This information is for educational purposes only. Off-label drug use carries risks. Always consult a qualified physician before using any drug outside its approved indication.
Celecoxib
Celecoxib
Brand names: Celebrex, Onsenal
ORIGINALLY APPROVED FOR
Arthritis, Acute Pain, Familial Adenomatous Polyposis (FAP)
Celecoxib is actually FDA-approved for cancer prevention in Familial Adenomatous Polyposis (FAP) — making it one of the few truly 'approved' repurposed drugs in oncology. It selectively inhibits COX-2, which is overexpressed in many cancers and drives prostaglandin E2 production, fuelling inflammation, angiogenesis, immune evasion, and metastasis. Multiple trials show celecoxib can reduce colorectal polyp recurrence and has activity in breast, prostate, and lung cancers.
Molecular Pathways Targeted
Mechanism of Action in Cancer
Selective COX-2 inhibition → reduces PGE2 synthesis → decreases tumour-promoting inflammation → reduces angiogenesis (VEGF suppression), immune evasion, and metastasis. At higher doses also directly inhibits Akt/PKB survival signalling and Bcl-2 family anti-apoptotic proteins independent of COX-2.
Cancers Studied
Typical Off-Label Dosing
200–400 mg twice daily (400–800 mg/day). FAP approved dose is 400 mg twice daily. Cancer prevention studies have used 200–400 mg twice daily. Cardiovascular risk increases with higher doses and prolonged use.
* Dosing information from research literature only. Not a prescription. Requires physician supervision.
Cautions & Drug Interactions
- Increased cardiovascular risk — especially at high doses, prolonged use, or pre-existing CVD
- GI ulcers and bleeding (lower risk than non-selective NSAIDs but not zero)
- Contraindicated after CABG surgery
- Sulfa allergy — celecoxib is a sulfonamide derivative
- Kidney impairment — avoid in significant renal disease
- Liver toxicity — rare but monitor LFTs with long-term use