Celecoxib

Administration

Adult Dosing

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

Pediatric Dosing

Only for ages > 2 years old

  • Juvenile idiopathic arthritis
    • 10-25 kg]: 50 mg PO bid
    • >25 kg: 100 mg PO bid

Special Populations

  • Pregnancy Risk Factor: C (prior to 30 weeks gestation)/D (≥30 weeks gestation)

Renal Dosing

  • Avoid use in severe renal impairment

Hepatic Dosing

  • Adult:Child-Pugh Class B: decr. 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

  • GI bleeding
  • GI perforation/ulcer
  • MI
  • stroke
  • thromboembolism

Common

  • headache
  • dyspepsia
  • URI
  • diarrhea
  • abdominal pain
  • nausea/vomiting

Pharmacology

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

Mechanism of Action

Comments

See Also

References

<Epocrates, UpToDate>