Celecoxib

What it is

Celecoxib is a non-steroidal anti-inflammatory drug that selectively inhibits COX-2, the enzyme induced at sites of inflammation, while largely sparing the COX-1 that protects the stomach lining. This selectivity gives it a gentler gastric profile than older NSAIDs at comparable anti-inflammatory effect. Its supply route is set nationally: in Thailand the FDA places celecoxib in its dangerous-drug tier, which a pharmacist may dispense on their own judgement without a doctor's prescription. It is used for pain, inflammation and joint conditions.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Pain
• Inflammation
• Joints

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It can be taken with or without food. Prostaglandin blockade blunts the effect of blood-pressure and fluid treatments, so blood pressure and swelling are watched when it is combined with lisinopril or furosemide, and the combination also puts extra strain on the kidneys. It is combined with anticoagulants such as warfarin only where that is authorised and only with monitoring, as celecoxib can raise INR and injure the gut lining and bleeding risk rises. Creatinine tracks kidney function and ALT liver tolerance; the cardiovascular caution is the reason long uninterrupted use is reviewed rather than simply continued.

When to see a doctor

Chest pain, sudden breathlessness, one-sided weakness or slurred speech require emergency care. Rising blood pressure, new or worsening ankle swelling, much less urine, yellowing of the skin or eyes, or dark stools all mean see a doctor rather than adjusting things alone.

Worth knowing

• Cardiovascular risk with long use
• Caution with kidney disease

Markers to watch

• Creatinine
• ALT