Celecoxib (Celebrex): What it treats and how to use it safely

Want pain relief but worried about stomach issues from regular NSAIDs? Celecoxib (brand name Celebrex) is a COX-2 selective NSAID many doctors choose for osteoarthritis, rheumatoid arthritis, acute pain, and menstrual cramps. It can cut inflammation with a lower chance of certain stomach bleeds than nonselective NSAIDs, but it still carries real risks you should know before taking it.

How to take celecoxib safely

Typical dosing is straightforward: for osteoarthritis, 100 mg twice daily or 200 mg once daily; for rheumatoid arthritis, doctors often use 100–200 mg twice daily. For short-term acute pain or menstrual cramps, an initial 400 mg dose followed by 200 mg as needed (usually not exceeding 400 mg per day) is common. Always follow your prescriber's instructions—these are common ranges, not personal medical advice.

Simple habits make a big difference. Take celecoxib with food or milk to ease stomach upset. Use the lowest dose that works and stop as soon as you can. If you need it long term, expect your doctor to check blood pressure, kidney function, and overall heart risk periodically.

Common side effects and red flags

Minor side effects include stomach pain, indigestion, diarrhea, headache, and dizziness. More serious problems can happen: higher risk of heart attack or stroke (especially with long use or higher doses), fluid retention, and kidney problems. Celecoxib can still cause GI bleeding, so watch for black stools or severe belly pain.

Stop celecoxib and seek help if you get chest pain, sudden weakness, slurred speech, severe stomach pain, bloody stools, shortness of breath, or sudden swelling of hands/feet.

Watch drug interactions. Celecoxib is processed by the liver enzyme CYP2C9, so strong CYP2C9 inhibitors (like fluconazole) can raise celecoxib levels. It can boost the effects of blood thinners such as warfarin and increase bleeding risk. Combining it with other NSAIDs or aspirin reduces safety and usually isn’t recommended. It can also blunt the effect of ACE inhibitors/ARBs and diuretics, and raise lithium levels—tell your doctor about all meds you take.

Special situations to avoid or be cautious in: if you have a sulfa allergy, talk to your doctor—celecoxib contains a sulfonamide group. Avoid it in late pregnancy because it can harm the baby’s heart and cause labor problems. Older adults may be more sensitive to side effects—doctors typically start low and monitor closely.

Final practical tips: keep a list of your medications, check with your pharmacist about interactions, monitor your blood pressure while on celecoxib, and use the lowest effective dose for the shortest period needed. If you’re unsure whether celecoxib is right for you, ask your healthcare provider for a quick risk-benefit check tailored to your health history.