Celecoxib Upjohn: Uses, Dosage & Side Effects
A COX-2 selective nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation in osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis
Celecoxib Upjohn is a prescription nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits the cyclooxygenase-2 (COX-2) enzyme. It is used to relieve pain, swelling, and inflammation associated with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, and primary dysmenorrhea. Unlike traditional NSAIDs that block both COX-1 and COX-2, celecoxib preferentially targets COX-2, which is primarily responsible for inflammation, while largely preserving COX-1 activity that helps protect the stomach lining. This selectivity provides effective anti-inflammatory and analgesic action with a lower risk of gastrointestinal ulceration and bleeding compared to conventional NSAIDs.
Quick Facts: Celecoxib Upjohn
Key Takeaways
- Celecoxib Upjohn is a COX-2 selective NSAID that provides effective pain relief and anti-inflammatory action for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, and menstrual pain, with a lower risk of gastrointestinal side effects than traditional NSAIDs.
- It should be used at the lowest effective dose for the shortest duration necessary; all NSAIDs, including COX-2 inhibitors, carry an increased risk of cardiovascular thrombotic events such as heart attack and stroke.
- Celecoxib is contraindicated in patients with known sulfonamide allergy, active gastrointestinal bleeding or ulceration, severe heart failure, and during the third trimester of pregnancy.
- Important drug interactions include warfarin (increased bleeding risk), lithium (increased lithium levels), fluconazole (increased celecoxib levels), ACE inhibitors and diuretics (reduced antihypertensive effect and renal risk), and methotrexate (increased toxicity).
- The recommended dose for osteoarthritis is 200 mg daily (taken as a single dose or divided into two 100 mg doses), and for rheumatoid arthritis 200 mg twice daily; the maximum recommended dose is 400 mg per day.
What Is Celecoxib Upjohn and What Is It Used For?
Celecoxib Upjohn contains the active substance celecoxib, which belongs to a class of medications known as cyclooxygenase-2 (COX-2) selective inhibitors, also commonly referred to as coxibs. The COX-2 inhibitors represent a significant advancement in anti-inflammatory therapy because they were specifically designed to target the enzyme isoform most directly responsible for inflammation and pain while minimizing the adverse effects associated with blocking the constitutive COX-1 enzyme.
To understand how celecoxib works, it is helpful to know about the prostaglandin pathway. When tissues are injured or inflamed, the enzyme cyclooxygenase converts arachidonic acid (a fatty acid found in cell membranes) into prostaglandins. There are two main isoforms of cyclooxygenase: COX-1, which is constitutively expressed in most tissues and produces prostaglandins involved in normal physiological functions such as gastric mucosal protection, platelet aggregation, and renal blood flow; and COX-2, which is primarily induced at sites of inflammation and is responsible for producing the prostaglandins that mediate pain, swelling, and fever. Traditional NSAIDs like ibuprofen, naproxen, and diclofenac inhibit both COX-1 and COX-2 non-selectively, which is why they are effective against inflammation but also carry a significant risk of gastrointestinal side effects such as stomach ulcers and bleeding.
Celecoxib was specifically engineered to selectively inhibit COX-2 at therapeutic concentrations without significantly affecting COX-1. This selectivity means that the drug effectively reduces inflammation, pain, and fever while largely preserving the protective prostaglandin production in the gastrointestinal tract. Clinical trials, including the landmark CLASS (Celecoxib Long-term Arthritis Safety Study) and PRECISION (Prospective Randomized Evaluation of Celecoxib Integrated Safety vs. Ibuprofen Or Naproxen) trials, have provided extensive safety and efficacy data for celecoxib in the treatment of arthritis and pain conditions.
Celecoxib Upjohn is approved for the following indications in adults:
- Osteoarthritis (OA): The most common form of arthritis, characterized by progressive cartilage degeneration in the joints. Celecoxib helps reduce joint pain, stiffness, and swelling, improving function and quality of life. It is recommended by the American College of Rheumatology (ACR) and EULAR guidelines as a treatment option when non-pharmacological measures and paracetamol are insufficient.
- Rheumatoid arthritis (RA): A chronic autoimmune inflammatory disease that primarily affects the joints. Celecoxib is used as symptomatic treatment alongside disease-modifying antirheumatic drugs (DMARDs) to manage pain and inflammation. EULAR guidelines support the use of NSAIDs, including COX-2 inhibitors, for short-term symptomatic relief in RA.
- Ankylosing spondylitis (AS): A chronic inflammatory condition that primarily affects the spine and sacroiliac joints. NSAIDs, including celecoxib, are considered first-line pharmacological therapy for ankylosing spondylitis according to the Assessment of SpondyloArthritis international Society (ASAS) and EULAR recommendations.
- Acute pain in adults: Celecoxib can be used for short-term management of acute pain conditions such as post-surgical pain, dental pain, and musculoskeletal injuries.
- Primary dysmenorrhea: Painful menstruation not caused by an underlying condition. Celecoxib is effective in reducing menstrual pain by inhibiting prostaglandin synthesis in the uterus.
The key clinical advantage of celecoxib over traditional NSAIDs is its improved gastrointestinal safety profile. The PRECISION trial, the largest randomized cardiovascular safety trial of NSAIDs ever conducted (over 24,000 patients), demonstrated that celecoxib at moderate doses was non-inferior to ibuprofen and naproxen for cardiovascular safety, and was associated with significantly fewer gastrointestinal events than either comparator. This makes celecoxib a preferred NSAID option for patients at increased risk of GI complications.
What Should You Know Before Taking Celecoxib Upjohn?
Contraindications
Celecoxib Upjohn must not be taken in the following circumstances:
- Hypersensitivity: Known allergy to celecoxib, any of the excipients, or to sulfonamides. Celecoxib contains a sulfonamide chemical moiety, and cross-reactivity with other sulfonamide drugs is possible.
- Aspirin-sensitive asthma: Patients who have experienced asthma, urticaria (hives), or allergic-type reactions after taking aspirin or other NSAIDs (including other COX-2 inhibitors) must not take celecoxib, as severe and potentially fatal bronchospasm may occur.
- Active gastrointestinal ulceration or bleeding: Celecoxib should not be used in patients with active peptic ulcer disease, gastrointestinal bleeding, or inflammatory bowel disease during a flare.
- Severe hepatic impairment: Patients with severe liver disease (Child-Pugh Class C) must not take celecoxib because the drug is extensively metabolized by the liver and accumulation may occur.
- Severe renal impairment: Patients with estimated creatinine clearance below 30 mL/min should not use celecoxib.
- Severe heart failure: Celecoxib is contraindicated in patients with established severe congestive heart failure (NYHA Class III-IV).
- Third trimester of pregnancy: All NSAIDs, including celecoxib, are contraindicated from week 28 of pregnancy onward due to the risk of premature closure of the ductus arteriosus in the fetus and impaired uterine contractility.
Warnings and Precautions
Several important warnings and precautions apply to the use of celecoxib. Discuss these risk factors thoroughly with your prescribing physician before starting treatment:
Cardiovascular risk: All NSAIDs, including COX-2 selective inhibitors, may increase the risk of serious cardiovascular thrombotic events, including myocardial infarction (heart attack) and stroke. This risk may increase with duration of use and in patients with pre-existing cardiovascular disease or risk factors (hypertension, hyperlipidemia, diabetes, smoking). The cardiovascular risk was notably highlighted when rofecoxib (Vioxx), another COX-2 inhibitor, was withdrawn from the market in 2004. However, the PRECISION trial subsequently demonstrated that celecoxib at doses up to 200 mg twice daily was non-inferior to ibuprofen and naproxen for cardiovascular safety. Patients with established cardiovascular disease or significant risk factors should use celecoxib with caution and at the lowest effective dose.
Gastrointestinal risk: Although celecoxib has a better gastrointestinal safety profile than non-selective NSAIDs, it can still cause serious GI adverse events including bleeding, ulceration, and perforation, which can be fatal. The risk increases in elderly patients, those with a history of peptic ulcer disease or GI bleeding, those taking concomitant corticosteroids, anticoagulants, or aspirin, and with higher doses or prolonged use. Your doctor may prescribe a proton pump inhibitor (PPI) for gastroprotection if you have additional GI risk factors.
Renal effects: NSAIDs, including celecoxib, can cause fluid retention, edema, and worsening of kidney function. Prostaglandins play an important role in maintaining renal blood flow, particularly in patients with reduced renal perfusion such as those with heart failure, liver cirrhosis, or renal impairment. Use celecoxib with caution and monitor renal function in these patients. Dehydration increases the risk of renal adverse effects.
Hepatic effects: Elevations of liver enzymes (ALT, AST) have been reported with celecoxib use. If signs or symptoms of liver dysfunction develop (jaundice, nausea, fatigue, dark urine, right upper abdominal tenderness), celecoxib should be discontinued and liver function investigated.
Blood pressure: NSAIDs, including celecoxib, can lead to new onset of hypertension or worsening of pre-existing hypertension. Blood pressure should be monitored during treatment, especially in the early weeks.
Pregnancy and Breastfeeding
Celecoxib Upjohn should be avoided during pregnancy unless the potential benefit justifies the potential risk to the fetus. It is absolutely contraindicated during the third trimester of pregnancy (from week 28 onward) because NSAIDs may cause premature closure of the ductus arteriosus, oligohydramnios (reduced amniotic fluid), neonatal renal impairment, and inhibition of uterine contractions potentially prolonging labor. During the first and second trimesters, celecoxib should only be used if clearly necessary, at the lowest dose and for the shortest duration possible, as NSAID use during early pregnancy has been associated with an increased risk of miscarriage and cardiac malformations.
Celecoxib is excreted in breast milk in very low concentrations. A decision must be made whether to discontinue breastfeeding or to discontinue celecoxib, taking into account the importance of the drug to the mother. If used during breastfeeding, the infant should be monitored for any adverse effects.
Women who are trying to conceive should be aware that NSAIDs, including celecoxib, may impair female fertility by inhibiting ovulation. This effect is reversible upon discontinuation of the drug.
All NSAIDs, including celecoxib, carry a boxed warning regarding the risk of serious cardiovascular thrombotic events. Patients with known cardiovascular disease or multiple risk factors may be at greater risk. Use the lowest effective dose for the shortest duration consistent with individual treatment goals. Celecoxib should not be used for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
How Does Celecoxib Upjohn Interact with Other Drugs?
Drug interactions are an important consideration when taking celecoxib, as the medication can affect or be affected by numerous other drugs through pharmacokinetic and pharmacodynamic mechanisms. Celecoxib is primarily metabolized by the cytochrome P450 enzyme CYP2C9, and it also weakly inhibits CYP2D6. Drugs that inhibit CYP2C9 can increase celecoxib plasma levels, while CYP2C9 inducers may decrease its effectiveness. Additionally, patients who are CYP2C9 poor metabolizers (approximately 3-5% of Caucasians) may experience significantly higher celecoxib concentrations and should use reduced doses.
Major Interactions
| Drug / Class | Interaction | Clinical Significance |
|---|---|---|
| Warfarin and other anticoagulants | Celecoxib may enhance anticoagulant effect; increased risk of bleeding | Monitor INR closely when starting or changing celecoxib dose; serious GI and other bleeding reported |
| Lithium | Celecoxib reduces renal lithium clearance, increasing plasma levels by approximately 17% | Monitor lithium levels; dose adjustment may be required; risk of lithium toxicity |
| Fluconazole | Potent CYP2C9 inhibitor; increases celecoxib AUC by approximately 130% | Halve the celecoxib dose when co-administered with fluconazole; monitor for increased side effects |
| Methotrexate | NSAIDs reduce renal clearance of methotrexate; increased risk of methotrexate toxicity | Monitor for methotrexate toxicity (myelosuppression, mucositis); particularly important at high methotrexate doses |
| ACE inhibitors / ARBs | NSAIDs can reduce the antihypertensive effect; combined use with ACE inhibitors/ARBs and diuretics increases risk of acute kidney injury | Monitor blood pressure and renal function; avoid triple combination (NSAID + ACE/ARB + diuretic) if possible |
Other Notable Interactions
| Drug / Class | Interaction | Clinical Significance |
|---|---|---|
| Low-dose aspirin | Combined use increases risk of GI ulceration and bleeding; does not provide the cardioprotective antiplatelet effect of aspirin | Consider gastroprotective therapy (PPI) if combination necessary; monitor for GI symptoms |
| Diuretics (thiazide, loop) | NSAIDs reduce diuretic and antihypertensive effect through sodium and water retention | Monitor blood pressure, weight, and renal function; may need diuretic dose adjustment |
| SSRIs / SNRIs | Serotonergic antidepressants impair platelet function; combined with NSAIDs increases bleeding risk | Consider gastroprotection; monitor for signs of bleeding |
| Ciclosporin | NSAIDs may increase nephrotoxicity of ciclosporin through renal prostaglandin inhibition | Monitor renal function closely when combining these drugs |
| CYP2D6 substrates | Celecoxib weakly inhibits CYP2D6; may increase levels of CYP2D6-metabolized drugs (e.g., atomoxetine, dextromethorphan) | Generally modest effect; consider in patients taking drugs with narrow therapeutic index metabolized by CYP2D6 |
The combination of an NSAID (including celecoxib) with an ACE inhibitor or ARB plus a diuretic is sometimes called the “triple whammy” because it significantly increases the risk of acute kidney injury. Each drug class independently affects renal hemodynamics: NSAIDs reduce prostaglandin-mediated renal perfusion, ACE inhibitors/ARBs decrease efferent arteriolar tone, and diuretics reduce intravascular volume. Together, these effects can severely compromise renal function, particularly in elderly or dehydrated patients. This combination should be avoided if possible, and if used, renal function must be closely monitored.
What Is the Correct Dosage of Celecoxib Upjohn?
Adults
The dosage of Celecoxib Upjohn should be individualized to achieve the lowest effective dose for each patient. Celecoxib capsules should be swallowed whole with water and can be taken with or without food, though taking it with food may reduce the risk of stomach discomfort. The following are the recommended adult dosages for the approved indications:
Osteoarthritis
The recommended dose is 200 mg per day, taken as a single 200 mg dose or as 100 mg twice daily. In some patients, a dose of 100 mg once daily may provide adequate relief. Dose should be titrated to the lowest effective level.
Rheumatoid Arthritis
The recommended dose is 100 to 200 mg twice daily (200-400 mg per day). Start at the lower end and adjust based on clinical response. The maximum recommended dose is 400 mg per day.
Ankylosing Spondylitis
The recommended dose is 200 mg per day, taken as a single dose or in two divided doses. If insufficient relief is achieved after 2 weeks, the dose may be increased to 400 mg per day. If there is no improvement at 400 mg daily after 2 weeks, the likelihood of response is low and alternative treatment should be considered.
Acute Pain and Primary Dysmenorrhea
The recommended initial dose is 400 mg, followed by an additional 200 mg dose on the first day if needed. On subsequent days, the recommended dose is 200 mg twice daily as needed. Treatment duration should be limited to the shortest period necessary to control symptoms.
| Indication | Daily Dose | Dosing Schedule | Maximum Dose |
|---|---|---|---|
| Osteoarthritis | 200 mg | Once daily or 100 mg twice daily | 200 mg/day |
| Rheumatoid Arthritis | 200-400 mg | 100-200 mg twice daily | 400 mg/day |
| Ankylosing Spondylitis | 200 mg | Once daily or divided; increase to 400 mg if needed | 400 mg/day |
| Acute Pain / Dysmenorrhea | 200-400 mg | 400 mg initial, then 200 mg twice daily | 400 mg on day 1; 400 mg/day thereafter |
Special Populations
Elderly patients: No specific dose adjustment is generally required for elderly patients based on age alone. However, elderly patients are at increased risk of adverse effects, particularly cardiovascular events, GI bleeding, and renal impairment. Treatment should be initiated at the lowest recommended dose and patients should be monitored more closely. Body weight tends to be lower in elderly patients, and the lowest dose should be used.
Hepatic impairment: In patients with mild hepatic impairment (Child-Pugh Class A), no dose adjustment is needed. For patients with moderate hepatic impairment (Child-Pugh Class B), the starting dose should be reduced by 50% (i.e., initiate at 100 mg daily). Celecoxib is contraindicated in severe hepatic impairment (Child-Pugh Class C).
Renal impairment: No dose adjustment is necessary for mild to moderate renal impairment. However, celecoxib should be used with caution and renal function should be monitored. It is contraindicated in patients with severe renal impairment (estimated creatinine clearance less than 30 mL/min).
CYP2C9 poor metabolizers: Patients who are known to be CYP2C9 poor metabolizers should start treatment at half the lowest recommended dose, as they may achieve significantly higher plasma concentrations of celecoxib.
Children
Celecoxib Upjohn is not indicated for use in children and adolescents under 18 years of age for the indications listed above. Safety and efficacy in the pediatric population for these indications have not been established. In some countries, celecoxib is approved for juvenile rheumatoid arthritis in children aged 2 years and older, but this is a specialist indication requiring careful weight-based dosing and monitoring.
Missed Dose
If you miss a dose of Celecoxib Upjohn, 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 missed one. If you are unsure about what to do, consult your doctor or pharmacist.
Overdose
There is limited clinical experience with celecoxib overdose. In clinical trials, single doses up to 1,200 mg and multiple doses up to 1,200 mg twice daily for up to 9 days did not result in clinically significant adverse effects. In the event of an overdose, general supportive measures should be employed. Symptoms of NSAID overdose may include nausea, vomiting, epigastric pain, drowsiness, and lethargy. Serious symptoms such as gastrointestinal bleeding, hypertension, acute renal failure, and respiratory depression are rare but can occur with substantial overdoses. There is no specific antidote for celecoxib. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion are unlikely to be useful because of celecoxib's high protein binding. If an overdose is suspected, contact your local poison control center or emergency services immediately.
Always use the lowest effective dose of celecoxib for the shortest duration necessary to control symptoms. The general principle for all NSAIDs is to minimize exposure while achieving adequate therapeutic benefit. Your doctor should regularly reassess the need for continued treatment. Do not exceed the maximum recommended dose of 400 mg per day without medical supervision.
What Are the Side Effects of Celecoxib Upjohn?
Like all medicines, Celecoxib Upjohn can cause side effects, although not everybody experiences them. The frequency and severity of side effects depend on the dose used, the duration of treatment, and individual patient factors. The side effects listed below are based on data from clinical trials and post-marketing surveillance reports. It is important to weigh the benefits of treatment against the potential risks, and to report any new or worsening symptoms to your doctor.
The following side effect frequency classifications are based on internationally standardized categories:
Common
- Headache
- Dizziness
- Insomnia (difficulty sleeping)
- Upper respiratory tract infections (sinusitis, pharyngitis, rhinitis)
- Urinary tract infection
- Nausea
- Diarrhea
- Abdominal pain
- Dyspepsia (indigestion)
- Flatulence (gas)
- Vomiting
- Peripheral edema (swelling in feet, ankles, or legs)
- Skin rash
- Hypertension (increased blood pressure)
- Accidental injury
Uncommon
- Anemia
- Anxiety, depression
- Fatigue, somnolence (drowsiness)
- Paresthesia (tingling or numbness)
- Tinnitus (ringing in ears)
- Blurred vision
- Heart failure, palpitations, tachycardia
- Gastritis, constipation, mouth ulceration
- Elevated liver enzymes (ALT, AST)
- Muscle cramps, arthralgia
- Urticaria (hives), pruritus (itching)
- Increased creatinine, weight gain
- Dyspnea (shortness of breath), cough
- Influenza-like illness
Rare
- Leukopenia, thrombocytopenia, pancytopenia
- Hallucinations, confusion
- Cerebrovascular event (stroke)
- Myocardial infarction (heart attack)
- Gastrointestinal bleeding, peptic ulcer perforation
- Hepatitis, jaundice, hepatic failure
- Acute renal failure, interstitial nephritis
- Angioedema (severe facial or throat swelling)
- Stevens-Johnson syndrome
- Toxic epidermal necrolysis
- Anaphylaxis (severe allergic reaction)
- Pulmonary embolism
- Aseptic meningitis
Not Known
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Acute generalized exanthematous pustulosis (AGEP)
- Exfoliative dermatitis
- Ageusia (loss of taste), anosmia (loss of smell)
Cardiovascular adverse events deserve special attention. Meta-analyses of clinical trial data suggest that COX-2 inhibitors may modestly increase the risk of cardiovascular thrombotic events compared to placebo. However, the PRECISION trial demonstrated that celecoxib at moderate doses (100-200 mg twice daily) was non-inferior to ibuprofen (600-800 mg three times daily) and naproxen (375-500 mg twice daily) with regard to cardiovascular safety over a mean treatment duration of approximately 20 months. The absolute cardiovascular risk increase is small, especially at recommended doses and in patients without pre-existing cardiovascular disease.
Gastrointestinal side effects, while less frequent with celecoxib than with non-selective NSAIDs, remain a concern. The reduction in GI risk is most pronounced in patients not concomitantly taking low-dose aspirin. In the SUCCESS-I study, celecoxib was associated with a significantly lower rate of complicated upper GI events compared with non-selective NSAIDs diclofenac and naproxen.
Stop taking celecoxib and seek emergency medical care if you experience: chest pain, sudden shortness of breath, or weakness on one side of the body (possible cardiovascular event); vomiting blood or passing black/bloody stools (possible GI bleeding); yellowing of skin or eyes (possible liver damage); severe skin rash with blistering (possible Stevens-Johnson syndrome); sudden swelling of face, lips, tongue, or throat with difficulty breathing (possible anaphylaxis).
How Should You Store Celecoxib Upjohn?
Proper storage of medications is essential to maintain their effectiveness and safety throughout the shelf life. Celecoxib Upjohn hard capsules should be stored under the following conditions:
- Temperature: Store at room temperature, below 25°C (77°F). Do not freeze the capsules. Brief exposure to temperatures up to 30°C during transport is generally acceptable, but prolonged exposure to heat should be avoided.
- Moisture: Keep the capsules in the original packaging (blister pack or bottle) to protect them from moisture. Avoid storing in humid environments such as bathrooms. Do not remove capsules from the blister until you are ready to take them.
- Light: Protect from direct sunlight. While brief exposure is not harmful, prolonged exposure to intense light may degrade the medication.
- Children: Keep all medicines out of the sight and reach of children. Consider using child-resistant containers where available.
- Expiry date: Do not use Celecoxib Upjohn after the expiry date stated on the carton and blister/bottle. The expiry date refers to the last day of that month.
- Disposal: Do not dispose of unused or expired medicines via household waste or wastewater. Return them to a pharmacy or follow local disposal guidelines to protect the environment.
If you notice any visible changes in the appearance of the capsules (discoloration, damage, or an unusual odor), do not take them and consult your pharmacist. If you have been carrying the medication in a travel bag exposed to high temperatures for extended periods, consult your pharmacist about whether the medication is still safe to use.
What Does Celecoxib Upjohn Contain?
Understanding the composition of your medication is important for several reasons, including identifying potential allergens and understanding why certain precautions apply. The composition of Celecoxib Upjohn 100 mg hard capsules is as follows:
Active ingredient: Each hard capsule contains 100 mg celecoxib. Celecoxib is a diaryl-substituted pyrazole with the chemical name 4-[5-(4-methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamide. It has a molecular weight of 381.37 g/mol and a molecular formula of C17H14F3N3O2S. Celecoxib is a white to off-white powder that is practically insoluble in water.
Excipients (inactive ingredients): The capsule contents typically include:
- Lactose monohydrate – a filler/diluent derived from milk sugar. Patients with rare hereditary conditions of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption should not take this medicine.
- Sodium lauryl sulfate – a surfactant that aids in wetting the drug substance and improving dissolution.
- Povidone – a binder that helps hold the capsule contents together.
- Croscarmellose sodium – a disintegrant that helps the capsule contents break apart in the gastrointestinal tract for absorption.
- Magnesium stearate – a lubricant used in the manufacturing process.
Capsule shell: The hard capsule shell is typically composed of gelatin, titanium dioxide (E171), and may contain additional coloring agents depending on the specific formulation. The capsule shell components are pharmacologically inert.
Note: The exact excipient composition may vary slightly between different manufacturers and formulations of celecoxib. Always refer to the patient information leaflet provided with your specific medication for the most accurate excipient listing. If you have known allergies to any excipients, particularly lactose or gelatin, discuss this with your doctor or pharmacist before taking Celecoxib Upjohn.
Celecoxib contains a sulfonamide (-SO2NH2) chemical group in its molecular structure. This is the reason it is contraindicated in patients with known sulfonamide allergy. While the clinical relevance of cross-reactivity between sulfonamide antibiotics and non-antibiotic sulfonamides (like celecoxib) is debated in the medical literature, caution is warranted. If you have experienced allergic reactions to sulfonamide-containing medications, inform your doctor.
Frequently Asked Questions About Celecoxib Upjohn
Celecoxib Upjohn is used to treat pain and inflammation associated with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain in adults, and primary dysmenorrhea (menstrual pain). It belongs to the class of COX-2 selective NSAIDs, which means it targets the enzyme primarily responsible for inflammation while largely sparing the enzyme that protects the stomach lining.
Celecoxib is a selective COX-2 inhibitor, meaning it preferentially blocks the COX-2 enzyme involved in inflammation while largely sparing COX-1, which protects the stomach lining and supports platelet function. Traditional NSAIDs like ibuprofen and naproxen inhibit both COX-1 and COX-2. This selectivity gives celecoxib a lower risk of gastrointestinal side effects such as stomach ulcers and bleeding compared to non-selective NSAIDs. However, cardiovascular risk remains a consideration with all NSAIDs.
Celecoxib contains a sulfonamide chemical group and is contraindicated in patients with a known allergy to sulfonamides. If you have previously experienced an allergic reaction to sulfonamide antibiotics or other sulfonamide-containing drugs, inform your doctor before taking celecoxib. Your doctor will assess the risk and may recommend an alternative medication.
Celecoxib can be used for long-term treatment of chronic conditions like osteoarthritis and rheumatoid arthritis, but it should be used at the lowest effective dose for the shortest duration necessary. Long-term use of any NSAID carries an increased risk of cardiovascular events and gastrointestinal complications. Your doctor should regularly reassess the need for continued treatment and monitor for side effects including blood pressure, kidney function, and gastrointestinal symptoms.
Celecoxib can be taken with low-dose aspirin for cardiovascular protection, but this combination increases the risk of gastrointestinal bleeding. Celecoxib should be used with extreme caution alongside anticoagulants such as warfarin, as it may enhance the anticoagulant effect. Your doctor may recommend gastroprotective therapy (such as a proton pump inhibitor) if you need to take celecoxib with aspirin or blood thinners. Always inform your doctor about all medications you are taking.
It is generally advisable to limit or avoid alcohol consumption while taking celecoxib. Alcohol increases the risk of gastrointestinal bleeding and ulceration when combined with NSAIDs. Additionally, both celecoxib and alcohol are metabolized by the liver, and their combination may increase the risk of liver-related side effects. If you drink alcohol, discuss this with your doctor to understand the risks in your individual situation.
References
All medical information in this article is based on peer-reviewed sources and international guidelines. No commercial funding is involved in the creation of this content.
- European Medicines Agency (EMA). Celecoxib – Summary of Product Characteristics. Updated 2025. Available from: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Celebrex (celecoxib) Prescribing Information. Updated 2024. Available from: www.accessdata.fda.gov
- 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.
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res. 2020;72(2):149-162.
- Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023;82(1):3-18.
- Joint Formulary Committee. British National Formulary (BNF). Celecoxib. London: BMJ Group and Pharmaceutical Press. Updated 2025.
- World Health Organization (WHO). WHO Model List of Essential Medicines. 23rd List. Geneva: WHO; 2023.
- 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.
- FitzGerald GA. COX-2 and beyond: approaches to prostaglandin inhibition in human disease. Nat Rev Drug Discov. 2003;2(11):879-890.
About Our Medical Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians with expertise in rheumatology, clinical pharmacology, and pain medicine. Our team follows the GRADE evidence framework and adheres to international guidelines from WHO, EMA, FDA, ACR, and EULAR.
Written by specialist physicians in rheumatology and clinical pharmacology based on EMA SmPC, FDA prescribing information, and peer-reviewed literature.
Reviewed by iMedic Medical Review Board according to international guidelines (WHO, EMA, FDA, ACR, EULAR). Evidence level 1A.
No commercial funding. No pharmaceutical company sponsorship or advertising. Completely independent medical editorial content.
WCAG 2.2 Level AAA compliant. Semantic HTML, keyboard-navigable, screen reader-optimized, with 7:1+ color contrast.