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Celecoxib

Also indexed as: Celebrex®

Celecoxib is used to treat rheumatoid arthritis and osteoarthritis; it is in a class of medications known as selective COX-2 inhibitor non-steroidal anti-inflammatory drugs (NSAIDs).

Interactions with Dietary Supplements

Sodium and Potassium
Controlled studies indicate that individuals on low-salt diets who take celecoxib retain sodium and potassium, which might result in higher than normal blood levels of these minerals.1 More research is needed to determine whether potassium supplements might produce unwanted side effects in people taking celecoxib. Until more information is available, people taking celecoxib should have their sodium and potassium blood levels monitored by their healthcare practitioner.

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression. Taking celecoxib together with the mineral can result in significant increases in lithium blood levels,2 which might cause unwanted side effects. Consequently, people taking celecoxib and lithium-containing supplements should consult their healthcare practitioner about having their lithium blood levels checked regularly.

Interactions with Herbs

Willow (Salix alba)
Willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. Taking aspirin and celecoxib together increases the likelihood of developing stomach and intestinal ulcers.3 Though no studies have investigated a similar interaction between willow bark and celecoxib, people taking the drug should avoid the herb until more information is available.

Summary of Interactions for Celecoxib

Depletion or interference Lithium
Potassium
Sodium
Adverse interaction Willow*
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Rossat J, Maillard M, Nussberger J. Renal effects of selective cyclooxygenase-2 inhibition in normotensive salt-depleted subjects. Clin Pharmacol Ther 1999;66:76–84.

2. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2901–4.

3. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2901–4.