Celebrex interactions: Alcohol, medications, and other factors

Celebrex (celecoxib) is a brand-name prescription drug used to treat the following conditions in certain people:

• rheumatoid arthritis
• osteoarthritis
• juvenile rheumatoid arthritis
• ankylosing spondylitis
• acute (short-term) pain
• menstrual cramps

As with other medications, Celebrex can interact with certain other drugs. An interaction occurs when one substance causes another substance to have a different effect than expected.

For details about Celebrex’s interactions, keep reading. For additional information about Celebrex, including details about its uses, see this article.

In some cases, a factor or condition could prevent your doctor from prescribing Celebrex due to the risk of harm. This is known as a contraindication. The contraindications of Celebrex include:

Planning to have or having recently had heart bypass surgery

Celebrex belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Taking an NSAID can increase your risk of serious, potentially life threatening cardiovascular problems such as heart attack and stroke.*

Due to this risk, doctors typically will not prescribe Celebrex if you’re due to have or have recently had a coronary artery bypass graft (CABG). This is a type of heart bypass surgery. Taking Celebrex for pain after CABG can increase the risk of heart attack and stroke. Ask your doctor about other treatments that may be better choices for you.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.

Having had an allergic reaction to sulfonamides

Celebrex is related to sulfonamide medications, such as trimethoprim/sulfamethoxazole (Septra, Bactrim), sulfasalazine (Azulfidine), and dapsone. Celebrex’s manufacturer recommends that people avoid taking Celebrex if they’ve had an allergic reaction to a sulfonamide medication. This is because taking Celebrex could cause another allergic reaction. However, doctors sometimes prescribe Celebrex to people with a sulfa allergy on a case-by-case basis.

If you’ve had an allergic reaction to sulfonamides, talk with your doctor about whether Celebrex is right for you.

Having had an allergic reaction to other NSAIDs

Celebrex is a type of drug called an NSAID. If you’ve had an asthma attack, hives, or other allergic reaction after taking a different NSAID, your doctor will likely not prescribe Celebrex. This is because taking Celebrex could cause another allergic reaction.

Examples of other NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn). Your doctor can recommend other treatments that may be better choices.

Having had an allergic reaction to Celebrex or any of its ingredients

If you’ve had an allergic reaction to Celebrex or any of its ingredients, your doctor will likely not prescribe Celebrex. Taking the drug could cause another allergic reaction. You can ask your doctor about other possible treatments.

Before taking Celebrex, it’s important to tell your doctor if any of these contraindications apply to you. They can determine whether to prescribe Celebrex.

Alcohol is not known to interact with Celebrex. Alcohol does not affect the way the medication works. However, drinking alcohol with Celebrex may increase the risk of certain side effects, such as:

• indigestion
• nausea
• diarrhea
• headache
• dizziness
• serious digestive problems, such as ulcers, bleeding, or perforations (tears) in your digestive system*

If you consume alcohol, talk with your doctor about how much, if any, is safe for you while taking Celebrex.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.

Before you start treatment with Celebrex, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Here’s a chart of drugs that can interact with Celebrex. Keep in mind that this chart does not include all drugs that may interact with Celebrex. Some of these interactions are described in detail just below in “Drug interactions in depth.”

* To learn more about the side effects of Celebrex, see this article.

Here’s a closer look at certain drug interactions of Celebrex.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are drugs that reduce inflammation and relieve pain. Celebrex is a type of NSAID.

Interaction result. Taking Celebrex with another NSAID can increase the risk of serious digestive problems.* These problems include ulcers (sores), bleeding, or perforations (tears) in the lining of your esophagus, stomach, or intestine. These side effects can sometimes be fatal.

Interaction explained. All NSAIDs can increase the risk of serious digestive problems. Taking more than one NSAID at the same time can further increase this risk.

Examples of NSAIDs. Here are some NSAIDs:

• aspirin
• ibuprofen (Advil, Motrin)
• diclofenac (Voltaren, Zorvolex)
• naproxen (Naprosyn, Aleve)
• meloxicam (Mobic, Vivlodex)

Steps you or your doctor may take. Due to this interaction, doctors typically will not prescribe Celebrex with other NSAIDs. You should not take over-the-counter (OTC) medications that contain NSAIDs with Celebrex either. Certain OTC pain relievers and cold, flu, and allergy medications may contain NSAIDs.

It’s important to check with your doctor or pharmacist before taking any other medications with Celebrex. However, in general, you should not take NSAIDs or products containing NSAIDs in combination with Celebrex.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.

Blood thinners

Blood thinners are drugs used to help prevent and treat dangerous blood clots.

Interaction result. Taking Celebrex with a blood thinner can increase the risk of serious bleeding, including bleeding in your digestive system.*

Interaction explained. Blood thinners make your blood less able to form clots, so you may bleed more easily. Celebrex can also have this effect on your blood. In addition, the drug may cause serious digestive problems, including bleeding in the lining of your esophagus, stomach, or intestine.

If you take Celebrex with a blood thinner, you may be more likely to have bleeding in your digestive system. Also, any bleeding may take longer than usual to stop, so you may have an increased risk of life threatening bleeding.

Examples of blood thinner drugs. Here are some blood thinner medications:

• anticoagulants, such as apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), and warfarin†
• antiplatelets, such as low-dose aspirin, clopidogrel (Plavix), and ticagrelor (Brilinta)

Steps you or your doctor may take. If you take a blood thinner, talk with your doctor about whether Celebrex is right for you. If they prescribe Celebrex, see your doctor right away if you have any symptoms of bleeding in your digestive system. These may include vomiting blood or a substance that looks like coffee grounds. The symptoms can also include passing bloody, black, or tar-like stools.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.
† Coumadin, a brand-name version of warfarin, used to be available but has been discontinued.

High blood pressure medications

Medications from several different drug classes may be used to treat high blood pressure.

Interaction result. Taking Celebrex with a high blood pressure medication can make the medication less effective at managing high blood pressure. This could increase your risk of serious cardiovascular problems* with Celebrex, such as heart attack and stroke. Also, taking Celebrex with high blood pressure medications can increase your risk of kidney problems.

Interaction explained. Celebrex may increase your blood pressure. This could mean that higher doses of blood pressure medications are needed to manage your blood pressure. Celebrex may also increase your risk of kidney problems. Since high blood pressure medications can also affect your kidneys, taking Celebrex with one of these blood pressure drugs may further increase your risk of kidney problems.

Examples of high blood pressure medications. Here are some drugs used to treat high blood pressure:

• angiotensin-converting enzyme (ACE) inhibitors, such as ramipril (Altace), quinapril (Accupril), and lisinopril (Zestril)
• angiotensin II receptor blockers, such as losartan (Cozaar), candesartan (Atacand), and valsartan (Diovan)
• beta-blockers, such as propranolol (Inderal LA, Innopran XL), atenolol (Tenormin), and bisoprolol
• diuretics, such as furosemide (Lasix), hydrochlorothiazide, chlorothiazide (Diuril)

Steps you or your doctor may take. If you take medication for high blood pressure, talk with your doctor about whether Celebrex is right for you. If they prescribe Celebrex, your doctor will likely monitor your blood pressure. If it rises, they may increase your dosage of blood pressure medication. Or they may prescribe additional drugs to help manage your blood pressure. In some cases, your doctor may have you stop taking Celebrex.

If you take Celebrex with an ACE inhibitor, an angiotensin II blocker, or a diuretic, your doctor may also monitor your kidney function. Be sure to drink enough fluids if you take this combination of medications. If you become dehydrated, that can increase your risk of kidney problems.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.

Celebrex may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below.

Celebrex and supplements

It’s possible for drugs to interact with supplements such as vitamins and herbs.

Celebrex and herbs

There were no specific reports of herbs interacting with Celebrex. However, it’s still important to check with your doctor or pharmacist before taking any of these products during treatment with Celebrex.

Celebrex and vitamins

Vitamins have not been reported to interact with Celebrex. You should still talk with your doctor or pharmacist before taking any vitamins during your Celebrex treatment.

Celebrex and food

No food interactions have been reported with Celebrex. If you’d like to learn more about eating certain foods during treatment with Celebrex, talk with your doctor.

Celebrex and vaccines

There were no specific reports of Celebrex interacting with vaccines. However, it’s still important to check with your doctor or pharmacist before getting vaccines while taking Celebrex.

Celebrex and lab tests

Lab tests have not been reported to interact with Celebrex. Keep in mind that if you have lab tests during treatment, you should tell the healthcare professional that you’re taking the medication.

Celebrex interaction with cannabis or CBD

Cannabis (marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Celebrex. Taking these products with Celebrex may raise the level of Celebrex in your body. This could increase your risk of side effects from the medication.

Before you start treatment with Celebrex, tell your doctor and pharmacist if you take cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Celebrex. Before you take Celebrex, be sure to talk with your doctor about your health history. Celebrex may not be the right treatment option for you if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Celebrex include the following.

Risk of digestive problems. Celebrex belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Taking a drug of this type can increase your risk of serious, potentially fatal digestive problems.* Certain health conditions or factors can increase your risk of these problems. Talk with your doctor about whether Celebrex is right for you if you:

• have had an ulcer, a perforation (tear), or bleeding in your digestive system in the past
• are age 65 years or older
• have blood clotting problems
• have severe liver disease
• drink alcohol or smoke

Risk of cardiovascular problems. Taking an NSAID such as Celebrex can increase your risk of serious, potentially life threatening cardiovascular problems such as heart attack or stroke.* If you have certain health conditions or factors, you may have an increased risk of these problems. Talk with your doctor about whether Celebrex is right for you if you:

• have had a heart attack
• have heart disease
• have risk factors for heart disease, such as diabetes, high cholesterol, high blood pressure, obesity, or smoking

Due to the risk of cardiovascular problems, doctors typically will not prescribe Celebrex if you’re planning to have or have recently had a coronary artery bypass graft. You can ask your doctor about other treatments. For more information, see “When to avoid Celebrex” above.

High blood pressure. Celebrex can cause and worsen high blood pressure. This could increase your risk of cardiovascular problems* with Celebrex (see above). If you have high blood pressure, talk with your doctor about whether Celebrex is right for you. If they prescribe Celebrex, they’ll likely monitor your blood pressure.

Heart failure. If you have heart failure, taking Celebrex could worsen your condition. You may also have an increased risk of kidney problems with Celebrex. Your doctor can help determine whether Celebrex is an option for you. If they prescribe the drug, tell your doctor if you develop symptoms of heart failure. These can include having new or worsening swelling in your legs, feet, or hands. Other symptoms include new or worsening shortness of breath and sudden weight gain.

Liver problems. If you have a liver problem, taking Celebrex could worsen it. Celebrex may also build up in your body and increase your risk of side effects.† To help determine whether Celebrex is the right treatment for you, talk with your doctor. If they prescribe the medication, your doctor will likely prescribe a dosage that’s lower than usual. They’ll also likely monitor your liver function.

Kidney problems. If you have a kidney problem, Celebrex could make it worse, especially if you become dehydrated. Your doctor can talk with you about whether Celebrex is right for you. If they prescribe Celebrex, your doctor will likely monitor your kidney function. To avoid dehydration, be sure to drink enough fluids while taking Celebrex.

Allergic reactions. If you’ve had an allergic reaction to Celebrex, any of its ingredients, other NSAIDs, or sulfonamide medications, your doctor will likely not prescribe Celebrex. You can ask them about other treatments that may be better choices for you. See “When to avoid Celebrex” above for more information.

Asthma. Celebrex can cause asthma attacks in some people. If you have asthma, check with your doctor to see whether the drug is an option.

If your doctor prescribes Celebrex, be sure to call them right away if you have an asthma attack or your asthma gets worse.

Pregnancy. Celebrex may increase the risk of kidney problems in the fetus if it’s taken from week 20 of pregnancy onward. The drug may cause serious fetal harm if it’s taken from week 30 of pregnancy onward. It’s not known if Celebrex is safe to take in earlier pregnancy.

If you’re pregnant or planning to become pregnant, talk with your doctor about whether Celebrex is right for you. Due to the risks of Celebrex in late pregnancy, your doctor will likely not prescribe the drug if you’re 30 or more weeks pregnant. You can ask them about other treatments.

Breastfeeding. Celebrex may pass into breast milk in small amounts. If you’re breastfeeding or planning to breastfeed, talk with your doctor about whether Celebrex is right for you.

* Celebrex has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Boxed warnings” above.
† To learn more about the side effects of Celebrex, see this article.

Here are some frequently asked questions about Celebrex and possible interactions.

Can I take Celebrex with pain relievers such as Tylenol or tramadol?

Yes, you can. Acetaminophen (Tylenol) is a pain-relieving drug that you can buy without a prescription. Tramadol (ConZip, Ultram) is a stronger medication that doctors often prescribe to treat pain. It’s a type of drug called an opioid. Acetaminophen and tramadol work in different ways than Celebrex, and they do not interact with Celebrex. It’s generally considered safe to take them together.

If you have additional questions about taking a pain reliever during your Celebrex treatment, talk with your doctor or pharmacist.

Are there interactions between Celebrex and baclofen?

There are not any known interactions between Celebrex and baclofen (Lioresal, Lyvispah). Baclofen is a muscle relaxer. It’s typically used to relieve muscle spasms and stiffness due to multiple sclerosis or spinal cord disease or injury. Doctors sometimes also prescribe it off-label to treat trigeminal neuralgia (a type of nerve pain). It’s generally considered safe to take Celebrex with baclofen.

Your doctor and pharmacist can tell you more about taking Celebrex and baclofen.

* Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Can I take Celebrex with Neurontin?

Celebrex is not known to interact with gabapentin (Neurontin). The drug Neurontin is a seizure medication that doctors sometimes prescribe to treat nerve pain. It’s generally considered safe to take Celebrex in combination with Neurontin together.

If you’d like to learn more about Celebrex and Neurontin, talk with your doctor or pharmacist.

You can take certain steps to help prevent interactions with Celebrex. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or take cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It’s also important to read the label of Celebrex and other paperwork that comes with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the prescribing information, may contain details about interactions. If this information is difficult to understand, ask your doctor or pharmacist to help explain it.

You can also help prevent interactions with Celebrex by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Celebrex. These resources might help:

• Overview of Celebrex. For a general overview of Celebrex, you can see this article.
• Drug comparison. Find information abouthow Celebrex compares with ibuprofen and Mobic.
• Facts about your condition. To learn more about your condition, see our:
  • arthritis hub and list of rheumatology articles
  • rheumatoid arthritis hub
  • women’s health hub and list of related articles

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.