celecoxib and tramadol

What is the most important information I should know about celecoxib and tramadol?

Celecoxib and tramadol can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Celecoxib and tramadol may also cause stomach or intestinal bleeding, which can be fatal. This can occur without warning, especially in older adults.

What is celecoxib and tramadol?

Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID). Tramadol is an opioid pain medicine.

Celecoxib and tramadol is a combination medicine used in adults for the management of pain when other medicines cannot be used or have not worked.

Celecoxib and tramadol may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking celecoxib and tramadol?

Celecoxib and tramadol can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Celecoxib and tramadol may also cause stomach or intestinal bleeding, which can be fatal. This can occur without warning, especially in older adults.

• an allergy to sulfa drugs or opioids;
• severe asthma, trouble breathing, or other breathing problems;
• a bowel blockage or narrowing of the stomach or intestines; or
• a history of asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Do not give celecoxib and tramadol to people:

• younger than 12 years or younger than 18 years after surgery to remove the tonsils and/or adenoids.

Avoid giving celecoxib and tramadol to people 12 to 18 years who have sleep apnea, obesity, or other breathing problems.

Do not use celecoxib and tramadol if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine.

Tell your doctor if you have ever had:

• head injury or seizures;
• thyroid problems;
• problems urinating;
• pancreas or gallbladder problems;
• a stomach ulcer, bleeding in your stomach or intestines;
• heart disease, high blood pressure;
• asthma;
• drug or alcohol addiction, opioid overdose, or mental health problems; or
• liver or kidney disease.

You should not take celecoxib and tramadol unless your doctor tells you to. If you use celecoxib and tramadol during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

Taking this medicine during the last 20 weeks of pregnancy may harm an unborn baby. Tell your doctor if you become pregnant or think that you may be pregnant.

How should I take celecoxib and tramadol?

Follow all directions on your prescription label and read all medication guides. Use the lowest dose that is effective in treating your condition. Do not take more than your prescribed dose.

You may have withdrawal symptoms if you stop using celecoxib and tramadol suddenly. Ask your doctor before stopping the medicine.

What happens if I miss a dose?

Skip the missed dose and take your next dose at the regular time. Do not take two doses at one time.

What happens if I overdose?

Your doctor may recommend you get naloxone (a medicine to reverse an opioid overdose) and keep it with you at all times. A person caring for you can give the naloxone if you stop breathing or don't wake up. Your caregiver must still get emergency medical help and may need to perform CPR (cardiopulmonary resuscitation) on you while waiting for help to arrive.

What should I avoid while taking celecoxib and tramadol?

Avoid taking aspirin or other NSAIDs unless your doctor tells you to.

What are the possible side effects of celecoxib and tramadol?

Stop using celecoxib and tramadol and seek medical treatment right away if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Celecoxib and tramadol can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

• severe headache, blurred vision, pounding in your neck or ears, or severe constipation;
• kidney problems --little or no urination, swelling in your feet or ankles, feeling tired or short of breath;
• decreased adrenal gland hormones --nausea, vomiting, stomach pain, loss of appetite, feeling tired or light-headed, muscle or joint pain, skin discoloration, craving salty foods;
• signs of a heart attack or stroke --chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath; or
• low red blood cells (anemia) --pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

• low blood sodium --headache, confusion, problems with thinking or memory, weakness, feeling unsteady;
• signs of stomach bleeding --bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• liver problems --nausea, stomach pain (upper right side), itching, tiredness, dark urine, jaundice (yellowing of the skin or eyes); or
• heart problems --swelling, rapid weight gain, feeling short of breath.

Common side effects may include nausea, vomiting, dizziness, headache, and drowsiness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect celecoxib and tramadol?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Many drugs can affect celecoxib and tramadol. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information?

Your doctor or pharmacist can provide more information about celecoxib and tramadol.