API: Celecoxib

What Is Celecoxib and How Does It Work?

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic, and antipyretic properties. It is commonly used to treat acute pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, and painful menstruation. Celecoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, which catalyzes the formation of prostaglandin precursors from arachidonic acid. Prostaglandins are lipid compounds that mediate inflammation, fever, and pain perception, so the drug reduces these symptoms.1 Unlike most other NSAIDs, celecoxib does not inhibit the COX-1 enzyme, which catalyzes the production of prostaglandins involved in gastrointestinal tract protection and kidney hemodynamics. As a result, celecoxib has fewer gastrointestinal and renal side effects. Celecoxib also has anti-cancer properties and can be used to reduce colon polyps in patients with familial adenomatous polyposis.2


  • Arthritis: Celecoxib is used to treat pain and inflammation from osteoarthritis and rheumatoid arthritis in adults. It has also been approved to treat juvenile rheumatoid arthritis in patients two years or older.
  • Painful Menstruation: The drug provides relief for painful menstrual symptoms, such as severe cramps.
  • Ankylosing Spondylitis: Celecoxib can reduce pain and inflammation from ankylosing spondylitis.
  • Acute Pain: The drug can help treat general acute pain in adults.
  • Familial Adenomatous Polyposis (FAP): FAP is a hereditary disease in which patients develop colon polyps that eventually become malignant. The only cure for FAP is to remove the entire colon, but celecoxib can be used as a secondary treatment because its anticancer effects help reduce the size and number of colon polyps

Side Effects and Drug Interactions

Common side effects of celecoxib include4:

  • Abdominal pain
  • Diarrhea
  • Heartburn or indigestion
  • Gas
  • Headache
  • Back pain
  • Trouble sleeping
  • Sore throat
  • Nasal congestion

Patients should contact a doctor immediately if they experience the following severe side effects:

  • Cough
  • Fever
  • Skin rash
  • Swelling of the face, fingers, feet, or lower legs
  • Sneezing

Although celecoxib is widely believed to be less damaging to the gastrointestinal tract than other NSAIDs, patients are still warned that taking the drug may cause intestinal bleeding or stomach ulcers. Celecoxib also puts patients at greater risk for heart attack and stroke than other NSAIDs. Patients who are allergic to sulfonamides or other NSAIDs should not take celecoxib.5

Celecoxib may interact with ACE inhibitors, angiotensin II receptor blockers, diuretics, aliskiren, cidofovir, and lithium. When taken alongside anti-platelet drugs or blood thinners, celecoxib may increase the risk of bleeding. Taking celecoxib in conjunction with other NSAIDs can increase the risk of side effects, but it is safe for patients to take celecoxib while they are taking low-dose aspirin to prevent heart attack or stroke.6

Latest News and Research

After the COX-2 enzyme was discovered in 1988, Celecoxib was developed by G.D. Searle & Company and Pfizer under the trade name Celebrex. It received FDA approval on December 31, 1998. The first generic versions of celecoxib were approved in 2014.7

In 2004, celecoxib was the subject of a federal patent dispute, University of Rochester v. GD. Searle & Co. The University of Rochester claimed that celecoxib was subject to the patent it had filed on a method for inhibiting COX-2. The court ruled in favor of Searle and declared the patent invalid, since the patent described only the method and not the inhibitory compound.8  

Celecoxib has also been the subject of ongoing federal investigations about safety and efficacy claims made by Pfizer and Pharmacia, the companies that market Celebrex. In 2001, it was revealed that the companies’ claim that Celebrex was better at protecting the stomach than other NSAIDS was based on results from only the first six months of a year-long study. Then, in 2009, an executive at Baystate Medical Center revealed that he had fabricated data in twenty-one studies he had authored on the efficacy of Celebrex. These papers exaggerated the analgesic effects of the drug.9 In 2012, a federal judge released thousands of documents relating to the overall securities fraud case against Pfizer. Despite these legal controversies, Celebrex has continued to enjoy commercial success: it is one of Pfizer’s best-selling drugs, prescribed for over 2.4 million people in 2011.10

Recent studies have probed the efficacy of celecoxib for treating and preventing cancer. Although the drug is currently only approved as a secondary treatment for FAP, studies show that the drug has anti-tumor activity in a wide range of epithelial cancers, including colorectal, breast, prostate, and non-small cell lung cancer.11 There is also growing evidence that celecoxib can improve symptoms in patients with psychiatric disorders, including major depressive disorder12 and bipolar disorder.13

Buying Guide

Many compound pharmacists prefer Meloxicam, another NSAID that is selective for COX-2. Other NSAIDs that treat some of the same conditions as Celecoxib include Diclofenac Sodium, Flurbiprofen, Ketoprofen, and Piroxicam. Please find more information about our Bulk APIs here

Show 13 footnotes

  1. “COX-1 and COX-2 Inhibitors,” October 2001, http://www.ncbi.nlm.nih.gov/pubmed/11566042
  2. “Celecoxib,” 2016, https://pubchem.ncbi.nlm.nih.gov/compound/celecoxib
  3. “Celecoxib,” September 18,2015, http://www.medicinenet.com/celecoxib/page2.htm
  4. “Celecoxib Side Effects,” May 30, 2016, https://www.drugs.com/sfx/celecoxib-side-effects.html
  5. “Non-Steroidal Anti-Inflammatory Drugs Comparison,” April 1, 2016, http://www.emedexpert.com/compare/nsaids.shtml
  6. “Celebrex,” 2016, http://www.webmd.com/drugs/2/drug-16849/celebrex-oral/details#
  7. “FDA approves first generic versions of celecoxib,” May 30, 2014, http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm399428.htm
  8. “A Patent Is Not a Hunting License Written Description Must Show Possession of Claimed Invention,” February 13, 2004, http://www.finnegan.com/publications/federalcircuit/FCCDetail.aspx?pub=9b02fb7f-116a-4dbb-b0e9-8ff2a7c2d345
  9. “Doctor’s Pain Studies Were Fabricated, Hospital Says,” March 10, 2009, http://www.nytimes.com/2009/03/11/health/research/11pain.html?ref=us&_r=0
  10. “In Documents on Pain Drug, Signs of Doubt and Deception,” June 24, 2012, http://www.nytimes.com/2012/06/25/health/in-documents-on-pain-drug-celebrex-signs-of-doubt-and-deception.html
  11. “Targeting apoptosis pathways by Celecoxib in cancer,” May 28, 2013, http://www.ncbi.nlm.nih.gov/pubmed/21345578
  12. “Efficacy of adjunctive celecoxib treatment for patients with major depressive disorder: a meta-analysis,” April 3, 2016, http://www.ncbi.nlm.nih.gov/pubmed/24056287
  13. “Celecoxib adjunctive therapy for acute bipolar mania: a randomized, double-blind, placebo-controlled trial,” September 2015, http://www.ncbi.nlm.nih.gov/pubmed/24056287