Celecoxib

Indications
 Oral
Osteoarthritis
Adult: 200 mg as a single dose or in 2 divided doses. May increase to 200 mg 2 times if necessary.
Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.
Oral
Rheumatoid arthritis
Adult: 100-200 mg bid.
Elderly: 100 mg bid.
Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.
Oral
Dysmenorrhoea
Adult: Initially, 400 mg followed by 200 mg if necessary on the 1st day. Maintenance: 200 mg bid.
Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.
Oral
Pain relief
Adult: Initially, 400 mg followed by 200 mg if necessary on the 1st day. Maintenance: 200 mg bid.
Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.
Oral
Familial adenomatous polyposis
Adult: 400 mg bid.
Hepatic impairment: Child-Pugh category B: Reduce dose by 50%. Child-Pugh category C: Avoid use.

Special Populations: Reduce dose to 50% in patients with moderate hepatic impairment.
Contraindications
 Hypersensitivity including those in whom attacks of angioedema, rhinitis and urticaria have been precipitated by aspirin, NSAIDs or sulfonamides. Severe hepatic impairment; severe heart failure; inflammatory bowel disease; peptic ulcer; renal impairment (creatinine clearance <30 mL/min); pregnancy and lactation.
Warnings / Precautions
 History of GI bleeding; renal/hepatic insufficiency; asthma or allergic disorders; hypertension; monitor Hb or haematocrit levels for signs of anaemia. History of cerebrovascular disease or ischaemic heart disease (IHD).
Adverse Reactions
 Abdominal pain, diarrhea, nausea, oedema, dizziness, headache, insomnia, upper respiratory tract infections (URTI); rash.
Potentially Fatal: Serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis.
Overdose Reactions
 Symptoms include lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. GI bleeding may occur. Hypertension, acute renal failure, respiratory depression and coma may also occur.
Drug Interactions
 Co-admin with fluconazole increases plasma concentrations of celecoxib. Avoid co-admin with cytochrome P450 2C9 inhibitors. Increased risk of GI bleeding when used with oral corticosteroids, anticoagulants or alcohol.
Potentially Fatal: Co-admin with lithium salts may result in an increase in plasma-lithium concentrations.
See Below for More celecoxib Drug Interactions
Lab Interactions
 May cause BUN elevation.
Food Interactions
 Increased absorption when taken with food.
Mechanism of Actions
 Celecoxib has COX-2 specific inhibitory activity. It inhibits the conversion of arachidonic acid to prostaglandins while having no effect on the formation of prostaglandins that mediate the normal homeostasis in the GI tract, kidneys and platelets catalysed by COX-1.
Absorption: Absorbed from the GI tract (oral); peak plasma concentrations after 3 hr.
Distribution: Protein-binding: 97%.
Metabolism: Hepatic; converted to inactive metabolites.
Excretion: Faeces and urine (as metabolites and unchanged drug); 11 hr (elimination half-life).
Administration
 May be taken with or without food. (Dose for OA/RA may be given w/ or w/o meals, but doses for FAP must be given w/ meals.)
Storage Conditions
 Oral: Store at 25°C.
ATC Classification
 L01XX33 - celecoxib ; Belongs to the class of other antineoplastic agents. Used in the treatment of cancer.
M01AH01 - celecoxib ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, coxibs.
Storage
 Oral: Store at 25°C.
Available As
  • Celecoxib 100 mg
  • Celecoxib 200 mg

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