Difference between revisions of "Celecoxib"

(Text replacement - "Category:Drugs" to "Category:Pharmacology")
(Mechanism of Action: added mechanism)
 
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==Administration==
 
==Administration==
*Type: Nonsteroidal Anti-inflammatory Drug (NSAID), COX-2 Selective
+
*Type: [[Nonsteroidal anti-inflammatory drugs]] (NSAID), COX-2 Selective
*Dosage Forms: 50,100,200,400
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*Dosage Forms: capsule
*Routes of Administration: Oral
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*Dosage Strengths: 50, 100, 200, 400mg
*Common Trade Names: CeleBREX
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*Routes of Administration: PO
 +
*Common Trade Names: Celebrex
  
 
==Adult Dosing==
 
==Adult Dosing==
*Osteoarthritis: 200 mg PO qd
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*[[Osteoarthritis]]: 200mg PO QD
  
*Rheumatoid arthritis: 100-200 mg PO bid
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*[[Rheumatoid arthritis]]: 100-200mg PO bid
**Use lowest effective dose, shortest effective tx duration
+
**Use lowest effective dose, shortest effective treatment duration
 
**Consider starting at 50% of lowest dose if poor CYP2C9 metabolizer
 
**Consider starting at 50% of lowest dose if poor CYP2C9 metabolizer
  
*Ankylosing spondylitis: 200 mg PO qd
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*[[Ankylosing spondylitis]]: 200mg PO QD
**Max: 400 mg/day
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**Max: 400mg/day
  
*Dysmenorrhea: 200 mg PO bid
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*[[Dysmenorrhea]]: 200mg PO bid
**Start: 400 mg PO x1, may give additional 200 mg on day 1 if needed
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**Start: 400mg PO x1, may give additional 200mg on day 1 if needed
  
*Pain, acute: 200 mg PO bid
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*Pain, acute: 200mg PO bid
**Start: 400 mg PO x1, may give additional 200 mg on day 1 if needed
+
**Start: 400mg PO x1, may give additional 200mg on day 1 if needed
  
 
==Pediatric Dosing==
 
==Pediatric Dosing==
 
===Only for ages > 2 years old===
 
===Only for ages > 2 years old===
*Juvenile idiopathic arthritis  
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*[[Juvenile idiopathic arthritis ]]
**10-25 kg]: 50 mg PO bid
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**10-25 kg]: 50mg PO bid
**>25 kg: 100 mg PO bid
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**>25 kg: 100mg PO bid
  
 
==Special Populations==
 
==Special Populations==
*Pregnancy Risk Factor: C (prior to 30 weeks gestation)/D (≥30 weeks gestation)
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*[[Drug ratings in pregnancy|Pregnancy Risk Factor]]:  
 +
**C (prior to 30 weeks gestation)
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**D (≥30 weeks gestation)
  
 
===Renal Dosing===
 
===Renal Dosing===
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===Hepatic Dosing===
 
===Hepatic Dosing===
*Adult:Child-Pugh Class B: decr. dose 50%; Child-Pugh Class C: avoid use
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*Adult:Child-Pugh Class B: decrease dose 50%; Child-Pugh Class C: avoid use
  
 
==Contraindications==
 
==Contraindications==
 
*hypersens. to drug/class/compon.
 
*hypersens. to drug/class/compon.
 
*hypersens. to sulfonamides
 
*hypersens. to sulfonamides
*ASA or NSAID-induced asthma or urticaria
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*[[ASA]] or [[NSAID]]-induced [[asthma]] or [[urticaria]]
 
*aspirin triad
 
*aspirin triad
 
*pregnancy starting at 30 wk gestation
 
*pregnancy starting at 30 wk gestation
 
*CABG surgery periop use
 
*CABG surgery periop use
*GI bleeding
+
*[[GI bleeding]]
  
 
==Adverse Reactions==
 
==Adverse Reactions==
 
===Serious===
 
===Serious===
*GI bleeding
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*[[GI bleeding]]
 
*GI perforation/ulcer
 
*GI perforation/ulcer
*MI
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*[[MI]]
*stroke
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*[[stroke]]
*thromboembolism
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*[[thromboembolism]]
 
===Common===
 
===Common===
*headache
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*[[headache]]
*dyspepsia
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*[[dyspepsia]]
*URI
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*[[URI]]
*diarrhea
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*[[diarrhea]]
*abdominal pain
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*[[abdominal pain]]
*nausea/vomiting
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*[[nausea/vomiting]]
  
 
==Pharmacology==
 
==Pharmacology==
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==Mechanism of Action==
 
==Mechanism of Action==
 +
Inhibits cyclooxygenase (COX)-2; does not affect COX-1 (at therapeutic concentrations), thereby decreasing formation of prostaglandin synthesis
  
 
==Comments==
 
==Comments==

Latest revision as of 18:33, 13 October 2017

Administration

  • Type: Nonsteroidal anti-inflammatory drugs (NSAID), COX-2 Selective
  • Dosage Forms: capsule
  • Dosage Strengths: 50, 100, 200, 400mg
  • Routes of Administration: PO
  • Common Trade Names: Celebrex

Adult Dosing

  • Rheumatoid arthritis: 100-200mg PO bid
    • Use lowest effective dose, shortest effective treatment duration
    • Consider starting at 50% of lowest dose if poor CYP2C9 metabolizer
  • Dysmenorrhea: 200mg PO bid
    • Start: 400mg PO x1, may give additional 200mg on day 1 if needed
  • Pain, acute: 200mg PO bid
    • Start: 400mg PO x1, may give additional 200mg on day 1 if needed

Pediatric Dosing

Only for ages > 2 years old

Special Populations

Renal Dosing

  • Avoid use in severe renal impairment

Hepatic Dosing

  • Adult:Child-Pugh Class B: decrease dose 50%; Child-Pugh Class C: avoid use

Contraindications

  • hypersens. to drug/class/compon.
  • hypersens. to sulfonamides
  • ASA or NSAID-induced asthma or urticaria
  • aspirin triad
  • pregnancy starting at 30 wk gestation
  • CABG surgery periop use
  • GI bleeding

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 11hr
  • Metabolism: CYP450
  • Excretion: feces, urine

Mechanism of Action

Inhibits cyclooxygenase (COX)-2; does not affect COX-1 (at therapeutic concentrations), thereby decreasing formation of prostaglandin synthesis

Comments

See Also

References

<Epocrates, UpToDate>