Elyxyb
Elyxyb, the brand name for celecoxib oral solution, is a prescription medication that's FDA approved for treating migraines in adults. It's a type of nonsteroidal anti-inflammatory drug (NSAID). Elyxyb (celecoxib) oral solution is taken when you feel migraine pain starting. You can only take it once in a 24-hour period. Side effects are rare but changes in taste are possible.
What is Elyxyb (celecoxib) oral solution?
What is Elyxyb (celecoxib) oral solution used for?
Treatment of migraine attacks with or without aura in adults
How Elyxyb (celecoxib) oral solution works
Elyxyb (celecoxib) oral solution is a COX-2 selective nonsteroidal anti-inflammatory drug (NSAID). It blocks a specific protein in the body that's involved with causing pain and swelling called cyclooxygenase-2 (COX-2). This helps relieve migraine pain.
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What are the side effects of Elyxyb (celecoxib) oral solution?
Common Side Effects
- Change in taste (3%)
Other Side Effects
Serious Side Effects
- Stroke: blurred vision, difficulty speaking, difficulty walking, weakness on one side of the body, severe headache
- Heart attack: chest pain or tightness that moves to the arm, neck, or jaw; difficulty breathing; sweating
- Heart failure: difficulty breathing, swelling, sudden weight gain, tiredness, dizziness
- Stomach or gut bleed: blood in your vomit, stool that looks like black coffee grounds, pain in your stomach that doesn't go away
- Serious allergic reaction or serious skin reaction: rash; hives; peeling skin; painful blisters; trouble breathing; swelling of the face, mouth, or lips; fever; body aches; cough
- Kidney problems: changes in your need to urinate, tiredness, dry and itchy skin, low appetite, muscle cramps
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bleeding—bloody or black, tar-like stools, vomiting blood or brown material that looks like coffee grounds, red or dark brown urine, small red or purple spots on skin, unusual bruising or bleeding
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart failure—shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness or fatigue
- Increase in blood pressure
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Round red or dark patches on the skin that may itch, burn, and blister
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Headache
- Loss of appetite
- Nausea
- Upset stomach
Pros and cons of Elyxyb (celecoxib) oral solution
Pros
Lower risk of stomach side effects than some other NSAIDs (like naproxen (Aleve) or ibuprofen (Advil, Motrin))
Can work as soon as 15 minutes for some people
Comes as a flavored liquid, which is a good choice for people who have trouble swallowing pills
Cons
Not for preventing migraines from happening
Can only take once within a 24-hour period
Can't take if you're allergic to sulfa drugs
Pharmacist tips for Elyxyb (celecoxib) oral solution
Take Elyxyb (celecoxib) oral solution at the first sign of a migraine. You can take Elyxyb (celecoxib) oral solution with or without food. Only take the medication once within a 24-hour period.
For a typical 120 mg dose of Elyxyb (celecoxib) oral solution, you can drink the entire amount of liquid directly from the bottle. Each glass bottle contains 120 mg of medication.
Some people, like those with liver problems, might a lower dose of Elyxyb (celecoxib) oral solution. Use an oral dosing syringe from the pharmacy to measure the medication from the glass bottle. Don't use household spoons because they're not accurate and you could take the wrong dose. After you take the medication, throw away any leftover solution in the bottle right away. Don't save it for later.
After you take Elyxyb (celecoxib) oral solution, you can drink up to a cup (8 oz) of water. This can help rinse your mouth and make sure you take your dose completely.
Take Elyxyb (celecoxib) oral solution for the fewest number of days per month. This helps lower the risk for serious side effects, like stomach ulcers and heart problems.
Let your healthcare team know about all the medications you're taking (including vitamins and supplements). Elyxyb (celecoxib) oral solution can interact with many medications, such as blood thinners, blood pressure medications, and certain antidepressants. Your care team can check for drug interactions and make sure your medications are safe to take together.
Don't take other NSAIDs when you take Elyxyb (celecoxib) oral solution. It can raise your risk for serious side effects like stomach ulcers. Many over-the-counter pain, fever, and cold medications contain an NSAID. Ask a pharmacist if you're not sure whether you're taking more than one NSAID. If you're taking low-dose aspirin, ask your prescriber if it's safe to take with Elyxyb (celecoxib) oral solution.
Keep a log of when you have migraines and need to take migraine medications like Elyxyb (celecoxib) oral solution to relieve them. Taking migraine medications for more than 9 days in a month can lead to rebound headaches (also called medication-overuse headaches). Talk to your prescriber about other medications that might treat your migraines better or options for preventing migraines.
Don't take Elyxyb (celecoxib) oral solution if you're pregnant. NSAIDs like Elyxyb (celecoxib) oral solution generally aren't recommended during pregnancy because they could harm to your baby. Talk to your prescriber or obstetrician-gynecologist (OB-GYN) about safer options for treating migraines, like acetaminophen (Tylenol).
Keep Elyxyb (celecoxib) oral solution somewhere at room temperature. Don't refrigerate or freeze the medication.
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Frequently asked questions about Elyxyb (celecoxib) oral solution
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What are the risks and warnings for Elyxyb (celecoxib) oral solution?
Elyxyb (celecoxib) oral solution can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk for stomach ulcers and stomach bleeding
Risk factors: Older adults | History of peptic ulcer disease | History of stomach bleeding | Bleeding problems | Severe liver problems | Taking another NSAID at the same time | Taking other medications that raise your risk of bleeds (e.g., oral corticosteroids, aspirin, blood thinners, certain antidepressants) | Taking Elyxyb (celecoxib) oral solution for a long time | Drinking alcohol | Smoking | Poor overall health
Elyxyb (celecoxib) oral solution, like all NSAIDs, can raise your risk for stomach damage, including inflammation, stomach ulcers (sores), and bleeds. These serious stomach problems can happen at anytime during treatment. It's a dangerous side effect that needs to be treated right away.
Make sure to tell your prescriber and pharmacist about all of your conditions and medications before you start Elyxyb (celecoxib) oral solution. They can talk with you about your risk for stomach ulcers and stomach bleeding.
Let your prescriber know if you have symptoms of a stomach ulcer, like burning pain in the stomach that doesn't go away, burning feeling in the chest, acid reflux, nausea, vomiting, or feeling full quickly. For stomach bleeds, people often don't experience any symptoms. But get urgent care if you're feeling faint, have bloody or dark stools, or have bloody vomit.
Risk for heart attack and stroke
Risk factors: Heart problems | Having risk factors for heart problems | Taking higher doses of Elyxyb (celecoxib) oral solution | Taking Elyxyb (celecoxib) oral solution for a long time | Recent or planned heart surgery
Studies suggest that NSAIDs like Elyxyb (celecoxib) oral solution might raise your risk of having blood clots that can lead to a heart attack or stroke. Talk to your prescriber if you have heart problems to make sure this medication is safe for you to take. Don't take Elyxyb (celecoxib) oral solution if you had a recent heart surgery or are planning to have one because your risk is especially high after the surgery.
To lower your risk of heart attack or stroke, take Elyxyb (celecoxib) oral solution for the fewest number of days per month as needed for migraine. Call 911 right away if you have symptoms of a heart attack like chest pain that travels to the arm, neck, or jaw; shortness of breath; sweating; or nausea. Also get medical help as soon as possible if you have symptoms of a stroke like weakness on one side of your body, facial drooping, or trouble speaking or walking.
High blood pressure, swelling, and risk for heart failure
Risk factors: High blood pressure | Heart failure
NSAIDs like Elyxyb (celecoxib) oral solution can cause your body to hold onto extra fluid. This might raise your blood pressure and also cause swelling in the legs or feet. Fluid buildup can also put you at risk for heart failure.
Before you start Elyxyb (celecoxib) oral solution, tell your prescriber if you have high blood pressure or heart failure. Let them know if you're taking any medications for these conditions. Your prescriber can check for your risk for problems from this side effect. People with severe heart failure shouldn't take Elyxyb (celecoxib) oral solution unless the benefits are greater than the risks.
Call your primary care provider if your blood pressure stays higher than usual while you're taking Elyxyb (celecoxib) oral solution. Also let them know if you have any signs of heart failure, like swelling in your legs or ankles, trouble breathing, sudden weight gain, tiredness, or dizziness.
Kidney damage
Risk factors: Older adults | Kidney problems | Liver problems | Heart failure | Not enough fluids in the body (dehydration) | Taking other medications that can cause kidney problems (e.g., diuretics, ACE inhibitors, ARBs)
Long-term use of NSAIDs like Elyxyb (celecoxib) oral solution can cause kidney damage. Your risk for kidney damage with NSAIDs is higher if you're of older age or if you have certain health conditions like kidney problems or heart failure. Your risk is also higher if you're taking other medications that can cause kidney problems.
If you're at risk for kidney damage, your prescriber might order lab tests to check your kidney health while you're taking Elyxyb (celecoxib) oral solution. If your kidney health worsens, your prescriber might tell you to stop taking the medication. Call your prescriber if you have any signs of kidney damage, including changes in your need to urinate, tiredness, dry and itchy skin, low appetite, and muscle cramps.
Liver problems
Risk factors: History of liver problems
Although it's not common, some people who took NSAIDs like Elyxyb (celecoxib) oral solution can have elevated liver enzyme levels. This could be a sign of liver problems. Rarely, these liver problems have led to liver failure.
Get medical help right away if you have pain in the upper right side of the stomach; yellowing of your skin or the whites of your eyes; nausea; stool changes (black, tarry, or bloody stools); itchiness; or flu-like symptoms. These could be symptoms of liver damage. You might need to stop taking the medication so your care team can check out your liver.
Severe allergic reactions and skin reactions
Risk factors: Aspirin allergy | NSAID allergy | Sulfa allergy
Severe and sometimes life-threatening allergic reactions to Elyxyb (celecoxib) oral solution can happen. They can include facial swelling, shock, and anaphylaxis. You can't take Elyxyb (celecoxib) oral solution if you're allergic to aspirin or other NSAIDs because you could have an allergic reaction. Get medical help right away if you have hives; rash; swelling of your face, lips, or tongue; or difficulty breathing after you take the medication.
Although rare, Elyxyb (celecoxib) oral solution can also cause serious skin reactions. They can include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Stop taking Elyxyb (celecoxib) oral solution and get medical help as soon as possible if you notice any unusual changes in your skin, such as rash, blisters, or skin peeling.
Worse headaches if you take Elyxyb (celecoxib) oral solution too often
Taking migraine medications, including Elyxyb (celecoxib) oral solution, too often can cause them to work less well. It can lead to medication-overuse headaches (also called rebound headaches). This is when you have more migraine-like headaches every day or more migraine attacks.
Let your prescriber know if you're taking more than one migraine medication and if you need to take them for more than 9 days in a month. Your prescriber can talk with you about better options to help with your migraines.
Avoid during pregnancy because of harm to an unborn baby
Elyxyb (celecoxib) oral solution can cause harm to an unborn baby, especially if it's taken in the second half of pregnancy (after week 20). It can cause serious complications, like heart, kidney, or other organ problems in your unborn baby. Talk to your prescriber or obstetrician-gynecologist (OB-GYN) about the risks and benefits of taking Elyxyb (celecoxib) oral solution if you're pregnant. Ask whether there are safer options for migraine relief.
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Elyxyb (celecoxib) oral solution dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 6 bottles of oral solution of 120mg/4.8ml | 1 carton | $848.18 | $848.18 |
Typical dosing for Elyxyb (celecoxib) oral solution
Each glass bottle of Elyxyb (celecoxib) oral solution contains 120 mg of medication.
The typical dose is 120 mg (a single glass bottle) by mouth once as a single dose for migraine pain. Don't take more than one bottle in 24 hours.
Your dose might differ if you have liver problems or if you have certain genetics that affect how well your body can break down the medication.
How much does Elyxyb (celecoxib) oral solution cost?
Elyxyb (celecoxib) oral solution contraindications
History of asthma, hives, or other allergic reaction after taking aspirin or another NSAID
Right before or after coronary artery bypass graft surgery (CABG), a type of open heart surgery
Allergy to celecoxib (Celebrex)
Allergy to sulfonamides ("sulfa drugs")
What are alternatives to Elyxyb (celecoxib) oral solution?
Treatment of migraine attacks with or without aura in adults
Treatment of migraine attacks with or without aura in adults
Short-term relief of minor aches and pains due to headache, muscle aches, minor arthritis pain, toothache, backache, the common cold, or menstrual cramps
Fever
Mild-to-moderate pain
Pain from rheumatoid arthritis (RA) or osteoarthritis (OA)
Pain from menstrual cramps
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References
Best studies we foundDean, L., et al. (2021). Celecoxib therapy and CYP2C9 genotype. Medical Genetics Summaries.
Lipton, R. B., et al. (2021). Acute treatment of migraine with celecoxib oral solution: Results of a randomized, placebo-controlled clinical trial. Journal of Pain Research.
National Heart, Lung, and Blood Institute. (2022). What is coronary artery bypass grafting?
National Kidney Foundation. (2020). 10 signs you may have kidney disease.
Preuss, C. V., et al. (2023). Prescription of controlled substances: Benefits and risks. StatPearls.
Scilex Pharmaceuticals Inc. (2023). Medication guide Elyxyb (ee-lix’-ib)) (celecoxib) oral solution.
Scilex Pharmaceuticals Inc. (2024). Elyxyb - Celecoxib- celecoxib liquid [package insert]. DailyMed.
U.S. Food and Drug Administration. (2022). FDA recommends avoiding use of NSAIDs in pregnancy at 20 weeks or later because they can result in low amniotic fluid.
Wright, J. M. (2002). The double-edged sword of COX-2 selective NSAIDs. Canadian Medical Association Journal.
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