Celecoxib is an anti-inflammatory painkiller used for arthritis, back pain and acute pain. It is a COX-2 selective NSAID, designed to be gentler on the stomach than ibuprofen or diclofenac — which it is. It comes as 100 mg and 200 mg capsules.

What is Celecoxib?

The South African Medicine Price Registry lists celecoxib under several names, all Schedule 3:

Product	Form	Strength
Celebrex	Capsule	Celecoxib 200 mg
Celecoxib 100 mg LHC, Celexii 100, Novabrex 100	Capsule	Celecoxib 100 mg
Celexii 200, Novabrex 200	Capsule	Celecoxib 200 mg

Celecoxib is a COX-2 selective inhibitor, and understanding that requires a short detour into how ordinary anti-inflammatories work.

NSAIDs block cyclo-oxygenase enzymes, which produce prostaglandins. There are two main forms:

COX-1 is present constantly in normal tissue. Its prostaglandins protect the stomach lining, support kidney blood flow, and help platelets clot.

COX-2 is produced mainly at sites of inflammation, and drives pain and swelling.

Ordinary NSAIDs such as ibuprofen and diclofenac block both. Blocking COX-2 relieves the pain; blocking COX-1 causes the stomach damage.

Celecoxib blocks COX-2 while largely sparing COX-1. The result is real and measurable: significantly fewer stomach ulcers and less gastrointestinal bleeding than with traditional NSAIDs. It also does not affect platelets in the way other NSAIDs do, so it does not increase bleeding around surgery — which is why surgeons and dentists sometimes prefer it.

That is the advantage. It is not the whole story, and the rest of it matters.

What is Celecoxib commonly used for?

Osteoarthritis — one of its main uses, for pain and stiffness.
Rheumatoid arthritis.
Ankylosing spondylitis and other inflammatory spinal conditions.
Acute pain, including after surgery and dental procedures.
Period pain (dysmenorrhoea).
Back and musculoskeletal pain, short-term.
Gout flares, in some prescribing.

It is chosen over an ordinary NSAID mainly when stomach risk is the concern — someone with a history of ulcers or gastritis, someone older, someone who has had trouble with ibuprofen or diclofenac, or someone who needs an anti-inflammatory around surgery where bleeding matters.

What celecoxib does not avoid is cardiovascular risk. This is the point most often misunderstood. COX-2 inhibitors as a class carry an increased risk of heart attack and stroke, particularly at higher doses and with longer use — a concern that emerged when rofecoxib (Vioxx) was withdrawn worldwide in 2004. Celecoxib remains registered and in wide use, and large trials have since found its cardiovascular risk broadly comparable to that of ibuprofen and diclofenac. But comparable is not zero, and it is a real consideration in anyone with heart disease.

The practical summary: celecoxib trades stomach protection for no reduction in cardiovascular risk. That trade is worth making for the right person, and it should be a deliberate decision rather than a default.

Use the lowest dose for the shortest time, as with every NSAID.

How Celecoxib fits into this medicine category

Group	Examples	Notes
COX-2 selective	Celecoxib, etoricoxib	Fewer stomach problems; cardiovascular caution
Traditional NSAIDs	Ibuprofen, diclofenac, naproxen	Effective; stomach, kidney and heart cautions
Simple analgesics	Paracetamol (Donapan)	Gentlest; no anti-inflammatory effect
Corticosteroids	Prednisone	Powerful anti-inflammatory, given as courses
Topical NSAIDs	Diclofenac gel	Localised joint pain; far lower body-wide exposure
Disease-modifying drugs	Methotrexate, biologics	Control the underlying disease in inflammatory arthritis

For a single painful joint, a topical NSAID often achieves as much with far less systemic exposure. For inflammatory arthritis, NSAIDs relieve symptoms while disease-modifying treatment does the real work. See the pain, inflammation and musculoskeletal medicines hub.

What to check before using Celecoxib

Do not take it if you are allergic to sulphonamides. Celecoxib contains a sulphonamide group, and this is a specific contraindication that does not apply to other NSAIDs.

Also tell your doctor or pharmacist if you:

Have heart disease, heart failure, high blood pressure, or a history of heart attack or stroke. Celecoxib is avoided in established cardiovascular disease.
Have had coronary bypass surgery — NSAIDs including celecoxib should not be used for pain around it.
Have kidney or liver disease.
Have had a stomach ulcer or bleeding, or take aspirin. Note that taking low-dose aspirin alongside celecoxib removes much of its stomach advantage.
Have asthma, particularly if aspirin or NSAIDs have triggered symptoms before.
Have inflammatory bowel disease.
Take warfarin, fluconazole, lithium, ACE inhibitors or ARBs, diuretics, or SSRIs.
Are pregnant. NSAIDs are avoided, particularly from 20 weeks. Tell your doctor if you are trying to conceive, as NSAIDs can interfere with ovulation.
Are breastfeeding, or over 65.

Practical points: take it with food if it causes stomach upset; use the lowest effective dose for the shortest period; do not combine it with another NSAID; and stay well hydrated, since dehydration plus an NSAID is hard on the kidneys.

Possible cautions and when to ask a pharmacist or doctor

Common effects are indigestion, abdominal pain, diarrhoea, nausea, headache, dizziness and swollen ankles. Fluid retention and a rise in blood pressure are recognised class effects.

Get emergency help for:

Chest pain, breathlessness, or pain spreading to the arm or jaw — possible heart attack.
Sudden weakness on one side, facial droop, slurred speech, or a severe unusual headache — possible stroke.
Vomiting blood, or material like coffee grounds.
Black, tarry stools, or severe stomach pain.
Sudden worsening of asthma or wheezing.
A rash with blistering or peeling, sores in the mouth or eyes, or a rash with fever — serious skin reactions are rare but are more of a concern with sulphonamide-containing medicines. Stop the medicine and seek help.
Swelling of the face, lips or tongue, or difficulty breathing.

Contact your doctor if:

You develop swollen ankles, weight gain, or breathlessness — possible fluid retention.
Your blood pressure rises.
You notice reduced urine output or unusual tiredness.
Pain is not controlled, or you are needing it long-term. Ongoing pain deserves a plan rather than an indefinite prescription.
You develop yellowing of the skin or eyes.
You are due for surgery, so it can be considered in advance.

Related medicine guides

Frequently asked questions

What is celecoxib used for? Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain including after surgery, period pain and back pain.

How is it different from ibuprofen? It blocks COX-2 selectively, so it causes significantly fewer stomach ulcers and less gastrointestinal bleeding. It does not reduce cardiovascular risk.

Is it safer than other anti-inflammatories? Safer for the stomach, yes. Not safer for the heart — COX-2 inhibitors carry cardiovascular risk broadly comparable to traditional NSAIDs.

Can I take it if I have heart disease? Generally not. Tell your doctor — celecoxib is avoided in established cardiovascular disease and after bypass surgery.

Can I take it if I am allergic to sulfa drugs? No. Celecoxib contains a sulphonamide group and is contraindicated in sulphonamide allergy.

Can I take aspirin with it? Only if your doctor has said so. Low-dose aspirin removes much of celecoxib’s stomach advantage.

Can I take it with ibuprofen? No. Do not combine two anti-inflammatories — it raises the risks without adding benefit.

How long can I take it for? The lowest dose for the shortest time that controls symptoms. Long-term use should be reviewed regularly by a doctor.

What Is Celecoxib Used For?