Celebrex

Celecoxib

Symptomatic treatment of OA & RA. Relief of signs & symptoms of ankylosing spondylitis (AS). Management of acute pain. Primary dysmenorrhea. Acute & chronic low back pain.

Adult Symptomatic treatment of OA 200 mg as a single dose or 100 mg bid. Symptomatic treatment of RA 100 or 200 mg bid. AS 200 mg as a single dose or 100 mg bid. Some patient may benefit from 400 mg total daily dose. Management of acute pain Initially 400 mg, followed by an additional 200 mg if needed on the 1st day; subsequently 200 mg bid or 400 mg once daily as needed. Primary dysmenorrhea Initially 400 mg, followed by an additional 200 mg if needed on the 1st day; subsequently 200 mg bid as needed. CYP2C9 poor metabolizers Start treatment at ½ the lowest recommended dose. Elderly <50 kg Initiate therapy at the lowest recommended dose. Arthritis or pain patient w/ moderate hepatic impairment (Child-Pugh class B) or receiving fluconazole Introduce at ½ the recommended dose.

May be taken with or without food: For patients w/ swallowing difficulties, open cap & empty contents in 1 tsp (5 mL) applesauce/rice gruel/yogurt/mashed banana. Swallow immediately w/ water.

Hypersensitivity to celecoxib or sulfonamides. Patients who experienced asthma, urticaria or allergic-type reactions after taking ASA (aspirin) or other NSAIDs, including other COX-2 specific inhibitors. Treatment of peri-operative pain in the setting of CABG surgery.

Patients w/ ischemic heart disease & those w/ risk factors for heart disease, HTN, hyperlipidemia, diabetes, smoking & patients w/ peripheral arterial disease. Increased risk of serious CV thrombotic events, MI, & stroke. Not a substitute for ASA for prophylaxis of CV thromboembolic diseases. Onset of new HTN or worsening of preexisting HTN. Patients w/ compromised cardiac function, preexisting edema or other conditions predisposing to, or worsened by, fluid retention including those taking diuretic treatment or otherwise at risk of hypovolemia. Risk of developing GI complications (upper & lower GI perforations, ulcers or bleeds) in patients w/ CV disease, concomitant use w/ glucocorticoids, antiplatelet drugs (eg, aspirin), or other NSAIDs, alcohol use or those w/ prior history of, or active GI disease (eg, ulceration, GI bleeding or inflammatory conditions). Dehydrated patients (rehydrate patients prior to start of therapy). Anaphylactoid reactions. Discontinue at the 1st appearance of skin rash, mucosal lesions, or any other signs of hypersensitivity. Patients who are known or suspected to be poor CYP2C9 metabolizers. Closely monitor BP during initiation & throughout the course of therapy; patients w/ preexisting CHF or HTN; renal function in patients w/ advanced renal disease; patients w/ symptoms &/or signs of liver dysfunction, or in whom abnormal LFT has occurred. Concomitant use w/ oral anticoagulants including warfarin/coumarin-type & novel oral anticoagulant (eg, apixaban, dabigatran & rivaroxaban). Avoid concomitant use w/ non-aspirin NSAID. May diminish utility of diagnostic signs in detecting infections eg, fever. Renal toxicity. Moderate hepatic impairment (Child-Pugh class B). Not recommended w/ severe hepatic impairment (Child-Pugh class C). Avoid use during 2nd & 3rd trimester of pregnancy. Lactation. Elderly. Debilitated patients.

Bronchitis, sinusitis, upper resp tract infection, UTI; insomnia; dizziness; HTN (including aggravated HTN); cough; vomiting, abdominal pain, diarrhea, dyspepsia, flatulence; pruritus (includes generalized pruritus), rash; peripheral edema. Ear & fungal infection; MI, angina pectoris; dyspnea; dysphagia, irritable bowel syndrome, GERD, nausea, diverticulum; increased hepatic enzyme (including ALT & AST); muscle spasms; nephrolithiasis, vag hemorrhage, prostatitis, benign prostatic hyperplasia; increased blood creatinine, prostatic specific antigen & wt.

Increased plasma conc w/ CYP2C9 inhibitors (eg, fluconazole). Decreased plasma conc w/ CYP2C9 inducers eg, rifampicin, carbamazepine & barbiturates. Increased risk of bleeding w/ oral anticoagulants including warfarin/coumarin-type & novel oral anticoagulants (eg, apixaban, dabigatran, & rivaroxaban). Increased lithium plasma levels. May diminish effects of anti-hypertensives including ACE inhibitors &/or ARBs, diuretics & β-blockers. Deterioration of renal function including possible acute renal failure w/ ACE inhibitors, AIIA or diuretics in patients who are elderly, vol-depleted (including those on diuretic therapy) or w/ compromised renal function. May increase risk of nephrotoxicity w/ cyclosporine. Increased plasma conc of dextromethorphan & metoprolol (CYP2D6 substrates). Reduced natriuretic effect of furosemide & thiazides.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

M01AH01 - celecoxib ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, coxibs.

Rx