Celecoxib

Anti-rheumatic, Systemic · Cox-2 inhibitor

Indications

Rheumatoid arthritis, osteoarthritis. Dysmenorrhoea. Acute pain.

Dosage

Adults: Osteoarthritis: 200 mg once daily or in two divided doses. Increase to 200 mg twice daily if necessary. Max 400 mg daily. Rheumatoid arthritis: 200-400 mg daily in two divided doses. Max 400 mg daily. Dysmenorrhoea: Day 1: 400 mg, then 200 mg if needed. Maintenance: 200 mg twice daily if needed. Acute Pain: Day 1: 400 mg, then 200 mg if needed. Maintenance: 200 mg twice daily if needed. Children: Not recommended.

Adverse Effects

Fluid retention, GI upset, dizziness, insomnia, upper respiratory tract disorder, skin rash, MI, hypertension, hypertonia, headache, sinusitis, pharyngitis, rhinitis, cough, dyspnoea, UTI, arthralgia, flu-like symptoms, pruritus, accidental injury. Reports of serious skin, hypersensitivity and hepatic reactions (discontinue).

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: History of hypersensitivity to sulphonamides or NSAIDs, active peptic ulceration or GI bleeding, inflammatory bowel disease, severe renal or hepatic impairment, severe congestive heart failure, ischaemic heart disease, peripheral artery disease, cerebrovascular disease. Contraception must be used. Precautions: Renal or hepatic impairment, history of GI disease, cardiac failure, left ventricular dysfunction, hypertension, oedema, risk of hypovolaemia and cardiovascular events. Monitor BP during initiation and throughout treatment. Elderly(>65 years); use lower initial dose.

Interactions

Diuretics, antihypertensives, ACE inhibitors, anticoagulants, drug metabolised by CYP2D6 or 2C19, lithium, cyclosporin, tacrolimus, methotrexate (monitor), rifampicin, carbamazepine, barbiturate, fluconazole, dextromethorphan, TCADs, SSRIs, antipsychotics, antiarrhythmics, diazepam, citalopram, imipramine, other inducers or inhibitors of CYP2C9, aspirin, other NSAIDs.

Advice to Patient

Take with or without meals. To reduce GI upset, take with meals. Swallow whole with a full glass of water. Discontinue medication and inform prescriber immediately if there is stomach pain, cramps, chest pain, difficulty in speaking, unusual bleeding or bruising, blood in stool/urine/vomitus. Contact prescriber if you experience changes in hearing, ringing in ears, persistent lack of sleep, skin rash, change in vision, difficulty in breathing, change in urinary pattern, black stool, muscle pain, tremors or weakness, unusual fatigue, sudden weight gain, edema, blisters, fever. Avoid taking with antacids. Avoid alcohol and smoking during therapy.

Pharmacokinetics

Absorption: Prolonged due to low solubility. Metabolism: Hepatic. Bioavailability: Absolute: Unknown. Half-life elimination: Children and adolescents (approx. 7-16 years) steady state: 6±2.7 hours (range: 3-10 hours); Adults: Approx. 11 hours (fasted). Time to peak: Children: Median: 3 hours (range: 1-5.8 hours); Adults: Approx. 3 hours. Excretion: Feces (approx. 57% as metabolites, <3% as unchanged drug); urine (27% as metabolites, <3% as unchanged drug).

Brands with this active ingredient

• Arshib
• Artiflex
• Bixo
• Bloxib
• Calaxib
• Cavil
• Celadon
• Celbexx
• Celebrex
• Celeflox
• Celenor
• Celewin
• Celicob
• Celmatic
• Celoflex

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.