by Dr Pandula Siribaddana

Created on: May 07, 2011   Last Updated: May 11, 2011

Celebrex is a drug belonging to the group celecoxib and is considered a non-steroidal anti-inflammatory drug (NSAID). However, it differs from other NSAIDs through its mechanism of action and it poses certain advantages when treating patients with inflammatory conditions such as arthritis and other conditions such as menstrual pain.

When considering the indications for giving Celebrex, it is obvious that there are many patients belonging to the category of ‘females in the reproductive age group’. This means, some of these patients would be breastfeeding during their treatment period. Although this is a matter of concern, the research pertaining to Celebrex and breastfeeding are few. Based on the few researches available, arriving at a conclusion regarding the safety of using Celebrex while breastfeeding is not possible. However, it gives valuable insight as to what clinicians can expect when they prescribe celecoxibs to nursing mothers.

In a research published in the Journal of Human Lactation, researchers of the Texas Tech University School of Medicine suggested, “the use of celecoxib in breastfeeding mothers at these doses is very unlikely to cause untoward effects in breastfed infants.” In their research, two groups of nursing mothers were given oral and intravenous doses of celecoxib and plasma and milk levels of the same were measures at designated intervals. Based on the results, they estimated the celecoxib transfers into human milk at around 0.3% of the weight adjusted maternal dose. Thus, the researchers believed that such a small dose would not be able to cause much harm to a healthy infant.

In a similar study published in the European Journal of Clinical Pharmacology, researchers made use of Refocoxib, a similar medication to celecoxib, to determine the transfer of the drug into human milk. They unearthed similar results, which indicated that the transfer rate was around 2.5% of the weight adjusted maternal dose. Thus, the researchers concluded that, the small amount of drug transferred into maternal milk would be ‘unlikely’ to cause harm to the suckling infant.

Thus, it is evident that the world is still trying to unravel the effects of Celebrex when used by lactating mothers. At the same time, researchers agree that, the probable transfer could be different from one person to another while its effects could also differ among individual infants. Therefore, the rational use of Celebrex should include a careful assessment of the patient and the infant by the clinician, which should be followed by a discussion between the clinician and the patient on pros, and cons of its use.

At the same time, if Celebrex is used, mothers should be aware of the potential side effects, which may manifest in their infants. These can include abdominal pain, diarrhea, headache, nausea, dizziness…etc, although any abnormality detected during the treatment period needs to be investigated thoroughly.

Reference:

Sharon J. Gardiner, Evan J. Begg, Mei Zhang and Ruth C. E. Hughes, PHARMACOKINETICS AND DISPOSITION :Transfer of rofecoxib into human milk, EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, Volume 61, Numbers 5-6, 405-408.

Thomas W. Hale et al, Transfer of Celecoxib into Human Milk, J Hum Lact November 2004 vol. 20 no. 4, 397-403.

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