For osteoarthritis the recommended dose is 200 mg daily given by mouth as a single dose or in two divided doses. If necessary, dose of 200 mg twice daily may be used. For rheumatoid arthritis, the dose is 100 to 200 mg given twice daily. In elderly patients treatment should begin at the lowest recommended dose. Ankylosing spondylitis the initial dose is 200 mg daily as a single dose or in 2 divided doses. If necessary, the dose may be increased to 400 mg daily after 6 weeks, although if no response is seen at this dose after a further 6 weeks, alternative treatments should be considered. In treatment of pain and dysmenorrhea, an initial dose of 400 mg followed by an additional dose of 200 mg, if necessary, is recommended on the first day; thereafter the dose is 200 mg twice daily. Celecoxib is also used as an adjunct to standard therapy to reduce the number of adenomatous colorectal polyps in patients with familial adenomatous polypsis. For this purpose, it may be given in doses of 400 mg twice daily with food.