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A. Cortisone (prednisone) is a corticosteroid.used to reduce pain caused from inflammation and swelling.and Celebrex (celecoxib) is a COX-2 (cyclooxygenase-2) inhibitor.and also reduces pain from inflammation and swelling.but is not as strong as a steroid.while Lortab/Vicodin (hydrocodone+acetaminophen) just «masks» the pain by blocking the pain signal from reaching the brain. Only your doctor can determine if you need surgery.but these medications will probably not keep the tendon on the bone.unless the problem is from inflammation. Celebrex (celecoxib) was created because NSAIDs (non-steroidal anti-inflammatory drugs).such as Motrin/Advil (ibuprofen) or Aleve (naproxen).which were invented first.can cause bleeding.over the GI (gastrointestinal) tract which includes the esophagus.leading into the stomach.the stomach.and the if you have a history of ulcers or GI bleeding.NSAIDs may not be the right pain relievers for you. An alternative is Tylenol (acetaminophen).as it works differently.but it does not reduce inflammation. NSAIDs work by reducing the effects of prostaglandins.which cause inflammation.pain.and fever in the body. Two enzymes.cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2) make the prostaglandins work. COX-1 makes prostaglandins that support platelets and protect the stomach lining. When they are blocked.the platelets cannot cause the blood to clot as easily. Cox-2 makes the prostaglandins that cause inflammation.swelling.and as a result.pain. Of the NSAIDs.Mobic (meloxicam) is thought to go down the COX-1 pathway less than cheapest generic celebrex of the NSAIDs. Scientists were able to make COX-2 inhibitors.which did not go down the COX-1 pathway much.but most of them (Vioxx.Bextra.etc.) were removed from the they caused heart problems. Celebrex (celecoxib) is a COX-2 inhibitor that is still on the market and is considered long as the person taking it does not have any past heart problems or risk factors for them. Patti Brown.PharmD.

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Advise patients to be alert for the symptoms of cardiovascular thrombotic eventsincluding chest painshortness of breathweaknessor slurring of speechand to report any of these symptoms to their health care provider immediatelysee WARNINGS AND PRECAUTIONS

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Known hypersensitivitye.ganaphylactic reactions and serious skin reactionsto celecoxibany components of the drug productsee WARNINGS AND PRECAUTIONSHistory of asthmaurticariaor other allergic-type reactions after taking aspirin or other NSAIDsSeveresometimes fatalanaphylactic reactions to NSAIDshave been reported in such patientssee WARNINGS AND PRECAUTIONSIn the setting of coronary artery bypass graftCABGsurgerysee WARNINGS AND PRECAUTIONSIn patients who have demonstrated allergic-type reactions to sulfonamides.

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Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusionIn these patientsadministration of an NSAID may cause a dose-dependent reduction in prostaglandin formation andsecondarilyin renal blood flowwhich may precipitate overt renal decompensationPatients at greatest risk of this reaction are those with impaired renal functiondehydrationhypovolemiaheart failureliver dysfunctionthose taking diureticsACE-inhibitors or the ARBsand the elderlyDiscontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.

In a cross-study comparisoncelecoxib AUC was approximately 40lower in patients with chronic renal insufficiencyGFR 35-60 mL/minthan that seen in subjects with normal renal functionNo significant relationship was found between GFR and celecoxib clearancePatients with severe renal insufficiency have not been studiedSimilar to other NSAIDsCELEBREX is not recommended in patients with severe renal insufficiencysee WARNINGS AND PRECAUTIONS

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200 mg PO once daily or divided q12hrif no effect after 6 weeksmay increase to 400 mg/dayif no adequate resonse observed after 6 weeks of taking 400 mg/day consider discontinuing therapy.

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