Celecoxib belongs to a drugs class named non-steroidal anti-inflammatory drugs (NSAIDs) known as selective inhibitors of cyclooxygenase-2 (COX-2) , which work by decreasing pain and inflammation.

This drug is indicated for the relief of osteoarthritis symptoms (a degenerative joint disease but without inflammation thereof), rheumatoid arthritis (a disease that primarily causes inflammation of the joints), and ankylosing spondylitis (a disease that primarily causes inflammation of the joints of the spine).

Allergy symptoms may include:

- Asthma attacks with shortness of breath, audible wheezing or rapid breathing.
- More or less sudden swelling of the face, lips, tongue or elsewhere in the body. It is especially critical if it affects the vocal cords.
- Hives, itching, rash
- Anaphylactic shock (loss of consciousness, paleness, sweating, etc.).

Nor you should take this medicine:

- If you have had an allergic reaction to any drug of the sulfonamide group (eg .: some are antibiotics used to treat infections)
- If you have an ulcer or bleeding from stomach or duodenum
- If you have previously suffered from any of the following symptoms after taking aspirin or other anti-inflammatory drugs: asthma (wheezing or difficulty breathing easily), nasal congestion, nasal polyps, or allergic symptoms such as swelling of the face, lips, tongue or throat ( angioedema) and/or itchy rash
- If you are or may be pregnant, or are breastfeeding your child
- If you have severe liver or kidney disease
- If you have inflammatory bowel disease (ulcerative colitis or Crohn's disease)
- If you have heart failure
- if you have heart disease and/or cerebrovascular disease, eg .: if you have had a heart attack or angina, or stroke, or transient stroke, or a blood clot which has prevented the blood pass to heart or brain, or you have undergone an operation to clean your arteries or for inserting a bypass; or if you have or have had problems with blood circulation in the legs (intermittent claudication).

- If you have had or develop an ulcer, bleeding or perforation in the stomach or duodenum, being able to manifest by intense or persistent abdominal pain, and/or black stools.
- If you could be dehydrated, for example, because of vomiting or diarrhea or use of diuretics
- If you have fluid retention (swollen ankles or feet)
- If you have heart problems, liver or kidney, especially if you are elderly
- If the symptoms of your heart disease (shortness of breath, chest pain or swelling) get worse
- If you develop any symptoms that could indicate a severe allergic reaction as difficulty breathing, coughing, swelling of the face or a serious skin reaction (eg .: redness, swelling, blistering and peeling) You should consult a doctor urgently. The appearance of these reactions can occur at any time, but usually, do it during the first month of treatment
- If you have an infection, since taking celecoxib can mask a fever or other signs of inflammation
- If you are taking aspirin or another anti-inflammatory drug. If you are currently taking low doses of aspirin to prevent a heart attack or a stroke, you should not stop treatment without consulting your doctor because celecoxib can not substitute for aspirin in this effect
- If you are over 65 years, your doctor may advise regular checks on your health status
- If you are taking medicines to reduce blood clotting, eg .: warfarin> or acenocoumarol
- If you smoke or you have any of the following problems: high cholesterol, diabetes and/or high blood pressure (hypertension)

As with other anti-inflammatory drugs (eg ibuprofen or diclofenac), this drug may increase your blood pressure , so your doctor will perform regular monitoring of it.

They have been reported some cases of severe liver damage, which on occasion has led to fatal liver failure or require a liver transplant. The most severe reactions occur mostly within the first month of treatment.

Celecoxib can hinder a woman to become pregnant. Tell your doctor if you are planning to become pregnant or if you have trouble get it.

Consult your doctor if any of the above circumstances had ever happened.

Remember that your doctor has prescribed this medicine only for you. Never give it to someone else.

If in doubt, consult your doctor.

Taking other medicines

Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including herbal products or drugs obtained without a prescription.

Certain medicines can interact with celecoxib; in these cases, it may be necessary to change the dose or stop treatment with any of them.

It is important that you tell your doctor if you are taking or have recently taken any of the following medications:

- Warfarin or other oral anticoagulants (used to prevent blood clots),
- ACE inhibitors or angiotensin II receptor antagonists (medicines used to treat high blood pressure and some heart problems).
- Diuretics (used to increase urine output as part of the treatment of hypertension, heart failure or fluid retention).
- Acetylsalicylic acid or other anti-inflammatory drugs.
- Cyclosporine or tacrolimus (medicines used in transplant patients).
- Lithium (used to treat bipolar disorder).
- Methotrexate (used in rheumatoid arthritis and in the treatment of some cancers).
- Dextromethorphan (used to treat a cough).
- Diazepam (used to treat anxiety).
- Antidepressants.
- Neuroleptics (used to treat psychosis).
- Antiarrhythmic (used to treat irregular heartbeat).
- Fluconazole (used to treat fungal infections).
- Rifampicin (used to treat bacterial infections and tuberculosis).
- Carbamazepine and barbiturates, as eg phenobarbital (used to treat epilepsy).

Use with food and beverages

This medicine may be taken with or without food.

Special physiological situations

Pregnancy and lactation

always consult your doctor or pharmacist before taking any medicine during pregnancy or lactation.

Celecoxib is contraindicated if you are pregnant or breastfeeding.

If you think you may be pregnant or planning to become pregnant, do not take this medicine. If you become pregnant during celecoxib treatment, you should discontinue this immediately and inform your doctor.

Children

This drug is not indicated for children.

Driving and using machines

Since you may experience symptoms of dizziness, vertigo or drowsiness after taking celecoxib, you should avoid performing tasks which may require special attention (driving or operating machinery) until know if you tolerate the drug.

Your doctor will indicate the dose and duration of treatment with this anti-inflammatory. Do not stop treatment earlier.

Celecoxib is taken orally.

Adults:

Check with your doctor regularly developments of disorder that motivates the use of celecoxib. Maybe there is some reason that prevented you properly receive the indicated doses and induce your doctor to erroneous conclusions about treatment.

Very common side effects

- Increased blood pressure (hypertension)

Common side effects:

- Sinusitis, upper respiratory tract infection, urinary infection
- Worsening allergy
- Insomnia
- Dizziness, muscular rigidity
- Myocardial infarction
- Pharyngitis , nasal congestion, cough, difficulty breathing
- Stomachache, diarrhea, indigestion, flatulence (gasses), vomiting, difficulty swallowing
- Rash, itching
- Flu-like symptoms , swelling of the legs and ankles, fluid retention.

Uncommon side effects:

- Anemia
- Anxiety, depression, tiredness
- Increased level of potassium in the blood
- Tingling, drowsiness, cerebral infarction
- Blurred vision
- Tinnitus (ringing in the ears), hearing loss
- Heart failure, palpitations (perception of heartbeat), tachycardia (Rapid heart beat)
- Worsening of high blood pressure
- Constipation, belching, mouth infection, stomach inflammation or aggravation of inflammation of the stomach or intestine
- liver and kidney problems (these are reflected in analytical testing of blood)
- skin reactions such as urticaria (skin redness and itching)
- Leg Cramps

Rare side effects:

- Decreased number of blood cells (platelets or white blood cells)
- Confusion
- Impaired coordination of movements,
- taste changes
- Ulcers in the digestive system, intestinal perforation, inflammation of the esophagus, black stools, inflammation of the pancreas
- Increased liver enzymes
- Hair loss, increased sensitivity to light

During the post-marketing phase have been reported the following adverse effects::

- Simultaneous reduction of blood cells (red cells, white cells, and platelets)
- Severe allergic reactions, anaphylactic shock
- Hallucinations
- Headachse, worsening of epilepsy, aseptic meningitis (non-infectious origin),loss of taste and smell, fatal intracranial hemorrhage
- Conjunctivitis, ocular hemorrhage, arterial or venous obstruction in the retina
- cardiac arrhythmia (irregular heart rhythm)
- Reddening of the skin, inflammation of blood vessels
- Difficulty breathing and cough
- Nausea, gastrointestinal bleeding, colitis or worsening of colitis
- Hepatitis (liver inflammation), jaundice (yellowing of the skin) , Liver failure
- Skin disorders such as redness, swelling, Blisters, desquamation, Stevens-Johnson syndrome (blistering reaction that affects the skin, mouth, eyes and genitals), toxic epidermal necrolysis (blistering and peeling of the skin) , swelling under the skin
- Pain in one or more joints, inflammation of muscles
- Acute renal failure, interstitial nephritis (severe inflammation of the kidney) , decreased concentration of sodium in the blood
- menstrual disorders

The side effects reported in clinical trials in which was administered 400 mg celecoxib daily in patients with unrelated diseases with arthritis, osteoarthritis or ankylosing spondylitis are:

- Cardiac disorders: chest pain (angina pectoris)
- Vascular disorders: red spot usually in the leg that causes pain, swelling or redness of the calf
- Renal and urinary disorders: kidney stones, prostatic hyperplasia (usually manifests as difficulty in urinating, especially when starting to urinating), need to urinate at night with more than the usual ,
- Analytical tests: high blood creatinine, high blood sodium
- Infections and infestations: herpes zoster infection, irritation and swelling of the inner ear (labyrinthitis), swelling or bleeding gums,
- Disorders of the skin and subcutaneous tissue: swelling or redness of the skin (erysipelas), skin disorder (allergic dermatitis), cystic formation (ganglion),
- Injury, poisoning, and procedural complications: lower limb fracture
- Gastrointestinal disorders: irritable bowel syndrome (including abdominal pain, diarrhea, indigestion, and gas), infection by Helicobacter (may cause irritation and ulcers in the stomach and intestine), hemorrhoidal bleeding frequent bowel movements ulceration of the mouth
- Metabolism and nutrition disorders: weight gain
- Respiratory, thoracic and mediastinal disorders: chest infection (a cough, fever, difficulty breathing), difficulty speaking
- Malignant neoplasms benign and unspecified (including cysts and polyps): Benign growth of adipose tissue cells (lipoma)
- Eye disorders: vision impairment or blurred vision bleeding red eye (conjunctival hemorrhage)
- Disorder of reproductive system and breast: vaginal bleeding breast pain to palpation

This list does not include all adverse reactions associated with the use of celecoxib, both well established as those that are under consideration or confirmation. In case you feel unwell, should immediately consult with the doctor who prescribed this medicine.

If you notice any side effects not listed in this website or in the leaflet accompanying the package, ask your doctor or pharmacist.