Celebra (Celecoxib): Uses, Dosage & Side Effects
A selective COX-2 inhibitor NSAID prescribed for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
Celebra (celecoxib) is a prescription non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits the cyclooxygenase-2 (COX-2) enzyme. It is used in adults for the symptomatic relief of pain and inflammation associated with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (Bechterew's disease). As a COX-2 selective inhibitor, celecoxib offers effective anti-inflammatory and analgesic properties while causing fewer gastrointestinal side effects than traditional NSAIDs such as ibuprofen or diclofenac. Like all NSAIDs, it carries risks of cardiovascular and gastrointestinal adverse events and should be used at the lowest effective dose for the shortest necessary duration.
Quick Facts: Celebra (Celecoxib)
Key Takeaways
- Celebra (celecoxib) is a COX-2 selective NSAID that provides effective pain and inflammation relief for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis while causing fewer stomach and intestinal side effects than traditional NSAIDs.
- Like all NSAIDs, celecoxib may increase the risk of serious cardiovascular events (heart attack, stroke), especially at higher doses and with long-term use. It is contraindicated in patients with established cardiovascular disease.
- The recommended dose is 200 mg daily for most conditions, which may be increased to a maximum of 400 mg daily if clinically necessary. Always use the lowest effective dose for the shortest duration needed.
- Celecoxib must not be used during pregnancy (especially the third trimester), during breastfeeding, or in patients with severe liver disease, severe kidney disease, active stomach ulcers, or inflammatory bowel disease.
- Important drug interactions exist with warfarin, lithium, methotrexate, ACE inhibitors, and fluconazole. Always inform your doctor about all medications you are taking before starting celecoxib.
What Is Celebra and What Is It Used For?
Celebra belongs to a class of medications called non-steroidal anti-inflammatory drugs (NSAIDs), and more specifically to the subgroup known as cyclooxygenase-2 (COX-2) selective inhibitors, sometimes referred to as "coxibs." Celecoxib was developed in the late 1990s by Pfizer (originally under the brand name Celebrex in North America) and was among the first COX-2 selective inhibitors approved for clinical use. It remains one of the most widely prescribed medications in this drug class worldwide.
The human body produces substances called prostaglandins, which play key roles in inflammation, pain, and fever. These prostaglandins are synthesized by two forms of the cyclooxygenase enzyme: COX-1 and COX-2. Traditional NSAIDs like ibuprofen and diclofenac inhibit both COX-1 and COX-2. While this effectively reduces pain and inflammation through COX-2 inhibition, the simultaneous suppression of COX-1 also reduces the production of prostaglandins that protect the stomach lining, maintain kidney blood flow, and support platelet aggregation. This is the primary reason traditional NSAIDs are associated with a significant risk of gastric ulcers and gastrointestinal bleeding.
Celecoxib was designed to selectively inhibit COX-2 while largely sparing COX-1 activity at therapeutic doses. This selectivity means that it effectively reduces the prostaglandins responsible for pain and inflammation in conditions such as arthritis, while preserving much of the stomach's protective prostaglandin production. As a result, celecoxib has a significantly lower incidence of gastrointestinal complications compared to traditional non-selective NSAIDs, as demonstrated in large clinical trials including the CLASS (Celecoxib Long-term Arthritis Safety Study) and PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen or Naproxen) trials.
Celebra is indicated for the symptomatic treatment of the following conditions in adults:
- Osteoarthritis (OA): The most common form of arthritis, caused by the gradual breakdown of joint cartilage. Celecoxib reduces the pain, stiffness, and swelling associated with OA, improving joint function and quality of life.
- Rheumatoid arthritis (RA): A chronic autoimmune inflammatory condition that primarily affects the joints. Celecoxib helps manage the pain and inflammation characteristic of RA, although it does not modify the underlying disease progression.
- Ankylosing spondylitis (AS): Also known as Bechterew's disease, this is a chronic inflammatory condition primarily affecting the spine and sacroiliac joints. NSAIDs, including celecoxib, are considered first-line treatment for managing pain and stiffness in AS according to international guidelines (ASAS/EULAR).
After oral administration, celecoxib is well absorbed from the gastrointestinal tract. You can expect the medication to begin providing pain relief within a few hours of taking the first dose. However, the full anti-inflammatory effect may take several days to develop, particularly in chronic inflammatory conditions like rheumatoid arthritis. Peak plasma concentrations are typically reached within 2 to 3 hours. The drug is extensively metabolized in the liver, primarily by the CYP2C9 enzyme, and has a plasma half-life of approximately 11 hours, allowing for once- or twice-daily dosing depending on the condition being treated.
Celecoxib is available under several brand names and as generic formulations. Besides Celebra, the same active ingredient is marketed as Celecoxib Accord, Celecoxib Krka, Celecoxib Sandoz, and Celecoxib Medical Valley, among others. In North America, the original brand name is Celebrex. All these products contain the same active substance and are therapeutically equivalent when approved by regulatory authorities.
What Should You Know Before Taking Celebra?
Celebra is a prescription medication that your doctor has determined is appropriate for your specific condition. The following information will help you use it safely and effectively. It is essential to provide your doctor with a complete medical history and a list of all medications, supplements, and herbal remedies you are taking before starting celecoxib therapy.
Contraindications
There are specific medical conditions and circumstances in which celecoxib must not be used. You should tell your doctor if any of the following apply to you, as patients with these conditions should not take Celebra:
- Allergy to celecoxib: If you are allergic to celecoxib or any of the other ingredients in the capsule (including lactose monohydrate, sodium lauryl sulfate, povidone, croscarmellose sodium, or magnesium stearate).
- Sulfonamide allergy: If you have had an allergic reaction to a group of medicines called sulfonamides (for example, certain antibiotics used for treating infections), as celecoxib contains a sulfonamide chemical moiety.
- NSAID or aspirin sensitivity: If you have experienced asthma, nasal polyps, severe nasal congestion, or allergic reactions such as hives, facial swelling, or breathing difficulties after taking aspirin or any other NSAID.
- Active gastrointestinal bleeding or ulcers: If you currently have an ulcer or bleeding in your stomach or intestines.
- Established cardiovascular disease: If you have heart failure, established ischemic heart disease (coronary artery disease), cerebrovascular disease (e.g., prior stroke or transient ischemic attack), or peripheral arterial disease.
- Severe liver disease: If you have significant hepatic impairment.
- Severe kidney disease: If you have severe renal impairment with estimated creatinine clearance less than 30 ml/min.
- Inflammatory bowel disease: If you have ulcerative colitis or Crohn's disease.
- Pregnancy and breastfeeding: Celebra must not be used during pregnancy or while breastfeeding. Women of childbearing potential should use effective contraception during treatment.
Warnings and Precautions
All NSAIDs, including celecoxib, may increase the risk of serious cardiovascular thrombotic events, including heart attack and stroke. This risk may increase with higher doses and longer duration of use. Patients with cardiovascular risk factors (smoking, diabetes, hypertension, high cholesterol) should discuss the benefits and risks with their doctor before starting treatment.
Talk to your doctor or pharmacist before taking Celebra if any of the following conditions apply to you:
- History of gastrointestinal ulcers or bleeding: Previous peptic ulcers or gastrointestinal hemorrhage increase the risk of these events recurring with NSAID use. Your doctor may consider prescribing a gastroprotective agent (such as a proton pump inhibitor) alongside celecoxib.
- Concurrent aspirin use: If you are taking low-dose aspirin (75 mg or less daily) for cardiovascular protection, the combination with celecoxib may reduce the gastrointestinal advantage of the COX-2 selective approach and may increase bleeding risk.
- Anticoagulant therapy: If you are taking blood-thinning medications such as warfarin, other coumarin anticoagulants, or newer direct oral anticoagulants (e.g., apixaban), as celecoxib may enhance their effect.
- Concurrent use of other NSAIDs: The simultaneous use of celecoxib with other NSAIDs (except low-dose aspirin) should be avoided, as this increases the risk of adverse effects without additional therapeutic benefit.
- Cardiovascular risk factors: If you smoke, have diabetes, high blood pressure, or elevated cholesterol levels, discuss the potential cardiovascular risks of NSAID therapy with your doctor.
- Impaired heart, liver, or kidney function: Your doctor may need to monitor you more closely and adjust your dose if any of these organs are not functioning optimally.
- Fluid retention: If you experience swelling of the ankles, feet, or hands, as NSAIDs can cause fluid retention and edema.
- Dehydration: If you are dehydrated due to vomiting, diarrhea, or diuretic use, as this increases the risk of kidney problems with NSAIDs.
- Active infections: Celecoxib may mask the signs and symptoms of infection, including fever, potentially delaying diagnosis and appropriate treatment.
- Age over 65: Elderly patients are at increased risk of NSAID-related adverse effects, particularly gastrointestinal bleeding, cardiovascular events, and renal impairment. Your doctor will monitor you more closely.
Serious liver reactions (including severe hepatitis, liver failure, and cases requiring liver transplantation) have been reported with celecoxib use. Most cases occurred within the first month of treatment. Additionally, serious and potentially life-threatening skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and exfoliative dermatitis, have been reported. Stop taking Celebra immediately and seek urgent medical attention if you develop a skin rash, blistering, peeling of the skin, or signs of liver problems such as jaundice (yellowing of the skin or eyes), dark urine, or persistent nausea.
Pregnancy and Breastfeeding
Celebra must not be used by women who are pregnant or may become pregnant during treatment. If you are of childbearing age, you should discuss suitable contraceptive methods with your doctor before starting celecoxib. If you become pregnant while taking Celebra, stop the medication immediately and contact your doctor for alternative treatment options.
NSAIDs, including celecoxib, are particularly dangerous in the third trimester of pregnancy. They can cause premature closure of the ductus arteriosus in the fetus (a blood vessel essential for fetal circulation), inhibit uterine contractions and delay labor, and increase the risk of bleeding. Earlier in pregnancy, NSAID use has been associated with increased risks of miscarriage and cardiac malformations, although the evidence is less conclusive for COX-2 selective agents specifically.
Celebra must not be used during breastfeeding. Celecoxib is excreted in breast milk in small amounts, and the potential effects on the nursing infant are not fully established. If you need anti-inflammatory treatment while breastfeeding, your doctor will recommend a safer alternative.
NSAIDs, including celecoxib, may impair female fertility by affecting ovulation. This effect is generally reversible upon discontinuation of the drug. If you are planning to become pregnant or are having difficulty conceiving, inform your doctor, who may advise discontinuing celecoxib.
Driving and Operating Machinery
You should be aware of how you react to Celebra before driving or operating machinery. Some patients may experience dizziness, drowsiness, or visual disturbances while taking celecoxib. If you experience any of these side effects, do not drive or use machines until they have resolved. You are responsible for assessing whether you are fit to drive or perform tasks requiring alertness.
Celebra capsules contain lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine. Each capsule also contains less than 1 mmol (23 mg) of sodium, making it essentially sodium-free.
How Does Celebra Interact with Other Drugs?
Celecoxib can interact with a number of other medications, potentially affecting their efficacy or safety, or altering the effects of celecoxib itself. It is essential to inform your doctor, pharmacist, or nurse about all medications you are currently taking, have recently taken, or might take, including over-the-counter drugs, herbal supplements, and vitamins. The following interactions are of particular clinical importance.
Major Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Warfarin and other coumarins | Celecoxib may enhance the anticoagulant effect of warfarin, increasing INR and the risk of serious bleeding events, including gastrointestinal hemorrhage | Monitor INR closely when starting, stopping, or changing celecoxib dose. Frequent INR checks during the first few weeks of co-administration. |
| Apixaban and other DOACs | Concurrent use of celecoxib with direct oral anticoagulants (apixaban, rivaroxaban, dabigatran) may increase the risk of bleeding | Use with caution. Monitor for signs of bleeding. Consider gastroprotective therapy if co-administration is necessary. |
| Lithium | Celecoxib can increase plasma lithium levels by reducing renal lithium clearance, potentially leading to lithium toxicity (symptoms: tremor, nausea, confusion) | Monitor lithium plasma levels closely when starting or stopping celecoxib. Dose adjustment of lithium may be necessary. |
| Fluconazole | Fluconazole inhibits CYP2C9, the primary enzyme responsible for celecoxib metabolism, approximately doubling celecoxib plasma concentrations and increasing the risk of adverse effects | Halve the celecoxib dose when used concomitantly with fluconazole. Avoid high doses of celecoxib during concurrent fluconazole therapy. |
| ACE inhibitors & ARBs | Celecoxib may reduce the antihypertensive effect of ACE inhibitors and angiotensin II receptor blockers. The combination may also increase the risk of acute kidney injury, particularly in dehydrated patients | Monitor blood pressure and kidney function regularly. Ensure adequate hydration. Consider alternative analgesics if blood pressure control worsens. |
| Methotrexate | NSAIDs including celecoxib can reduce renal excretion of methotrexate, potentially increasing methotrexate plasma levels and toxicity (bone marrow suppression, mucositis, liver and kidney damage) | Use with caution, particularly with high-dose methotrexate. Monitor for methotrexate toxicity and check blood counts regularly. |
Other Important Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Diuretics (furosemide, thiazides) | Celecoxib may reduce the diuretic and antihypertensive effects of diuretics through renal prostaglandin inhibition, and may increase the risk of kidney impairment | Monitor kidney function and blood pressure. Ensure adequate hydration, especially in elderly patients. |
| Rifampicin | Rifampicin induces CYP2C9, increasing celecoxib metabolism and potentially reducing its analgesic and anti-inflammatory efficacy | The dose of celecoxib may need to be increased. Monitor clinical response. Consider alternative analgesics. |
| Dextromethorphan | Celecoxib is a moderate inhibitor of CYP2D6 and may increase plasma levels of dextromethorphan and other CYP2D6 substrates | Be aware of potential increased effects of cough medicines containing dextromethorphan. Usually not clinically significant at standard doses. |
| Ciclosporin & Tacrolimus | NSAIDs including celecoxib may enhance the nephrotoxic effects of ciclosporin and tacrolimus through additive renal prostaglandin inhibition | Monitor kidney function closely. Use the lowest effective dose of celecoxib for the shortest duration necessary. |
| Corticosteroids (e.g., prednisone) | Concurrent use of corticosteroids with NSAIDs increases the risk of gastrointestinal ulceration and bleeding | Use combination with caution. Consider gastroprotective therapy (proton pump inhibitor) when both are used concurrently. |
| Carbamazepine & Barbiturates | These enzyme inducers may increase the metabolism of celecoxib, potentially reducing its efficacy | Monitor analgesic response. Dose adjustment of celecoxib may be needed. |
Celebra can be taken together with low-dose aspirin (75 mg or less per day) for cardiovascular protection. However, combining celecoxib with aspirin may diminish the gastrointestinal advantage of the COX-2 selective approach. If you are taking both medications, consult your doctor about whether gastroprotective therapy (such as a proton pump inhibitor) is appropriate. Do not start or stop aspirin without medical advice.
The consumption of alcohol alongside NSAIDs, including celecoxib, may increase the risk of gastrointestinal irritation, ulceration, and bleeding. Patients taking celecoxib should limit or avoid alcohol consumption and discuss their alcohol intake with their prescribing physician.
What Is the Correct Dosage of Celebra?
Always take Celebra exactly as your doctor or pharmacist has told you. The correct dose depends on your specific condition and individual medical circumstances. Because the risk of cardiovascular side effects may increase at higher doses and with prolonged treatment, it is important not to take more than prescribed or use Celebra for longer than necessary to control your symptoms.
Adults: Standard Dosing by Condition
Osteoarthritis
Recommended dose: 200 mg daily
How to take: One 200 mg capsule once daily, OR one 100 mg capsule twice daily
Maximum dose: 400 mg daily (if your doctor determines it is necessary)
Rheumatoid Arthritis
Recommended dose: 200 mg daily
How to take: One 100 mg capsule twice daily
Maximum dose: 400 mg daily (if your doctor determines it is necessary)
Ankylosing Spondylitis (Bechterew's Disease)
Recommended dose: 200 mg daily
How to take: One 200 mg capsule once daily, OR one 100 mg capsule twice daily
Maximum dose: 400 mg daily (if your doctor determines it is necessary)
Celebra capsules are taken orally (swallowed whole). Your dose can be taken at any time of day, with or without food, but try to take each dose at the same time every day for consistent effect. If you have difficulty swallowing capsules, the capsule contents can be sprinkled onto a level teaspoon of soft food at room temperature (such as applesauce, rice pudding, yogurt, or mashed banana) and swallowed immediately with approximately 240 ml of water. To open the capsule, hold it upright so the granules settle at the bottom, then gently squeeze the top and twist it off. Do not chew or crush the granules.
Special Populations
| Population | Dosage Guidance | Monitoring |
|---|---|---|
| Elderly (over 65 years) | Start with the lowest recommended dose. Extra caution in patients weighing less than 50 kg | Regular monitoring of renal function, blood pressure, and gastrointestinal symptoms |
| Hepatic impairment (mild to moderate) | Consider starting at the lower dose range. Severe hepatic impairment: contraindicated | Monitor liver function tests regularly, especially during the first month |
| Renal impairment (mild to moderate) | Use with caution at the lowest effective dose. Severe renal impairment: contraindicated | Monitor renal function and electrolytes. Ensure adequate hydration |
| CYP2C9 poor metabolizers | Patients known to be poor metabolizers of CYP2C9 substrates should start with half the recommended dose | Close monitoring for adverse effects, as celecoxib exposure may be significantly higher |
Children
Celebra is intended for adults only and should not be used in children. There is insufficient evidence to support the safe and effective use of celecoxib in pediatric patients for the approved indications. If a child requires anti-inflammatory treatment, the prescribing physician will recommend an age-appropriate alternative medication.
Missed Dose
If you forget to take a dose of Celebra, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a forgotten one, as this increases the risk of side effects, particularly gastrointestinal and cardiovascular adverse events.
Overdose
Do not take more capsules than your doctor has prescribed. If you take too many Celebra capsules, or if a child accidentally ingests the medication, contact your doctor, go to the nearest emergency department, or call your local poison control center immediately for assessment and advice. Symptoms of overdose may include nausea, vomiting, stomach pain, drowsiness, and in severe cases, gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression.
Stopping Treatment
If you suddenly stop taking Celebra, your underlying symptoms of pain and inflammation may return or worsen. Do not discontinue Celebra without discussing it with your doctor first. Your doctor may advise gradually reducing your dose over a few days before stopping treatment completely, particularly if you have been taking the medication for an extended period.
You should not take more than 400 mg daily under any circumstances. Contact your doctor if you do not experience any improvement after two weeks of treatment, as an alternative therapeutic approach may be needed.
What Are the Side Effects of Celebra?
Like all medications, Celebra can cause side effects, although not everyone experiences them. The side effects listed below have been observed in patients using celecoxib for arthritis and other conditions. Side effects marked with an asterisk (*) were reported at higher frequencies in patients taking celecoxib at high doses (400 mg daily) for the prevention of colorectal polyps over extended periods.
Stop taking Celebra and contact your doctor or emergency services immediately if you experience: an allergic reaction (rash, facial swelling, wheezing, breathing difficulties); chest pain or symptoms of a heart attack; signs of stomach bleeding (black or bloody stools, vomiting blood); skin rash with blistering or peeling; or signs of liver failure (yellowing of skin or eyes, dark urine, persistent nausea).
Very Common
May affect more than 1 in 10 people
- High blood pressure, including worsening of pre-existing hypertension*
Common
May affect up to 1 in 10 people
- Heart attack (myocardial infarction)*
- Fluid retention causing swelling of ankles, legs, or hands (edema)
- Urinary tract infection
- Breathing difficulties*, sinusitis, nasal congestion, runny nose, sore throat, cough, cold or flu-like symptoms
- Dizziness, difficulty sleeping (insomnia)
- Nausea, vomiting*, stomach pain, diarrhea, indigestion, flatulence
- Skin rash, itching
- Muscle stiffness, joint pain
- Difficulty swallowing*
- Headache
- Worsening of existing allergies
Uncommon
May affect up to 1 in 100 people
- Stroke*
- Heart failure, palpitations, rapid heartbeat
- Changes in liver function tests
- Changes in kidney function tests
- Anemia (reduced red blood cells, causing weakness and breathlessness)
- Anxiety, depression, fatigue, drowsiness, tingling sensations
- Increased potassium levels (may cause nausea, fatigue, muscle weakness, or palpitations)
- Blurred or impaired vision, tinnitus (ringing in ears), mouth soreness, mouth ulcers, impaired hearing*
- Constipation, belching, stomach inflammation, worsened gastrointestinal inflammation
- Leg cramps, hives (urticaria)
- Eye inflammation, breathing difficulties
- Bruising, chest pain (non-cardiac), facial swelling
Rare
May affect up to 1 in 1,000 people
- Stomach, esophageal, or intestinal ulcers and bleeding; intestinal perforation; pancreatitis; esophagitis; dark or black stools
- Low blood sodium (hyponatremia)
- Decreased white blood cells (increased infection risk) and platelets (increased bleeding risk)
- Confusion, taste changes, muscle coordination difficulties, hair loss
- Increased light sensitivity, eye bleeding
- Irregular heartbeat, hot flushes
- Pulmonary embolism (blood clot in the lungs, causing sudden breathlessness, sharp chest pain, or collapse)
- Severe liver inflammation (hepatitis), liver damage, liver failure (may cause jaundice, dark urine, pale stools, itching)
- Acute kidney failure, menstrual irregularities
- Hallucinations, facial/lip/tongue/throat swelling (angioedema)
Very Rare
May affect up to 1 in 10,000 people
- Severe allergic reactions including anaphylactic shock (potentially life-threatening)
- Severe skin conditions: Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, acute generalized exanthematous pustulosis (AGEP)
- Delayed hypersensitivity reaction (DRESS syndrome) with rash, fever, swollen lymph nodes, abnormal liver and blood tests
- Cerebral hemorrhage (brain bleeding, potentially life-threatening)
- Meningitis (inflammation of brain and spinal cord membranes)
- Liver failure (some cases fatal or requiring transplantation)
- Kidney inflammation (nephritis, nephrotic syndrome, minimal change disease)
- Worsening of epilepsy (increased frequency or severity of seizures)
- Partial or complete vision loss due to retinal vascular occlusion
- Vasculitis (inflammation of blood vessels, causing fever, pain, purple skin patches)
- Pancytopenia (deficiency of all blood cell types)
- Muscle pain and weakness (myalgia), loss of smell, loss of taste
In clinical studies where celecoxib was used at doses of 400 mg daily for up to 3 years for the prevention of colorectal polyps, the following additional side effects were observed: angina (chest pain) and irritable bowel syndrome as common effects; and deep vein thrombosis, gastrointestinal infection, bone fractures, skin infections, kidney stones, and weight gain as uncommon effects.
If you experience any side effects, including any not listed above, talk to your doctor or pharmacist. You can also report side effects directly to your national medicines regulatory authority (e.g., FDA MedWatch in the United States, the Yellow Card Scheme in the United Kingdom, or EMA in the European Union). By reporting side effects, you help provide more information on the safety of this medicine.
How Should You Store Celebra?
Proper storage of medication is essential to maintain its effectiveness and safety. Celebra capsules should be stored at a temperature not exceeding 30°C (86°F). Keep the capsules in their original blister packaging to protect them from moisture and light. Do not transfer the capsules to a different container unless specifically advised to do so by your pharmacist.
Keep Celebra out of the sight and reach of children at all times. Children are particularly vulnerable to accidental ingestion, and NSAID overdose can cause serious harm. Store the medication in a secure location, preferably in a locked cabinet.
Do not use Celebra after the expiry date stated on the blister pack and carton. The expiry date refers to the last day of the stated month. Using expired medication may result in reduced effectiveness and potentially altered safety profile.
Do not dispose of unused or expired medication by flushing it down the toilet or placing it in household waste. Instead, return unused medications to your local pharmacy for safe disposal through an appropriate medication take-back program. These measures help protect the environment and prevent accidental exposure.
What Does Celebra Contain?
Active Ingredient
The active substance is celecoxib. Each hard capsule contains either 100 mg or 200 mg of celecoxib. Celecoxib is a diaryl-substituted pyrazole that functions as a selective inhibitor of the cyclooxygenase-2 (COX-2) enzyme. Its chemical name is 4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamide, and its molecular formula is C17H14F3N3O2S.
Inactive Ingredients (Excipients)
In addition to the active ingredient, Celebra capsules contain the following excipients that help with the manufacturing, stability, and delivery of the medication:
- Lactose monohydrate – a sugar used as a filler (important for patients with lactose intolerance)
- Sodium lauryl sulfate – a surfactant that aids drug dissolution and absorption
- Povidone – a binding agent
- Croscarmellose sodium – a disintegrant that helps the capsule contents dissolve
- Magnesium stearate – a lubricant used in manufacturing
The capsule shell is composed of gelatin, titanium dioxide (E171), sodium lauryl sulfate, and sorbitan monolaurate. The printing ink on the capsules contains shellack, propylene glycol, and either indigotine (E132) for the 100 mg capsule or iron oxide (E172) for the 200 mg capsule.
Appearance and Pack Sizes
Celebra capsules are available in two strengths, each with a distinct appearance for easy identification:
- 100 mg capsules: Opaque, white hard capsules with two blue bands, imprinted with "7767" and "100"
- 200 mg capsules: Opaque, white hard capsules with two yellow bands, imprinted with "7767" and "200"
The capsules are packaged in clear or opaque PVC/aluminum blister packs. Various pack sizes are available, including 2, 5, 6, 10, 20, 30, 40, 50, 60, and 100 capsules. Not all pack sizes may be marketed in your country.
Frequently Asked Questions About Celebra
Celebra (celecoxib) is a prescription NSAID used to relieve pain and inflammation in adults with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (Bechterew's disease). It belongs to a class of drugs called COX-2 selective inhibitors, which target the specific enzyme responsible for inflammation while having less effect on the stomach-protective enzyme COX-1, resulting in fewer gastrointestinal side effects than traditional NSAIDs like ibuprofen or diclofenac.
Yes, celecoxib has a significantly lower risk of causing stomach ulcers and gastrointestinal bleeding compared to traditional NSAIDs like ibuprofen and diclofenac. The CLASS and PRECISION trials demonstrated that celecoxib causes fewer upper gastrointestinal complications. However, celecoxib still carries some gastrointestinal risk, especially at higher doses or with long-term use, and patients with a history of stomach ulcers should discuss the benefits and risks with their doctor.
Like all NSAIDs, celecoxib may increase the risk of cardiovascular events including heart attack and stroke, particularly at higher doses and with long-term use. The FDA-mandated PRECISION trial (2016), published in the New England Journal of Medicine, found that celecoxib at moderate doses (200 mg daily) was non-inferior to naproxen and ibuprofen regarding cardiovascular safety. Celecoxib should not be used by patients with established heart disease, prior heart attack, stroke, or severe heart failure. Always use the lowest effective dose for the shortest necessary duration.
For osteoarthritis, the recommended starting dose is 200 mg daily, taken as a single 200 mg capsule once daily or as 100 mg twice daily. For rheumatoid arthritis and ankylosing spondylitis, the usual dose is also 200 mg daily, which may be increased to a maximum of 400 mg daily if your doctor determines it is necessary. The lowest effective dose should always be used for the shortest duration needed to control symptoms. Do not exceed 400 mg per day.
Celecoxib can interact with blood thinners such as warfarin and newer oral anticoagulants like apixaban. If you are taking warfarin, celecoxib may enhance its anticoagulant effect, increasing the risk of bleeding. Your doctor should monitor your INR closely if you need to take both medications. Celecoxib can be taken with low-dose aspirin (75 mg or less per day) for cardiovascular protection, but this combination may reduce the gastrointestinal safety advantage. Always inform your doctor about all medications you are taking.
Celecoxib contains a sulfonamide chemical group and is officially contraindicated in patients who have had allergic reactions to sulfonamide-type drugs (such as certain antibiotics like sulfamethoxazole). If you have a known sulfonamide allergy, inform your doctor before starting celecoxib. However, recent pharmacological evidence suggests that cross-reactivity between sulfonamide antibiotics and non-antibiotic sulfonamides like celecoxib is rare. Your doctor will assess your individual risk-benefit ratio before prescribing.
References
- 1 European Medicines Agency (EMA). Celecoxib – Summary of Product Characteristics. EMA. 2024. Available at: ema.europa.eu
- 2 U.S. Food and Drug Administration (FDA). Celebrex (celecoxib) capsules – Prescribing Information. FDA. 2024. Available at: fda.gov
- 3 Nissen SE, Yeomans ND, Solomon DH, et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. New England Journal of Medicine. 2016;375(26):2519-2529. doi: 10.1056/NEJMoa1611593
- 4 Silverstein FE, Faich G, Simon LS, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study. JAMA. 2000;284(10):1247-1255. doi: 10.1001/jama.284.10.1247
- 5 European Alliance of Associations for Rheumatology (EULAR). 2022 EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs. Annals of the Rheumatic Diseases. 2023;82(1):3-18.
- 6 American College of Rheumatology/Arthritis Foundation (ACR/AF). 2019 Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research. 2020;72(2):149-162. doi: 10.1002/acr.24131
- 7 Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis & Rheumatology. 2019;71(10):1599-1613.
- 8 British National Formulary (BNF). Celecoxib monograph. National Institute for Health and Care Excellence (NICE). 2024. Available at: bnf.nice.org.uk
- 9 World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. WHO. 2023. Available at: who.int
- 10 Bhala N, Emberson J, Merhi A, et al. (Coxib and traditional NSAID Trialists' Collaboration). Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. The Lancet. 2013;382(9894):769-779.
Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in clinical pharmacology, rheumatology, and internal medicine. Our editorial process follows the GRADE evidence framework, and all medical claims are supported by peer-reviewed research and international clinical guidelines.
All drug information is reviewed against the official Summary of Product Characteristics (SmPC) from the European Medicines Agency, the FDA-approved prescribing information, and the British National Formulary to ensure accuracy and completeness.
We prioritize Level 1A evidence from systematic reviews and meta-analyses of randomized controlled trials. Our content is updated regularly to reflect the latest clinical guidelines from EULAR, ACR, NICE, WHO, and other international medical organizations.
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