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Is Celecoxib Safe To Prevent Nighttime Urination (Nocturia)?

How do you prevent nighttime urination? Some people take an NSAID such as celecoxib, diclofenac or ibuprofen. Are they safe and effective?

There is nothing more annoying than waking up in the middle of the night with a strong urge to pee. Well, actually there is. Waking up to discover that you have had an accident in bed is uncomfortable and embarrassing. Unfortunately, some people have to get up multiple times during the night to go to the bathroom. That messes up their sleep. It’s not always easy to fall asleep once you have to get up a few times. Is it safe to take an NSAID like celecoxib or ibuprofen to prevent nighttime urination? Several readers wonder about this.

NSAIDs to Prevent Nighttime Urination:

Q. When Flomax did nothing to reduce frequent nighttime urination, my urologist said anecdotal information suggests that ibuprofen may help in some cases. Trying it, I have reduced my nightly visits from about four down to around two.

Googling, I found that ibuprofen reduces prostaglandins. Another article suggested prostaglandins activate the “sensor” responsible for signaling the brain that the bladder needs emptying. I have a urologist visit next week and will discuss this with him.

Meanwhile, I will add the raisin regimen you’ve described to see if that is beneficial. Do you have any other suggestions?

Reducing Nighttime Bathroom Visits:

A. We first heard about using nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib (Celebrex) for men with nighttime urination due to prostate enlargement (Urology, Oct. 2008).  Regular use of NSAIDs, however, might harm the kidneys. You should ask the urologist to monitor your renal function. These drugs can also increase the risk for stomach ulcers and high blood pressure as well as heart attacks and strokes.

You might consider munching a handful of raisins in the evening. There’s no science to this remedy you’ve read about, but many readers report it can be helpful. Other options include Pycnogenol (Minerva Medica, Aug. 2018), pygeum bark (American Journal of Medicine, Dec. 1, 2001) and lycopene (Journal of Functional Foods, July, 2021).

Does Celecoxib Reduce Nighttime Urination?

Q. My husband read that celecoxib could reduce his number of nighttime trips to the bathroom (nocturia). That has worked, but now he is complaining of stomach upset and his blood pressure has inched up.

He likes getting better sleep but not if celecoxib causes more problems. Do you have any safer suggestions?

A. There is scientific support that NSAIDs like celecoxib (Celebrex) can help control hard-to-treat nocturia (nighttime urination). In one small study celecoxib reduced nighttime trips to the bathroom from 5.17 to 2.5 (Urology, Oct. 2008).

A Doctor Warns Against using NSAIDs for Nocturia:

Q. You have written about men taking ibuprofen or celecoxib to cut down on nighttime urination (nocturia). As a physician, I’d say taking an NSAID like that to reduce nocturia is a bad idea. The effect is to reduce blood flow to the kidneys, which translates to reduced glomerular filtration rate (GFR).

As a result, less urine is produced. This is amplified if someone is taking an ACE inhibitor or ARB and/or a diuretic, which act by different mechanisms on the kidney.

Less urine means fluid is retained and consequently blood pressure increases. Also, reduced blood flow to the kidneys can result in kidney damage. I’d stay away from NSAIDS if you can, especially if you are older.

A. Thank you for a thorough explanation of why some people have noticed fewer nighttime bathroom visits after taking NSAIDs. Although a systematic review and meta-analysis of drugs like celecoxib (Celebrex) shows benefit for men with nocturia (American Journal of Men’s Health, May-June, 2023), we agree with you.

Instead of an NSAID, some people might want to consider home remedies such as raisins or beets. Even though there are no scientific studies, readers can find more details in our eGuide to Favorite Home Remedies. This online resource can be found under the Health eGuides tab.

Ibuprofen to the Rescue?

We heard about NSAIDs to prevent nighttime urination several years ago. A runner told us that if he took ibuprofen to alleviate post-exercise soreness, he was much less likely to have to get up at night to pee.

After some digging, we found articles that confirmed this observation. A Japanese study tested loxoprofen (not available in the U.S.) on 93 men with benign prostatic hypertrophy (BPH).

The investigators reported that:

“Nocturia improved or disappeared in 74.2% of patients: excellent, improved, unchanged, and worsened results were obtained in 37.6%, 36.6%, 21.5%, and 4.3% of patients, respectively. The effects were better in patients whose baseline nocturia was > 2 times than in those with a lesser frequency at enrollment  Loxoprofen can be an effective and useful treatment option for patients with BPH complaining of refractory [hard to treat] nocturia.” (Acta Medica Okayama, Feb. 2004).

A British study published in European Urology (April, 2006) reported positive results with diclofenac (Voltaren).

The authors concluded:

“NSAIDs are effective in the treatment of nocturnal polyuria [nighttime excessive urination] causing a decrease in nocturnal frequency with subjective symptom improvement. Our study suggests a novel treatment option for this common condition.”

The Downsides of NSAIDs to Prevent Nighttime Urination:

Taking an NSAID like celecoxib, diclofenac or ibuprofen to prevent nighttime urination carries substantial risk. Such drugs can increase the risk for indigestion, stomach pain, ulcers, hypertension, heart failure, heart attacks and strokes.

There is another complication. NSAIDs affect the kidneys. Such medications can cause renal damage in susceptible patients. Sodium and fluid retention are potential problems, especially in older individuals (Pharmaceuticals Basel, July 2010).  In our opinion, that makes such drugs inappropriate for a lot of people, especially when taken regularly.

Raisins to Prevent Nighttime Urination?

Your husband may find that a handful of raisins before bedtime may help with his nocturia. Many readers report improvement with this simple approach.

Lyn in Arizona shares this experience:

“Raisins work for me. If you get up only one time to pee you need to take an extra raisin. I take 8-9 sometimes once or twice a day and the every-2-hour-waking-up-to-pee cycle is gone. I use dark raisins.”

William in Whitby, Ontario, warns about a raisin risk:

“I’ve been on Flomax (tamsulosin) for years and it is not working as well as I age. I sometimes have to get up 3 to 4 times a night to pee. I wasn’t getting proper sleep and as a result I was tired during the day.

“Recently I had to get up 6 times. Before I went to the doctor to increase my dose of Flomax, I decided to try the raisin solution. To my surprise and amazement it worked incredibly well. I ate about a dozen raisins before bed, and only had to get up once in the night, after sleeping soundly for 5 hours! This continues to work, but it’s necessary to brush your teeth after eating the raisins as they are high in sugar content and small pieces stick to your teeth.

“I have read about the raisin remedy for years but was very skeptical. Now I’m a believer. Thanks to People’s Pharmacy!”

Raisins won’t work for everyone. Some folks tell us the raisin remedy does not prevent nighttime urination. Hey, that’s true of home remedies as well as potent prescription drugs. There are no guarantees.

You can learn more about this and a beet soup recipe for reducing nighttime urination in our eGuide to Favorite Home Remedies. It can be found in the Health Guide section at www.PeoplesPharmacy.com.

Please share your own experience with the raisin remedy to prevent nighttime urination in the comment section.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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Citations
  • Falahatkar S et al, "Celecoxib for treatment of nocturia caused by benign prostatic hyperplasia: a prospective, randomized, double-blind, placebo-controlled study." Urology, Oct. 2008. DOI: 10.1016/j.urology.2008.04.069
  • Ledda A et al, "Benign prostatic hypertrophy: Pycnogenol® supplementation improves prostate symptoms and residual bladder volume." Minerva Medica, Aug. 2018. DOI: 10.23736/S0026-4806.18.05572-6
  • Ishani A et al, "Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis." American Journal of Medicine, Dec. 1, 2001. DOI: 10.1016/s0002-9343(00)00604-5
  • Quiros-Roldan E et al, "Symptoms and quality of life in HIV-infected patients with benign prostatic hyperplasia are improved by the consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study." Journal of Functional Foods, July, 2021. https://doi.org/10.1016/j.jff.2021.104495
  • Saraki, T., et al, "Effectiveness of a nonsteroidal anti-inflammatory drug for nocturia on patients with benign prostatic hyperplasia: a prospective non-randomized study of loxoprofen sodium 60 mg once daily before sleeping," Acta Medica Okayama, Feb. 2004, doi: 10.18926/AMO/32115
  • Addla, S.K., et al, "Diclofenac for treatment of nocturia caused by nocturnal polyuria: a prospective, randomised, double-blind, placebo-controlled crossover study," European Urology, April, 2006, doi: 10.1016/j.eururo.2005.11.026
  • Horl WH, "Nonsteroidal anti-inflammatory drugs and the kidney." Pharmaceuticals (Basel), July 2010. doi: 10.3390/ph3072291
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