On November 2, 2007, the FDA approved safety labeling revisions for
celecoxib capsules (Celebrex;
GD Searle, LLC) to advise of the risk for adverse
renal effects in
patients receiving treatment with celecoxib and other nonsteroidal
anti-inflammatory drugs (NSAIDs).As with other NSAIDs, long-term
use of celecoxib can lead to renal papillary necrosis, renal
insufficiency, acute renal failure, and other renal injuries. In
patients for whom renal prostaglandins have a compensatory role in the
maintenance of renal perfusion, NSAIDs may cause a dose-dependent
reduction in prostaglandin formation and, secondarily, renal blood flow
that may precipitate overt renal decompensation.Patients with
impaired renal function, heart failure, or liver dysfunction; elderly
patients; and those taking diuretics, angiotensin-converting enzyme
(ACE) inhibitors, and
angiotensin II receptor
antagonists are at
greatest risk for this reaction. Discontinuation of NSAID
therapy usually is followed by recovery to the pretreatment state.According
to the FDA, studies also suggest that NSAIDs may diminish the
antihypertensive effect of ACE inhibitors and angiotensin II receptor
antagonists. This interaction should be considered when concomitant
therapy with these agents is prescribed.Celecoxib is indicated
to relieve signs and symptoms of osteoarthritis, ankylosing
spondylitis, and rheumatoid arthritis. It may also be used for the
management of acute pain in adults, the treatment of primary
dysmenorrhea, and the reduction in the number of colorectal polyps in
familial adenomatous polyposis.
More abstracts about the Long-Term Use of Celecoxib (Celebrex) and Other NSAIDs Linked to Adverse Renal Effects