Celebrex

The amount of Celebrex (Celecoxib) and how long it is taken varies according to the condition being treated. It should be used at the lowest dose possible for the shortest possible length of time to achieve pain relief.

Osteoarthritis: The usual recommended daily dose is 200 mg taken as a single dose or as 100 mg twice daily.

Ankylosing spondylitis: The usual recommended daily dose is 200 mg taken as a single dose or as 100 mg twice daily.

Rheumatoid arthritis: The usual recommended starting dose is 100 mg twice daily. This may be increased to 200 mg twice daily as directed by your doctor.

Moderate-to-severe pain: The usual recommended dose is 400 mg as a single dose on the first day, followed by 200 mg once daily. Treatment should not exceed 7 days. The maximum recommended dose is 400 mg a day.

Celebrex (Celecoxib) may be taken with or without food.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that Celebrex (Celecoxib) be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Celebrex (Celecoxib) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause diarrhea; it may cause stomach ache; it may cause indigestion; it may increase your blood pressure; it could cause water retention and swelling; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

100 mg
Each white-to-off-white hard-gelatin capsule with blue ink band on body marked in white with "100" and with blue ink band on cap marked in white with "7767" contains 100 mg of Celebrex (Celecoxib). Nonmedicinal ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate, povidone, and sodium lauryl sulfate; shell: edible ink (indigotine [E132]), gelatin, and titanium dioxide (E171).

200 mg
Each white-to-off-white hard-gelatin capsule with gold ink band on body marked in white with "200" and with gold ink band on cap marked in white with "7767" contains 200 mg of Celebrex (Celecoxib). Nonmedicinal ingredients: croscarmellose sodium, lactose monohydrate, magnesium stearate, povidone, and sodium lauryl sulfate; shell: edible ink (ferric oxide [E172]), gelatin, and titanium dioxide (E171).

Do not take Celebrex (Celecoxib) if you:

• are allergic to Celebrex (Celecoxib) or any ingredients of the medication
• are allergic to sulfonamides (sulfa medications; e.g., sulfamethoxazole)
• are breast-feeding or planning to breast-feed
• are in the third trimester of pregnancy (28 weeks or more)
• are planning to have or recently have had heart surgery
• have an active stomach or intestinal ulcer or active gastrointestinal (stomach and intestines) bleeding
• have bleeding in the brain
• have experienced Asthma, Hives, or allergic-type reactions after taking acetylsalicylic acid (Asa) or other NSAIDs (e.g., Naproxen, Ibuprofen, Diclofenac, Meloxicam)
• have high blood potassium levels
• have inflammatory bowel disease
• have severe, uncontrolled heart failure
• have severely decreased kidney function or kidney function that is getting worse
• have severely decreased liver function or active liver disease
• have high levels of potassium in your blood

There may be an interaction between Celebrex (Celecoxib) and any of the following:

• Abiraterone
• acetylsalicylic acid (ASA) and other salicylate medications
• alcohol
• Aliskiren
• aluminum- and magnesium-containing antacids
• aminoglycoside antibiotics (e.g., Amikacin, gentamicin, tobramycin)
• Amiodarone
• angiotensin-converting enzyme inhibitors (ACEIs; e.g., Captopril, Enalapril, Ramipril)
• angiotensin II receptor blockers (ARBs; e.g., Losartan, Irbesartan)
• Aprepitant
• Atomoxetine
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• bisphosphonates (e.g., Alendronate, etidronate)
• Bosentan
• Capecitabine
• Carbamazepine
• chloroquine
• Chlorpheniramine
• Chlorpromazine
• Cholestyramine
• Codeine
• Colesevelam
• Colestipol
• corticosteroids taken by mouth (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• Clopidogrel
• Cyclosporine
• dabigatran
• Deferasirox
• delavirdine
• Desmopressin
• Dextromethorphan
• Digoxin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Doxepin
• Enzalutamide
• Eplerenone
• estrogens (e.g., conjugated estrogen, Estradiol, ethinyl estradiol)
• etravirine
• evening primrose
• fenofibric acid
• feverfew
• Flecainide
• Fluorouracil
• garlic
• Gemfibrozil
• ginger
• green tea
• Heparin
• Hydralazine
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• methamphetamine
• Methotrexate
• Mexiletine
• mifepristone
• milk thistle
• Mirtazapine
• nefazodone
• other NSAID medications (e.g., diclofenac, ibuprofen, Ketorolac, naproxen)
• Omeprazole
• peginterferon alfa-2b
• Phenytoin
• Pioglitazone
• Porfimer
• primidone
• probenecid
• procainamide
• pyrimethamine
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• Repaglinide
• rifampin
• Rivaroxaban
• Risperidone
• Rosiglitazone
• selective serotonin reuptake inhibitors (SSRIs, e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sodium phosphate
• sulfonamide antibiotics ("sulfas"; e.g., sulfisoxazole, sulfamethoxazole)
• Tacrolimus
• Tamoxifen
• tenofovir
• thioridazine
• Ticagrelor
• Ticlopidine
• Tolterodine
• Tramadol
• tretinoin
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• Trimethoprim
• Venlafaxine
• Warfarin
• Zafirlukast
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

June 8, 2021

Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.

Allergy: Some people who are allergic to sulfonamide medications such as certain antibiotics also experience allergic reactions to Celebrex (Celecoxib). Before you take Celebrex (Celecoxib), inform your doctor about any previous adverse reactions you have had to medications, especially sulfonamides and acetylsalicylic acid (ASA) or other anti-inflammatories. Contact your doctor at once if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Blood counts: Celebrex (Celecoxib) can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. Contact your doctor immediately if you notice an increased occurrence of signs of infection (e.g., fever, chills, or sore throat), feel unusually tired, lack energy, or experience unusual bleeding or bruising.

Drowsiness/reduced alertness: Celebrex (Celecoxib) may cause drowsiness, dizziness or, sometimes, blurred vision. Avoid driving, operating machinery, or engaging in other activities that require alertness and coordination if you find that Celebrex (Celecoxib) affects you in this way.

Fertility: As with other NSAIDs, Celebrex (Celecoxib) may make it more difficult for a couple to conceive if the woman is taking Celebrex (Celecoxib). Stopping the medication allows the body's chemistry to return to normal which often resolves this issue.

Fluid retention: Celebrex (Celecoxib) may cause fluid retention and swelling, possibly worsening high blood pressure, Congestive Heart Failure, or decreased heart function. If you have any of these conditions, discuss with your doctor how Celebrex (Celecoxib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Celebrex (Celecoxib), and whether any special monitoring is needed. Consult your doctor immediately if you develop shortness of breath, fatigue, excessive weight gain, chest pain, or swelling of the legs, feet, or ankles while taking Celebrex (Celecoxib).

Heart Attack and Stroke: The use of selective COX-2 inhibitor NSAIDs, including Celebrex (Celecoxib), is associated with an increased risk of cardiovascular events such as heart attack and stroke, similar to the risk associated with most traditional NSAIDs (e.g., ibuprofen, diclofenac, naproxen). The risk is increased with higher total daily doses and when taking the medication over long periods of time. Due to this increased risk, people with the following conditions or risk factors should be closely monitored by their doctor if they use Celebrex (Celecoxib):

• congestive heart failure
• Diabetes
• heart attack
• heart disease
• high blood pressure
• High Cholesterol
• impaired kidney function
• poor circulation
• smoking
• stroke

Kidney Disease: Like other NSAIDs, Celebrex (Celecoxib) may cause decreased kidney function and is not recommended for people with advanced kidney disease. If you have kidney disease, discuss with your doctor how Celebrex (Celecoxib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Celebrex (Celecoxib), and whether any special monitoring is needed.

If you experience signs of kidney problems, such as blood in your urine or decreased urine production, contact your doctor as soon as possible.

Liver function: Celebrex (Celecoxib) may worsen liver disease. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Celebrex (Celecoxib), and whether any special monitoring is needed.

Contact your doctor immediately if you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin.

Meningitis: On rare occasions, people taking NSAIDs such as Celebrex (Celecoxib) experience symptoms of inflammation of the tissues surrounding the brain (meningitis). This appears to be more likely for people who have an autoimmune disorder. If you experience symptoms of meningitis not caused by infection, such as stiff neck, severe headache, nausea, vomiting, or changes in consciousness and awareness, contact your doctor immediately.

Potassium levels: Celebrex (Celecoxib) may increase the risk of high potassium levels in the blood, especially for seniors, people who have conditions such as diabetes or kidney failure, or people taking certain other types of medications. Your doctor may order blood tests periodically during long-term treatment to monitor the amount of potassium in your blood. People who have been diagnosed with having high potassium levels in their blood should not take Celebrex (Celecoxib).

Stomach problems: Celebrex (Celecoxib) may cause stomach problems such as ulcers or bleeding. If you have stomach problems, discuss with your doctor how Celebrex (Celecoxib) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Celebrex (Celecoxib), and whether any special monitoring is needed. Call your doctor immediately if you notice signs such as stomach or abdominal pain, black tarry stools, or vomiting blood. Using acetylsalicylic acid (ASA) at the same time as Celebrex (Celecoxib) increases the risk of stomach ulcers and bleeding.

Urinary tract problems: Some people experience ongoing symptoms of urinary problems. If you experience bladder pain, pain when urinating, or increased frequency of urination, stop taking Celebrex (Celecoxib) and contact your doctor.

Pregnancy: The safety of using Celebrex (Celecoxib) during pregnancy has not been established. Celebrex (Celecoxib) should not be used during pregnancy unless the benefits outweigh the risks, and it should be avoided during the last trimester of pregnancy (after 28 weeks of pregnancy). Using Celebrex (Celecoxib), as with any NSAID, late in pregnancy may cause labour to be prolonged. If you become pregnant while taking Celebrex (Celecoxib), contact your doctor immediately.

Breast-feeding: Celebrex (Celecoxib) may pass into breast milk. If you are a breast-feeding mother and are taking Celebrex (Celecoxib), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Celebrex (Celecoxib) have not been established for children and adolescents under 18 years old.

Seniors: Seniors are more likely to experience side effects of Celebrex (Celecoxib). Discuss the risks and benefits of using Celebrex (Celecoxib) with your doctor.

The dosage of this medication depends on what it is used for. Depending on the circumstance, it may be used regularly or only as needed. Follow the instructions provided by your health care professional. This medication may be taken with or without food. Avoid consuming alcohol or alcohol-containing products while taking this medication.