Celecoxib

Administration

• Type: Nonsteroidal anti-inflammatory drugs (NSAID), COX-2 Selective
• Dosage Forms: capsule
• Dosage Strengths: 50, 100, 200, 400mg
• Routes of Administration: PO
• Common Trade Names: Celebrex

Adult Dosing

• Osteoarthritis: 200mg PO QD

• Rheumatoid arthritis: 100-200mg PO bid
  • Use lowest effective dose, shortest effective treatment duration
  • Consider starting at 50% of lowest dose if poor CYP2C9 metabolizer

• Ankylosing spondylitis: 200mg PO QD
  • Max: 400mg/day

• Dysmenorrhea: 200mg PO bid
  • Start: 400mg PO x1, may give additional 200mg on day 1 if needed

• Pain, acute: 200mg PO bid
  • Start: 400mg PO x1, may give additional 200mg on day 1 if needed

Pediatric Dosing

Only for ages > 2 years old

• Juvenile idiopathic arthritis
  • 10-25 kg]: 50mg PO bid
  • >25 kg: 100mg PO bid

Special Populations

• Pregnancy Risk Factor:
  • C (prior to 30 weeks gestation)
  • D (≥30 weeks gestation)

Renal Dosing

• Avoid use in severe renal impairment

Hepatic Dosing

• Adult:Child-Pugh Class B: decrease dose 50%; Child-Pugh Class C: avoid use

Contraindications

• hypersens. to drug/class/compon.
• hypersens. to sulfonamides
• ASA or NSAID-induced asthma or urticaria
• aspirin triad
• pregnancy starting at 30 wk gestation
• CABG surgery periop use
• GI bleeding

Adverse Reactions

Serious

• GI bleeding
• GI perforation/ulcer
• MI
• stroke
• thromboembolism

Common

• headache
• dyspepsia
• URI
• diarrhea
• abdominal pain
• nausea/vomiting

Pharmacology

• Half-life: 11hr
• Metabolism: CYP450
• Excretion: feces, urine

Mechanism of Action

Inhibits cyclooxygenase (COX)-2; does not affect COX-1 (at therapeutic concentrations), thereby decreasing formation of prostaglandin synthesis

See Also

• NSAIDs
• NSAID toxicity

References

<Epocrates, UpToDate>