Celebrex dosage, forms, and strengths

Celebrex is the brand-name version of celecoxib, a prescription nonsteroidal anti-inflammatory drug (NSAID). Healthcare professionals use it to treat arthritis, pain, and painful periods. As a prescription NSAID, Celebrex has the potential to cause serious side effects and has a boxed warning about increased risk in cardiovascular thrombotic events, such as a stroke, and severe gastrointestinal (GI) side effects. For this reason, doctors use the smallest effective dose for the shortest period possible.

Celebrex forms and strengths

Celebrex comes in only one dosage form. 

• Capsules: 50 mg, 100 mg, 200 mg, 400 mg

Celebrex dosage for adults

The U.S. Food and Drug Administration (FDA) has approved Celebrex to treat pain and swelling in adults due to osteoarthritis, rheumatoid arthritis, and inflammatory arthritis of the spine. It can also be used to treat acute pain and painful periods. 

Healthcare providers typically do not use Celebrex in people who have had an allergic reaction, such as shortness of breath or hives, to celecoxib or other NSAIDs. Celebrex is also contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Although celecoxib is a sulfa drug, doctors do use it in people with allergies to sulfonamides, as research suggests there is a low risk of cross-reactivity. However, they will watch carefully for symptoms of a hypersensitivity reaction, such as skin rash or swelling.

Celecoxib is a powerful prescription NSAID that does not have some of the same side effects as other NSAIDs. As a selective cyclooxygenase-2 inhibitor (COX-2 inhibitor), it blocks the enzyme responsible for producing prostaglandins, an important component of the pain and inflammation pathway. However, celecoxib weakly blocks a similar enzyme (COX-1) that makes the prostaglandins that help drive the blood clotting process. As a result, celecoxib eases pain but typically causes fewer bleeding problems compared to other NSAIDs.

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Celebrex dosage for osteoarthritis

Osteoarthritis is a degenerative condition in which cartilage at the ends of bones gradually wears down, leaving bones to rub against each other. It’s a painful condition characterized by swelling, stiffness, and limited joint movement. The mainstay treatments typically involve nonpharmacologic treatments, such as weight loss and occupational therapy. When drugs are used, healthcare providers usually start with over-the-counter (OTC) acetaminophen (Tylenol), OTC NSAIDs, or prescription NSAIDs.

Because of the potentially severe side effects of celecoxib, healthcare professionals use Celebrex sparingly for osteoarthritis. They try to use the lowest effective dose for the shortest period possible, and at some point, the prescriber will try to transition to another treatment.

• Standard Celebrex dosage for osteoarthritis: 200 mg taken once per day or 100 mg taken twice per day

Celebrex dosage for rheumatoid arthritis

Rheumatoid arthritis (RA) is an inflammatory disease of the joints caused by the immune system attacking joint tissues, causing pain, swelling, stiffness, and damage to the joints. NSAIDs like Celebrex are the first-line treatments for relieving the pain and swelling of an RA flare-up. People taking Celebrex may need to take other drugs that block the immune system to manage and prevent flare-ups. 

• Standard Celebrex dosage for rheumatoid arthritis: 100–200 mg taken twice daily

Celebrex dosage for ankylosing spondylitis

Ankylosing spondylitis is similar to rheumatoid arthritis. The immune system attacks the joints, but the attacks are concentrated on the joints in the spinal cord, though other joints may be involved. This causes back pain, neck pain, stiffness, and spinal damage and limits people’s ability to move. As with rheumatoid arthritis, NSAIDs like Celebrex are first-line treatments for relieving the pain and swelling of a flare-up. Healthcare providers will use celecoxib at the recommended dosage for six weeks. If it doesn’t help, they will increase the dose to 400 mg daily for six weeks. If that doesn’t work, they’ll discontinue the treatment and switch to other medications.

• Standard Celebrex dosage for ankylosing spondylitis: 200 mg taken once per day or 100 mg taken twice per day

Celebrex dosage for acute pain

Celebrex can help manage pain caused by causes other than arthritis. Doctors may use it for common pain conditions, such as pain following a medical procedure. Although the initial dose on the first day of treatment may be large, later doses will be smaller if necessary.

• Standard Celebrex dosage for acute pain: 400 mg initial dose followed by 200 mg every 12 hours if needed

Celebrex dosage for primary dysmenorrhea

Dysmenorrhea is monthly menstrual pain that is worse than average menstrual cramps. The pain is usually felt in the lower part of the abdomen but can also involve the back or inner thighs. Healthcare professionals diagnose this pain as primary dysmenorrhea when they can identify no other cause besides the menstrual cycle itself. As with osteoarthritis, healthcare providers prefer treatments that don’t involve drugs, like applying heat, physical activity, dietary changes, and therapies such as acupuncture or behavioral therapy. When drugs are used, NSAIDs, such as ibuprofen or naproxen, are the first-line treatment. Celebrex is no longer a first choice because of its potentially severe side effects, such as unexplained weight gain, edema, or fluid retention.

• Standard Celebrex dosage for primary dysmenorrhea: 400 mg initial dose followed by 200 mg every 12 hours if needed

Celebrex dosage for children

The U.S. Food and Drug Administration (FDA) has approved Celebrex for use in children two years and older to treat juvenile rheumatoid arthritis (JRA), a hereditary disorder similar to rheumatoid arthritis in adults. JRA is the most common rheumatoid condition in children. As in adults, Celebrex relieves pain and swelling, though other immune-suppressing drugs are required to control the condition. Pediatric dosages are based on body weight.

Celebrex dosage restrictions

Celebrex should be avoided or used with caution in patients at risk for or have existing cardiovascular disease, GI disease, kidney impairment, chronic liver disease, or risk for increased bleeding.

• Geriatric patients are started at the lower end of the dosing range.

• Providers may prescribe Celebrex in combination with a proton pump inhibitor (PPI), such as pantoprazole, in patients at an increased risk for a GI bleed.

How to take Celebrex

Celebrex can cause serious side effects, including heart disease. It’s very important to take this medicine as prescribed. Do not increase the dose or take it more often than prescribed. Here are basic instructions for taking Celecoxib capsules safely:

• Use Celebrex for the shortest time possible. 

• Please read the NSAID Medication Guide that comes with this medicine. 

• Celebrex capsules can be taken with or without food.

• Taking the dose with food can help prevent digestive system side effects and improve the body’s absorption of the drug.

• If you cannot swallow the capsule, open it and pour it into a teaspoon of applesauce. Stir the mixture well and swallow right away. Drink enough water to make sure you swallow all of the medicine.

  • The applesauce mixture is good for six hours if stored in the refrigerator.

• Store Celebrex capsules in a closed container at room temperature.

Celebrex dosage FAQs

How long does it take Celebrex to work?

Celebrex begins to work shortly after it’s taken and reaches its peak effect of relieving pain three hours after a dose.

How long does Celebrex stay in your system?

Celecoxib's half-life is 11 hours, so it will take around two days to completely clear a Celebrex dose from the system.

What happens if I miss a dose of Celebrex?

If a dose is missed, take it when remembered. Skip the missed dose if it’s almost time for the next dose, and take that next dose as scheduled. Never take extra Celebrex capsules to make up for a missed dose.

How long can you take Celebrex?

Celebrex is for short-term use only. The longer it’s used, the more likely people will experience severe adverse effects, including blood clots, heart attack, stroke, gastrointestinal bleeding, ulcers, perforation, or serious skin reactions.

How do I stop taking Celebrex?

Celebrex can be discontinued at any time without causing withdrawal. However, a doctor may need to stop Celebrex quickly if people experience gastrointestinal bleeding or other severe side effects. In those cases, the doctor can turn to other drugs, including other NSAIDs, corticosteroids, or other pain relievers.

Can you overdose on Celebrex?

A Celebrex overdose can cause severe problems, including gastrointestinal bleeding, high blood pressure (hypertension), kidney failure, and slowed breathing. Get medical help immediately in case of an overdose. If you’re not sure, the symptoms of a celecoxib overdose include drowsiness, chest pain, lethargy, nausea, vomiting, and abdominal pain. 

What interacts with Celebrex?

To avoid potentially hazardous drug interactions, make sure the prescribing healthcare professional knows about all the prescription drugs, over-the-counter medications, and supplements you are taking. Drugs that could cause problems when taken with Celebrex include:

• Other NSAIDs such as aspirin, ibuprofen, or naproxen

• Anticoagulants such as warfarin

• Blood pressure drugs called ACE inhibitors, angiotensin-II receptor blockers (ARBs),

• Drugs that increase the production of urine (diuretics)

• The heart failure drug digoxin

• The bipolar disorder medication lithium

• The immune suppressants methotrexate and cyclosporine

• Corticosteroids

• Drugs that slow down the ability of the body to break down celecoxib (such as the antifungal drug fluconazole)

What happens when you mix Celebrex and alcohol?

Avoid drinking alcohol when taking Celebrex capsules. Both alcohol and NSAIDs like Celebrex can hurt the digestive system, causing stomach pain, bleeding, or ulcers. Combining the two will worsen these problems.

Is it safe to take Celebrex during pregnancy?

NSAIDs like Celebrex are not safe to take after the 19th week of pregnancy because of the increased risk of heart or kidney problems in the fetus. 

Is it safe to take Celebrex while breastfeeding?

Celecoxib is present in human breast milk in very tiny amounts. There is no evidence that it can cause an adverse reaction in a nursing infant. Mothers who are concerned should ask the prescribing healthcare provider for medical advice. 

Sources

• Absence of cross-reactivity between sulfonamide antibiotics and sulfonamide nonantibiotics, The New England Journal of Medicine

• Celebrex celecoxib capsule prescribing information, DailyMed (NIH National Library of Medicine)

• Celecoxib, Drugs and Lactation Database (LactMed)

• Celecoxib, StatPearls

• Dysmenorrhea, StatPearls

• FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid, U.S. Food and Drug Administration

• Juvenile idiopathic arthritis, StatPearls

• Osteoarthritis, StatPearls