Celecoxib
A selective COX-2 inhibitor NSAID used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain and period pain.
Drug card
- Class
- Selective COX-2 inhibitor, and an NSAID
- How it works
- Blocking COX-2 selectively, sparing the COX-1 that protects the stomach
- Used for
- Osteoarthritis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Acute pain
- Known for
- Heart attack and stroke
- Its name
- -coxib means a selective COX-2 inhibitor
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does celecoxib work?
Celecoxib, a diaryl-substituted pyrazole with a sulfonamide group, selectively blocks COX-2 and so cuts prostaglandin production. Even at high doses it does not reduce platelet aggregation. CYP2C9 breaks it down, so poor CYP2C9 metabolizers and people on CYP2C9 inhibitors reach higher levels.
Uses
What is celecoxib used for?
- Osteoarthritis
- Rheumatoid arthritis
- Ankylosing spondylitis
- Acute pain
- Period pain (primary dysmenorrhea)
Side effects
Side effects of celecoxib
- Heart attack and strokeKnown forSerious
- Indigestion and stomach pain
- Diarrhea
- Dizziness
- Rash
- Swelling of the legs (edema)
- Raised blood pressure
- Stomach ulcers, less often than with older NSAIDsSerious
- Bleeding from the stomach or gutSerious
- Acute kidney injurySerious
- Allergic reactions, including anaphylaxisSerious
- Severe skin reactions (SJS, TEN, DRESS)Serious
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Avoid in sulfonamide allergy and in asthma or hives brought on by aspirin or other NSAIDs.
- Poor CYP2C9 metabolizers need a lower dose; fluconazole raises its levels and rifampicin lowers them.
- It has no antiplatelet effect, so it cannot replace low-dose aspirin for heart protection.
Good to know: In the PRECISION trial, in arthritis patients with or at high risk of heart disease, celecoxib was no worse than ibuprofen or naproxen for heart attack, stroke and cardiovascular death at the doses studied.
Remember it
A way to remember it
Coxibs: kinder to the stomach, no help to the heart.
Sparing COX-1 means fewer stomach ulcers, but coxibs have no antiplatelet effect, cannot stand in for aspirin, and still raise the risk of heart attack and stroke.
Written for biofideX
Its name
-coxib means selective COX-2 inhibitor
Celecoxib, etoricoxib and parecoxib share it. Ibuprofen and naproxen block COX-1 as well as COX-2, so they lack it; coxibs still carry the NSAID heart and gut warnings.
- Every drug name stem
Its class
Selective COX-2 inhibitors
Coxibs selectively block COX-2, the cyclooxygenase linked to pain and inflammation, and leave COX-1 largely alone. They ease pain and inflammation as other NSAIDs do, cause fewer ulcers on endoscopy, and do not stop platelets clumping, so they cannot replace aspirin for heart protection. Like all NSAIDs, they raise the risk of heart attack and stroke.
Easily mixed up with non-steroidal anti-inflammatory drugs and paracetamol.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Pain, fever and inflammation
Celecoxib is one of 15 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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