Celebrex as a Migraine Treatment and Why It's Unique

Risks and Side Effects of Celebrex for Migraine Therapy


Celebrex — generic name celecoxib — is a type of nonsteroidal anti-inflammatory, or NSAID. It works by counteracting prostaglandin-induced inflammation in the body, thereby reducing pain. While commonly used to treat arthritis, some doctors prescribe Celebrex for acute migraines.

How is Celebrex Different from a Traditional NSAID, like Ibuprofen or Naproxen?

Celexbrex targets an enzyme in the body called COX-2, which is responsible for inflammation in the body.

Ibuprofen and naproxen, on the other hand, target both the enzymes COX-2 and COX-1 — so they are called non-selective NSAIDs. COX-1 is an enzyme that helps maintain the lining of the stomach and intestines.

While NSAIDs can reduce pain and inflammation by targeting COX-2, they also can cause injury to the stomach and intestinal lining, leading to gastrointestinal bleeding and ulcers. By selectively targeting COX-2, Celebrex decreases the risk of stomach and intestinal problems. 

Is Celebrex Prescribed by Neurologists for Migraines?

Even though NSAIDs are considered first-line therapy for acute migraines, there is still caution used by many doctors in prescribing Celebrex. This is due from the withdrawal of other COX-2 inhibitors from the market, like Vioxx (rofecoxib), due to their association with cardiovascular problems.

Now all NSAIDs, including Celebrex, carry a boxed warning for increased risk of cardiovascular disease, like heart attack and stroke.


That being said, Celebrex may be an alternative mode of therapy in the treatment of acute migraines, especially for people at risk for NSAID-induced injury to their stomach and intestines. To support this theory, one small 2007 study in Singapore Medical Journal found that 400mg of celecoxib was equal to 550mg naproxen in alleviating acute migraines — and celecoxib caused less stomach pain than naproxen.


What are Some Questions Your Doctor Might Ask You if Prescribed Celebrex?

As with any medication, it's important to discuss all the possible risks and side effects with your doctor. Here are examples of a few questions your doctor may ask you:

  • What other medications are you taking? Some medications interact with Celebrex or worsen its potential for side effects.
  • Do you have any allergies? For example, you should not take Celebrex if you have had asthma, hives, or an allergic reaction to an NSAID in the past.
  • Do you have any medical problems? For example, Celebrex should not be given before or after heart bypass surgery. 
  • Are you pregnant? Celebrex should not be used in the later stages of pregnancy. 

What are Some Serious Side Effects of Celebrex?

These require that you contact your doctor immediately and include:

  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives)
  • abdominal pain, tenderness, or discomfort
  • bloody, black, or tarry stools
  • nausea or heartburn
  • bloody vomit
  • unexplained weight gain
  • swelling or water retention
  • unusual fatigue or lethargy
  • a skin rash or itching
  • yellowing of your skin or eyes
  • "flu-like" symptoms
  • unusual bruising or bleeding

Due to the potential increased risk of heart attack and stroke with Celebrex and other non-aspirin NSAIDs, like ibuprofen and naproxen, it's important to seek medical attention right away if you experience chest pain, problems breathing, weakness on one part or side of the body, or slurred speech. 

Other less serious possible side effects include: flatulence, diarrhea, dizziness, cold symptoms. It's important to contact your doctor if you notice any side effects that are bothersome, persistent, or are concerning to you or others. 

What Does This Mean?

If your doctor prescribes Celebrex for your migraines, you might find it gentler on your stomach than Aleve (naproxen) or Motrin (ibuprofen). 


American Academy of Neurology. Evidence-Based Guidelines for Migraine Headache in the Primary Care Setting: Pharmacological Management of Acute Attacks. Retrieved December 2nd 2015. 

FDA. FDA approves first generic versions of celecoxib. Retrieved December 2nd 2014.

Hawkey CJ. COX-1 and COX-2 inhibitors. Best Pract Res Clin Gastroenterol. 2001 Oct;15(5):801-20. 

Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache. 2012;52:930-45.

Loo CY, Tan HJ, Teh HS & Raymond AA. Randomized, open label, controlled trial of celecoxib in the treatment of acute migraine. Singapore Med J. 2007 Sep;48(9):834-9.

U.S. Food and Drug Administration. (July 9th 2015). FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NsAIDs) can cause heart attacks or strokes. 

U.S. Food and Drug Administration. Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). 

Material on this page is for informational purposes only, and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications.

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