Celebrex

Management of acute pain in adults & treatment of primary dysmenorrhea. Relief of acute & chronic pain & inflammation of RA & OA. Relief of signs & symptoms of ankylosing spondylitis (AS). 200 mg: Management of low back pain (LBP).

Adult Acute pain & primary dysmenorrhea Initially 400 mg, followed by 200 mg if needed on 1st day. Subsequently, 200 mg bd as needed. AS 200-400 mg daily. OA 200 mg once daily. RA 200 mg bd. LBP 200 mg once daily or 100 mg bd.

May be taken with or without food.

Hypersensitivity to celecoxib or sulfonamides. Patients who have experienced asthma, urticaria or allergic-type reactions after taking ASA or NSAIDs including other COX-2 inhibitors. Peri-op pain treatment in CABG, established CV disease (ischemic heart disease & stroke).

Discontinue use at 1st appearance of skin rash, mucosal lesions or any other signs of hypersensitivity. Not a substitute for ASA in CV thromboembolic disease prophylaxis. Increased risk of serious CV thrombotic events, MI & stroke. Patients w/ prior history of or active GI disease eg, ulceration, bleeding or inflammation or other risk factors associated w/ PUD eg, alcoholism, smoking or corticosteroid therapy. Heart failure, HTN, compromised cardiac function, preexisting edema or other conditions predisposed to or worsened by fluid retention or at risk of hypovolemia. Serious skin reactions eg, DRESS syndrome, exfoliative dermatitis, SJS & TEN. Patients known or suspected to be CYP2C9 poor metabolizers. Ensure adequate hydration. Avoid concomitant use w/ non-aspirin NSAIDs. Concomitant use w/ glucocorticoids, antiplatelets, other NSAIDs, oral corticosteroids & anticoagulants, SSRIs. Not recommended in severe hepatic impairment. Moderate hepatic impairment (Child-Pugh class B). Advanced renal disease; severe renal impairment. May affect female fertility. Avoid use during 2nd or 3rd trimesters of pregnancy. Lactation. Not to be used in childn. Elderly or debilitated patients.

Bronchitis, sinusitis, URTI, UTI, ear & fungal infection; insomnia; dizziness; HTN eg, aggravated HTN; cough, dyspnoea; vomiting, abdominal pain, diarrhoea, dyspepsia, flatulence, dysphagia, irritable bowel syndrome, GERD, nausea, diverticulum; pruritus (eg, generalized pruritus), rash; oedema, peripheral edema; MI, angina pectoris; increased hepatic enzyme; muscle spasms; nephrolithiasis; vag haemorrhage, prostatitis, benign prostatic hyperplasia; increased blood creatinine, PSA & wt.

Increased plasma conc w/ CYP2C9 inhibitors. Decreased plasma conc w/ CYP2C9 inducers eg, rifampicin, carbamazepine, barbiturates. Increased lithium plasma levels. Diminished effect of antihypertensives eg, ACE inhibitors &/or ARBs, diuretics, β-blockers. Increased risk of nephrotoxicity w/ cyclosporine. Increased plasma conc of dextromethorphan, metoprolol. 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.

B