Coxib Special Precautions

General: Celecoxib cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency. Abrupt discontinuation of corticosteroids may lead to exacerbation of corticosteroid-responsive illness.
Gastrointestinal Effects: Risk of gastrointestinal ulceration, bleeding and perforation. Serious gastrointestinal toxicity eg, bleeding, ulceration and perforation of the stomach, small or large intestines, can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. Minor upper gastrointestinal problems eg, dyspepsia, are common and may also occur at any time during NSAID therapy.
Use in pregnancy: In late pregnancy, celecoxib should be avoided because it may cause premature closure of the ductus arteriosus.
Use in lactation: Celecoxib is excreted in the milk of lactating rats at concentrations similar to those in plasma. It is not known whether celecoxib is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from celecoxib, a decision should be made whether to discontinue nursing or to discontinue celecoxib, taking into account the importance of celecoxib to the mother.