Frequently Asked Questions about Celebrex

Health Professional

Although Celebrex (celecoxib) is no longer marketed on television or in magazines, this selective anti-inflammatory medication is commonly prescribed and very useful for certain individuals.  Knowing the answers to these frequently asked question about Celebrex may help you decide to talk to your doctor about whether it is right for you.

What is Celebrex?  This anti-inflammatory medication is part of a special family of medications that specifically target a certain enzyme (cyclooxygenase-2) in the chemical cascade that triggers inflammation.  Thus, it is considered a COX-2 inhibitor because it blocks this enzyme for working and producing an avalanche of inflammation.  The benefit of the selective action of a COX-2 inhibitor like Celebrex is that it avoids stimulating other enzymes that trigger stomach acid production or enzymes that interfere with blood clotting.

Is it safe?  In 2005, a whirlwind of controversy surrounded the COX-2 inhibitors because sister drugs rofecoxib (Vioxx) and Valdecoxib (Bextra) came under fire for increasing cardiovascular risk.  In fact, both Vioxx and Bextra were removed from the market.  Many people mourned the loss of these medications because they were greatly improving their quality of life.  But at what cost??  The biggest risk was to those with known heart disease and/or taking the medications for longer than one year.  Because Celebrex seems to generate less risk, it remained on the market and is safely used by certain people in order to relieve pain.  In fact, all anti-inflammatory medications increase the risk of high blood pressure and heart attack but that result is seen in less than one percent of users.  When select for the right individual, the benefits often outweigh the risks.

Who should consider using Celebrex?  Celebrex is best considered in two different scenarios: stomach irritation with traditional anti-inflammatory medications and around the time of surgeries.  Because Celebrex is selective and does not increase stomach acid production like other traditional NSAID’s , anyone that cannot tolerate the older anti-inflammatory medications due to stomach irritation should consider Celebrex if pain and inflammation relief is needed.  The second set of individuals that should consider a COX-2 inhibitor like Celebrex is anyone that will be having a surgery.  COX-2 anti-inflammatory medications used before and after surgery have been proven to improve pain relief, reduce opioid use, and improve outcomes.  Anyone scheduled for surgery, including total knee replacements, total hip replacements and even general surgeries, should consider using Celebrex (1) (2).  Unlike traditional anti-inflammatory medications, the COX-2 inhibitor medications are safe to use before and after surgery because they do not increase blood loss.

How can I get my insurance to pay for Celebrex?  Insurance companies often times require prior authorization before they will pay for Celebrex.  It is more expensive than traditional NSAID’s like ibuprofen.  But some people cannot take ibuprofen because it upsets their stomachs or they are having surgery.  Insurance companies will cover this medication if traditional NSAID’s have been tried, if the person has a history of stomach upset, or, possibly, if a person is having surgery.  Once one of these criteria’s has been met, this medication should be paid for by the insurance company.

Thankfully Celebrex survived the attacks on COX-2 inhibitors years ago.  It has proven to be a very valuable tool in the pain relief toolbox because it produces fewer side effects and is effective at improving quality of life.

Reference:

(1)       Carmichael, NM, Katz, J, et. al; An Intensive Perioperative Regimen of Pregabalin and Celecoxib Reduces Pain and Improves Physical Function Scores Six Weeks After Total Hip Arthroplasty; Pain Research and Management; 2013, May/June18(3):127-32

(2)       Zhu, Y, Wang, S; Effect of Perioperative Parecoxib on Postoperative Pain and Local Inflammation Factors PGE-2 and IL-6 for Total Knee Arthroplasty; European Journal of Orthopaedic Surgery and Traumatology; 2014, April, 24(3):395-401

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