Classifications: analgesic, nsaid; cyclooxygenase-2 (cox-2) inhibitor; antiinflammatory; Therapeutic: analgesic, nsaid; cyclooxygenase-2 (cox-2) inhibitor; antiinflammatory
Pregnancy Category: C first and second trimester; D third trimester
100 mg, 200 mg, 400 mg capsules
Although an NSAID, unlike ibuprofen celecoxib inhibits prostaglandin synthesis by inhibiting cyclooxygenase-2 (COX-2), but
does not inhibit cyclooxygenase-1 (COX-1).
Exhibits antiinflammatory, analgesic, and antipyretic activities. Reduces or eliminates the pain of rheumatoid and osteoarthritis.
Relief of S&S of osteoarthritis and rheumatoid arthritis. Treatment of acute pain and primary dysmenorrhea. Reduction of
polyp formation in familial adenomatous polyposis (FAP), ankylosing spondylitis, juvenile rheumatoid arthritis.
Severe hepatic impairment; hypersensitivity to celecoxib, salicylate, or sulfonamide; asthmatic patients with aspirin triad;
advanced renal disease; concurrent use of diuretics and ACE inhibitors; anemia; pain from CABG surgery; pregnancy (category
C in first and second trimesters and category D in third trimester); children <18 y; lactation.
Patients who are P450 2C9 poor metabolizers; patients who weigh <50 kg; mild or moderate hepatic impairment; renal insufficiency;
aspirin use; prior history of GI bleeding or peptic ulcer disease; alcoholics; concurrent use of anticoagulants; asthmatics;
bone marrow suppression; CVA; PVD; elevated liver function tests; heart failure; kidney disease; hypertension; fluid retention.
Route & Dosage
Adult: PO 100200 mg b.i.d. or 200 mg q.d.
Acute Pain, Dysmenorrhea
Adult: PO 400 mg 1st dose, then 200 mg same day if needed, then 200 mg b.i.d. prn
Adult: PO 400 mg b.i.d.
Juvenile Rheumatoid Arthritis
Adolescents/Child (>2 y, >25 kg): PO 100 mg b.i.d.
Child (>2 y, 1025 kg): PO 50 mg b.i.d.
- Give 2 h before/after magnesium or aluminum-containing antacids.
- Store in tightly closed container and protect from light.
Adverse Effects (≥1%)Body as a Whole:
Back pain, peripheral edema. Increased risk of cardiovascular events. GI:
Abdominal pain, diarrhea
, dyspepsia, flatulence, nausea. CNS:
Dizziness, headache, insomnia
Pharyngitis, rhinitis, sinusitis
, URI. Skin:
May diminish effectiveness of ace inhibitors
increases celecoxib concentrations; may increase lithium
concentrations; may increase INR in older patients on warfarin.
3 h. Distribution:
97% protein bound; crosses placenta. Metabolism:
In liver by CYP2C9. Elimination:
Primarily in feces (57%), 27% in urine. Half-Life:
Assessment & Drug Effects
- Therapeutic effectiveness is indicated by relief of joint pain.
- Lab tests: Periodically monitor Hct and Hgb, liver functions, BUN and creatinine, and serum electrolytes.
- Monitor closely lithium levels when the two drugs are given concurrently.
- Monitor closely PT/INR when used concurrently with warfarin.
- Monitor for fluid retention and edema especially in those with a history of hypertension or CHF.
Patient & Family Education
- Avoid using celecoxib during the third trimester of pregnancy.
- Promptly report any of the following: unexplained weight gain, edema, skin rash.
- Stop taking celecoxib and promptly report to physician if any of the following occurs: S&S of liver dysfunction including
nausea, fatigue, lethargy, itching, jaundice, abdominal pain, and flulike symptoms; S&S of GI ulceration including black,
tarry stools and upper GI distress.