Celebrex is a COX-2 Inhibitor, a specific subclass of a class of drugs called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), which works to treat pain and inflammation while sparing the enzymes that protect the gastrointestinal lining. Whereas Vioxx (Rofecoxib) and Bextra (Valdecoxib) were withdrawn from the market in 2004 and 2005 respectively, Celebrex and Metacam remain available to consumers suffering from the pain and inflammation of osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, severe menstrual pain, or other conditions as determined by specific physicians.

Both Celebrex and Metacam carry prominent FDA-required black box warnings regarding the risk of serious cardiovascular complications. Since the bans of Vioxx and Bextra, many successful lawsuits have been filed by patients who have suffered drastic side effects while taking these drugs. Thousands of Celebrex-related lawsuits have also been filed against Pfizer. Pfizer is settling Celebrex lawsuits individually, in contrast to Merck’s attempt to negotiate a massive settlement to cover Vioxx litigants. Pfizer attorneys report that the drug company expects to pay $500 million in settlements to consumers filing Celebrex lawsuits.

Vioxx (Rofecoxib)

Vioxx was the first release of the then-promising new class of drugs called “super-aspirins.” Merck spent over $80 million on advertising to promote Vioxx, hoping to rival sales of the almost simultaneous release of Celebrex by Pfizer. Vioxx was removed from the market in 2004 after several studies found an increased risk of heart attack and stroke associated with the drug, particularly after long-term use.

Since the removal of Vioxx from the market, thousands of lawsuits have been filed against Merck. The company made a mass settlement in 2007, in an attempt to wipe out the vast majority of the suits at once, but many lawsuits are still pending and more are expected to be filed.

Bextra (Valdecoxib)

Bextra, manufactured by G.D. Searle & Co., became available in 2001 and was prescribed, similarly to other NSAIDs, for the symptoms of osteoarthritis, rheumatoid arthritis, and painful menstruation. It was voluntarily removed from the market in 2005, after the ban of Vioxx caused widespread fear of the major cardiovascular side effects of COX-2 Inhibitors and the risks of Bextra were placed under intense scrutiny. Bextra’s withdrawal from the market was attributed not only to the increased risk of serious cardiovascular events, but to a rare but serious skin reaction associated with the drug.

Mobic (Metacam, Meloxicam)

Meloxicam is currently approved in the US, under the name Metacam, for the treatment of osteoarthritis. Though it is not generally classed into the same category as Celebrex, Bextra, and Vioxx, Metacam has been shown to selectively inhibit COX-2 over COX-1. Metacam has long been used in veterinary applications, primarily for treating osteoarthritis in dogs. It wasn’t until 2004 that it was approved in the US for treatment of osteoarthritis. Its main side effects are similar to other drugs in the class: gastrointestinal complications including ulcers, nausea, vomiting, stomach pain, and in rare cases liver disease and toxicity. It carries the same label warnings as Celebrex, including serious cardiovascular events, allergic reactions, and peptic ulcers or other gastrointestinal complications.

Celebrex is most commonly used to treat the pain and inflammation of arthritis, the most common types of which are osteoarthritis, rheumatoid arthritis, and gout. It has also been prescribed for acute pain and menstrual pain. Though various uses have been tested, Celebrex continues to be prescribed primarily for its original application, patients suffering the long-term pain and inflammation of arthritis. In 2006, Celebrex was approved for treating Juvenile Rheumatoid Arthritis in patients aged 2-17 years. Previously, it had only been recommended for use in adult patients.

The idea behind COX-2 inhibitors like Celebrex is that they can be ingested in higher doses than traditional pain killers such as ibuprofen, thereby increasing their effectiveness in treating pain. However, the high incidence of fatal cardiovascular events caused Vioxx and Bextra to be removed from the market. In the case of Celebrex, which is still on the market, the associated side effects and risk factors have caused most medical organizations, including the FDA, to recommend that it be administered in the lowest possible effective dosages.

Celebrex and Ankylosing Spondylitis

Celebrex can be prescribed for the symptoms of Ankylosing Spondylitis, a condition commonly known as “spinal arthritis” in which patients experience inflammation and loss of motion in the spine and neck. In the preliminary trials, Celebrex provided relief for many patients with AS by reducing the swelling and pressure on the spine.

Celebrex and Colorectal Cancer

Celebrex has been widely used as an agent for preventing colon polyps in patients with Familial Adenomatous Polyposis (FAP), a hereditary condition causing the development of colon polyps which give patients a predisposition toward colon and rectal cancer. Although early results showed a decrease in colorectal polyps in patients using high doses of Celebrex, trials also showed an increase in heart attacks and strokes. The risk of cardiovascular complications seems to be directly related to dosages; however, lower dosages of Celebrex did not have the same preventative effect on colon polyps.

Celebrex and Alzheimer’s Disease

A trial funded by the U.S. National Institute on Aging, and concluded in 2008, tested the effects of the NSAIDs Celebrex and Naproxen (found in Aleve) on patients with a family history of Alzheimer’s Disease. It was hoped that the drugs would have a preventative effect by treating the brain swelling that seems to be a symptom of Alzheimer’s Disease. Unfortunately, evidence showed that the drugs had no positive effects, and in fact there was some evidence that the medications worsened cognitive decline in these patients.

How does Celebrex Work?