Celecoxib — NZ Medication Guide
📋 Reviewed by a Registered Pharmacist NZ — This information is for general educational purposes only and does not replace professional medical advice. Always consult your doctor or pharmacist before starting, stopping, or changing any medication.
What is Celecoxib?
Celecoxib is a selective COX-2 inhibitor (coxib) NSAID with a lower risk of gastrointestinal side effects than non-selective NSAIDs. This medication is funded by Pharmac under Special Authority for osteoarthritis and rheumatoid arthritis with GI risk factors.
What is Celecoxib Used For?
Celecoxib is used for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain where GI tolerability is a concern — particularly in older patients or those at elevated GI risk.
How Does Celecoxib Work?
Celecoxib selectively inhibits COX-2 (induced at sites of inflammation) while largely sparing COX-1 (which maintains the gastric mucosal protective prostaglandin barrier). This selectivity provides anti-inflammatory and analgesic efficacy with significantly lower GI ulceration and bleeding risk compared to non-selective NSAIDs.
How to Take Celecoxib
For osteoarthritis: 100–200 mg once or twice daily. For rheumatoid arthritis: 100–200 mg twice daily. For acute pain: 400 mg initially, then 200 mg twice daily. Take with food to improve absorption and tolerability.
Common Side Effects of Celecoxib
- Headache
- Dyspepsia (less common than non-selective NSAIDs)
- Diarrhoea
- Peripheral oedema
- Dizziness
- Rash
Serious Side Effects — Seek Medical Attention
Contact your doctor or call 111 immediately if you experience any of the following:
- Cardiovascular events — MI and stroke (celecoxib carries a meaningful cardiovascular risk similar to other NSAIDs — do not use in patients with established CVD without careful risk-benefit assessment)
- Renal impairment
- Severe skin reactions (celecoxib contains a sulphonamide group — potential cross-reactivity with sulphonamide allergy)
- Hypertension
Drug Interactions
Celecoxib may interact with other medicines. Always inform your doctor and pharmacist of all medications you are taking. Key interactions include:
- Anticoagulants (increased bleeding risk despite lower GI risk)
- ACE inhibitors/ARBs (reduced antihypertensive effect)
- Fluconazole (CYP2C9 inhibitor — doubles celecoxib levels)
- Lithium (increased levels)
New Zealand Prescribing Information
Celecoxib (100 mg and 200 mg capsules — Celebrex® and generics) is funded by Pharmac under Special Authority for patients at elevated GI risk. It is contraindicated in patients with sulphonamide allergy. Despite lower GI risk, celecoxib still carries cardiovascular risks and should not be seen as “safe” for patients with CVD — the PRECISION trial showed cardiovascular risks broadly equivalent to naproxen and ibuprofen.
Frequently Asked Questions
If celecoxib is easier on the stomach, can I use it without checking with a doctor?
Celecoxib still requires careful patient selection — its lower GI risk does not eliminate cardiovascular and renal risks. It is funded under Special Authority in NZ, meaning your GP must assess whether it is appropriate for your specific circumstances.
Is celecoxib safe if I’m allergic to sulphonamides?
Celecoxib contains a sulphonamide group, and there is a theoretical risk of cross-reactivity with sulphonamide antibiotic allergy. The evidence for cross-reactivity is debated, but caution is warranted — always inform your prescriber of any sulphonamide allergy before taking celecoxib.
⚠️ Disclaimer: This page is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or a qualified health provider. In New Zealand, medication availability and funding may vary — check with Pharmac or your pharmacist for current information.
Reviewed by a Registered Pharmacist NZ
References & Further Information
The following New Zealand and international resources were used to inform this page: