100 Migraine Drugs, A to Z: celecoxib

Celecoxib (Celebrex) is a non-steroidal anti-inflammatory drug (NSAID) that belongs to a subclass of selective COX-2 inhibitors. This subclass of drugs tends to be safer on the stomach compared to aspirin, naproxen (Aleve), ibuprofen (Advil) and other non-selective NSAIDs.

400 mg of Celecoxib was shown to be as effective as 550 mg of naproxen for the acute treatment of migraine headaches. A course of celecoxib was also shown to be better than a course of prednisone for the treatment of medication overuse headaches. Celecoxib is a prescription drug and even though it is available as a generic, it costs $3-$4 a pill, but many insurers do pay for it.

Another selective COX-2 inhibitor, rofecoxib (Vioxx) was possibly even more effective than celecoxib for the acute treatment of migraines. However, its long-term use for arthritis in those with heart disease or risk factors for heart disease was found to contribute to heart disease and heart attacks and it was taken off the market. This was very unfortunate because migraine patients tend to be young without risk factors for heart disease and they tended to use rofecoxib only occasionally. Such use was perfectly safe and certainly safer than the use of naproxen, ibuprofen, diclofenac, and other NSAIDs.

Valdecoxib (Bextra) was another COX-2 inhibitor taken off the market.