Celecoxib STADA: Uses, Dosage & Side Effects
A selective COX-2 inhibitor (coxib) used for symptomatic relief of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in adults
Celecoxib STADA is a prescription non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2), the enzyme primarily responsible for producing prostaglandins at sites of inflammation. It is used in adults for symptomatic relief of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. Compared to traditional non-selective NSAIDs such as ibuprofen and diclofenac, celecoxib offers a lower risk of gastrointestinal complications such as stomach ulcers and bleeding. Available as hard capsules in 100 mg and 200 mg strengths, celecoxib begins to provide pain relief within hours of the first dose, though full anti-inflammatory benefit may take several days. It requires a prescription and should be used at the lowest effective dose for the shortest duration necessary.
Quick Facts: Celecoxib STADA
Key Takeaways
- Celecoxib STADA is a selective COX-2 inhibitor that reduces pain and inflammation in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis while offering a lower risk of gastrointestinal side effects than traditional NSAIDs.
- The usual dose is 200 mg daily for osteoarthritis and ankylosing spondylitis, and 200–400 mg daily (divided into two doses) for rheumatoid arthritis, with a maximum daily dose of 400 mg.
- Celecoxib should not be used in patients with established cardiovascular disease, active gastrointestinal ulcers, severe liver or kidney disease, inflammatory bowel disease, or during pregnancy and breastfeeding.
- Like all NSAIDs, celecoxib may increase the risk of cardiovascular events (heart attack, stroke) at high doses and with prolonged use; always use the lowest effective dose for the shortest duration necessary.
- Important drug interactions exist with warfarin, lithium, methotrexate, fluconazole, ACE inhibitors, and diuretics – always inform your doctor about all medications you are taking.
What Is Celecoxib STADA and What Is It Used For?
Celecoxib STADA belongs to a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs), and more specifically to the subgroup of selective cyclooxygenase-2 (COX-2) inhibitors, also called coxibs. The body produces two main forms of the cyclooxygenase enzyme: COX-1 and COX-2. COX-1 is constitutively expressed in most tissues and plays a protective role in the gastrointestinal tract, supporting the production of mucus that shields the stomach lining from acid damage. COX-1 also contributes to platelet aggregation and normal kidney function. COX-2, by contrast, is primarily induced at sites of tissue injury and inflammation, where it drives the production of prostaglandins such as prostaglandin E2 (PGE2) and prostacyclin (PGI2) that mediate pain, swelling, redness, and fever.
Traditional NSAIDs like ibuprofen and diclofenac inhibit both COX-1 and COX-2. While effective at reducing inflammation, their inhibition of COX-1 removes the protective prostaglandin layer in the stomach, increasing the risk of gastrointestinal ulceration and bleeding. Celecoxib was specifically designed to selectively inhibit COX-2 with minimal effect on COX-1, thereby preserving the gastric protective mechanisms while still effectively reducing inflammation and pain. Clinical studies, including the landmark CLASS (Celecoxib Long-term Arthritis Safety Study) trial and the more recent PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen or Naproxen) trial, have provided evidence regarding the gastrointestinal and cardiovascular safety profile of celecoxib compared to non-selective NSAIDs.
In conditions such as osteoarthritis and rheumatoid arthritis, the body produces elevated levels of COX-2 in the inflamed joints, leading to an overproduction of prostaglandins that amplify pain signals and perpetuate the inflammatory cascade. By selectively blocking COX-2, celecoxib reduces the concentration of these inflammatory mediators at the site of disease, providing relief from pain, joint stiffness, and swelling. Patients can typically expect the medication to begin providing analgesic effects within a few hours after the first dose, although the full anti-inflammatory benefit may take several days to develop fully.
Celecoxib STADA is approved for use in adults for the following conditions:
- Osteoarthritis (OA): The most common form of arthritis, characterized by progressive degradation of articular cartilage in weight-bearing and frequently used joints such as the knees, hips, and hands. Celecoxib helps manage the chronic pain and stiffness associated with OA, improving functional ability and quality of life.
- Rheumatoid arthritis (RA): A chronic autoimmune condition in which the immune system attacks the synovial membranes lining the joints, causing persistent inflammation, pain, swelling, and eventual joint destruction. Celecoxib is used as part of the symptomatic management of RA, often in conjunction with disease-modifying antirheumatic drugs (DMARDs).
- Ankylosing spondylitis (AS): A chronic inflammatory condition primarily affecting the sacroiliac joints and the spine, leading to pain, stiffness, and in advanced cases, fusion of the vertebrae. NSAIDs, including celecoxib, are considered first-line pharmacological therapy for managing the symptoms of ankylosing spondylitis according to international guidelines from ASAS/EULAR.
Celecoxib begins to provide pain relief within a few hours of taking the first dose. However, the full anti-inflammatory effect may take several days of regular use to become apparent. If you do not experience any improvement after two weeks of treatment, consult your doctor to discuss whether your dose needs adjustment or an alternative therapy should be considered.
What Should You Know Before Taking Celecoxib STADA?
Contraindications
There are several situations in which Celecoxib STADA must not be used. It is essential that your doctor is aware of your complete medical history before prescribing this medication. Do not take Celecoxib STADA if any of the following apply to you:
- Hypersensitivity: If you are allergic to celecoxib or any of the other ingredients in the capsules (listed in the composition section below).
- Sulfonamide allergy: If you have previously experienced an allergic reaction to a group of medications called sulfonamides (for example, certain antibiotics used to treat infections), as celecoxib has a sulfonamide chemical structure.
- NSAID-sensitive asthma or allergic reactions: If you have ever developed asthma, nasal polyps, severe nasal congestion, or allergic reactions such as itchy skin rash, facial swelling, lip or tongue swelling, or difficulty breathing after taking aspirin or any other NSAID.
- Active gastrointestinal bleeding or ulceration: If you currently have an ulcer or bleeding in the stomach or intestines.
- Cardiovascular disease: If you have heart failure, established ischemic heart disease (coronary artery disease), cerebrovascular disease (history of stroke or transient ischemic attack), or peripheral arterial disease. This includes patients who have had a heart attack, stroke, mini-stroke, angina, or have undergone surgical procedures on blood vessels of the heart or legs.
- Severe liver disease: If you have significant liver impairment.
- Severe kidney disease: If you have severe renal insufficiency.
- Inflammatory bowel disease: If you have ulcerative colitis or Crohn’s disease.
- Pregnancy and breastfeeding: Celecoxib must not be used during pregnancy or while breastfeeding. Women of childbearing potential must use effective contraception during treatment.
Warnings and Precautions
All NSAIDs, including celecoxib, may increase the risk of serious cardiovascular thrombotic events such as heart attack and stroke. This risk may be greater with longer use and at higher doses. Use the lowest effective dose for the shortest duration consistent with individual treatment goals. Patients with cardiovascular risk factors (hypertension, diabetes, high cholesterol, smoking) require particularly careful assessment.
Talk to your doctor or pharmacist before taking Celecoxib STADA if any of the following conditions apply to you:
- History of gastrointestinal problems: If you have previously had stomach or intestinal ulcers or bleeding, you are at higher risk. Do not take Celecoxib STADA if you currently have active ulcers or bleeding.
- Concurrent aspirin use: If you take low-dose aspirin for cardiovascular protection, combining it with celecoxib increases the risk of gastrointestinal side effects.
- Anticoagulant therapy: If you take blood-thinning medications such as warfarin, apixaban, or other anticoagulants.
- Corticosteroid use: If you are taking corticosteroids (such as prednisone), which can independently increase the risk of gastrointestinal ulceration.
- Cardiovascular risk factors: If you smoke, have diabetes, high blood pressure, or elevated cholesterol levels, your doctor needs to carefully assess whether celecoxib is appropriate for you.
- Impaired heart, liver, or kidney function: Your doctor may need to monitor you more closely and potentially adjust your dose.
- Fluid retention: If you experience swelling in your ankles, legs, or feet, as NSAIDs can cause fluid retention.
- Dehydration: If you are dehydrated from vomiting, diarrhea, or diuretic use, ensure adequate hydration before starting celecoxib.
- Infection: Celecoxib can mask the signs of fever and inflammation, potentially hiding symptoms of an underlying infection.
- Elderly patients (over 65): Older adults are at higher risk of adverse effects, particularly gastrointestinal and cardiovascular complications. More frequent monitoring is recommended.
Serious liver reactions have been reported with celecoxib use, including severe hepatitis, liver damage, and liver failure (some cases with fatal outcome or requiring liver transplantation). Most serious liver reactions occurred within the first month of treatment. Seek immediate medical attention if you develop symptoms such as nausea, fatigue, yellowing of the skin or eyes (jaundice), dark urine, pale stools, or unusual bleeding.
Like other NSAIDs, celecoxib may cause elevated blood pressure. Your doctor may wish to monitor your blood pressure regularly during treatment. Additionally, celecoxib may make it more difficult to become pregnant. If you are planning a pregnancy or having difficulty conceiving, discuss this with your doctor.
Pregnancy and Breastfeeding
Celecoxib STADA must not be used during pregnancy. NSAIDs can cause serious harm to the developing fetus, particularly during the third trimester when they may lead to premature closure of the ductus arteriosus (a critical blood vessel in the fetal heart), impaired fetal kidney function resulting in reduced amniotic fluid (oligohydramnios), and inhibition of uterine contractions that may delay or prolong labor. Women of childbearing potential who are not using adequate contraception should not take celecoxib. If you become pregnant while taking this medication, stop it immediately and contact your doctor for alternative treatment.
Celecoxib must not be used during breastfeeding. Celecoxib is excreted in human breast milk, and the potential effects on the nursing infant have not been adequately studied. If treatment with an NSAID is essential, your doctor will advise you on whether to discontinue breastfeeding or choose an alternative medication.
NSAIDs, including celecoxib, may impair female fertility by interfering with ovulation. This effect is generally reversible upon discontinuation of the drug. Inform your doctor if you are planning to become pregnant or are experiencing difficulty conceiving.
Driving and Operating Machinery
You should be aware of how celecoxib affects you before driving or operating machinery. Some patients experience dizziness or drowsiness while taking this medication. If you notice these effects, do not drive or use machines until the symptoms have subsided. You are personally responsible for assessing whether you are fit to perform activities that require alertness.
How Does Celecoxib STADA Interact with Other Drugs?
Drug interactions with celecoxib can significantly alter its efficacy or increase the risk of adverse effects. The primary metabolism of celecoxib occurs through the cytochrome P450 2C9 (CYP2C9) enzyme in the liver. Drugs that inhibit CYP2C9 can increase plasma concentrations of celecoxib, while CYP2C9 inducers may decrease its effectiveness. Additionally, celecoxib can affect the pharmacokinetics and pharmacodynamics of several other medications. Always inform your doctor about every medication you are taking, including prescription drugs, over-the-counter products, vitamins, and herbal supplements.
Major Interactions
| Drug / Class | Effect of Interaction | Clinical Recommendation |
|---|---|---|
| Warfarin and oral anticoagulants | Increased anticoagulant effect and bleeding risk; celecoxib may elevate INR values | Monitor INR closely when starting, adjusting, or stopping celecoxib; watch for signs of bleeding |
| Fluconazole | Strong CYP2C9 inhibitor; approximately doubles celecoxib plasma concentrations | Halve the celecoxib dose when co-administered with fluconazole; consider alternatives |
| Lithium | NSAIDs reduce renal lithium clearance, increasing plasma lithium levels and toxicity risk | Monitor lithium levels frequently; adjust lithium dose as needed |
| Methotrexate | Potential reduction in methotrexate clearance, increasing toxicity risk | Monitor for methotrexate toxicity; check blood counts and liver function |
| Ciclosporin / Tacrolimus | Increased risk of nephrotoxicity when combined with NSAIDs | Monitor renal function closely during combination therapy |
Minor Interactions
| Drug / Class | Effect of Interaction | Clinical Recommendation |
|---|---|---|
| ACE inhibitors & ARBs | NSAIDs may reduce the antihypertensive effect of these drugs and increase renal impairment risk | Monitor blood pressure and renal function; ensure adequate hydration |
| Diuretics (thiazides, loop) | NSAIDs can reduce the natriuretic effect of diuretics; risk of acute kidney injury | Monitor renal function and blood pressure; ensure adequate hydration |
| Beta-blockers | NSAIDs may attenuate the blood pressure-lowering effect of beta-blockers | Monitor blood pressure; adjust antihypertensive dose if necessary |
| Low-dose aspirin | Increased risk of gastrointestinal ulceration and bleeding with combination use | May be used together (aspirin ≤75 mg/day) with gastroprotective strategy; consult doctor |
| Rifampicin | CYP2C9 inducer; may reduce celecoxib plasma levels and effectiveness | Consider dose adjustment or alternative NSAID |
| Dextromethorphan | Celecoxib inhibits CYP2D6; may increase dextromethorphan levels | Monitor for increased dextromethorphan effects; usually not clinically significant |
| Other NSAIDs (ibuprofen, diclofenac) | Additive gastrointestinal and cardiovascular risk without additional benefit | Do not combine celecoxib with other NSAIDs; use one agent only |
Celecoxib STADA can be taken with low-dose aspirin (75 mg or less per day) for cardiovascular protection, but this combination increases the risk of gastrointestinal adverse events. Your doctor may recommend a proton pump inhibitor (PPI) for gastric protection if you need both medications. Always seek medical advice before combining these treatments.
What Is the Correct Dosage of Celecoxib STADA?
Always take Celecoxib STADA exactly as prescribed by your doctor. Because the risk of cardiovascular side effects may increase with higher doses and longer treatment duration, it is crucial to use the lowest effective dose for the shortest time necessary to control your symptoms. Your doctor will determine the appropriate dose based on your condition, response to treatment, and individual risk factors.
Celecoxib STADA capsules are for oral use and should be swallowed whole with water. They can be taken at any time of day, with or without food, but try to take each dose at the same time every day to maintain consistent blood levels. If you do not notice any improvement after two weeks of treatment, consult your doctor about adjusting your therapy.
Adults
Osteoarthritis
The usual dose is 200 mg daily, which can be taken as one 200 mg capsule once daily or one 100 mg capsule twice daily. If needed, your doctor may increase the dose to a maximum of 400 mg daily (200 mg twice daily).
Rheumatoid Arthritis
The usual starting dose is 200 mg daily, divided into two doses (one 100 mg capsule twice daily). If needed, your doctor may increase the dose to a maximum of 400 mg daily (200 mg twice daily).
Ankylosing Spondylitis
The usual dose is 200 mg daily, which can be taken as one 200 mg capsule once daily or one 100 mg capsule twice daily. If needed, your doctor may increase the dose to a maximum of 400 mg daily.
| Condition | Usual Daily Dose | Maximum Daily Dose | Dosing Schedule |
|---|---|---|---|
| Osteoarthritis | 200 mg | 400 mg | Once daily or divided into two doses |
| Rheumatoid Arthritis | 200 mg | 400 mg | Divided into two doses (100 mg twice daily) |
| Ankylosing Spondylitis | 200 mg | 400 mg | Once daily or divided into two doses |
Children and Adolescents
Celecoxib STADA is intended for use in adults only and should not be given to children or adolescents under 18 years of age. There are insufficient data to establish the safety and efficacy of celecoxib in the pediatric population for these indications.
Elderly Patients
If you are over 65 years of age, particularly if you weigh less than 50 kg, your doctor may wish to monitor you more carefully during treatment. Elderly patients are at increased risk of adverse effects from NSAIDs, including gastrointestinal bleeding, cardiovascular events, and renal impairment. No specific dose adjustment is required solely based on age, but the general principle of using the lowest effective dose for the shortest duration applies even more strongly in older adults.
Kidney or liver impairment: If you have mild to moderate kidney or liver impairment, your doctor may reduce your dose. Celecoxib is contraindicated in severe hepatic or renal impairment.
Missed Dose
If you forget to take a dose of Celecoxib STADA, 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. If you are unsure about what to do, contact your doctor or pharmacist for advice.
Overdose
If you take more Celecoxib STADA than prescribed, or if a child accidentally ingests the medication, seek immediate medical attention or contact your local poison control center. Symptoms of overdose may include nausea, vomiting, abdominal pain, drowsiness, and in severe cases, gastrointestinal bleeding or renal impairment. Bring the medication packaging with you to help healthcare providers assess the situation. There is no specific antidote for celecoxib overdose, and treatment is supportive.
If you abruptly stop taking Celecoxib STADA, your symptoms may worsen. Do not discontinue the medication without consulting your doctor. If treatment needs to be stopped, your doctor may advise a gradual dose reduction over several days.
What Are the Side Effects of Celecoxib STADA?
Like all medications, Celecoxib STADA can cause side effects, although not everyone will experience them. The side effects listed below have been observed in patients taking celecoxib for osteoarthritis and other conditions. If you experience any of the following serious symptoms, stop taking Celecoxib STADA and seek immediate medical attention:
- Allergic reactions such as skin rash, facial swelling, wheezing, or difficulty breathing
- Heart problems such as chest pain or pressure
- Severe stomach pain, black or blood-stained stools, or vomiting blood
- Signs of liver failure: nausea, jaundice (yellowing of skin or eyes), dark urine
- Severe skin reactions: widespread rash with blistering or skin peeling
Very Common
May affect more than 1 in 10 people
- High blood pressure (hypertension), including worsening of pre-existing hypertension
Common
May affect up to 1 in 10 people
- Heart attack (myocardial infarction)
- Fluid retention causing swelling in ankles, legs, or hands
- Urinary tract infection
- Breathing difficulties, sinusitis, nasal congestion, cough, sore throat, cold and flu-like symptoms
- Dizziness, difficulty sleeping (insomnia)
- Nausea, vomiting, stomach pain, diarrhea, indigestion, flatulence, difficulty swallowing
- Skin rash, itching (pruritus)
- Muscle stiffness
- Headache
- Joint pain (arthralgia)
- Worsening of existing allergies
Uncommon
May affect up to 1 in 100 people
- Stroke
- Heart failure, palpitations, rapid heart rate
- Changes in liver or kidney function tests
- Anemia (reduced red blood cell count)
- Anxiety, depression, fatigue, drowsiness, tingling sensations (paresthesia)
- Increased blood potassium levels
- Blurred or impaired vision, tinnitus (ringing in the ears), mouth sores, impaired hearing
- Constipation, belching, gastritis, worsening of stomach or intestinal inflammation
- Leg cramps
- Hives (urticaria), eye inflammation
- Bruising, chest pain, facial swelling
Rare
May affect up to 1 in 1,000 people
- Stomach, esophageal, or intestinal ulcers and bleeding; intestinal perforation; pancreatitis; esophagitis
- Low blood sodium (hyponatremia)
- Decreased white blood cell or platelet counts
- Confusion, taste changes, increased sensitivity to light, hair loss
- Hallucinations, eye bleeding
- Irregular heartbeat, hot flushes
- Pulmonary embolism (blood clot in the lungs)
- Severe hepatitis (liver inflammation), acute kidney failure
- Menstrual irregularities
- Angioedema (swelling of face, lips, mouth, tongue, or throat)
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)
- Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)
- Cerebral hemorrhage (brain bleeding)
- Meningitis (inflammation of the brain and spinal cord membranes)
- Liver failure, liver damage, fulminant hepatitis (some cases fatal or requiring transplantation)
- Cholestasis, cholestatic hepatitis
- Kidney inflammation (nephritis), nephrotic syndrome, minimal change disease
- Worsening of epilepsy
- Partial or complete vision loss
- Vasculitis (inflammation of blood vessels)
- Pancytopenia (deficiency of all blood cell types)
- Muscle pain and weakness, loss of smell or taste
If you experience any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed above. Reporting suspected adverse reactions helps in the continuous monitoring of the benefit-risk balance of medications. You can report side effects to your national medicines regulatory authority.
How Should You Store Celecoxib STADA?
Proper storage of medications is essential to ensure they remain effective and safe to use. Follow these storage guidelines for Celecoxib STADA:
- Temperature: Store at or below 30°C (86°F). Do not freeze.
- Keep out of reach: Store this medication out of the sight and reach of children at all times.
- Expiry date: Do not use Celecoxib STADA after the expiry date printed on the blister pack and carton after “EXP.” The expiry date refers to the last day of the stated month.
- Original packaging: Keep the capsules in their original blister packaging to protect them from moisture.
- Disposal: Do not dispose of medications via wastewater or household waste. Return unused or expired medications to your pharmacy for proper disposal. This helps protect the environment.
What Does Celecoxib STADA Contain?
Understanding the full composition of your medication is important, particularly if you have allergies or intolerances to specific substances. Celecoxib STADA contains the following ingredients:
Active substance: Celecoxib. Each 100 mg hard capsule contains 100 mg of celecoxib. Each 200 mg hard capsule contains 200 mg of celecoxib.
Other ingredients (excipients): Lactose monohydrate, croscarmellose sodium, povidone K 30, sodium lauryl sulfate, magnesium stearate, titanium dioxide (E171), gelatin.
- Celecoxib STADA 100 mg capsules: White hard gelatin capsules with a blue cap, filled with a white or almost white crystalline powder. Contains indigo carmine (E132) as colorant.
- Celecoxib STADA 200 mg capsules: White hard gelatin capsules with a yellow cap, filled with a white or almost white crystalline powder. Contains yellow iron oxide (E172) as colorant.
The capsules are packaged in PVC-aluminium or PVC/PVdC-aluminium blisters. Available pack sizes include 10, 20, 30, 40, 50, 60, 80, 90, 100, 120, 150, 160, and 180 capsules. Not all pack sizes may be available in your country.
Celecoxib STADA contains lactose monohydrate. If you have been told by your doctor that you are intolerant to certain sugars, contact your doctor before taking this medication. This medicine contains less than 1 mmol (23 mg) sodium per capsule, meaning it is essentially sodium-free.
Frequently Asked Questions About Celecoxib STADA
Celecoxib STADA is used in adults for symptomatic relief of osteoarthritis (degenerative joint disease), rheumatoid arthritis (chronic inflammatory joint disease), and ankylosing spondylitis (inflammation of the spinal joints). It belongs to the COX-2 selective inhibitor class of NSAIDs and works by reducing the production of prostaglandins that cause pain and inflammation.
Celecoxib typically begins to provide pain relief within a few hours of taking the first dose. However, it may take several days of regular use to achieve the full anti-inflammatory effect. If you do not notice any improvement after two weeks of treatment, consult your doctor about adjusting your therapy.
Yes, like all NSAIDs, celecoxib may slightly increase the risk of cardiovascular events such as heart attack or stroke, particularly when used at high doses for prolonged periods. The risk is higher in people who already have heart disease, high blood pressure, diabetes, high cholesterol, or who smoke. Your doctor will prescribe the lowest effective dose for the shortest duration necessary to control your symptoms.
Celecoxib can be taken with low-dose aspirin (75 mg or less daily) for cardiovascular protection, but this combination increases the risk of gastrointestinal side effects such as stomach ulcers and bleeding. You should not take celecoxib with full-dose aspirin or other NSAIDs such as ibuprofen or diclofenac. Always consult your doctor before combining these medications.
No, celecoxib must not be used during pregnancy. It can harm the developing fetus, particularly during the third trimester when NSAIDs can cause premature closure of the ductus arteriosus and impair fetal kidney function. Women of childbearing potential must use effective contraception during treatment. If you become pregnant while taking celecoxib, stop the medication immediately and contact your doctor.
Both celecoxib and ibuprofen are NSAIDs, but celecoxib selectively inhibits only COX-2, the enzyme involved in inflammation, while ibuprofen inhibits both COX-1 and COX-2. This selectivity means celecoxib generally causes fewer gastrointestinal side effects (stomach ulcers and bleeding) compared to traditional NSAIDs like ibuprofen. However, celecoxib requires a prescription, while ibuprofen is available over the counter in many countries. The PRECISION trial showed that celecoxib at moderate doses was not inferior to ibuprofen or naproxen regarding cardiovascular safety.
References
- European Medicines Agency (EMA). Celecoxib – Summary of Product Characteristics. Available at: www.ema.europa.eu. Accessed January 2026.
- U.S. Food and Drug Administration (FDA). Celebrex (celecoxib) – Prescribing Information. Available at: www.accessdata.fda.gov. Accessed January 2026.
- Nissen SE, Yeomans ND, Solomon DH, et al. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med. 2016;375(26):2519-2529. doi:10.1056/NEJMoa1611593 (PRECISION Trial).
- Silverstein FE, Faich G, Goldstein JL, 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.
- American College of Rheumatology (ACR). 2022 Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res. 2022.
- van der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis. Ann Rheum Dis. 2017;76(6):978-991. doi:10.1136/annrheumdis-2016-210770.
- EULAR. 2022 EULAR Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs. Ann Rheum Dis. 2023.
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd list, 2023. Available at: www.who.int.
- British National Formulary (BNF). Celecoxib monograph. Available at: bnf.nice.org.uk. Accessed January 2026.
- National Institute for Health and Care Excellence (NICE). CG177: Osteoarthritis: care and management. Updated 2022.
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