Celecoxib

DEA Class: Rx

COX-II Inhibitor Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Other Anti-migraine Agents

Oral, selective cyclooxygenase-2 (COX-2) inhibitor nonsteroidal anti-inflammatory drug (NSAID)

Used for osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis (JRA), ankylosing spondylitis, primary dysmenorrhea, acute pain, and migraine with or without aura

As with other NSAIDs, serious GI and CV adverse events may occur; use lowest effective dose for shortest possible duration

Celecoxib is primarily indicated in conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and can also be given in adjunctive therapy as an alternative drug of choice in acute moderate pain or severe pain, dysmenorrhea and toothache.

Celecoxib is contraindicated in conditions like Asthma, Urticaria, Hypersensitivity. 

In the setting of coronary artery bypass graft.

Demonstrated allergic-type reactions to sulfonamides.

Known hypersensitivity (eg, anaphylactic reactions, serious skin reactions) to celecoxib or its components.

Headache

Hypertension 

Fever

Dyspepsia 

Upper respiratory track infections

Arthralgia 

Vomiting, Diarrhea 

Congestive heart failure, hypertension

Increased risk of adverse cardiovascular events and skin reactions

Caution in asthma (bronchial), bleeding disorder, bronchospasm, duodenal/gastric/peptic ulcer, renal impairment.

Risk of GI bleeding, ulceration, and perforation; factors that increase risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants; or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status

Pregnancy; ( Category C) Avoid celecoxib use during the third trimester of pregnancy (starting at 30 weeks of gestation) due to the risk of premature closure of the fetal ductus arteriosus and persistent pulmonary hypertension in the neonate.

If NSAID treatment is deemed necessary between 20 to 30 weeks of pregnancy, limit use to the lowest effective dose and shortest duration possible.

Lactation; Limited data from 12 breastfeeding women showed low levels of celecoxib in breast milk

Adults

800 mg/day PO for capsules; 120 mg/day PO for oral solution.

Geriatric

400 mg/day PO for capsules; 120 mg/day PO for oral solution.

Adolescents

200 mg/day PO for capsules for juvenile rheumatoid arthritis. Safety and efficacy have not been established for other indications or for oral solution.

Children

2 to 12 years weighing more than 25 kg: 200 mg/day PO for capsules for juvenile rheumatoid arthritis. Safety and efficacy have not been established for other indications or for oral solution.

2 to 12 years weighing 10 to 25 kg: 100 mg/day PO for capsules for juvenile rheumatoid arthritis. Safety and efficacy have not been established for other indications or for oral solution.

1 year: Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Neonates

Safety and efficacy have not been established.

Capsules 

50mg

100mg

200mg

400mg

Oral Solution 

25mg/mL (120mg/4.8mL)