Relief of signs & symptoms of OA, RA in adults, ankylosing spondylitis & the short-treatment of acute pain in adults following surgery or musculoskeletal injury.
Use lowest effective dose for the shortest duration consistent w/ individual patient treatment goals. OA 200 mg once daily or 100 mg twice daily. RA 100 to 200 mg twice daily. Ankylosing spondylitis 200 mg once daily or 100 mg twice daily. Max total daily dose: 400 mg. Acute pain Initially 400 mg followed by an additional 200 mg, if needed on the 1st day. On subsequent days, 200 mg twice daily. Max: 7 days. Moderate hepatic impairment Reduce dose by 50%.
View Celebrex overdosage for action to be taken in the event of an overdose.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity to celecoxib or sulfonamides. Patients who have experienced asthma, urticaria or allergic-type reactions after taking ASA or other NSAIDs including other COX-2 specific inhibitors. Treatment of peri-op pain in the setting of CABG surgery.
Increased risk of serious CV thrombotic events, MI & stroke; serious GI adverse events including bleeding, ulceration & perforation of the stomach or intestines. Patients w/ fluid retention or heart failure. Concurrent use w/ ASA, non-aspirin NSAID, diuretics, ACE inhibitors. New onset of HTN or worsening of preexisting HTN. Closely monitor BP during initiation & throughout course of therapy. Fluid retention or heart failure; compromised cardiac function, pre-existing edema, or other conditions predisposing to, or worsened by, fluid retention including those taking diuretic treatment or otherwise at risk of hypovolemia. Prior history of peptic ulcer disease &/or GI bleeding & who use NSAIDs. Dehydrated patients; rehydrate patients prior to start of therapy. Not to be given to patients w/ ASA triad. Serious skin reactions eg, DRESS, exfoliative dermatitis, SJS & TEN. Discontinue at 1st appearance of skin rash or any other sign of hypersensitivity. Long-term administration of NSAIDs. Periodically check CBC & chemistry profile. Not a substitute for corticosteroids or to treat corticosteroid insufficiency. Check Hb or hematocrit if patient exhibit any signs or symptoms of anemia or blood loss. Pre-existing asthma. Unexplained wt gain or edema. Advanced renal disease. Evaluate patients w/ signs &/or symptoms suggesting liver dysfunction or in whom abnormal liver test occurred. Consider w/drawal of treatment in women who have difficulties conceiving or who are undergoing investigation of infertility. Avoid use at 30 wk of pregnancy onwards. Lactation. Ped patient <18 yr. Elderly or debilitated patient.
Increased plasma conc w/ CYP2C9 inhibitors & fluconazole. Decreased plasma conc w/ CYP2C9 inducers eg, rifampicin, carbamazepine & barbiturates. May diminish effect of antihypertensives including ACE inhibitors, angiotensin receptor blockers, diuretics & β-blockers. Possible deterioration of renal function w/ ACE inhibitors, AIIA or diuretics in patients who are elderly, vol-depleted or w/ compromised renal function. Increased risk of nephrotoxicity w/ cyclosporine. Reduce natriuretic effect of furosemide & thiazides. Increased rate of GI ulceration or other complications w/ ASA. Not a substitute for ASA for CV prophylaxis. Increased plasma conc of lithium, dextromethorphan & metoprolol. Increased risk of bleeding w/ oral anticoagulants.
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