Several studies or scientific reviews have been performed in the area
of COX 2
inhibitors and heart disease, including some preventive qualities of
(1-11). There is some evidence that Celebrex and Vioxx increase the
heart disease. (12).
I took Celecoxib (Celebrex) for seven years for the pain of lumbar
stenosis. That disease causes back and leg pain.
seemed to help a lot, causing me to
suffer less pain. But, as a COX-2 inhibitor it may have put me at risk
heart disease. Indeed, six years ago I was diagnosed with 90% clogging
coronary arteries and 70-80% clogging in two other coronary arteries. I
know if this is coincidental or if the coronary arteries being clogged
somehow caused by my taking Celebrex.
I finally decided to stop taking celecoxib (Celebrex) after
all the negative publicity about Vioxx (also a COX-2 inhibitor) ensued.
called the nurse of my cardiologist (I do not get to speak to the
directly, as most people probably find if they try to communicate with
doctor). I got the answering machine and I asked about the wisdom of
vs. discontinuing Celebrex. She never returned my call. I called the
whoever it was who worked in the doctor's office; it might not have
been a nurse)
of my regular doctor, and this “nurse” incorrectly informed me that
was taken off the market and I should stop taking it immediately. I
her that she was thinking of Vioxx which had just been taken off the
but she wrongly insisted that she was correct.
SEEKING ADDITIONAL HELP
Unable to find out locally what I should do, I sought advice from my
Yale University Ph.D. in medical sociology, who works for a large HMO
Maintenance Organization) in another state. He asked some doctors there
said I should not take Celebrex for more than a year, due to possible
damage. I had already taken it for seven years. I quit immediately. For
weeks I felt more pain than I should, but after that my pain went away.
get back and leg pain, especially if I walk to any great extent or bend
But, after initially helping a lot, Celebrex was apparently no longer
much for me in everyday matters, and things seemed to work out well
when I stopped
CONCERNS ABOUT VIOXX AND CELEBREX
An excellent summary of information regarding concerns about
Celebrex and related drugs can be found in Bennett et al. (13).
Bennett et al. said
“Recent clinical trial data have raised questions about the
degree to which patients and their physicians should consider an
of cardiovascular or cerebrovascular events when selecting medications
relief. In September 2004, Merck announced a voluntary worldwide
Vioxx (rofecoxib) because of an increased risk of heart attack and
early December 2004, the US Food and Drug Administration (FDA)
announced a "black
box" warning for Bextra (valdecoxib), stating that its use in patients
undergoing coronary artery bypass grafting is contraindicated. A week
the National Institutes of Health suspended the use of Celebrex
the APC (Adenoma Prevention with Celecoxib) clinical trial because of
cardiovascular events. The drug was not removed from the market, but
advised physicians to consider alternate therapy or to use the smallest
effective dose of Celebrex. Three days later, the National Institutes
announced that the ADAPT (Alzheimer’s Disease Anti-inflammatory
showed an increase in the risk of cardiovascular events in patients
naproxen but not in those given celecoxib; the trial was halted. At the
2004, the FDA issued a Public Health Advisory summarizing the agency’s
recommendations concerning the use of the nonsteroidal
anti-inflammatory drug products
(NSAIDs) Vioxx, Bextra, Celebrex, and naproxen.” (13, p. 1713).
Thus, Celebrex was never removed from the market (contrary
to what the “nurse” told me) but the federal government did temporarily
its use in a clinical trial, because of concern about possible
of heart attack.
Presented below is information from the U.S. Food and Drug
Administration regarding Celebrex (14), which raised questions about
THE U. S.
FOOD AND DRUG ADMINISTRATION ALERT ON CELEBREX
Patient Information Sheet
Celecoxib (marketed as Celebrex)
This is a summary of the most important information about
Celebrex. For details, talk to your healthcare provider.
What is Celebrex?
Celebrex is used to:
relieve symptoms of osteoarthritis (the arthritis caused by
age-related “wear and tear” on bones and joints)
relieve symptoms of rheumatoid arthritis in adults
manage acute pain in adults (like the short term pain you
can get after a dental or surgical operation)
treat painful menstrual cycles
reduce the number of colon and rectum growths (colorectal
polyps) in patients with a disease called Familial Adenomatous
FAP is an inherited disease in which the rectum and colon are covered
polyps. Celebrex is used along with the usual care for FAP patients
surgery and exams of the rectum and colon.
Who Should Not Take Celebrex?
Do not take Celebrex if you:
have had an allergic-type reaction to sulfa medicines.
have had asthma, hives or allergic-type reactions after
taking aspirin or other NSAID (nonsteroidal anti-inflammatory drugs)
If you have asthma, you may have aspirin-sensitive asthma. If an
aspirin-sensitive asthmatic takes aspirin it can cause severe narrowing
airway (bronchospasm), and even death. Since this type of reaction also
occurred after taking NSAIDs Celebrex should not be given to
Some examples of NSAIDs are ibuprofen (Motrin, Advil),
naproxen (Naprosyn, Aleve), diclofenac (Voltaren, Cataflam), and
(Orudis). You can ask your doctor or pharmacist for a complete list of
are pregnant, especially during your last 3 months
What are The Risks?
Celebrex and other NSAID medicines can cause serious
problems such as:
Stomach ulcers that bleed. The chance of this serious
problem increases the longer you take Celebrex, but it can also happen
suddenly. Stop taking Celebrex and call your healthcare professional
if you get a burning stomach pain, black bowel movements that look like
vomit that looks like blood or coffee grounds.
Liver damage. Some of the warning signs of liver damage are
nausea, vomiting, tiredness, loss of appetite, itching, yellow coloring
or eyes, “flu-like” symptoms and dark urine. If this happens, stop
Celebrex and call your healthcare professional right away.
Kidney problems that include sudden kidney failure or
worsening of kidney problems that you already have.
Fluid retention (holding of water in your body) and
swelling. Fluid retention can be a serious problem if you have high
pressure or heart failure.
In addition to the serious side effects listed above, some
common, but less serious side effects with Celebrex may include:
upper respiratory tract infection (a "cold")
What Should I Tell My Healthcare Professional?
Tell your healthcare professional if you:
have heart problems or high blood pressure
have liver or kidney problems
have or had stomach ulcers or stomach bleeding
are allergic to aspirin or other NSAID medicines
are trying to become pregnant, are already pregnant, or are
Are There Any Interactions With Drugs or Foods?
Tell your healthcare professional about all the medicines
you take, including prescription and non-prescription medicines,
herbal supplements. Some medicines may affect how Celebrex works or
may affect how your other medicines work. Your healthcare professional
to adjust your dose or watch you closely if you take any of the
certain blood pressure medicines called ACE inhibitors
fluconazole or ketoconazole
Celebrex FDA Approved 1998
Patient Information Sheet Revised 04/2005
Patient Information Sheet - Questions? Call Drug Information
Date created: April 7, 2005
In conclusion, there is no way to know for sure if Celebrex
led to my coronary artery disease or my current liver problems (see
I should have received warnings from doctors about that possibility and
should have been warned about not using Celebrex for more than one year
possible liver damage.
As a patient, I
may have been put at risk unnecessarily, for heart disease and for
More information from doctors
and nurses would have been appropriate and perhaps very beneficial.
I have lumbar spinal stenosis, which involves a wearing away
of the protective covering of the spinal cord.
Spinal cord problems can be associated with psychological
well, as recently shown by Craig, Tran, Lovas, and Middleton (15). And
lead to loss of intimacy, as shown by Bral, Shaughnessy and Eisenman
Celebrex helped ease some of the pain associated with lumbar spinal
But, the threat of heart
disease made me give it up, after seven years usage.
I also have heart
disease (specifically, coronary artery disease) although the blockage
less than when originally diagnosed.
However, the medical tests done on me in recent years do not
cardiologist to say exactly how much less blockage there is.
Probably, quite a bit of blockage remains.
Heart disease can also lead to psychological problems, as well as the
medical ones. Thus, I have suffered from physical and, likely,
problems due to limitations on what I can do, imposed by my conditions.
And, some of my problems may have been caused
by medicine intended to help me.
fact, I just recently had a Hida Scan to evaluate my liver, and it is
My family doctor suggested
that I either have my liver taken out or avoid dairy, fatty, and greasy
I am opting for the latter.
I previously wrote of some my experiences with physical
This current article
takes the discussion of illness further, to consider other diseases and
consider if Celebrex is potentially harmful.
Not all treatment will be ideal, and often patients will receive
than should be the case (18).