Celebrex

Trade name / manufacturer

Celebrex® hard capsules from Mack, Illert (Pfizer).

Chemical name

4 - [5 - (4 - methylphenyl) - 3 - (trifluoromethyl) - 1H - pyrazol - 1 - yl] benzenesulfonamide

Active ingredient: Celecoxib

definition

Celebrex® belongs to the group of non-steroidal anti-inflammatory drugs (NSAIDs). In addition to good pain-relieving, it also has anti-inflammatory potency. It is mainly used for complaints that affect the skeleton or bones.

application areas

Typical areas of application for Celebrex® are:

• arthrosis
• Rheumatoid arthritis
• Swelling conditions after sports injuries and surgery
• Back pain
• disc prolapse

effect

All NSAIDs inhibit an endogenous enzyme, the so-called cyclooxygenase. This enzyme plays a key role in the formation of prostaglandins. A distinction is made between two classes of these Cyclooxygenase (COX-1 and COX-2).
Prostaglandines are so-called pain mediators that regulate functions such as pain, inflammation and fever. Prostaglandines also affect blood clotting.
Celebrex® is a member of a new class of anti-inflammatory drugs; it is a selective cyclooxygenase 2 (COX-2) inhibitor. This means it predominantly inhibits the COX-2, which is responsible for pain and swelling, while it inhibits the COX-1, which i.a. Regulated for stomach protection, only slightly inhibit.

In summary, the COX-2 inhibitors are a good approach to treating more selectively, it remains to be seen whether this selective therapy will not result in an increased risk of side effects (heart attack and stroke in particular).

Celebrex® takes effect

The active ingredient celecoxib, unlike most other active ingredients from the group of non-steroidal anti-inflammatory drugs, is absorbed relatively slowly, so that the full analgesic effect is only achieved after 24 to 48 hours.
For this, a daily intake is necessary so that a sufficiently high blood level of the drug is achieved. For the treatment of acute pain, Celebrex® is only moderately suitable, it should then be combined with an active ingredient that works faster and bridges the time until Celebrex® takes full effect.

dosage

Celebrex® is available as hard capsules in doses of 100 and 200 mg.
The manufacturer recommends 2 x 100 mg (1-0.-1) or 2 x 200 mg (1-0-1).

The maximum daily dose is 400 mg per day, if the weight is less than 50 kg, the recommended maximum dose is 200 mg per day.

price

Since there is always talk of cost pressure in the healthcare sector, I think it is important to also find out prices for drugs:

Celebrex® 100 mg 20 hard capsules (N1) € 21.41

Celebrex® 200 mg 100 hard capsules (N3) € 120.83

Celebrex® for the treatment of back pain

Celebrex® is primarily used to treat degenerative changes (signs of wear and tear) in the joints and spine. It is also often used to treat back pain.
Both Celebrex® and its active ingredient partner Arcoxia® are popular drugs for the treatment of back pain. However, therapy with diclofenac or ibuprofen can also be considered, depending on what is causing the pain. Ibuprofen, for example, works very reliably, especially with muscular pain, such as tension that has nothing to do with wear and tear.

Side effects

We limit ourselves to the most common ones Side effects. Since every person reacts individually to medication, side effects not mentioned can of course occur.
Allergic reaction:

• Rash (redness, itching)
• Drop in blood pressure
• shock

Gastrointestinal complaints
In some cases, Celebrex® causes one Inflammation of the stomach lining. The gastric mucosal inflammation is triggered by the direct absorption of Celebrex® through the stomach.

dizziness

Water retention in the tissue (edema)

Tinnitus

Psychological complaints:

• sleepiness
• a headache
• Poor concentration
• depression

Laboratory changes (Laboratory values)

• Increase in liver enzymes in the blood
• Decrease in red blood cells

Edema as a side effect

Like other active ingredients from the group of non-steroidal anti-inflammatory drugs, Celebrex® can lead to fluid retention with the formation of edema, i.e. water retention in certain parts of the body.
Edema usually forms first in the area of ​​the lower legs. The lower legs increase in size, stockings leave marks and when the finger is pressed on the lower leg, small bumps appear that quickly recede. If this side effect occurs during therapy with Celebrex®, the attending physician should be consulted. In otherwise healthy patients, edema is not dangerous, it is only an aesthetic problem.
In patients who suffer from cardiac insufficiency, for example, the increased fluid retention can have consequences so that it may be necessary to discontinue the drug.
In the package insert, the frequency of the occurrence of edema during therapy with Celebrex® is stated as often. This means that one in 10 to one in 100 patients who take Celebrex will develop edema.

Fatigue as a side effect

Fatigue is a very unspecific symptom and can have numerous causes. Many medications can also cause fatigue. According to the package insert, taking Celebrex® can occasionally lead to tiredness. This means that one in 100 to one in 1000 people who take Celebrex suffer from increased fatigue.

Note

Celebrex® belongs to the group of new COX-2 inhibitors, also to the group to which Vioxx belonged, a drug that was withdrawn from the market on September 30th due to side effects in the cardiovascular area. Such side effects are currently for Celebrex® not known to this extent.

Do I need stomach protection when taking Celebrex®?

There are two different types of non-steroidal anti-inflammatory drugs. The selective COX2 inhibitors to which Celebrex® belongs and the non-selective COX inhibitors to which, for example, ibuprofen belongs. Purely in terms of the effect on the cellular level, the selective COX2 inhibitors do not attack the stomach and should therefore not have any damaging effect on the gastric mucosa.
In contrast, drugs such as ibuprofen are said to significantly increase the risk of developing gastric ulcers, especially when taken for a long time. Therefore ibuprofen should always be combined with a stomach protector when taken over a longer period of time.
This is not the case with the selective COX2 inhibitors. In principle, they do not have to be combined with stomach protection. However, if there are risk factors such as a history of gastric ulcers, old age, poor general condition, regular alcohol consumption or co-medication with other medications that increase the risk of gastric ulcers, the additional intake of a gastric protection tablet is recommended.

interaction

Anticoagulant:

Celebrex® should not be given at the same time as anticoagulant preparations or preparations of the same class of active substances (diclofenac / indomethacin / piroxicam / ibuprofen).
Particularly with the simultaneous administration of Marcumar®, it should be taken into account that the blood-thinning effect of Marcumar® increases.

The effect of antihypertensive drugs (ACE inhibitors, beta blockers, diuretics) can be weakened.

Can you take Celebrex® together with ibuprofen?

A combination of Celebrex® and ibuprofen is not recommended. Both drugs are among the non-steroidal anti-inflammatory drugs, with Celebrex® being a subgroup of selective COX2 inhibitors.
It is generally not recommended to take two active ingredients from this group of drugs, as they have a similar effect and the intake does not promise increased effectiveness. If it is not effective enough, it should be considered with the treating physician whether an increase in the dose is an option. If two drugs from the group of NSAIDs are taken, it also increases the risk of potential side effects.
According to the World Health Organization, there are 3 levels of pain management (WHO level scheme). Level 1 is used to treat mild pain. Pain relievers such as ibuprofen, Celebrex®, paracetamol or metamizole are used here. As a rule, however, these are not combined with one another.
Combination therapy takes place at level 2, for the treatment of moderate to severe pain. A combination therapy of level 1 drugs (for example ibuprofen / Celebrex) with low-potency opioids is recommended.
So if therapy with Celebrex is not enough, there are two options: You change the drug, i.e. try another drug from level 1, such as metamizol (Novalgin), paracetamol or ibuprofen.Or you combine Celebrex® with a weakly effective opioid. Both measures should ideally be carried out after consulting a doctor.

Contraindication

You mustn't Celebrex® take if you:

• Pregnant are or will be
  (See also: Medication during the pregnancy)
• breastfeeding
  (See also: Medication during breastfeeding)
• already once allergic have reacted to one of the ingredients in Celebrex® capsules
• have already been allergic to a drug from the drug group "sulfonamides" (are among others as Antibiotics used in cystitis) have reacted.
• after taking aspirin® or other non-steroidal anti-inflammatory agents (NSAIDs) like for example Ibuprofen allergic reactions such as skin rashes, swelling, itching, or shortness of breath have occurred
• on inflammatory bowel disease suffer (e.g. Crohn's disease)
• a Gastric ulcer and duodenal ulcer (ulcer)
• severe disorder of liver and kidney to have
• a very difficult one Heart failure (decompensated heart failure)

Celebrex® and alcohol - are they compatible?

As with many other drugs, Celebrex® also means that alcohol consumption should be very moderate and that tablets should be taken regularly at the same time. If alcohol is consumed in large quantities and Celebrex® is taken at the same time, this increases the risk of gastrointestinal bleeding, liver damage and impairment of the cardiovascular system.
Other possible side effects of Celebrex® can also be aggravated by alcohol consumption. We therefore recommend a very moderate alcohol consumption with regular consumption of Celebrex.
In principle, however, the attending physician should always be consulted again in individual cases regarding the question of whether there are other aspects that speak against alcohol consumption. For example, taking other medication or certain concomitant diseases.

What are the alternatives to Celebrex®?

Celebrex® is mainly used to treat pain in the musculoskeletal system, more precisely the skeletal system. For example, with joint diseases such as osteoarthritis, back pain or rheumatic pain.
As an alternative, either drugs of the same level (level 1 of the WHO level scheme) or drugs from higher groups can be considered. Possible alternatives from level 1 are other coxibs such as etoricoxib (Arcoxia®) or non-selective COX2 inhibitors such as diclofenac or ibuprofen. If the aim is to find an alternative because the analgesic effect is not sufficient, a combination of Celebrex® with low-potency opioids such as tramadol or tilidine should be considered.