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Celebrex Vs Ibuprofen
Introduction
Celebrex and Ibuprofen are both nonsteroidal anti-inflammatory drugs (NSAIDs) and are used to treat certain pain types. For instance, Celebrex is a selective cyclooxygenase-2 (COX-2) inhibitor that is used for treating osteoarthritis, acute pain, menstrual symptoms, and more. On the other hand, Ibuprofen is derived from propionic acid and is used to manage fever, inflammation, and mild to moderate pain.
NSAIDs are common drugs used for treating pain and inflammation, but long-term use can result in serious side effects, such as bleeding and stomach ulcers. Celebrex causes fewer side effects than Ibuprofen but is only available through prescription, whereas Ibuprofen is available as an over-the-counter drug in a racemic mixture.
About Celebrex and Ibuprofen
What is Celebrex?
Celecoxib is the generic name of the drug, which has been sold under the brand name Celebrex since 1998. It is a nonsteroidal anti-inflammatory drug (NSAID) that is used for the treatment and management of inflammation and various arthritis symptoms. The drug is popular because it causes fewer GI side effects than other NSAIDs. It has also been studied as a potential cancer treatment and is known to reduce precancerous polyps in the colon.
It is a selective cyclooxygenase-2 (COX-2) inhibitor that is indicated for acute pain, inflammation, and arthritis. However, it is not a substitute for aspirin for cardiovascular event prophylaxis. It can also be taken in combination with other drugs, like tramadol, to manage acute pain in adults where other treatments fail or remain inadequate.
What conditions is Celebrex approved to treat?
Celebrex was approved by the FDA in 1998 and was granted permission to be sold under the brand name to treat different pain types associated with arthritis. It is available in oral capsule form and treats pain and inflammation. It also has the lowest risk of heart attack compared to other NSAIDs.
Celebrex is approved to treat the following conditions:
- Acute pain
- Osteoarthritis
- Rheumatoid Arthritis, Juvenile
- Rheumatoid Arthritis
- Primary Dysmenorrhoea
- Ankylosing Spondylitis (AS)
- Familial adenomatous polyposis as an adjunct treatment
During the initial approval phase, many concerns were raised regarding the potential cardiovascular risks, but after evaluating data from several clinical trials, the FDA approved the drug and determined that its benefits outweigh its risks.
How does Celebrex work for Osteoarthritis?
This pain and inflammation-reducing drug works by blocking the COX-2 enzyme. Unlike most NSAIDs, Celebrex is a selective inhibitor of the cyclooxygenase-2 (COX-2) enzyme. This enzyme is induced by inflammatory mediators and is heavily expressed in inflamed muscles. By using Celebrex, you can inhibit the production of this enzyme and the synthesis of inflammation-causing molecules like prostaglandins E2 (PGE2), prostacyclin (PGI2), prostaglandin D2 (PGD2), and prostaglandin F2 (PGF2). By blocking these mediators, pain, and inflammation are reduced significantly.
What is Ibuprofen?
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) sold under the brand name Motrin, Advil, etc. It was first developed as an alternative to aspirin in 1960. It was patented in 1961 and first launched for treating rheumatoid arthritis in the UK in 1969 and the USA in 1974. It is also indicated for relieving symptoms of osteoarthritis and primary dysmenorrhea.
It is derived from propionic acid and is considered the first of the propionic. It is safe to eat and available over the counter as a racemic mixture, i.e., it contains both the R- and S-enantiomers. It treats pain and symptoms of common conditions like menstrual cramps, backaches, toothaches, and sports-related injuries.
What conditions is Ibuprofen approved to treat?
Ibuprofen is one of the most commonly prescribed NSAIDs and is generally used for treating acute pain, fever, and inflammation. It is also used to manage mild to moderate pain regarding migraine, headaches, dental pain, and other soft tissue-related conditions.
Ibuprofen is approved to treat the following conditions:
- Osteoarthritis
- Gastric ulcer
- Mild to acute pain
- Rheumatoid arthritis
- Menstrual distress
- Migraine
- Fever
- Cystic fibrosis
- Orthostatic hypotension
It is also safe for children and comes in different flavored options for easier intake. Research shows Ibuprofen was able to target novel structures to attenuate the inflammation associated with an AlCl3-induced mouse model of neurotoxicity and, thus, can be considered as a potential therapeutic option for Parkinson's Disease, other neurodegenerative diseases, and breast cancer.
How does Ibuprofen work for Osteoarthritis?
The exact mechanism of Ibuprofen is unknown, but like other NSAIDs, it works by blocking the production of certain substances called prostanoids or prostaglandins. These substances are inflammatory mediators and cause pain and inflammation in the affected muscles. Ibuprofen is also a non-selective COX inhibitor and inhibits the activity of both COX-1 and COX-2. The inhibition of the synthesis of COX-2 reduces pain, inflammation, fever, and swelling. On the other hand, the inhibition of COX-1 can cause some GI side effects.
A study reviewed the efficiency of Ibuprofen compared to a placebo. It was found that Ibuprofen results in approximately 50-60% improvement over placebo in WOMAC scores, including those reflecting inflammatory joint pain in knee and hip OA.
Effectiveness
How effective are Celebrex and Ibuprofen for treating Osteoarthritis?
Celebrex and Ibuprofen are nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain and symptoms associated with osteoarthritis. Both have a similar mechanism of action, with one major difference. Celebrex is a selective cyclooxygenase-2 (COX-2) inhibitor, whereas Ibuprofen is a non-selective cyclooxygenase inhibitor. Ibuprofen blocks both COX-1 and COX-2, rather than only COX-2 like Celebrex. Due to this reason, Celebrex is known to have a gastrointestinal tolerability profile relative to nonselective NSAIDs.
A COX-2 inhibitor is easier on the stomach and causes fewer GI side effects, such as ulcers and bleeding than a non-selective cyclooxygenase inhibitor.
A 6-week, multicentre, double-blind, non-inferiority trial with 388 patients was conducted. The trial involved an intake of 200 mg celecoxib once daily, 800 mg Ibuprofen three times daily, or a placebo through randomization. The results showed that the mean difference (95% confidence interval) between celecoxib and Ibuprofen in the Patient’s Assessment of Arthritis Pain was 2.76 (−3.38, 8.90). Celebrex was found to be non-inferior to Ibuprofen, and patients were more satisfied with Celebrex as compared to Ibuprofen and placebo.
Several studies have also found Ibuprofen more effective in treating osteoarthritis than Celebrex. Thus, the main difference comes in terms of safety and side effects. Long-term use of both drugs has been associated with an increased risk of myocardial infarction, cardiovascular events, stroke, and GI side effects. Although, as stated above, selective NSAIDs, like Celebrex, result in fewer side effects.
Dosage information
How is Celebrex administered for Osteoarthritis?
Celebrex comes in tablet form and is taken orally. It is available in 50, 100, 200, and 400 mg doses. The GI tract rapidly absorbs it; for instance, when a 200 mg dose was given to healthy research subjects, the peak plasma levels of Celebrex occurred within 3 hours. These timings can change based on the type of meals they are taken with and the dosage.
How is Ibuprofen administered for Osteoarthritis?
Ibuprofen is available in multiple forms, such as pills, chewables, suspensions, and drops. Dosage varies for children and adults. Motrin, the brand name for Ibuprofen, is given to any child or adult at least 6 months of age. Moreover, oral administration results in rapid absorption by the GI tract in adults. The absorption rate is slightly reduced when taken with a meal.
Side Effects
Since both medications are NSAIDs, patients may experience common side effects.
What are the most common side effects of Celebrex?
Some of the common side effects of this medication include:
- Abdominal pain
- Headache
- Hypertension
- Diarrhea
- Dyspepsia (indigestion)
- Back pain
- Upper respiratory infection
- Swelling
- Dizziness
- Sore throat
Are there any potentially serious side effects of Celebrex?
* If you experience any of these serious side effects, seek medical help immediately
- High blood pressure
- Gastrointestinal bleeding
- Sluggishness
- Nausea
- Difficulty in breathing
- Drowsiness
- Kidney failure
- Vomiting
Note that gastrointestinal tract ulcers and bleeding can occur without any preceding symptoms; thus, the patient should be monitored for GI tract ulceration.
What are the most common side effects of Ibuprofen?
Some of the common side effects of this medication include:
- Abdominal pain
- Headache
- Diarrhea
- Dyspepsia (indigestion)
Ibuprofen is not considered a safe alternative for adults above 60 years or pregnant women.
Are there any potentially serious side effects of Ibuprofen?
* If you experience any of these serious side effects, seek medical help immediately
- Abdominal pain
- Nausea
- Vomiting
- Lethargy
- Vertigo
- Drowsiness (somnolence)
- Dizziness
- Insomnia
- Loss of consciousness
- Tinnitus
- CNS depression
- Convulsions and seizures.
Pediatric patients may rarely experience severe side effects, such as acute renal failure, metabolic acidosis, dyspnea, abnormal hepatic function, hyperkalemia, respiratory depression, and apnea.
Contraindications and interactions
Warnings and general precautions for Celebrex and Ibuprofen
Both medications are rapidly absorbed by the GI tract and thus, long-term use can result in serious complications and cause symptoms like stomach bleeding and permanent kidney damage. Celebrex and Ibuprofen (selective and non-selective NSAIDs, respectively) increase the risk of stroke, heart attack, or serious cardiovascular events which can be life-threatening and fatal. The dosage depends on the condition being treated and should be adjusted by consulting a healthcare professional team and ensuring it is the right fit for you.
Contraindications and important interactions for Celebrex and Ibuprofen
Contraindications
Celebrex
Not recommended for people with sulfonamide allergies.
Pregnant women should not use NSAIDs at 20 weeks or later in pregnancy unless advised by their healthcare professional.
Ibuprofen
Not recommended for pregnant women.
Not recommended for adults above 60 years of age.
Drug/Medication Interactions
Celebrex
- Brigatinib
- Cyclopentamine
- Cabazitaxel
- Fluorouracil
- Fosphenytoin
- Acebutolol
Ibuprofen
- Brigatinib
- Cabazitaxel
- Abacavir
- Erlotinib
- Fluorouracil
- Enasidenib
Food/Beverage/Supplement Interactions
Celebrex
200mg doses can be taken with or without food, but 400 mg doses should be taken with food.
Avoid alcohol to decrease the risk of gastrointestinal irritation.
Avoid multivalent ions or separate administration of magnesium and aluminum-containing drugs for several hours.
Ibuprofen
Should be taken with food to decrease gastrointestinal irritation.
Avoid alcohol to decrease the risk of gastrointestinal irritation.
Cost Comparison
How much do Celebrex and Ibuprofen cost?
Both medications are covered by insurance, and prices vary by prescription strength. For instance, Celebrex (30 tablets of 200 mg) can cost approximately $217.49. In 2020, the average spending per dosage unit for Celebrex was $12.16. In contrast, Ibuprofen is an over-the-counter drug that is available for cheap. The average spending per dosage unit was $0.12, and the retail price for 30 tablets of 800 mg Ibuprofen costs anywhere from $6-30.
Popularity of Celebrex and Ibuprofen
Celebrex and Ibuprofen are popular drugs for treating pain and osteoarthritis. Both are taken orally and follow the same route of administration and absorption. Celebrex is available only by prescription, whereas Ibuprofen is an over-the-counter drug in tablet, suspension, and chewable forms. Ibuprofen was ranked #38 in 2020 and was a commonly prescribed drug. Both are NSAIDs and, thus, have similar side effects and warnings. However, Celebrex is known to cause fewer side effects and was ranked #98 in 2020 in the U.S.
Conclusion
Takeaway
According to the information sourced, there is little difference between the route of administration, side effects, and contraindications in Celebrex and Ibuprofen. Both drugs are effective in treating osteoarthritis, although dosage may vary depending on the patient’s age, weight, and severity of the symptoms. Celebrex is a selective cyclooxygenase COX-2 inhibitor known to cause fewer GI side effects. However, long-term use of any NSAID should be avoided, and patients should adjust the dosage to the least effective dose when the desired result is achieved.