Celebra 200 mg celecoxib Hard Capsules
1. what Is Celebra, And What Celebra Used For?
Celebra is used in adults for symptom relief in treating chronic rheumatoid arthritis, osteoarthritis, and pelvic pondylitis (Mb. Bechterews, a rheumatic back disease).
Celebra belongs to a group of medicines called non-steroidal anti-inflammatory drugs ( NSAIDs ) and, more specifically, to the subgroup inhibitors of cyclooxygenase-2 ( COX-2).
Your body produces prostaglandins that can cause pain and inflammation; in conditions such as rheumatoid arthritis and osteoarthritis, it produces more of them. Celebra works by reducing the production of prostaglandins and thus reducing pain and inflammation.
You can expect the medicine to start working within a few hours of taking the first dose, but it may take several days before it takes full effect.
Celecoxib contained in Celebra may also be approved for treating other conditions not mentioned in this product information. Ask your doctor, pharmacist, or other healthcare professionals if you have further questions, and always follow their instructions.
2. What You Need To Know Before Using Celebra?
Do Not Use Celebra:
You have been prescribed celebra medicine by your doctor. The following information will help you get the best results from your treatment. If you have any further questions, ask your doctor or pharmacist.
Do not take Celebra:
Tell your doctor if any of the following apply to you, as patients with these conditions should not take Celebra.
- If you are allergic to celecoxib or any of the other ingredients of this medicine (listed in section 6)
- If you have had an allergic reaction to a group of medicines called ‘sulfonamides’ (e.g., some antibiotics used to treat infections )
- If you currently have ulcers or bleeding in the stomach/intestines
- If you have had asthma, nasal polyps, severe nasal congestion, or an allergic reaction such as itchy kin rash, swelling of the face, lips, tongue, or throat, difficulty breathing or wheezing after taking acetylsalicylic acid or any other anti-inflammatory and analgesic medicine ( NSAID )
- If you are pregnant. If you are likely to become pregnant during treatment, you should discuss appropriate contraceptive methods with your doctor
- If you are breast-feeding
- If you have severe liver disease
- If you have severe kidney disease
- If you have an inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
- If you have heart failure or known ischemic heart disease or disease of the blood vessels of the brain, e.g., if you have had a heart attack, stroke, temporary decrease in blood flow to the brain (also known as “mini-stroke”), angina, or narrowing of the blood vessels to the heart or brain
- If you have or have had problems with blood circulation ( peripheral vascular disease) or if you have had surgery on the blood vessels in your legs
Warnings And Cautions:
Talk to your doctor or pharmacist before taking Celebra:
- If you have previously had ulcers or bleeding in the stomach or intestines( Do not take Celebra if you currently have ulcers or bleeding in the stomach or intestines)
- If you are taking acetylsalicylic acid (even at low doses to protect your heart)
- If you are taking medicines that reduce the formation of platelets
- If you are taking medicines to reduce blood clots (e.g., warfarin / warfarin-like anticoagulants or new oral blood thinners, e.g., apixaban)
- If you are taking medicines called corticosteroids (e.g., prednisone)
- If you take Celebra while taking other NSAIDs (besides acetylsalicylic acid ), such as ibuprofen or diclofenac. Concomitant use of these drugs should be avoided
- If you smoke, have diabetes, high blood pressure, or high cholesterol
- If your heart, liver, or kidneys are not working correctly, your doctor may want to check you regularly
- If you have fluid retention in your body (such as swollen ankles and feet)
- If you are dehydrated, e.g., due to vomiting, diarrhea, or if you are taking diuretics(to treat fluid retention in the body)
- If you have had a severe allergic reaction or a severe skin reaction to any medicine
- If you have an infection or suspect you have an infection, as Celebra may mask fever or other signs of infection and inflammation
- If you are over 65, your doctor will check you regularly
- Intake of alcohol and NSAIDs may increase the risk of gastrointestinal upset
Like other NSAIDs (such as ibuprofen or diclofenac ), this medicine may cause high blood pressure, so your doctor may ask you to check your blood pressure regularly. Some cases of severe hepatic reaction have been reported following the use of celecoxib, such as:
- Severe hepatitis
- Liver damage
- Liver failure (some cases fatal or requiring liver transplantation)
In cases where the time of onset of symptoms was reported, most severe liver reactions were seen within one month of starting treatment. Celebra can make it harder to get pregnant. You should tell your doctor if you are planning to become pregnant or have difficulty getting pregnant (see the section on Pregnancy and breast-feeding).
Other Medicines And Celebra:
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines:
- Dextromethorphan (used to treat cough)
- ACE inhibitors, angiotensin II inhibitors, beta-blockers, and diuretics (used for high blood pressure and heart failure )
- Fluconazole and rifampicin (used to treat fungal and bacterial infections)
- Warfarin or other warfarin-like medicines (blood thinners that reduce blood clotting), including newer medicines like apixaban
- Lithium (used to treat certain types of depression)
- Other medicines for depression, sleep disorders, high blood pressure or irregular heartbeat
- Neuroleptics (used to treat certain mental illnesses)
- Methotrexate (used to treat rheumatic joint disease, psoriasis, and leukemia )
- Carbamazepine (used to treat epilepsy/seizures and certain forms of pain or depression)
- Barbiturates (used to treat epilepsy/seizures and certain sleep disorders)
- Ciclosporin and tacrolimus (used to suppress the immune system, e.g., after transplants)
Celebra can be taken with a low dose of acetylsalicylic acid (75 mg or less per day). Ask your doctor for advice before taking these medicines at the same time.
Pregnancy, Breastfeeding, And Fertility:
If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Pregnancy
Celebra must not be used by pregnant women or may become pregnant during treatment (i.e., women of childbearing potential not using adequate contraception). If you become pregnant during treatment with Celebra, you should stop and contact your doctor for other treatment.
Breast-feeding
Celebra must not be used during breast-feeding.
Fertility
NSAIDs, including Celebra can make it harder to get pregnant. Tell your doctor if you plan to become pregnant or have problems getting pregnant.
Driving And Using Machines:
You should know how to react to Celebra before driving or using machines. If you feel dizzy or drowsy after taking Celebra, do not drive or use machines until these effects have subsided.
You are responsible for assessing whether you can drive a motor vehicle or perform work requiring increased vigilance. One of the factors that can affect your ability in these respects is the use of drugs due to their effects or side effects.
Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.
Celebra Contains Lactose:
Celebra contains lactose (a sugar). If your doctor has told you that you are intolerant to some sugars, contact your doctor before taking this medicine.
3. How To Take Celebra?
- Always take this medicine exactly as your doctor or pharmacist has told you. Ask your doctor or pharmacist if you are unsure. If you have the impression that the effect of Celebra is too strong or too weak, talk to your doctor or pharmacist.
- Your doctor will tell you which dose to take. As the risk of heart side effects may increase with high doses and long-term treatment, you mustn’t take a higher dose or use Celebra for longer than you need to control your symptoms.
- Method of administration:
- Celebra is for oral use (should be swallowed). Your dose can be taken at any time, with or without food, but try to take each dose simultaneously.
- If you have difficulty swallowing capsules, all capsule contents can be sprinkled on a teaspoon of semi-solid food (e.g., cold or room-warm apple puree, rice gruel, yogurt or mashed banana) and swallowed immediately with about 240 ml of water.
- Hold the capsule upright so the granules collect at the bottom. Then gently squeeze the upper part and remove it with a twisting motion. Be careful not to spill any of the contents. Granules must not be chewed or crushed.
Contact your doctor if you do not experience any improvement after two weeks of treatment.
- In osteoarthritis, the recommended dose is 200 mg daily, which can be increased to a maximum of 400 mg if your doctor deems it necessary. The usual dose is:
- One 200 mg capsule once a day, or
- One capsule of 100 mg twice a day.
- In chronic rheumatoid arthritis, the recommended dose is 200 mg daily, which can be increased to a maximum of 400 mg if your doctor deems it necessary.
- The usual dose is:
- One capsule of 100 mg twice a day.
- In the case of pelvic pondylitis , the usual dose is 200 mg daily, which can be increased to a maximum of 400 mg if your doctor deems it necessary.
- The usual dose is:
- One 200 mg capsule once a day, or
- One capsule of 100 mg twice a day.
- The usual dose is:
- Kidney or liver failure: If you have kidney or liver failure, tell your doctor, as you may need to take a lower dose.
- Elderly people, especially those weighing less than 50 kg: If you are over 65, and especially if you weigh less than 50 kg, your doctor may want to check you more closely.
- You should not take more than 400 mg daily.
Use In Children:
Celebra is for adults only and should not be used in children.
If You Forget To Take Celebra:
If you forget to take your dose, take it as soon as you remember. Do not take a double dose to make up for a forgotten dose.
If You Stop Taking Celebra:
If you suddenly stop taking Celebra, your symptoms may get worse. Do not stop taking Celebra unless your doctor tells you to. Your doctor may ask you to reduce your dose for a few days before stopping treatment altogether. Ask your doctor or pharmacist if you have any further questions about using this product.
4. Possible Celebra Side Effects:
This medicine can cause side effects like all medicines, although not everybody gets them. The side effects listed below have been observed in patients with osteoarthritis who have used Celebra. Side effects marked with an asterisk (*) are indicated with the higher frequency seen in patients who used Celebra to prevent colon polyps. These patients took Celebra in high doses and for a long time.
If any of the following occur, stop taking Celebra and contact a doctor immediately:
If you experience:
- An allergic reaction such as skin rash, swelling of the face, wheezing, or difficulty breathing
- Heart problems such as chest pain
- Severe stomach pain or signs of bleeding in the stomach or intestines, e.g., black or bloodstained stools or vomiting with blood in
- A skin reaction such as rash, blistering or flaking
- Liver failure (symptoms may include nausea, diarrhea, jaundice (your skin or whites of the eyes look yellowish))
Very common: may affect more than 1 user in 10:
- High blood pressure, including an increase in already high blood pressure *
Common: may affect up to 1 user in 10:
- Myocardial infarction*
- Accumulation of fluid in the body that can cause swelling in the ankles, legs, or hands
- Urinary tract infection
- Difficulty breathing *, sinusitis, nasal congestion or runny nose, sore throat, cough, cold, flu-like symptoms
- Dizziness, difficulty sleeping
- Vomiting *, stomach pain, diarrhea, digestive problems
- Flatulence
- Rash, itching
- Muscle tension
- Difficulty swallowing *
- Headache
- Nausea
- Joint pain
- Worsening of existing allergies you
- Damage in the event of an accident
Uncommon: may affect up to 1 user in 100:
- Stroke*
- Heart failure , palpitations, rapid heartbeat
- Changes in liver values during blood tests
- Changes in kidney values during blood tests
- Anemia (decreased number of red blood cells, which can cause weakness and shortness of breath)
- Anxiety, depression, fatigue, drowsiness, ant crawling.
- Increased potassium in the blood (may cause nausea, fatigue, muscle weakness, or palpitations)
- Impaired vision or blurred vision, tinnitus, soreness in the mouth, cold sores, hearing loss *
- Constipation, belching, gastritis (indigestion, stomach pain, or vomiting), worsening inflammation of the stomach or intestines
- Leg cramps
- Elevated, itchy rash ( hives )
- Eye inflammation
- Breathing difficulties
- Discolored skin (bruises)
- Chest pain (general pain not related to the heart)
- Facial swelling
Rare: may affect up to 1 user in 1,000:
- Ulcers (bleeding) in the stomach, esophagus, and intestine, ruptured intestine (may cause abdominal pain, fever, nausea, vomiting, intestinal obstruction), dark or black stools, inflammation of the pancreas (may cause abdominal pain), inflammation of the esophagus ( esophagitis )
- Decreased amount of sodium in the blood (a condition known as hyponatremia )
- Reduced white blood cell count (which helps protect the body against infection ) and platelets (increased risk of bleeding or bruising)
- Difficulty coordinating muscle movements
- Confusion, taste changes
- Increased light sensitivity
- Hair loss
- Hallucinations
- Bleeding in the eye
- The acute reaction that can lead to pneumonia
- Irregular heartbeats
- Pastures
- Blood clots in the blood vessels of the lungs. Symptoms may include sudden shortness of breath, sharp pain when breathing, or collapse.
- Bleeding in the stomach or intestines (may cause bloody stools or vomiting), intestinal inflammation.
- Serious liver inflammation ( hepatitis ). Symptoms may include nausea, diarrhea, jaundice (yellowing of the skin or eyes), dark urine, pale stools, increased tendency to bleed, itching, or chills.
- Acute renal failure
- Menstrual disorders
- Swelling of the face, lips, mouth, tongue or throat, wheezing or difficulty swallowing
Very rare: may affect up to 1 user in 10,000:
- Severe skin reactions (including anaphylactic shock, which may be life-threatening)
- Severe skin conditions such as Stevens-Johnson syndrome, exfoliative dermatitis and toxic epidermal necrolysis (which may cause rash, blistering, or flaking of the skin) and acute rash-like generalized pustulosis (red, swollen area with many small blisters)
- A delayed allergic reaction with possible symptoms such as rash, swelling of the face, fever, swollen glands, and abnormal test results (eg, liver and blood cell tests ( eosinophilia, a increased white blood cell count ))
- Cerebral hemorrhage, which can be life-threatening
- Meningitis ( inflammation of the meninges)
- Liver failure, liver damage, and severe liver inflammation ( fulminant hepatitis ) (some with fatal outcome or requiring liver transplant). Symptoms may include nausea, diarrhea, jaundice (yellowing of the skin or eyes), dark urine, pale stools, increased tendency to bleed, itching, or chills.
- Liver problems (eg, cholestasis and cholestatic hepatitis, which may be accompanied by symptoms such as discolored stools, nausea, and yellow skin or yellow eyes)
- Kidney inflammation and other kidney problems (eg, nephrotic syndrome and minimal change disease that may be accompanied by symptoms such as fluid retention ( edema ), frothy urine, fatigue, and loss of appetite)
- Impaired epilepsy (possibly increased number of seizures or increased severity)
- Partial or complete vision loss caused by blockage of a blood vessel in the eye
- Inflammation of the blood vessels (may cause fever, aches, dark purple spots on the skin)
- Deficiency of all blood cells (may cause fatigue, increase the tendency to get bruises, frequent nosebleeds, and increased risk of infection)
- Muscle aches and weakness
- Impaired sense of smell
- Loss of taste
No known frequency: (occurrence cannot be calculated from available data):
- Decreased fertility in women, which is usually transient at the end of treatment
In addition, in clinical trials of conditions other than osteoarthritis or joint problems, where Celebra was given in a dose of 400 mg daily for up to 3 years, the following side effects have been observed:
Common: may affect up to 1 user in 10:
- Angina (chest pain)
- Irritable bowel syndrome (may include abdominal pain, diarrhea, digestive problems, flatulence)
- Kidney stones (may cause pain in the abdomen or back, blood in the urine), urinary incontinence
- Weight gain
Uncommon: may affect up to 1 in 100 users:
- Deep vein thrombosis (blood clot, usually in the legs, which can cause pain, swelling or redness in the calf or difficulty breathing)
- Stomach infection (which can cause irritation and ulcers in the stomach and intestines)
- Fracture of the forearm / lower leg, shingles, skin infection, eczema (dry, itchy rash), pneumonia (cough, fever, difficulty breathing)
- Visual impairment caused by small spots in the visual field
- Dizziness caused by problems in the inner ear, tender, inflamed or bleeding gums, cold sores, need to urinate frequently at night, bleeding from hemorrhoids, anxious intestine, lumps of fat in the subcutaneous tissue, ganglion (benign swelling of the wrist and ankle tendons)
- Speech problems, abdominal bleeding, breast tenderness, increased sodium in the blood.
Reporting of side effects
Talk to your doctor, pharmacist, or nurse if you get any side effects. This includes any possible side effects not listed in this leaflet. You can also report side effects directly to the Medical Products Agency, www.lakemedelsverket.se. By reporting side effects, you can help increase drug safety information.
5. How To Store Celebra?
- Keep this medicine out of sight and reach of children.
- Do not use this medicine after the blister and carton expiry date. The expiration date is the last day of the specified month.
- Do not store above 30 ° C.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer required. These measures will help to protect the environment.
6. Contents Of The Packaging And Other Information
Content Declaration
- The active substance is celecoxib.
- 1 capsule contains 100 mg or 200 mg celecoxib.
- Other ingredients are:
- Lactose monohydrate
- Sodium lauryl sulfate
- Povidone
- Croscarmellose sodium
- Magnesium stearate
- The capsule shell contains gelatin, titanium dioxide E171, sodium lauryl sulfate, and sorbitan monolaurate. The printing ink contains shellac, propylene glycol, indigo carmine E132 (100 mg capsule) iron oxide E172 (200 mg capsule).
What The Medicine Looks Like And The Vontents Of The Pack?
- Celebra is available as hard capsules.
- Opaque, white with two blue stripes, marked with 7767 and 100 (Celebra 100 mg).
- Opaque, white with two yellow stripes, marked with 7767 and 200 (Celebra 200 mg).
- The capsules are packaged in transparent or opaque PVC / aluminum blisters.
- Celebra is available in packs of 2, 5, 6, 10, 20, 30, 40, 50, 60, 100, 10 × 10, 10 × 30, 10 × 50, 1 × 50 (single dose), 1 × 100 (single dose) , 5x (10×10).
- Not all pack sizes may be marketed.
Marketing Authorization Holder And Manufacturer
Pfizer AB
191 90 Sollentuna
Tel: 08-550 520 00
Email: eumedinfo@pfizer.com
Manufacturer:
R-Pharm Germany GmbH
Heinrich-Mack-Str. 35, 89257 Illertissen
Germany
or
Pfizer Manufacturing Deutschland GmbH
Company Freiburg
Mooswaldallee 1, 79090 Freiburg
Germany