Celebrex vs. ibuprofen: Differences, similarities, and which is better for you

Drug overview and main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Arthritis is known to cause aches and pains. There are so many medications out there for arthritis pain that it can be confusing which one to take. Two common medications in the NSAID (nonsteroidal anti-inflammatory drug) category are Celebrex (celecoxib) and ibuprofen.

NSAIDs can be effective in treating osteoarthritis and rheumatoid arthritis, as well as a variety of other conditions. Both Celebrex and ibuprofen are available in generic form. While Celebrex is only available by prescription, you can buy lower doses of ibuprofen over-the-counter. Higher doses of ibuprofen are available by prescription. Because Celebrex and ibuprofen are in the same class of drugs, they are similar, but they also do have some notable differences.

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Conditions treated by Celebrex and Ibuprofen

Celebrex, a nonsteroidal anti-inflammatory drug (NSAID), is indicated for the following conditions: osteoarthritis, rheumatoid arthritis,   juvenile rheumatoid arthritis in patients two years and older, ankylosing spondylitis, acute pain, primary dysmenorrhea, and familial adenomatous polyposis as an adjunct to usual care.

Ibuprofen is also an NSAID and is indicated for relief of the signs and symptoms of osteoarthritis and rheumatoid arthritis, mild to moderate pain, and primary dysmenorrhea.

NSAID drugs work by blocking prostaglandins (prostaglandins cause pain and inflammation) from being made. Prostaglandin is made by two enzymes, cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2).

Is Celebrex or Ibuprofen more effective?

Celebrex is known as a selective COX-2 inhibitor. While it is still an NSAID like ibuprofen, Celebrex only blocks COX-2, as opposed to ibuprofen, which blocks both COX-1 and COX-2. What does this mean? A COX-2 inhibitor can be easier on the stomach, with a lower risk of causing stomach ulcers.

In clinical studies for efficacy, Celebrex demonstrated:

• Reduced joint pain in osteoarthritis patients
• Reduced joint pain and swelling in rheumatoid arthritis patients
• Improvement in patients with juvenile rheumatoid arthritis
• Improvement in patients with ankylosing spondylitis (in pain intensity, disease activity, and functional impairment)
• Relief of moderate to severe pain caused by surgical pain or dysmenorrhea

In clinical studies for efficacy, ibuprofen demonstrated:

• A similar effect to aspirin in patients with osteoarthritis and rheumatoid arthritis for pain and inflammation
• Relief of pain from episiotomy, dental procedures, and dysmenorrhea

Which medication is more effective? It is difficult to say. In one study, Celebrex was shown to be “as effective as” ibuprofen for patients with osteoarthritis of the knee. Some studies show ibuprofen to be more effective, while others conclude Celebrex may be more effective.

In terms of safety, clinical trials of Celebrex, as well as non-selective NSAIDs (such as ibuprofen) of up to three years have shown an increased risk of serious cardiovascular events, myocardial infarction, and stroke, which can be fatal. Therefore, all NSAIDs (including both Celebrex and ibuprofen) may be potentially associated with this risk. Also, all NSAIDs, including Celebrex and ibuprofen, have an increased risk of GI events, such as bleeding and ulcers.

The best drug for you can only be determined by your healthcare provider, who can take into account the whole picture of your medical condition(s), risk factors, health history, and other medications you are taking.

Coverage and cost comparison of Celebrex vs. Ibuprofen

Celebrex is typically covered by insurance and Medicare Part D in its generic form of celecoxib. A typical prescription would be for 30 capsules of 200 mg celecoxib. The out-of-pocket price is approximately $217.49 but you can get celecoxib for $105-145 at participating pharmacies with a SingleCare coupon.

Ibuprofen is typically covered by insurance and Medicare Part D, in prescription strengths of 400 mg, 600 mg, and 800 mg. Doctor’s prescriptions vary. For example, the retail price for 30 tablets of 800 mg ibuprofen costs anywhere from $6-30. With a SingleCare coupon, the cost for ibuprofen is $4-8.

Side effects of Celebrex vs. Ibuprofen

The most common adverse events of Celebrex and ibuprofen include abdominal pain, diarrhea, indigestion, and headaches. See warning section for more information about cardiovascular risk and risk of GI bleeding.

*Frequency of adverse effects of ibuprofen is not provided with drug information; only that these effects occurred in 3-9% of patients.

Source: DailyMed (Celebrex), DailyMed (ibuprofen)

This is not a complete list; other side effects may occur. Consult with your healthcare provider for details.

Drug interactions of Celebrex and Ibuprofen

Celebrex and ibuprofen have many of the same interactions with other prescription drugs. Both medications interact with blood thinners such as Coumadin (warfarin), certain blood pressure medications (ACE inhibitors, ARBs, and beta blockers), antidepressants, and diuretics such as hydrochlorothiazide and methotrexate. Consult your healthcare provider for guidance.

Alcohol should be avoided when taking Celebrex or ibuprofen. Using either of these medications with alcohol can increase the risk of GI (stomach) bleeding or inflammation. The combination could also cause kidney damage or kidney failure.

This is a partial list of drug interactions. Contact your healthcare provider for more information.

Warnings of Celebrex and Ibuprofen

Celebrex should be avoided in patients who are allergic to NSAIDs, as well as patients who are allergic to sulfa. Ibuprofen should be avoided in patients who are allergic to NSAIDs.

Because both drugs are NSAIDs, Celebrex and ibuprofen have the same warnings. They have a boxed warning (the strongest warning as required by the Food and Drug Administration, or FDA). Celebrex or ibuprofen may increase the risk of serious cardiovascular events, MI (myocardial infarction, or heart attack), and stroke, all of which could be fatal. All NSAIDs have a similar risk, which increases the longer you use it. Patients with heart disease or who have cardiovascular risk factors are at greater risk. Celebrex or ibuprofen should not be used for pain during coronary artery bypass graft (CABG) surgery.

Also in the boxed warning is the risk of serious GI, or gastrointestinal events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Any of these events could occur at any time, and without warning symptoms. Elderly patients and those with a history of ulcers or GI bleed are at higher risk for serious GI events.

Other Celebrex and ibuprofen warnings include:

• Risk of elevated liver enzymes and, rarely, severe hepatic reactions.
• New cases or worsening of hypertension (high blood pressure). Use with caution in hypertension patients; monitor blood pressure closely during treatment.
• Fluid retention and edema. Use with caution in patients with fluid retention or heart failure
• Renal papillary necrosis/other renal injury with long term use. Use with caution in the elderly, patients with impaired renal function, heart failure, liver dysfunction, and patients who take diuretics, ACE inhibitors, or angiotensin II blockers.
• Anaphylactoid reactions. Do not use it for patients with Samter’s triad.
• Serious skin reactions can occur such as exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal and occur without warning. Discontinue Celebrex and seek immediate medical treatment if rash or skin reaction occurs.

There is limited data on NSAIDs use in pregnancy. The use of all NSAIDs, including both Celebrex and ibuprofen, during the third trimester of pregnancy, increases the risk of premature closure of the fetal ductus arteriosus. Therefore, NSAIDs should not be used after 30 weeks of gestation.

Consult your healthcare provider regarding Celebrex or ibuprofen use in pregnancy. If you are already taking Celebrex or ibuprofen and find out that you are pregnant, contact your healthcare provider for guidance.

There is limited data on Celebrex and ibuprofen with breastfeeding; consult your doctor for guidance.

Frequently asked questions about Celebrex vs. Ibuprofen

What is Celebrex?

Celebrex is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the following conditions: osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in patients two years and older, ankylosing spondylitis, acute pain, primary dysmenorrhea, and familial adenomatous polyposis as an adjunct to usual care.

What is Ibuprofen?

Ibuprofen is an NSAID and used to treat signs and symptoms of osteoarthritis, rheumatoid arthritis, mild to moderate pain, and primary dysmenorrhea.

Are Celebrex and Ibuprofen the same?

Because both drugs are NSAIDs, they are similar and have similar side effects and warnings. They differ in indications and price. See above to find out more about the similarities and differences.

Is Celebrex or Ibuprofen better?

Both drugs can be very effective in treating arthritis as well as other conditions. Depending on what condition(s) you are treating, and taking into account any other medical conditions and risk factors you have, as well as other medications you are taking, your doctor can help recommend the appropriate medication for you.

Can I use Celebrex or Ibuprofen while pregnant?

If you find out you are pregnant and using Celebrex or ibuprofen contact your healthcare provider for recommendations.

Pregnant women should not use these NSAIDs after 30 weeks of pregnancy. Using Celebrex and ibuprofen during the third trimester of pregnancy can increase the risk of premature closure of the fetal ductus arteriosus.

Can I use Celebrex or Ibuprofen with alcohol?

No. Using either of these medications with alcohol can increase the risk of GI (stomach) bleeding or stomach inflammation. The combination could also cause kidney damage or kidney failure.

Is Celebrex more effective than ibuprofen?

Both drugs can be very effective in treating arthritis pain as well as other conditions. Consult with your healthcare provider to learn which medication is best for you given your condition(s), health history, and other medications you might be taking.

Why did they take Celebrex off the market?

Celebrex is still on the market as of today. Vioxx (rofecoxib), a similar drug to Celebrex, was removed from the market by its manufacturer, Merck, in 2004, due to increased risk of cardiovascular events with chronic use. In 2005, another similar drug, Bextra (valdecoxib), was pulled off the market by manufacturer Pfizer for the same reasons.

Is Celebrex a painkiller?

Celebrex is an NSAID (nonsteroidal anti-inflammatory) drug that helps with symptoms of pain and inflammation from a variety of conditions (see above). Because it only works on COX-2 enzymes, it may be safer for the stomach, although there is still a GI risk.