Millions of Americans take Celebrex for arthritis or other pain. Many, if they
are middle-aged or older, also take a low-dose aspirin tablet daily to reduce
the risk of heart attack and stroke. Yet they may be getting little protection,
because Celebrex keeps the aspirin from doing its job effectively, a new study
suggests.

In laboratory studies, University of Michigan researchers found that several
coxibs, the drug class to which Celebrex belongs, interfere with aspirin's
ability to discourage blood clots, if the aspirin is taken in low doses.
Celebrex, also known as celecoxib, is the only coxib currently on the market.
The results appear online in the Proceedings of the National Academy of
Sciences.

Doctors frequently advise daily low-dose aspirin (81 mg) for patients who have
heart conditions, notably a serious form of angina known as unstable angina, or
for patients who are at risk of second heart attacks. Aspirin is well-known for
its ability to discourage formation of blood clots that can lead to heart
attack and stroke. In addition, arthritis patients who take Celebrex regularly
are often put on low-dose aspirin because this is thought to counteract
Celebrex's own potential clot-promoting effect.

"There are many people who take low-dose aspirin, perhaps as many as half of
men over 50. If they are also prescribed Celebrex for arthritis or other pain,
our results suggest that the Celebrex will probably interfere with the
aspirin's action," says William L. Smith, Ph.D., the study's senior author,
Minor J. Coon Professor of Biological Chemistry and chair of the biochemistry
department at the U-M Medical School.

"The greatest risk is having people take Celebrex who are taking aspirin for
cardiovascular problems that are known to be mitigated by aspirin, including
patients with unstable angina or those at risk for a second heart attack," he
says. In unstable angina, small clots form in arteries and interfere with blood
flow.

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