation. In Witorsch RJ, ed. Reproductive Toxicology. 2nd ed. New York, NY:Raven Press, 1995:17593.
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Dawood MY. Nonsteroidal antiinflammatory drugs and reproduction. Am J Obstet Gynecol 1993;169:125565.
Questions and Answers
Has anyone taken Celecoxib and what was the outcome?, I've been prescribed this by my specialist. Is it as bad as the side affects mentioned on other websites? Ectoricoxib gave me heart palpitations so they were no good!
There has been a lot of controversy surrounding anti-arthritics of this type, the coxibs and several have been withdrawn due to concerns about cardiac ( heart ) toxicity. Some of them were very effective and many patients did get a lot of benefit. When I was using them, when they were still fashionable, and before most of the concerns surfaced, I tended to avoid celecoxib as I found it to be the least potent drug in the group.
what would happen if i take Tramadol 100mg tabs with Celecoxib 200mg ( brand name is COBIX-200)?, I'm 45 yers old and currently on Tramadol for about 1 year
I'm Insulin dependent
My physician doesn't know that I'm on Tramadol,
I don't drink, but what would happen if i drink alcohol
thank you
There a few issues involved in your situation that relate to drinking alcohol.
First, alcohol can raise your blood sugar, which may be problematic since you are diabetic. As long as you limit your intake to 1 or 2 servings, this probably won't be a serious problem.
Secondly, celecoxib is an NSAID (the same class of drugs as aspirin, ibuprofen, etc.) On their own NSAIDs can cause irritation to the lining the of the stomach - for example, elderly people experiencing stomach bleeds while on chronic aspirin therapy. Alcohol is also irritating to the lining of the stomach. When you combine the two, you increase your risk for developing complications.
Thirdly, tramadol is a medication that causes CNS depression, with symptoms such as drowsiness, confusion, and impaired coordination. Alcohol is also a CNS depressant, so in this case as well it can increase the risk of complications with the tramadol.
While none of these are reasons to completely avoid alcohol, they put you in the situation of needing to be especially cautious if you do choose to drink.
It's always a good idea for you physician and your pharmacist to know all the medications you are taking. This helps to prevent dangerous drug interactions and complications.
Celecoxib drug is not using in india but other countries r using more y, full detail about celecoxib
actually there may be two reasons.
1. the company manufactured should have patent right for that. or
2. the standards for this drug is not according to indian standards
What is the classification of Celecoxib ?,
It is a COX-2 inhibitor. It is part of the general category of
non-steroidal anti-inflammatory drugs (NSAIDS). It is used mainly for treatment of rheumatoid arthritis joint pain
i have pain in my knee.doctor gave me celecoxib(number of capsule:40)?, doctor said:you will better after 5 month.i must take the celecoxib for 1 month.and then go to doctor again.what is my problem?will my knee better?
Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain or inflammation. Your doctor is probably trying conservative treatment and then will check your response. If there has been no improvement, he or she may elect to order more extensive testing such as an MRI to see if any tendon or ligament damage has taken place and if so, refer you to an orthopedic specialist.
what is the use of celecoxib celcox?, please help me... i want to know more about this medicine.. is it safe for us human? what are the disadvantages and advantages of this med? what is this medicine for? It is used for what? thanks..
It is an NSAID or non-steroidal antiinflammatory drug. Shares the same mode of action as Aspirin, without the risk of ulcers and stomach irritation. Commonly prescribed for arthritis pain.
The Drug interaction site says there is a interaction between the drug vicodin and celebrex?, Can anyone put the following in layman's language?
Coadministration with celecoxib may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by celecoxib
Just call the nearest 24 hour pharmacy to you and ask them to explain the interactions to you. With the competition to get customers these days, they will help you.
I have a bad back, I'm currently taking 750mg of vicodin. But have been thinking abouting switching.?, I have a bad back, I currently have been taking 750mg of vicodin. But have been thinking abouting switching to another Med, like 200mg Celecoxib, or 50mg of Tramadol HCI (That's all the on-line store stocks) . What one would be better? And is the strenth the same as the Vic 750mg?
The other Meds would be less expensive than what I'm paying now.
Vicodin 7.5/750 and celecoxib are completely different types of meds. Vicodin is a combination of hydrocodone (an opioid analgesic) and acetominophen (a mild analgesic/antipyretic) this is indicated for moderate nocioceptive pain. Celecoxib is a COX-2 inhibitor class antiinflammatory. They do not treat the same issue and therefore cannot be compared properly for head-to-head pain relief. If celecoxib relieves the pain it is by decreasing the inflammation primarily. Hydrocodone relieves pain by decreasing the perception of pain in the brain.
Generally hydrocodone would be expected to relieve the pain from injury more than celecoxib. However if the pain you feel is due to inflammatory changes (and most pain conditions have some component of inflammation) the celecoxib should be more effective. But if I was to select medications for chronic back pain, I would most likely put the patient on both celecoxib and an opioid analgesic.
Ultram is a opioid derivative and has similar mechanism of action to hydrocodone. Some studies have found the tramadol to be more effective than hydrocodone in managing moderate pain.
My experience with these drugs would indicate that while all patients have a reasonably similar response to hydrocodone and celecoxib, tramadol response is very patient dependent. While one person taking tramadol would get great response another would seem to have almost no relief. However, when tramadol works it is very effective.
NOTE: Tramadol may lower the seizure threshold in some patients and there has, therefore, been shown an increased seizure risk while taking this medication. tramadol should not be taken by persons with a history of addiction to drugs or alcohol.
Please see the precautions before taking any medications. All these medications are dispensed in the US by prescrition only. Do not allow yourself to be given these medications by an online, unseen provider with no knowledge of your condition. Seek your doctor's advice before switching to a new med or starting any medication.
pain or weak in my knee?, i feel infirmity(weak) in my knee.doctor say your cartilage rubed.at first my doctor gave me celecoxib.
and yet he gave me a medicine.i can't read his handwriting.but ist like "pias clu".what is that medicine?(excuse me,i can't write english good)
call a pharmacist and ask them?
