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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 time.in the GI (gastrointestinal) tract which includes the esophagus.leading into the stomach.the stomach.and the intestines.so 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 market.as they caused heart problems. Celebrex (celecoxib) is a COX-2 inhibitor that is still on the market and is considered safe.as 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
Liver problemsnauseaupper stomach painitchingtired feelingflu-like symptomsloss of appetitedark urineclay-colored stoolsjaundiceyellowing of the skin or eyes
The following adverse reactions are discussed in greater detail in other sections of the labeling:
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.
New or worse high blood pressure heart failure liver problems including liver failure kidney problems including kidney failure low red blood cellsanemialife-threatening skin reactions life-threatening allergic reactions.
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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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Of the total number of patients who received CELEBREX in pre-approval clinical trialsmore than 3,300 were 65-74 years of agewhile approximately 1,300 additional patients were 75 years and overNo substantial differences in effectiveness were observed between these subjects and younger subjectsIn clinical studies comparing renal function as measured by the GFRBUN and creatinineand platelet function as measured by bleeding time and platelet aggregationthe results were not different between elderly and young volunteersHoweveras with other NSAIDsincluding those that selectively inhibit COX-2there have been more spontaneous post-marketing reports of fatal GI events and acute renal failure in the elderly than in younger patientssee WARNINGS AND PRECAUTIONS
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.
Advise patients to report symptoms of ulcerations and bleedingincluding epigastric paindyspepsiamelenaand hematemesis to their health care providerIn the setting of concomitant use of low-dose aspirin for cardiac prophylaxisinform patients of the increased risk for and the signs and symptoms of GI bleedingsee WARNINGS AND PRECAUTIONS
Cardiovascular safety outcomes were also evaluated in the CLASS trialKaplan-Meier cumulative rates for investigator-reported serious cardiovascular thromboembolic adverse eventsincluding MIpulmonary embolismdeep venous thrombosisunstable anginatransient ischemic attacksand ischemic cerebrovascular accidentsdemonstrated no differences between the CELEBREXdiclofenacor ibuprofen treatment groupsThe cumulative rates in all patients at nine months for CELEBREXdiclofenacand ibuprofen were 1.21.4and 1.1respectivelyThe cumulative rates in non-ASA users at nine months in each of the three treatment groups were less than 1The cumulative rates for myocardial infarction in non-ASA users at nine months in each of the three treatment groups were less than 0.2There was no placebo group in the CLASS trialwhich limits the ability to determine whether the three drugs tested had no increased risk of CV events or if they all increased the risk to a similar degree.
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