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Celebrex and Bextra COX-2

Active ingredient: Celecoxib
Category: NSAID (non-steroidal anti-inflammatory drug)
Company: Pharmacia/Pfizer
FDA Approval: December, 1999
Indications: Celebrex is approved use for osteoarthritis, rheumatoid arthritis in adults, painful menstrual cramps, and acute pain in adults.

COX-2 inhibitors
Two pain medications—Celebrex and Bextra—are the some of the first drugs approved by the FDA that are classified as selective COX-2 inhibitors, a relatively new class of non-steroidal anti-inflammatory drugs (NSAIDs). These COX-2 inhibitors work by limiting the formation of inflammation, which is a common component of many forms of back pain and neck pain.

What’s different about COX-2 inhibitors
The main difference between Celebrex, Bextra and any COX-2 inhibitors versus traditional anti-inflammatory drugs (such as aspirin or ibuprofen) is their selectivity in inhibiting the COX enzyme (cyclooxygenase). In 1991, research discovered that the COX enzyme actually had two isoforms: COX-1 and COX-2.

The COX-1 enzyme works to maintain the integrity of the lining of the stomach. It also helps maintain normal platelet and kidney functions.

The COX-2 enzyme is associated with instances of inflammation, as well as fever and pain.

Thus, suppression of only the COX-2 enzyme with a medication like Bextra or Celebrex helps treat the symptoms from inflammation without stifling the important functions of the COX-1 enzyme. In the past, patients who took traditional NSAIDs had the risk of multiple side effects, including: gastrointestinal tract symptoms such as stomach ulcers and heartburn, excess bleeding from loss of platelet function, and degradation of renal blood flow in the kidneys. With selective COX-2 inhibitors like Celebrex, and Bextra, patients can now take a medication that allows the COX-1 enzyme to maintain its necessary functions.

Understanding Celebrex and Bextra
The current major brands of COX-2 inhibitors—Celebrex, and Bextra—have been developed with the goal of reducing pain and inflammation with as few side effects as possible. Although the overall medications are quite similar, each of the brands is based on a different chemical composition that produces some differences in dosages, possible side effects, etc.

Celebrex is a prescription pain medication in the COX-2 inhibitor class of drugs. The active ingredient in Celebrex is Celecoxib, and it works by reducing inflammation, which often is a component of back pain and neck pain.

People who should not take Celebrex include:
Patients allergic to Celecoxib
Persons who have experienced asthma, hives, or allergic reactions after taking aspirins or other NSAIDs
Women who are in late pregnancy

Celebrex may be taken as a 100 mg, 200 mg, or 400 mg pill. Dosage of Celebrex is based on the patient’s medical condition and response to therapy.

The FDA has recommended the following dosages for Celebrex:
For osteoarthritis, oral dosage of 100 mg twice daily or 200 mg once daily
For rheumatoid arthritis, oral dosage of 100 mg twice daily or 200 mg twice daily
For acute pain or painful menstrual cramps, oral dosage of 400 mg initially followed by 200 mg the same day if needed. Oral dosage of 200 mg twice daily thereafter

Celebrex may be taken with or without food

If a dose of Celebrex is missed, the patient may take it as soon as remembered, unless it is near the time of the next dose, in which case the patient should skip the missed pill and take the next dose at the right time.

Celebrex should be stored at room temperature and away from light and moisture.

Possible side effects
As with all NSAIDs, there is a risk of stomach problems when taking Celebrex. Although this is a very rare side effect with Celebrex, it is still a possible side effect, and the risk increases with length of time Celebrex is taken.

Other rare but serious potential problems from Celebrex include: heart attacks, serious allergic reactions, kidney problems, and liver problems.

The most common Celebrex side effects experienced by patients participating in clinical studies included stomachache, diarrhea, and headache.

General Precautions
Patients should never take Celebrex or any other medications without first discussing it with their doctor. It is important to discuss any other medications that are being taken (including those taken without a prescription and vitamins/supplements), and to be complete and accurate in providing a medical history to the doctor.

Patients who have any reaction to aspirin (such as asthma) or other NSAIDs (such as ibuprofen or naproxen) may be sensitive to Celebrex and other COX-2 inhibitors.

Patients who have had allergic reactions to sulfa medicines should avoid Celebrex.

Daily use of alcohol or excessive alcohol consumption may increase the patient’s risk of serious stomach problems.

Extra caution is warranted for elderly patients taking Celebrex, as elderly patients tend to be susceptible to possible side effects.

It is not yet known whether or not Celebrex can pass through breast milk and affect infants who are breastfeeding.