Harvard Health Letter

By the way, doctor: Celebrex and bleeding

Q. I take Celebrex for arthritis. I learned that it and the other NSAID medicines increase the risk of bleeding. If that's true, is my risk for hemorrhagic stroke higher?

A. It's all about the platelets. Platelets are tiny fragments of blood cells that help blood clot. Many nonsteroidal anti-inflammatory drugs (NSAIDs) have a tendency to reduce the ability of platelets to form clots, so they increase the risk of bleeding.

But celecoxib (Celebrex) is a COX-2 inhibitor, and the COX-2 inhibitors have just the opposite problem: they tend to cause the blood to clot, which in a coronary artery can lead to a heart attack, and in a cerebral one, to an ischemic stroke. Two other COX-2 inhibitors, rofecoxib (Vioxx) and valdecoxib (Bextra), were taken off the market for this reason. So far, Celebrex is proving to be safer, which is why the FDA has allowed it to stay on the market.

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