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Have pinched nerve. Suggested celebrex. Taking Warfarin for AFIB. Take metoprolol and digoxin. Continue medications?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I have a pinched nerve in my neck, one of my docs suggested Celebrex twice a day instead of Tylenol. I am worried because I have many issues.. I take warfarin 1mg for AFIB .. Have high BP which I take metoprolol 75mg, digoxin 125 mcg, I had ulcers 30 yrs ago, not bleeding though .. They are gone now. I also have an ileostomy .. Went thru chemo & radiation 2010 to 2012.. Seem to be clear on last scan in May 2012... So my question is... Do you think taking Celebrex for the treatment of the pinched nerves.. Obtw I tried PT, it didn't help.
Posted Thu, 17 Oct 2013 in General Health
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Brief Answer:
Celebrex is better than Tylenol

Detailed Answer:
Hi, thanks for writing to XXXXXXX

Celebrex (celecoxib) which is cox 2 inhibitor is indicated in treating several conditions that are related to pain and inflammation. The drug works by blocking the COX-2 enzyme, which plays a role in pain and inflammation in the body. Whereas tylenol is only a weak analgesic agent.

Though there are many other potent analgesic agents (pain killers), the doctor might have prescribed you celebrex because of its relative safety in elderly age group patients with preexisting comorbidities (as in your case).

The general recommendations for a pinched nerve in the neck are as follows -

Soft Collar: Soft collar allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.

Medicines: Analgesic are needed in the acute phase. Muscle relaxants are essential for relieving muscle spasms once the acute pain subsides. Neurotropic vitamins like METHYLCOBALAMINE (activated Vit B12) or PREGABALIN will help in alleviating the neuropathic pain.

Cervical traction: may enlarge the disc space, permitting the prolapse to subside. Intermittent cervical traction for not more than 30 minutes at a time. Weight upto 8kg can be added.

Physiotherapy: Once the acute phase of pain has subsided, Isometric strengthening exercises of the paravertebral muscles are started. Improving neck strength and flexibility with simple exercises may lessen discomfort and pain. Moist heat can be useful

Epidural steroids: are useful for patients with severe radicular pains in the limbs. Cortisone is a powerful anti-inflammatory preparation and so its injections in the "epidural space" can decrease swelling as well as pain.

Hope I have addressed your query. Happy to help further.

Above answer was peer-reviewed by
Follow-up: Have pinched nerve. Suggested celebrex. Taking Warfarin for AFIB. Take metoprolol and digoxin. Continue medications? 18 minutes later
So are you saying that celebrex shouldn't pose a problem or interfere with the warfrin and cause more of a bleeding threat? I will assuratedly take the pills with food. I am nervous to start them on Wednesday .. Obtw, is Celebrex a strong pain killer? Stronger than Tylenol? The dose my doc prescribed is 200 mg twice a day.. I noticed on the dosing directions on the site, mentioned that 400 mg can be the FIRST DOSE.. Do you recommend that to start?
I await your reply.
Thank you.
Answered by Dr. K. Naga Ravi Prasad 15 minutes later
Brief Answer:
Dosages of a drug will be individual based.

Detailed Answer:
Hi, Nice to hear from you.

It looks like that you have misinterpreted by answer. I made it clear that celebrex is better than tylenol in terms of potency and efficacy. I didn't admitted that celebrex will not interfere with warfarin.

Infact, Using warfarin TOGETHER with celecoxib may cause you to bleed more easily. You may need a dose adjustment based on your prothrombin time or International Normalized Ratio (INR). As you are taking different other medications also, it is always wise to approach your treating doctor and discuss the issues so as to avoid drug interactions.

There is no hard and fast rule that celebrex has to be taken as 400mg starting dose. It depends upon the disease condition and the individuals general condition. Please follow your treating doctors advice.

Hope I have justified your query. Good day
Above answer was peer-reviewed by
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