Beyond analgesia: A comprehensive opinion review on the dual-action strategy of celecoxib and duloxetine in knee osteoarthritis

Core Tip

Core Tip: Combining celecoxib and duloxetine is more effective than celecoxib alone for pain, depression, and anxiety in patients with knee osteoarthritis. However, its assertion of safety after only eight weeks is overly optimistic. Prescribers must be warned about the serious long-term risks that were not adequately covered. Celecoxib carries established cardiovascular and gastrointestinal risks, while duloxetine poses significant risks for hepatotoxicity, central nervous system side effects (like dizziness and falls), and a severe discontinuation syndrome. Given that typical knee osteoarthritis patients are often older and present with comorbidies, the combination requires thorough cardiovascular and hepatic screening, meticulous review for drug-drug interactions, and informed consent regarding the mandatory slow tapering of duloxetine. The evidence is preliminary; this dual-action treatment should be reserved for patients who have failed simpler strategies.