II. Indications
- FDA approved indications in adults
- Osteoarthritis
- Ankylosing Spondylitis
- Rheumatoid Arthritis
- Acute Pain
- Dysmenorrhea
- Familial Adenoma Polyposis
- FDA approved indications in children
III. Contraindications
- Sulfonamide Allergy
- Immediate Post-Operative CABG state
IV. Metabolism
- See COX2 Inhibitor
- Celecoxib is an NSAID that is more COX2 selective (COX2 Inhibitor)
- Diaryl-substituted pyrazole
V. Medications
- Celecoxib (Celebrex) capsules 50, 100, 200, 400 mg
- Celecoxib capsules may be opened, sprinkled into applesauce and immediately taken with water
VI. Dosing: Adult
-
Osteoarthritis or Ankylosing Spondylitis
- Dose: 200 mg orally daily (or 100 mg orally twice daily)
-
Rheumatoid Arthritis, Acute Pain, Dysmenorrhea
- Dose: 100 to 200 mg orally daily to twice daily
- Familial Adenoma Polyposis
- Dose: 400 mg orally twice daily
- Dosing adjustments
- Decrease dose to 50% in moderate liver dysfunction
VII. Dosing: Child
-
Juvenile Rheumatoid Arthritis (age 2 to 17 years)
- Weight 10 to 25 kg: 50 mg orally twice daily
- Weight >25 kg: 100 mg orally twice daily
VIII. Adverse Effects
- See COX2 Inhibitor
- Precautions
- NSAID Renal Adverse Effects also apply to COX2 Inhibitors
- Gastrointestinal
- Less gastrointestinal adverse effects than other NSAIDs
- Abdominal Pain
- Diarrhea
- Dyspepsia
- Peptic Ulcer Disease risk (see COX2 Inhibitor)
- Cardiovascular
- Celebrex appears safer than Ibuprofen in terms of Cardiovascular Risk
- As with NSAIDs, avoid COX2 Inhibitors immediately after CABG
- COX2 Inhibitors may also result in fluid retention, edema and worsening Congestive Heart Failure
- Hematologic
- Does not increase Bleeding Time or affect Platelets
IX. Safety
- See NSAID
- Unknown safety in Lactation
- Celecoxib is Pregnancy Category C (except for Category D in third trimester)
- As with NSAIDs, avoid COX2 Inhibitor in pregnancy outside the first part of the second trimester (13 to 20 weeks)
X. Pharmacokinetics
- Oral Bioavailability: 22 to 40%
- Half Life: 11 hours
XI. Drug Interactions
-
CYP2C9 Inhibitors
- Celecoxib levels raised by, for example, Zafirlukast, Fluconazole, and Fluvastatin
- Celecoxib Inhibits CYP2D6
- Increases levels of Beta Blockers, Lithium and other psychotropics
XII. Resources
Images: Related links to external sites (from Bing)
Related Studies
| celecoxib (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CELECOXIB 100 MG CAPSULE | Generic | $0.10 each |
| CELECOXIB 200 MG CAPSULE | Generic | $0.11 each |
| CELECOXIB 400 MG CAPSULE | Generic | $0.49 each |
| CELECOXIB 50 MG CAPSULE | Generic | $0.13 each |
| celebrex (on 3/15/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CELEBREX 200 MG CAPSULE | Generic | $0.11 each |