Celebrex As a Migraine Treatment

Commonly used for arthritis, it can reduce migraine-related inflammation

Celebrex (celecoxib) is a prescription nonsteroidal anti-inflammatory drug (NSAID). It is approved for the treatment of conditions such as osteoarthritis, rheumatoid arthritis, and acute pain in adults.

Though it isn't a first-line therapy to treat or prevent migraines, Celebrex can be used for some types of headaches and migraines, especially when inflammation is a major cause. A liquid form of celecoxib, Elyxyb, was approved by the U.S. Food and Drug Administration in 2020 for the treatment of migraine with or without aura in adults.

Your healthcare provider may consider prescribing celecoxib for migraines, particularly if you experience stomach upset from taking other NSAIDs.

This article discusses how celecoxib works to treat migraines, how it is given and how effective it is, as well as the side effects to watch for if you are prescribed the drug.

African woman sitting on couch feels unhappy having problems
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How Celecoxib Works

NSAID medications work by targeting COX enzymes in the body. There are two types of COX enzymes: COX-1 enzymes help maintain the lining of the stomach and intestines, and COX-2 enzymes are responsible for inflammation.

Most NSAIDs, including ibuprofen (Advil) and naproxen (Aleve), target both types of COX enzymes. These medicines can reduce pain and inflammation by targeting COX-2. But because they also target COX-1, they can cause injury to the stomach and intestinal lining. This could lead to gastrointestinal (GI) bleeding or even ulcers.

COX-2 inhibitors—like Celebrex and Elyxyb—treat inflammation by specifically blocking just the COX-2 enzyme. This makes COX-2 inhibitors more gentle on the stomach and GI tract than other NSAIDs.

Celebrex is less likely to cause stomach upset and gastrointestinal bleeding than most other NSAIDs, which can make it a preferred option if you are at risk of these problems.

How Effective Is It?

Celebrex may be effective in treating migraines associated with inflammation, and may work just as well as over-the-counter NSAIDs.

According to one study, medication withdrawal headaches can improve in response to Celebrex. This type of headache is usually treated with prednisone, a steroid that has a powerful anti-inflammatory effect.

Another study showed that a combination of Celebrex and antiviral treatment improved migraines associated with herpes simplex virus (HSV), which likely have an inflammatory component.

Who Can Take It?

NSAID medications are generally considered safe, provided they are used appropriately. They have, however, been linked to increased risks of bleeding, stroke, and heart attack. They can also impact your kidney function.

Be sure to talk with your healthcare provider if you have any conditions that could make these risks worse, or if you are taking medications that could interact with celecoxib.

You should not take Celebrex or Elyxyb if:

  • You have had asthma, hives, or an allergic reaction to an NSAID in the past
  • You have had a reaction to sulfonamides in the past
  • You have had or are planning to have heart bypass surgery
  • You are pregnant and past 29 weeks' gestation

Dosing

There are two forms of celecoxib available:

  • Celebrex comes in capsule form, in doses of 50 mg, 100 mg, 200 mg, and 400 mg.
  • Elyxyb is an oral solution that contains 120 mg per teaspoon.

Your healthcare provider will work with you to determine the best dosage for your specific situation.

It's important to note that manufacturers recommend taking the lowest effective dose for each of these drugs, so be sure to follow your provider's instruction.

Side Effects

Some common side effects of Celebrex and Elyxyb are not serious. These can include:

  • Bloating or gas
  • Constipation
  • Dizziness
  • Sore throat
  • Cold symptoms

If these symptoms are bothersome, contact your healthcare provider.

Serious Side Effects

Some side effects are more serious, and can even be life-threatening. Some of these include:

  • An allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives)
  • Unexplained weight gain
  • Swelling of the arms, hands, legs, or feet
  • Water retention
  • Unusual fatigue or lethargy
  • A skin rash or itching
  • Yellowing of your skin or eyes
  • Flu-like symptoms
  • Unusual bruising or bleeding
  • Changes to the color of your urine or how often you need to urinate

Contact your healthcare provider right away if these occur.

COX-2 Warnings

Another COX-2 inhibitor, Vioxx (rofecoxib), was withdrawn from the U.S. market in 2004 due to an increased risk of cardiovascular problems. Celecoxib has not been associated with a risk of cardiovascular problems.

Studies have shown that the risk of cardiovascular problems with celecoxib is low, and approximately equal to that of ibuprofen and naproxen.

Drug Interactions

Celebrex interacts with a number of other medications, and you should tell your healthcare provider and pharmacist about all other prescription and over-the-counter drugs and vitamins or supplements that you are taking before you start your new prescription.

Celebrex interacts with:

  • Anti-inflammatory medications (such as other NSAIDs like ibuprofen) and steroids, such as cortisone and prednisone. Combining these medicines can cause gastrointestinal upset, ulcers, and bleeding, and may increase the risk of vascular events, such as stroke.
  • Blood thinners: Celecoxib can increase the risk of bleeding when taken with these drugs.
  • Blood pressure lowering medications: Celecoxib can cause heart problems when taken with medications that reduce blood pressure, including diuretics.
  • Digoxin, lithium, methotrexate, cyclosporin: Celecoxib can interfere with how these drugs are processed by your body, which could lead to toxic levels in the blood.

Summary

Celecoxib isn't used to prevent migraine headaches, but it can be effective in treating them. If you suffer from migraines that don't respond to other NSAIDs or medications, your healthcare provider may prescribe celecoxib to help you get relief.

Celecoxib is not without risk. Be sure to talk with your provider about any other medications you're taking or underlying conditions that could get worse if you take Celebrex or Elyxyb.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. American Academy of Orthopaedic Surgeons. What are NSAIDs?.

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  4. Napier BL, Morimoto M, Napier E. Migraine headache treated with Famciclovir and Celecoxib: A case report. Perm J. 2017;22. doi:10.7812/TPP/17-020

  5. Davis A, Robson J. The dangers of NSAIDs: look both waysBr J Gen Pract. 2016;66(645):172-173. doi:10.3399%2Fbjgp16X684433

  6. U.S. Food and Drug Administration. Drug approval package: Elyxyb.

  7. U.S. National Library of Medicine. Celecoxib.

  8. Nissen SE, Yeomans ND, Solomon DH, et al. Cardiovascular safety of celecoxib, naproxen, or ibuprofen for arthritis. N Engl J Med. 2016;375(26):2519-29. doi:10.1056/NEJMoa1611593

By Teri Robert
 Teri Robert is a writer, patient educator, and patient advocate focused on migraine and headaches.