Is Celebrex Better Than Ibuprofen?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for the treatment of acute pain and chronic inflammatory and degenerative joint diseases. The long term use of NSAIDS is restricted by the occurrence of upper gastrointestinal (GI) complications such as ulcers and bleeding.

Celebrex is a more selective NSAID which is marketed as having fewer GI side effects and similar effectiveness. Celebrex is more expensive and prescription-only, but is it better than ibuprofen (Motrin, Advil)? Let’s look.

Celebrex and ibuprofen have been compared in numerous studies for specific types of pain. Results swing both ways. Here are some examples: Celebrex was more effective for pain from ankle sprain, ibuprofen for dental pain, and both were equal for postoperative pain and treatment of acute gout attacks. I’d say it’s a wash and they both work just as well. It’s a draw for pain.

Long term use of NSAIDS carries a slightly increased risk of stroke and heart disease. The most frequently used NSAIDs in clinical practice like ibuprofen and Celebrex are associated with an increased risk of heart attack at high doses or in persons with diagnosed coronary heart disease. It’s a draw here for the heart, both carry small risks long term.

The use of any NSAID has been associated with a 3- to 5-fold increase in the risk of stomach irritation, ulcer or bleeding. However, Celebrex is associated with a lower risk of bleeding. There are some more differences to know: with ibuprofen the higher the dose, the higher the risk of GI bleed (200 mg = less risk, 600 mg = more risk), but the risk of GI bleed does not increase with higher doses of celecoxibWinner = Celebrex

Serum creatinine and creatinine clearance, measures of kidney function, have been found to be significantly increased in patients treated with ibuprofen in comparison with celecoxib. This is important—Celebrex is safer on the kidneys. Winner = Celebrex

Neither Celebrex nor ibuprofen have harmful effects on the liver compared to placebo. Winner = Both

Cost is a huge difference between the two, but the patent for Celebrex (celecoxib) expires in December 2014 so a generic option should soon be available. That should drop the cost quite a bit. Winner = Ibuprofen

Ibuprofen 200 mg tablets are easily available over the counter whereas Celebrex is a prescription medication only. Winner = Ibuprofen

Dr O.

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