Celebrex vs. Indomethacin
See how Celebrex and Indomethacin compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Celebrex is a COX-2 selective NSAID usually taken once or twice a day, while indomethacin is an older, non-selective NSAID typically taken 2 to 4 times a day.
Both drugs carry the same class-wide NSAID warnings for heart attack, stroke, and stomach bleeding, but celecoxib's selectivity is linked to fewer stomach ulcers in trials.
Indomethacin is FDA-approved for acute gout attacks and painful shoulder from bursitis or tendinitis, uses that are not on Celebrex's label.
Celebrex vs. Indomethacin Drug Summary
Celebrex
Celebrex (celecoxib) is a COX-2 selective NSAID used to relieve pain and inflammation from osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and menstrual cramps. It comes as a capsule taken once or twice daily, with doses ranging from 100 mg to 400 mg depending on the condition.
Indomethacin
Indomethacin is an older, non-selective NSAID used for moderate to severe rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, acute gout, and painful shoulder from bursitis or tendinitis. It is taken as a capsule 2 to 4 times a day, with the dose adjusted weekly based on response.
Celebrex vs. Indomethacin Side Effects
Celebrex
Indomethacin
Celebrex vs. Indomethacin Dosage
Celebrex
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 200 mg once daily | At the start |
| Maximum dose | 200 mg twice daily | Day 1 |
| Dose changes | 4 increases | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | 50 mg three times daily | If needed |
| Dose changes | 4 increases | As tolerated |
Celebrex
| STAGE | DOSE | WHEN |
| Starting dose | 200 mg once daily | At the start |
| Maximum dose | 200 mg twice daily | Day 1 |
| Dose changes | 4 increases | As tolerated |
Indomethacin
| STAGE | DOSE | WHEN |
| Starting dose | 25 mg 2-3 times daily | At the start |
| Maximum dose | 50 mg three times daily | If needed |
| Dose changes | 4 increases | As tolerated |
Celebrex vs. Indomethacin Indications
Celebrex
Celebrex (celecoxib) is FDA-approved to treat pain and inflammation from osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in children 2 and older, and ankylosing spondylitis. It's also approved for short-term management of acute pain and for menstrual cramps.
Osteoarthritis
Rheumatoid arthritis (adults and children 2+)
Ankylosing spondylitis
Acute pain
Primary dysmenorrhea (menstrual cramps)
Indomethacin
Indomethacin is FDA-approved to treat moderate to severe rheumatoid arthritis, ankylosing spondylitis, and osteoarthritis, including acute flares of chronic disease. It's also approved for acute gouty arthritis and for acute painful shoulder caused by bursitis or tendinitis.
Rheumatoid arthritis
Ankylosing spondylitis
Osteoarthritis
Acute gouty arthritis
Bursitis or tendinitis (painful shoulder)
Celebrex vs. Indomethacin Pros and Cons
Celebrex
Celebrex's COX-2 selectivity is associated with lower rates of stomach ulcers than older NSAIDs, though it still carries the same cardiovascular warning as the rest of the class. Both brand and generic versions are on the market, so coverage and cost vary widely by plan.
Pros
Once or twice daily dosing, less frequent than indomethacin
Selective COX-2 action linked to fewer stomach ulcers in trials
Approved for a broader range of uses, including menstrual cramps and pediatric JRA
Cons
Contains a sulfonamide group, so it's avoided in patients with sulfa allergy
Not FDA-approved for gout, unlike indomethacin
Brand-name capsules can be costly without insurance
Indomethacin
Indomethacin is a stronger, non-selective NSAID with decades of clinical use, including a specific approval for acute gout flares. It tends to cause more stomach and nervous system side effects than newer NSAIDs, and its label advises against long-term use.
Pros
Specifically FDA-approved for acute gout flares
Long track record of use since 1965
Available in capsule, extended-release, suspension, and suppository forms
Cons
Requires dosing 2 to 4 times a day, more often than Celebrex
Non-selective COX inhibition carries a higher risk of GI ulcers and bleeding
Higher rates of headache and dizziness than celecoxib
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