The use of Celecoxib cannot be expected to be a substitute in order to treat corticosteroid
insufficiency. On the other hand, an abrupt discontinuation of corticosteroids may result in exacerbation of corticosteroid-responsive illness. Patients on prolonged treatment with corticosteroids should have their therapy reduced slowly if a decision is made to discontinue corticosteroids.
Patients who are in their late pregnancy
, usually starting at 30 weeks gestation are at an increased risk when using this drug. The use of Celecoxib should be avoided during pregnancy as it may cause premature closure of ductus arteriosus, which is a blood vessel that connects the major pulmonary artery to the descending aorta in an unborn child. Celecoxib should be used during pregnancy only if the potential benefit outweighs the potential risk to the unborn baby.
Patients using Celecoxib may see an increased risk of serious skin side effects such as exfoliative dermatitis
and Stevens-Johnson syndrome
(SJS) which can be fatal. These severe side-effects
can occur without any warning and in patients without known previous allergy
to sulfa drugs. Patients should be notified about the signs and symptoms of severe skin reactions, and use of the drug should be withdrawn during the first appearance of skin rash or any other sign of allergic reaction.
Patients taking Celecoxib are at increased risk of allergic reactions (swelling of the lower layer of the skin). Celecoxib should not be given to patients with the symptoms of aspirin intolerance. This symptom complex typically occurs in patients who have inflammation of airways of lungs (asthma
), with rhinitis with or without painless growth on the lining of the nose (nasal polyps
), or who display severe and potentially fatal bronchospasm after taking aspirin or other NSAIDs
. Emergency help should be given in cases where such allergic reactions occur.
Use of Celecoxib in patients with abnormal functioning of the kidney may lead to an increased risk of kidney damage. In such patients, taking NSAID's
may cause a dose-dependent reduction in the formation of prostaglandins and, secondly, in kidney blood flow, which may precipitate the inability of kidneys to compensate for the overload of organ failure. Treatment with Celecoxib should not be used in patients with advanced kidney disease. If therapy with Celecoxib must be started, close monitoring of the functioning of kidneys of the patient is recommended.
Patients taking Celecoxib may have increased risk of severe liver reactions, including jaundice
and liver function problems and liver damage with fatal outcome. Careful monitoring of the patients should be done for the occurrence of severe liver reactions while on the treatment with Celecoxib.
Stomach and intestinal events
Use of Celecoxib in patients may produce severe stomach and intestinal effects including bleeding
, ulceration, and formation of holes all the way through the stomach, small intestine or large intestine, which can be fatal. Extreme care is recommended when Celecoxib is taken by patients with a prior history of ulcer
disease or gastrointestinal bleeding.
Patients with heart failure and swelling of the various parts of the body
Patients taking Celecoxib may see an increased risk of swelling and excess fluid build up inside the body (fluid retention). Take necessary precautions while using Celecoxib in such patients.
Patients with high blood pressure
Patients taking thiazide or loop diuretics
are at an increased risk to experience any damaging response when taking Celecoxib. The use of Celecoxib in such patients can lead to the development of high blood pressure or may worsen the existing high blood pressure both of which may increase the incidence of heart diseases. Proper care and monitoring of the blood pressure should be considered while initiating and undergoing the treatment with Celecoxib in such patients.
Blood clot inside a blood vessel of the heart
With the long-term use of Celecoxib, there is an increased risk of formation of a blood clot inside the blood vessel of the heart (severe heart related thrombotic events), heart attack and brain damage, which may be fatal. Patients should be advised for lowering the useful doses of Celecoxib for the shortest duration with the intention of individual patient therapy.
Blood related disorders
Patients on long-term treatment with Celecoxib may exhibit the signs or symptoms of insufficient production of red blood cells (anemia
) or blood loss conditions.
Blood clot formation throughout the body (disseminated intravascular coagulation)
Patients with an age group of 16 or older are at an increased risk when using this medicine. Celecoxib should only be used with caution in children with systemic onset of inflammation of the joints (rheumatoid arthritis
) due to the risk of blood clot formation throughout the body (disseminated intravascular coagulation).
Existing condition of narrowing of the airways of lungs (asthma)
Patients with the existing condition of asthma
who are undergoing treatment with Celecoxib are at an increased risk when using this medicine. The use of aspirin in patients with aspirin-sensitive asthma may lead to the severe condition of tightening of the muscles of the lungs (bronchospasm), which can be fatal. Celecoxib should not be used in patients with this form of aspirin sensitivity.
Due to the severe risk of stomach and intestinal ulcerations and bleeding
without any warning symptoms, the doctor should monitor for the signs and symptoms of stomach and intestinal bleeding. Patients who are on long-term treatment with NSAIDs
should undergo complete blood count, and a chemistry profile checked regularly. If abnormal liver tests or kidney tests continue or worsens, the use of Celecoxib should be discontinued.
Inherited disorder which is characterized by cancer of the large intestine and rectum (stomach and intestinal cancer in familial adenomatous polyposis)
Treatment with Celecoxib has not been shown to diminish the risk of stomach and intestinal cancer
or the need for a surgical procedure as a preventive
measure or other related surgeries. Therefore, the care of such patients should not be changed because of the usage of Celecoxib. In particular, the frequency of routine endoscopic
examination should not be reduced, and surgery
as a preventive measure or other related surgeries should not be delayed.