Know more about medicine | Why should patients with cardiovascular disease use celecoxib with caution?

During his ward rounds, Dr. Jiang from the Department of Cardiology discovered that a 60-year-old patient named Lao Wang had recently developed a rash all over his body and palpitations after taking celecoxib for pain relief due to osteoarthritis. Lao Wang asked Dr. Jiang if the painkillers were to blame.

Celecoxib is the first selective cyclooxygenase-2 (COX-2) inhibitor to be marketed among nonsteroidal anti-inflammatory drugs (NSAIDs), and is widely used in the treatment of acute pain such as osteoarthritis. Compared with traditional non-selective NSAIDs, this type of drug has strong targeting and fewer side effects, but it can also cause adverse reactions such as cardiovascular damage, and patients with cardiovascular disease should use it with caution.

Celecoxib can affect the antithrombotic balance of prostacyclin I2 produced by vascular endothelial cells, easily increase serious cardiovascular thrombotic events, and is contraindicated for the treatment of perioperative pain during coronary artery bypass surgery; it can reduce the excretion of water and sodium, aggravate water and sodium retention in patients with heart failure, and is contraindicated for patients with severe heart failure; it can also activate the renin-angiotensin-aldosterone system, thereby antagonizing the antihypertensive effect of antihypertensive drugs in this pathway. Therefore, if patients experience symptoms such as chest tightness, edema, and increased blood pressure while taking this drug, they need to seek medical attention in a timely manner.