[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Nonsteroidal anti-inflammatory drugs (NSAIDs)](https://durgical.com/en/pharmacology/classes/nonsteroidal-anti-inflammatory-drugs/) › Celecoxib [Pharmacology](https://durgical.com/en/pharmacology/) · [Nonsteroidal anti-inflammatory drugs (NSAIDs)](https://durgical.com/en/pharmacology/classes/nonsteroidal-anti-inflammatory-drugs/) # Celecoxib A COX-2-selective NSAID (a coxib): it eases pain and inflammation with less stomach damage, but does not protect arteries and can favor clots. Updated 2026-11-01 - Class: [Nonsteroidal anti-inflammatory drugs (NSAIDs)](https://durgical.com/en/pharmacology/classes/nonsteroidal-anti-inflammatory-drugs/) - Enzyme: Cyclooxygenase 2 (COX-2) - ATC code: M01AH01 ✂**Cyclooxygenase 2 (COX-2)**Celecoxib ⓘ The figure shows celecoxib in the active site of mouse COX-2, with its sulfonamide inside the side pocket unique to COX-2. **Target in 3D:** Cyclooxygenase 2 (COX-2). PDB structure 3LN1 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/3LN1) · Drag to rotate · pinch to zoom ## Mechanism of action Celecoxib reversibly and selectively inhibits COX-2, the isoform that rises in inflamed tissue. Its sulfonamide group enters a side pocket that exists in COX-2 because a valine replaces the isoleucine of COX-1. It spares gastric and platelet COX-1: fewer ulcers, but no antiplatelet effect. - Its sulfonamide fits the side pocket found only in COX-2 - Inflammatory prostaglandins fall; gastric COX-1 keeps working - Less pain and inflammation with less damage to the gastric lining - Less prostacyclin without less thromboxane: higher clot risk ## Pharmacokinetics **Absorption** Oral; a high-fat meal delays the peak level. **Distribution** Highly bound to albumin. **Metabolism** Liver, mainly CYP2C9, to inactive metabolites. **Elimination** Feces and urine, as inactive metabolites. **Half-life** About 11 hours. ## Indications - Knee osteoarthritis [Knee Osteoarthritis →](https://durgical.com/en/conditions/knee-osteoarthritis/) - Hip osteoarthritis [Hip Osteoarthritis →](https://durgical.com/en/conditions/hip-osteoarthritis/) - Ankylosing spondylitis [Ankylosing spondylitis →](https://durgical.com/en/conditions/ankylosing-spondylitis/) - Rheumatoid arthritis (symptom control) [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/) - Primary dysmenorrhea and acute pain [Dysmenorrhoea →](https://durgical.com/en/conditions/dysmenorrhoea/) ## Adverse effects ### Common - Dyspepsia and abdominal pain - Edema and high blood pressure - Headache ### Serious (rare, important) - Myocardial infarction and stroke - Gastrointestinal bleeding (less often than with nonselective NSAIDs, but possible) - Acute kidney injury - Severe skin reactions ## Contraindications - Sulfonamide allergy - The period right before or after coronary artery bypass surgery - Asthma or urticaria triggered by NSAIDs - Active ulcer or gastrointestinal bleeding - Established cardiovascular disease or severe heart failure (high risk) ## Key interactions **CYP2C9 inhibitors (fluconazole)** Raise celecoxib levels (fluconazole can double them). **Warfarin** More bleeding risk; the INR may rise. **Aspirin** Part of the coxib's gastric advantage is lost. **ACE inhibitors, ARBs, diuretics and lithium** More kidney risk, weaker antihypertensive effect and higher lithium levels. ## What is monitored - Blood pressure - Kidney function with prolonged use ## Memory aid Celecoxib looks for COX-2's spare room: its sulfonamide key slips in, the stomach breathes easy, but the platelet scale tips toward a clot. ## Test yourself Think of the answer, then tap the question to see it. ## Why can celecoxib not replace aspirin for preventing heart attacks? It barely inhibits platelet COX-1, so it does not lower thromboxane A2 or platelet aggregation. ## Which allergy history is asked about before celecoxib, and why? Sulfonamide allergy, because the celecoxib molecule contains a sulfonamide group. ## What is one advantage and one drawback of celecoxib compared with ibuprofen? Advantage: fewer ulcers and gastrointestinal bleeds because gastric COX-1 is spared. Drawback: higher thrombotic risk from lower prostacyclin without blocking platelet thromboxane. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/celecoxib/) ## Related drugs - [Ibuprofen](https://durgical.com/en/pharmacology/ibuprofen/) - [Acetylsalicylic acid](https://durgical.com/en/pharmacology/acetylsalicylic-acid/) ## Related conditions - [Knee Osteoarthritis](https://durgical.com/en/conditions/knee-osteoarthritis/) - [Hip Osteoarthritis](https://durgical.com/en/conditions/hip-osteoarthritis/) - [Ankylosing spondylitis](https://durgical.com/en/conditions/ankylosing-spondylitis/) - [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/) - [Dysmenorrhoea](https://durgical.com/en/conditions/dysmenorrhoea/) [← Back to the class: Nonsteroidal anti-inflammatory drugs (NSAIDs)](https://durgical.com/en/pharmacology/classes/nonsteroidal-anti-inflammatory-drugs/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Celecoxib: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a699022.html) (MedlinePlus (U.S. National Library of Medicine), 2021); [Structure of celecoxib bound at the COX-2 active site](https://www.rcsb.org/structure/3LN1) (RCSB Protein Data Bank, 2010); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=M01AH01) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/celecoxib/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/celecoxib/