Celecoxib is a painkiller that is in the family of medications called the non-steroidal anti-inflammatory drugs (NSAIDs). Like other NSAIDs, the combination of celecoxib and alcohol can prove dangerous. For this reason, both medical professionals and the drug's manufacturers warn against mixing it with alcohol, even when taken in low doses.
The danger of mixing celecoxib and alcohol comes largely from the way that each of these substances work in the body. One danger comes from potential stomach damage, although this risk is not as great as with other types of NSAIDs. Celecoxib, like other NSAIDs, suppresses inflammation in the body by inhibiting a protein called cyclooxygenase-2 (COX-2), which is involved in the immune response. This drug, for the most part, specifically targets COX-2, unlike NSAIDs like ibuprofen, but there is some residual inhibition of a related enzyme, COX-1.
Found in the stomach, COX-1 assists in protecting the stomach from its own acids. Even small amounts of inhibition can lower the defenses of the stomach against damage. Alcohol can directly irritate the stomach lining and promote the release of stomach acid, further damaging his area. Combining celecoxib and alcohol can cause stomach bleeding through these mechanisms. In essence, celecoxib can leave the stomach unable to protect itself against damage mediated by alcohol.
As noted, celecoxib's specific targeting of COX-2 lowers the risk of stomach bleeding and ulcers, though does not eliminate it entirely. Drinking large amounts of alcohol, taking large doses of the medication, or engaging in both activities for long periods of time can all increase the risks of adverse effects. Taking other NSAIDs like acetaminophen or ibuprofen with celecoxib and alcohol can also significantly increase the chances of harmful events.
Another possible risk from the mixture of celecoxib and alcohol comes from effects that each substance can have on the heart. NSAIDs such as celecoxib that specifically target the COX-2 enzyme seem to have a greater chance of leading to major cardiovascular problems, including strokes and heart attacks. Drinking heavily can lead to cardiovascular problems as well, such as a condition that enlarges the heart, which also increases the risk of serious adverse events, which also can include heart attacks and strokes. More research must be performed on individuals that have mixed celecoxib and alcohol, but from the evidence available, there appears to be a possible risk of this combination contributing to life-threatening heart problems.