CELECOXIB

Nonsteroidal anti-inflammatory drugs (including celecoxib) may rarely increase the risk of a heart attack or stroke.

Also, this drug may infrequently cause serious (rarely fatal) bleeding from the stomach or intestines.

Tell your doctor or pharmacist promptly if stomach upset or gas persists or worsens.

This medication may raise your blood pressure.

Tell your doctor right away if you have any serious side effects, including:

• severe headache
• unexplained weight gain
• swelling of the hands or feet
• pain/swelling/warmth in the groin/calf
• change in amount of urine
• difficult/painful swallowing
• unusual tiredness

Stop taking celecoxib and get medical help right away if you notice any of the following rare but serious side effects:

• bloody or black/tarry stools
• persistent stomach/abdominal pain
• vomit that looks like coffee grounds
• chest/jaw/left arm pain
• shortness of breath
• unusual sweating
• weakness on one side of the body
• sudden vision changes
• slurred speech

This drug may rarely cause serious (possibly fatal) liver disease

A very serious allergic reaction to this drug is rare.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

Precautions

Consult your doctor regarding these precautions:

• Allergic reaction to this medication.
• Patients with medical history, especially of:

1. asthma (including a history of worsening breathing after taking aspirin or other NSAIDs)
2. liver disease
3. stomach/intestine/esophagus problems (such as bleeding, ulcers, recurring heartburn)
4. heart disease (such as angina, heart attack)
5. high blood pressure
6. stroke
7. blood disorders (such as anemia, bleeding/clotting problems)
8. growths in the nose (nasal polyps)

• Kidney problems are more likely to occur if you are:

1. Dehydrated
2. have heart failure or kidney disease
3. an older adult
4. if you take certain medications (see also Drug Interactions section)

• Limit alcohol and smoking.
• Tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products) before having surgery.
• Older adults may be more sensitive to stomach bleeding and kidney problems.
• Caution is advised when using this drug for children with a certain type of arthritis (systemic onset juvenile rheumatoid arthritis).
• This medication should be used only when clearly needed during pregnancy.
• Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions.

Some products that may interact with this drug include:

• Aliskiren
• ACE inhibitors (such as captopril, lisinopril)
• angiotensin II receptor blockers (such as valsartan, losartan)
• cidofovir
• lithium
• “water pills” (diuretics such as furosemide)

This medication may increase the risk of bleeding when taken with anti-platelet drugs such as clopidogrel and “blood thinners” such as dabigatran/enoxaparin/warfarin.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as naproxen or ibuprofen). These drugs are similar to celecoxib and may increase your risk of side effects if taken together.

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. Symptoms of overdose may include severe stomach pain, coffee ground-like vomit, change in amount of urine, slow or shallow breathing, severe headache, or loss of consciousness.

Notes

Do not share this medication with others.

Laboratory and/or medical tests (such as blood pressure, complete blood count, liver and kidney function tests) may be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Non-drug treatment for arthritis that is approved by your doctor (such as weight loss if needed, strengthening and conditioning exercises) may help improve your flexibility, range of motion, and joint function. Consult your doctor for specific instructions.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

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