How Celebrex works
Celebrex is the brand name for Celecoxib, a nonsteroidal anti-inflammatory drug (NSAID) prescribed to relieve the pain and stiffness of arthritis.
Celebrex is a selective COX-2 (Cyclooxygenase-2) inhibitor that works by blocking an enzyme that produces pain and inflammation. Other drugs in this class include Vioxx and Bextra, both of which have been pulled from the market. However, in 2005 the Food and Drug Administration stated that for certain patients Celebrex's benefits outweigh the risks and it has never been taken off the market.
Anti-inflammatory drugs are normally used to relieve the symptoms associated with joint pain including swelling, stiffness, and inflammation. They are also used to treat other pains such as headaches, pain associated with some surgeries, sports injuries, and menstrual cramping. Celebrex is most often used to relieve swelling of the joint linings (rheumatoid arthritis), breakdown of the joint linings (osteoarthritis), and arthritis of the spine (ankylosing spondylitis). This drug treats the symptoms of inflammation and pain, but does nothing to cure the cause of the symptoms.
Pros and Cons of usage
Celebrex has provided relief to millions of users that could not get the same level of relief from other prescription and nonprescription medications. For most users, one 200mg capsule per day provides significant relief. In some studies, Celebrex users experienced less nausea, indigestion, and abdominal pain than those using naproxen and ibuprofen. Celebrex can be taken with low doses of aspirin, but this may raise the risk for ulcers and stomach bleeding.
All prescription NSAIDs carry a warning that such drugs may increase the chances of stroke and heart failure, resulting in possible death. The odds of these consequences increase if you already suffer from heart disease or if you have high blood pressure. They also carry a warning for severe stomach and intestinal complications including ulcers and bleeding. Studies have shown that COX-2 inhibitors such as Celebrex cause fewer ulcers and less bleeding than other NSAIDs. The more common side effects are upset stomach, nausea, diarrhea, and indigestion. The drug is normally only prescribed in the lowest effective dosage for the shortest possible time period.
Video: Doctors Vary on Different Drugs to Avoid
Flawed research data
Dr. Scott Reuben has conducted research on multiple pain medications including Vioxx, Celebrex, and Bextra. His work conducted at the Baystate Medical Center in Springfield, Massachusetts has been challenged by a hospital panel that claims he fabricated the results. Reuben's research resulted in largely favorable conclusions regarding the use of these drugs, and his findings have been used as the basis for other independent researchers. Several prominent medical journals subsequently retracted his published studies, as well as those that relied on them. The ripple effect is that any clinical trials of drugs that used his data will most likely be invalidated.
It was also revealed that Reuben received research grants from Pfizer over a five year period while writing and speaking about the benefits of its blockbuster drug Bextra. While Pfizer attempted to distance itself from the results of Reuben's studies, the financial link could not be disputed. Other studies have shown that some of these drugs pose significant risks ranging from severe digestive complications to possible death, resulting in some of them being pulled off the market.
Video: FDA Actions on NSAIDs
Litigation issues
There have been several class action lawsuits regarding the safety of Celebrex. The basis for the suits is the claim that regular use of the drug has been linked to blood clots, strokes, and other heart and cardiovascular diseases. In addition, the plaintiffs have claimed that Pfizer aggressively marketed the drug without providing proper warnings, and that it downplayed any risks while seeking approval of the drug from the US Food and Drug Administration (FDA). During this process, Pfizer funded a clinical trial to show that Celebrex posed lower gastrointestinal risk than ibuprofen and aspirin. The suits also alleged that the tests failed to properly address cardiovascular risk and that the clinical results reviewed by the FDA neglected this safety aspect. As a result, the suits maintained that the FDA approved the drug for arthritis treatment without full awareness of the cardiovascular issues.
These legal cases are in various stages of litigation and settlement. The lawsuits notwithstanding, Celebrex remains on the market. In April 2005, the FDA concluded that the benefits of the drug outweighed the potential risks for certain patients. It also required that a “black boxed” warning be included in the product label which is the most serious level that a drug can receive.
Obtaining Celebrex
There are a variety of medications available to treat arthritic pain. Which one is right for you should be a subject of discussion between you and your doctor. While there are risks associated with most arthritis pain medications, Celebrex is currently the number one selling drug in this category. Celebrex must be prescribed by your doctor and it requires close monitoring to track your progress and susceptibility to any negative side-effects. Make sure your doctor is aware of your full medical history, and describe your pain issues in detail. A complete understanding of the frequency and nature of your symptoms will help your doctor to determine the best treatment option. Also engage in a thorough discussion of the projected benefits and risks before you decide to take a drug that could potentially harm you.
The cost of the drug varies but the 200mg dosage is priced in the $3-4 range per capsule at online pharmacies. A generic version won't be available until 2013 when the drug goes off-patent. Celecoxib is not a generic version, but is the active ingredient in Celebrex. If you decide to take this drug, keep records of changes in your symptoms and any side-effects that you experience. Follow up with your doctor on a regular basis, especially if the changes or side-effects are unexpected or worsen.