Patient leaflet - Celebrex 100 mg capsules hard
1. What Celebrex is and what it is used for
Celebrex belongs to a group of medicines called nonsteroidal anti-inflammatory drugs (NSAID), and specifically a sub-group known as cyclooxygenase-2 (COX-2) inhibitors. Your body makes prostaglandins that may cause pain and inflammation. In conditions such as rheumatoid arthritis and osteoarthritis your body
makes more of these. Celebrex acts by reducing the production of prostaglandins, thereby reducing the pain and inflammation.
Celebrex is used in adults for the relief of signs and symptoms of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis.
You should expect your medicine to start working within hours of taking the first dose, but you may not experience a full effect for several days.
2. What you need to know before you take Celebrex
You have been prescribed Celebrex by your doctor. The following information will help you get the best results with Celebrex. If you have any further questions please ask your doctor or pharmacist. Do not take Celebrex
Tell your doctor if any of the following are true for you as patients with these conditions should not take Celebrex.
if you are allergic to celecoxib or
any of the other ingredients of this medicine (listed in section 6)
if you have had an allergic reaction
to a group of medicines called “sulfonamides” (e.g. some antibiotics used to treat infections)
if you currently have an ulcer in your
stomach or intestines, or bleeding in your stomach or intestines
if as a result of taking acetylsalicylic
acid or any other anti-inflammatory and pain-relieving medicine (NSAID) you have had asthma, nose polyps, severe nose congestion, or an allergic reaction such as an itchy skin rash, swelling of the face, lips, tongue or throat, breathing difficulties or wheezing
if you are pregnant. If you can
become pregnant during ongoing
treatment you should discuss methods of contraception with your doctor
- if you are breast-feeding
- if you have severe liver disease
- if you have severe kidney disease
if you have an inflammatory disease
of the intestines such as ulcerative colitis or Crohn’s disease
if you have heart failure, established
ischaemic heart disease, or cerebrovascular disease, e.g. you have been diagnosed with a heart attack, stroke, or transient ischaemic attack (temporary reduction of blood flow to the brain; also known as “mini-stroke”), angina, or blockages of blood vessels to the heart or brain
if you have or have had problems
with your blood circulation
(peripheral arterial disease) or if you have had surgery on the arteries of your legs
Warnings and precautions
Talk to your doctor or pharmacist before taking Celebrex:
if you have previously had an ulcer
or bleeding in your stomach or intestines. (Do not take Celebrex if you currently have an ulcer or bleeding in your stomach or intestine)
if you are taking acetylsalicylic acid
(even at low dose for heart protective purposes)
if you are taking antiplatelet
therapies
if you use medicines to reduce blood
clotting (e.g. warfarin/warfarin like anticoagulants or novel oral anti-clotting medicines, e.g. apixaban)
if you use medicines called
corticosteroids (e.g. prednisone)
if you are using Celebrex at the same
time as other non-acetylsalicylic NSAIDs such as ibuprofen or
diclofenac. The use of these medicines together should be avoided
if you smoke, have diabetes, raised
blood pressure or raised cholesterol
if your heart, liver or kidneys are not
working well your doctor may want to keep a regular check on you
if you have fluid retention (such as
swollen ankles and feet)
if you are dehydrated, for instance
due to sickness, diarrhoea or the use of diuretics (used to treat excess fluid in the body)
if you have had a serious allergic
reaction or a serious skin reaction to any medicines
if you feel ill due to an infection
or think you have an infection, as Celebrex may mask a fever or other signs of infection and inflammation
if you are over 65 years of age your
doctor will want to monitor you regularly
the consumption of alcohol and
NSAIDs may increase the risk of gastrointestinal problems
As with other NSAIDs (e.g. ibuprofen or diclofenac) this medicine may lead to an increase in blood pressure, and so your doctor may ask to monitor your blood pressure on a regular basis. Some cases of severe liver reactions, including severe liver inflammation, liver damage, liver failure (some with fatal outcome or requiring liver transplant), have been reported with celecoxib. Of the cases that reported time to onset, most severe liver reactions occurred within one month of start of treatment. Serious skin reactions have been reported in association with Celebrex treatment. Stop using Celebrex and seek medical attention immediately if you notice any of the symptoms of serious skin reactions described in section 4, Possible side effects.
Celebrex may make it more difficult to become pregnant. You should inform your doctor if you are planning to become pregnant or if you have problems to become pregnant (see section on Pregnancy and breast-feeding). Other medicines and Celebrex
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines:
Dextromethorphan (used to treat
coughs)
ACE inhibitors, angiotensin II
antagonists, beta blockers and diuretics (used for high blood pressure and heart failure)
Fluconazole and rifampicin (used to
treat fungal and bacterial infections)
Warfarin or other warfarin like
medicines (“blood-thinning” agents that reduce blood clotting) including newer medicines like apixaban
Lithium (used to treat some types of
depression)
Other medicines to treat depression,
sleep disorders, high blood pressure or an irregular heartbeat
Neuroleptics (used to treat some
mental disorders)
Methotrexate (used to treat rheumatoid
arthritis, psoriasis and leukaemia)
Carbamazepine (used to treat
epilepsy/seizures and some forms of pain or depression)
Barbiturates (used to treat epilepsy/
seizures and some sleep disorders)
Ciclosporin and tacrolimus (used for
immune system suppression e.g. after transplants)
Celebrex can be taken with low dose acetylsalicylic acid (75 mg or less daily). Ask your doctor for advice before taking both medicines together. Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are
planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Pregnancy
Celebrex must not be used by women who are pregnant or can become pregnant (i.e. women of child bearing potential who are not using adequate contraception) during ongoing treatment. If you become pregnant during treatment with Celebrex you should discontinue the treatment and contact your doctor for alternative treatment.
Breast-feeding
Celebrex must not be used during breast-feeding.
Fertility
NSAIDs, including Celebrex, may make it more difficult to become pregnant. You should tell your doctor if you are planning to become pregnant or if you have problems becoming pregnant. Driving and using machines
You should be aware of how you react to Celebrex before you drive or operate machinery. If you feel dizzy or drowsy after taking Celebrex, do not drive or operate machinery until these effects wear off.
Celebrex contains lactose
Celebrex contains lactose (a type of sugar). If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. Celebrex contains sodium
This medicine contains less than 1 mmol sodium (23 mg) per capsule, that is to say essentially ‘sodium-free’.
3. How to take Celebrex
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. If you think or feel that
the effect of Celebrex is too strong or too weak, talk to your doctor or pharmacist. Your doctor will tell you what dose you should take. As the risk of side effects associated with heart problems may increase with dose and duration of use, it is important that you use the lowest dose that controls your pain and you should not take Celebrex for longer than necessary to control symptoms. Method of administration
Celebrex is for oral use. The capsules can be taken at any time of the day, with or without food. However, try to take each dose of Celebrex at the same time each day.
If you have difficulty swallowing capsules: The entire capsule contents can be sprinkled onto a level teaspoon of semi-solid food (such as cool or room temperature applesauce, rice gruel, yogurt or mashed banana) and swallowed immediately with a drink approximately 240 ml of water. To open the capsule, hold upright to contain the granules at the bottom then gently squeeze the top and twist to remove, taking care not to spill the contents. Do not chew or crush the granules.
Contact your doctor within two weeks of starting treatment if you do not experience any benefit.
The recommended dose is
For osteoarthritis the recommended dose is 200 mg each day, increased by your doctor to a maximum of 400 mg, if needed.
The dose is usually:
one 200 mg capsule once a day; or one 100 mg capsule twice a day. For rheumatoid arthritis the
recommended dose is 200 mg each day, increased by your doctor to a maximum of 400 mg, if needed.
The dose is usually:
one 100 mg capsule twice a day. For ankylosing spondylitis the recommended dose is 200 mg each day, increased by your doctor to a maximum of 400 mg, if needed. The dose is usually:
one 200 mg capsule once a day; or one 100 mg capsule twice a day. Kidney or liver problems: make sure your doctor knows if you have liver or kidney problems as you may need a lower dose.
The elderly, especially those with a weight less than 50 kg: if you are over 65 years of age and especially if you weigh less than 50 kg, your doctor may want to monitor you more closely. You should not take more than 400 mg per day.
Use in children
Celebrex is for adults only, it is not for use in children.
If you take more Celebrex than you should
You should not take more capsules than your doctor tells you to. If you take too many capsules contact your doctor, pharmacist or hospital and take your medicine with you.
If you forget to take Celebrex
If you forget to take a capsule, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose.
If you stop taking Celebrex
Suddenly stopping your treatment with Celebrex may lead to your symptoms getting worse. Do not stop taking Celebrex unless your doctor tells you to. Your doctor may tell you to reduce the dose over a few days before stopping completely.
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If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
The side effects listed below were observed in arthritis patients who took Celebrex. Side effects marked
with an asterisk (*) are listed below at the higher frequencies that occurred in patients who took Celebrex to
prevent colon polyps. Patients in these studies took Celebrex at high doses and for a long duration. If any of the following happen, stop
taking Celebrex and tell your doctor immediately:
If you have:
an allergic reaction such as skin
rash, swelling of the face, wheezing or difficulty breathing
heart problems such as pain in the
chest
severe stomach pain or any sign of
bleeding in the stomach or intestines, such as passing black or bloodstained stools, or vomiting blood
a skin reaction such as rash,
blistering or peeling of the skin
liver failure (symptoms may include
nausea (feeling sick), diarrhoea, jaundice (your skin or the whites of your eyes look yellow)).
Very common: may affect more than
1 in 10 people
High blood pressure, including
worsening of existing high blood pressure *
Common: may affect up to 1 in
10 people
Heart attack*
Fluid build up with swollen ankles,
legs and/or hands
- Urinary infections
Shortness of breath*, sinusitis
(sinus inflammation, sinus infection, blocked or painful sinuses), blocked or runny nose, sore throat, coughs, colds, flu-like symptoms
- Dizziness, difficulty sleeping
Vomiting*, stomach ache, diarrhoea,
indigestion, wind
- Rash, itching
- Muscle stiffness
- Difficulty swallowing*
- Headache
- Nausea (feeling sick)
- Painful joints
- Worsening of existing allergies
- Accidental injury
Uncommon: may affect up to 1 in
100 people
- Stroke*
Heart failure, palpitations (awareness
of heart beat), fast heart rate
Abnormalities in liver-related blood
tests
Abnormalities in kidney-related
blood tests
Anaemia (changes in red blood
cells that can cause fatigue and breathlessness)
Anxiety, depression, tiredness,
drowsiness, tingling sensations (pins and needles)
High levels of potassium in blood
test results (can cause nausea (feeling sick), fatigue, muscle weakness or palpitations)
Impaired or blurred vision, ringing
in the ears, mouth pain and sores, difficulty hearing*
Constipation, burping, stomach
inflammation (indigestion, stomach ache or vomiting), worsening of inflammation of the stomach or intestine
- Leg cramps
- Raised itchy rash (hives)
- Eye inflammation
- Difficulty breathing
- Skin discolouration (bruising)
Chest pain (generalised pain not
related to the heart)
- Face swelling
Rare: may affect up to 1 in
1,000 people
Ulcers (bleeding) in the stomach,
gullet or intestines; or rupture of the intestine (can cause stomach ache, fever, nausea, vomiting, intestinal blockage), dark or black stools, inflammation of the pancreas (can lead to stomach pain), inflammation of the gullet (oesophagus)
Low levels of sodium in the blood (a
condition known as hyponatraemia)
Reduced number of white blood
cells (which help to protect the body from infection) or blood platelets (increased chance of bleeding or bruising)
Difficulty coordinating muscular
movements
Feeling confused, changes in the
way things taste
- Increased sensitivity to light
- Loss of hair
- Hallucinations
- Bleeding in the eye
Acute reaction that may lead to lung
inflammation
- Irregular heartbeat
- Flushing
Blood clot in the blood vessels in
the lungs. Symptoms may include sudden breathlessness, sharp pains when you breathe or collapse
Bleeding of the stomach or
intestines (can lead to bloody stools or vomiting), inflammation of the intestine or colon
Severe liver inflammation (hepatitis).
Symptoms may include nausea (feeling sick), diarrhoea, jaundice
(yellow discolouration of the skin or eyes), dark urine, pale stools, bleeding easily, itching or chills
- Acute kidney failure
- Menstrual disturbances
Swelling of the face, lips, mouth,
tongue or throat, or difficulty swallowing
Very rare: may affect up to 1 in
10,000 people
Serious allergic reactions (including
potentially fatal anaphylactic shock)
Serious skin conditions such
as Stevens-Johnson syndrome, exfoliative dermatitis and toxic epidermal necrolysis (can cause rash, blistering or peeling of the skin) and acute generalised exanthematous pustulosis
(symptoms include the skin becoming red with swollen areas covered in numerous small pustules)
A delayed allergic reaction with
possible symptoms such as rash, swelling of the face, fever, swollen glands, and abnormal test results (e.g., liver, blood cell (eosinophilia, a type of raised white blood cell count))
Bleeding within the brain causing
death
Meningitis (inflammation of the
membrane around the brain and spinal cord)
Liver failure, liver damage and
severe liver inflammation (fulminant hepatitis) (sometimes fatal or requiring liver transplant). Symptoms may include nausea (feeling sick), diarrhoea, jaundice (yellow discolouration of the skin or eyes), dark urine, pale stools, bleeding easily, itching or chills
Liver problems (such as cholestasis
and cholestatic hepatitis, which may be accompanied by symptoms such
as discoloured stools, nausea and yellowing of the skin or eyes)
Inflammation of the kidneys and
other kidney problems (such as nephrotic syndrome and minimal change disease, which may be accompanied by symptoms such as water retention (oedema), foamy urine, fatigue and a loss of appetite)
Worsening of epilepsy (possible
more frequent and/or severe seizures)
Blockage of an artery or vein in the
eye leading to partial or complete loss of vision
Inflamed blood vessels (can cause
fever, aches, purple blotches on the skin)
A reduction in the number of red
and white blood cells and platelets (may cause tiredness, easy bruising, frequent nose bleeds and increased risk of infections)
- Muscle pain and weakness
- Impaired sense of smell
- Loss of taste
Not known: frequency cannot be estimated from the available data
Decreased fertility in females,
which is usually reversible on discontinuation of the medicine
Other serious skin conditions such
as fixed drug eruption (a distinctive cutaneous allergic reaction that usually recurs at the same site(s) on re-exposure to the medication and may look like round or oval patches of redness and swelling of the skin, blistering (hives), itching) and generalised bullous fixed drug eruption (can involve widespread skin reactions)
In clinical studies not associated with arthritis or other arthritic conditions, where Celebrex was
taken at doses of 400 mg per day for up to 3 years, the following additional side effects have been observed: Common: may affect up to 1 in
10 people
- Heart problems: angina (chest pain)
Stomach problems: irritable bowel
syndrome (can include stomach ache, diarrhoea, indigestion, wind)
Kidney stones (which may lead to
stomach or back pain, blood in urine), difficulty passing urine
- Weight gain
Uncommon: may affect up to 1 in
100 people
Deep vein thrombosis (blood clot
usually in the leg, which may cause pain, swelling or redness of the calf or breathing problems)
Stomach problems: stomach
infection (which can cause irritation and ulcers of the stomach and intestines)
- Lower limb fracture
Shingles, skin infection, eczema
(dry itchy rash), pneumonia (chest infection (possible cough, fever, difficulty breathing))
Floaters in the eye causing blurred
or impaired vision, vertigo due to inner ear troubles, sore, inflamed or bleeding gums, mouth sores
Excessive urination at night,
bleeding from piles/ haemorrhoids, frequent bowel movements
Fatty lumps in skin or elsewhere,
ganglion cyst (harmless swellings on or around joints and tendons in the hand or foot), difficulty speaking, abnormal or very heavy bleeding from the vagina, breast pain
High levels of sodium in blood test
results
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes
any possible side effects not listed in this leaflet. You can also report side effects directly (see details below). By reporting side effects you can help provide more information on the safety of this medicine.
United Kingdom
Yellow Card Scheme website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
5. How to store Celebrex
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the blister and carton. The expiry date refers to the last day of that month. Do not store Celebrex above 30 oC. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6. Contents of the pack
and other information What Celebrex contains
The active substance is celecoxib.
Each capsule contains 100 mg or 200 mg celecoxib.
The other ingredients are Lactose
monohydrate, sodium laurilsulfate, povidone, croscarmellose sodium, magnesium stearate. Capsule shells contain gelatin, titanium dioxide E171, sodium laurilsulfate and sorbitan monolaurate. Printing ink contains shellac, propylene glycol, indigotine E132 (100 mg capsule), iron oxide E172 (200 mg capsule).
What Celebrex looks like and contents of the pack
Celebrex is available as capsules. Opaque, white with two blue bands marked 7767 and 100 (Celebrex 100 mg). Opaque, white with two gold bands marked 7767 and 200 (Celebrex 200 mg). The capsules are packaged in clear or opaque PVC/aluminium blisters. Celebrex is contained in packs of 2, 5, 6, 10, 20, 30, 40, 50, 60, 100, 10x10, 10x30, 10x50, 1x50 unit dose, 1x100 unit dose, 5x(10x10).
Not all pack sizes may be marketed. Marketing Authorisation Holder and
Manufacturer
Marketing Authorisation Holder United Kingdom
Viatris Products Limited,
Station Close,
Potters Bar,
EN6 1TL,
United Kingdom.
Manufacturer
Pfizer Manufacturing Deutschland GmbH
Mooswaldallee 1,
79108 Freiburg Im Breisgau
Germany or
Klocke Verpackungs-Service GmbH Max-Becker-Str. 6
76356 Weingarten (Baden)
Germany
This leaflet was last revised in
600103904 3989268
