Celecoxib and Fish Oil, a caution.
Fish oil has mild antiplatelet effects and may add bleeding risk to celecoxib in higher-risk situations. Modern randomized-trial evidence suggests usual omega-3 doses do not greatly increase bleeding, but high-dose EPA/DHA or combination with aspirin can matter. The risk is most relevant around procedures or in people with prior GI bleeding.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
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At a glance
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Fish oil has mild antiplatelet effects and may add bleeding risk to celecoxib in higher-risk situations. Modern randomized-trial evidence suggests usual omega-3 doses do not greatly increase bleeding, but high-dose EPA/DHA or combination with aspirin can matter. The risk is most relevant around procedures or in people with prior GI bleeding.
Mechanism. EPA and DHA can reduce platelet aggregation and thromboxane A2 production, although clinical bleeding effects are usually small at standard doses. Celecoxib can still cause GI injury, particularly with aspirin or other risk factors.
Recommendation. Use caution with high-dose fish oil while taking celecoxib, especially if you also take aspirin. Pause fish oil before procedures if your clinical team requests it, and report black stools, vomiting blood, or unusual bruising.
Sources (2)
- Javaid M, Kadhim K, Bawamia B, Cartlidge T, Farag M, Alkhalil M. Bleeding Risk in Patients Receiving Omega-3 Polyunsaturated Fatty Acids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Am Heart Assoc. 2024;13(10):e032390. PMID 38742535
- Bays HE. Safety considerations with omega-3 fatty acid therapy. Am J Cardiol. 2007;99(6A):35C-43C. PMID 17368277
Stack Score
How this pair moves the number.
Effect on the composite score
If both Celecoxib and Fish Oil are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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