Celecoxib, Oral

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KEY POINTS

• This medicine is taken by mouth to relieve pain and inflammation. Take it exactly as directed.
• NSAIDs may increase the chance of a heart attack or stroke that can lead to death. This medicine may cause ulcers and bleeding in the stomach and intestines at any time during treatment. This medicine should not be used right before or after a heart surgery called coronary artery bypass graft (CABG).
• This medicine may also cause other unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: nonsteroidal anti-inflammatory drug (NSAID); COX-2 inhibitor; analgesic

Generic and brand names: celecoxib, oral; Celebrex

What is this medicine used for?

This medicine is a nonsteroidal anti-inflammatory drug (NSAID) taken by mouth to treat the symptoms of rheumatoid arthritis and osteoarthritis.

This medicine is also taken to relieve:

• Ankylosing spondylitis (arthritis of the spine)
• Juvenile idiopathic arthritis
• Dysmenorrhea (painful menstrual periods)
• General pain in adults

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A blood disorder such as anemia
• A stroke or transient ischemic attack (TIA)
• Asthma
• Edema (fluid buildup)
• Heart disease or heart failure
• High blood pressure
• Liver or kidney disease
• Stomach problems such as ulcers or bleeding

Tell your healthcare provider if you smoke or drink alcohol. Alcohol and smoking may increase the risk of ulcers or stomach bleeding.

Tell your provider if you have recently had heart surgery. Also tell your provider if you are taking one aspirin a day for heart disease or stroke, or if you take other medicine that reduces the chance of blood clots forming such as warfarin (Coumadin).

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. This medicine is not usually given to pregnant women because it can harm the baby, especially in late pregnancy. Do not take this medicine during the last 3 months of pregnancy. If you become pregnant, contact your healthcare provider right away. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Read the Medication Guide that comes in the medicine package when you start taking this medicine and each time you get a refill.

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or for a longer period than prescribed because of the risk of side effects.

Check with your healthcare provider before using this medicine in children under age 2.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach. Swallow the capsule whole with a full glass of water. If you have trouble swallowing, the capsule may be opened and the powder sprinkled on soft food such as applesauce. Swallow the mixture right away. Then drink a full glass of water.

Ask your healthcare provider how long you should take this medicine. If you are taking it for osteoarthritis, you may need to take it for a long time to continue to relieve your pain.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, stomach pain, drowsiness, black or bloody bowel movements, coughing blood, shallow breathing, fainting, coma.

What should I watch out for?

Warning: This medicine may cause ulcers and bleeding in the stomach and intestines at any time during treatment. This may happen without warning symptoms. You may be at higher risk if you smoke, are over the age of 65 or in poor health, drink alcohol, or take this medicine for a long time. If you have stomach pain, or bloody or black tarry bowel movements, stop taking this medicine and contact your healthcare provider right away.

NSAIDs may increase the chance of a heart attack or stroke that can lead to death. This chance increases if you:

• Use NSAIDs for a long time
• Have heart disease

Talk with your healthcare provider about this.

This medicine should not be used right before or after a heart surgery called coronary artery bypass graft (CABG). Talk with your healthcare provider about this.

You may need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

Contact your healthcare provider if your condition does not improve or if it gets worse.

Do not take other pain medicines or drink alcohol while you are taking this medicine without your healthcare provider's approval.

This medicine cannot take the place of aspirin for the prevention of heart attacks or strokes. If you are taking aspirin for these purposes, do not discontinue the aspirin without the approval of your healthcare provider.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; tightness in your chest; swelling of your lips, tongue, or throat; trouble breathing); sudden weakness, numbness, or tingling, especially on one side of your body; sudden or severe headache; sudden trouble with vision, speech, balance, or walking; chest pain.

Serious (Report these to your healthcare provider right away.): Mouth sores; severe skin redness, peeling, or blisters; stiff neck; confusion; bloody, dark, or tarry bowel movements; unusual bruising or bleeding; stomach pain; unexplained tiredness; loss of appetite; fever; muscle and joint pains; yellowing of your skin or eyes; dark colored urine; light-colored bowel movements; vomiting blood or material that looks like coffee grounds; swelling of the hands, ankles or feet, or any unexplained swelling; decreased urination; wheezing; irregular heartbeat.

Other: Diarrhea, gas, constipation, runny or stuffy nose, dizziness, sensitivity to the sun, headache, trouble sleeping, back pain, joint pain, nausea, sore throat, hoarse voice.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), and quinapril (Accupril)
• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), ofloxacin, rifampin (Rifadin), and rifapentine (Priftin)
• Antidepressants such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), and venlafaxine (Effexor)
• Antifungal medicines such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• Antipsychotic medicines such as aripiprazole (Abilify), brexpiprazole (Rexulti), haloperidol (Haldol), and thioridazine
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), phenobarbital, phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Aspirin and other salicylates
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bosentan (Tracleer)
• Cancer medicines such as capecitabine (Xeloda), dasatinib (Sprycel), floxuridine, fluorouracil (Adrucil, Carac, Efudex, Fluoroplex), ibritumomab (Zevalin), ibrutinib (Imbruvica), obinutuzumab (Gazyva), pemetrexed (Alimta), pralatrexate (Folotyn), and tamoxifen
• Capecitabine (Xeloda)
• Corticosteroids such as methylprednisolone (Medrol, Solu-Medrol), prednisolone (Omnipred, Orapred, Prelone), and prednisone (Prednisone Intensol)
• Desmopressin (DDAVP)
• Digoxin (Lanoxin)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), eplerenone (Inspra), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Gemfibrozil (Lopid)
• HIV medicines such as delavirdine (Rescriptor) and efavirenz (Sustiva)
• Hydralazine
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Lithium (Lithobid)
• Medicines to treat or prevent blood clots such as abciximab (ReoPro), argatroban, bivalirudin (Angiomax), clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine), fondaparinux (Arixtra), lepirudin (Refludan), prasugrel (Effient), rivaroxaban (Xarelto), tirofiban (Aggrastat), and warfarin (Coumadin)
• Methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall)
• Natural remedies such as alfalfa, anise, bilberry, cat’s claw, celery, chamomile, chaparral, comfrey, dong quai, evening primrose, fenugreek, feverfew, fish oil, flaxseed, garlic, ginkgo, ginseng, glucosamine, grape seed, green tea, horse chestnut, kava, ma huang, pennyroyal, red clover, SAMe, turmeric, valerian, and willow
• Other medicines that contain nonsteroidal anti-inflammatory medicines (NSAIDs) such as other pain or fever medicines, or allergy, cold, or cough medicines
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Sulfamethoxazole/trimethoprim (Bactrim, Septra)

Do not drink alcohol while taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.