arket, generally considered to be very rare, ie affecting less than 1 in 10,000 people)
Bleeding (haemorrhage) in the stomach or intestines.
Liver failure or inflammation (hepatitis).
Kidney failure.
Severe skin reactions.
Severe allergic reactions.
Aggravation of epilepsy.
Increased blood pressure, shortness of breath, heart attack and stroke have also been reported with this medicine in clinical trials involving people taking high doses (400mg daily) for long periods of time (up to three years).
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.
Celecoxib may be taken with low-dose (75mg daily) aspirin. However, the combination may carry an increased risk of ulceration or bleeding in the stomach or intestines compared to taking celecoxib on its own. Celecoxib should not be taken with higher daily doses of aspirin. For more information and advice ask your doctor or pharmacist.
This medicine should not be taken with other non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, as using more than one NSAID together may also increase the risk of side effects on the gut.
There may be an increased risk of bleeding if celecoxib is taken by people taking anti-blood-clotting medicines (anticoagulants) such as warfarin. If you are taking an anticoagulant you should have your blood clotting time (INR) monitored while taking celecoxib, particularly in the first few days after starting treatment, or if your dose is changed.
This medicine may oppose the effect of diuretics and medicines for high blood pressure (antihypertensives).
There may be an increased risk of side effects on the kidney if celecoxib is taken with any of the following medicines. Your kidney function should be monitored if you are taking any of these medicines in combination with celecoxib, particularly if you are elderly:
ACE inhibitors, eg enalapril
angiotensin II antagonists, eg losartan
ciclosporin
diuretics, eg bendroflumethiazide, furosemide
tacrolimus.
Celecoxib may increase the blood level of the mood stabilising medicine lithium. If you are taking lithium, your lithium blood level should be monitored when starting, changing dose, or stopping treatment with celecoxib.
Other NSAIDs can reduce the removal of the medicine methotrexate from the body. This has not been reported with celecoxib, but people taking methotrexate should be monitored for any side effects of methotrexate while taking celecoxib.
There is a possibility that celecoxib may increase the blood levels of the following medicines:
dextromethorphan
antidepressants (tricyclics, eg amitriptyline and SSRIs, eg fluoxetine)
antipsychotic medicines (eg haloperidol)
anti-arrhythmic medicines (eg flecainide).
The antifungal medicine fluconazole may increase the blood level of celeco