Pregnancy Risk Category C
How supplied
Capsules: 100 mg, 200 mg
Action
A selective NSAID that is thought to inhibit prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2). Its anti-inflammatory effects and analgesic and antipyretic properties are thought to be related to a decrease in prostaglandin synthesis.
Indications & dosage
Relief of signs and symptoms of osteoarthritis--
Adults: 200 mg P.O. daily as a single dose or divided equally b.i.d.
Relief of signs and symptoms of rheumatoid arthritis--
Adults: 100 to 200 mg P.O. b.i.d.
Adjunct to treatment for familial adenomatous polyposis to reduce the number of adenomatous colorectal polyps--
Adults: 400 mg P.O. b.i.d. with food for up to 6 months.
Adjust-a-dose: For patients weighing less than 50 kg (110 lb), start at lowest recommended dosage. For patients with moderate hepatic impairment (Child-Pugh Class II), start therapy with reduced dosage.
Adverse reactions
CNS: dizziness, headache, insomnia.
EENT: pharyngitis, rhinitis, sinusitis.
GI: abdominal pain, diarrhea, dyspepsia, flatulence, nausea.
GU: elevated BUN level.
Hepatic: elevated liver enzyme levels.
Metabolic: hyperchloremia, hypophosphatemia.
Musculoskeletal: back pain.
Respiratory: upper respiratory tract infection.
Skin: rash.
Other: peripheral edema, accidental injury.
Interactions
Drug-drug. ACE inhibitors: diminished antihypertensive effects. Monitor patient's blood pressure.
Aluminum- and magnesium-containing antacids: reduced celecoxib levels. Separate administration times.
Aspirin: increased risk of ulcers; low aspirin dosages can be used safely to prevent CV events. Monitor patient for signs and symptoms of GI bleeding.
Fluconazole: increased celecoxib levels. Reduce dosage of celecoxib to minimal effective dose.
Furosemide: NSAIDs can reduce sodium excretion associated with diuretics, leading to sodium retention. Monitor patient for swelling and increased blood pressure.
Lithium: increased lithium level. Monitor plasma lithium levels closely during treatment.
Warfarin: increased PT and bleeding complications. Monitor PT and INR, and check for signs and symptoms of bleeding.
Drug-lifestyle. Long-term alcohol use, smoking: increased risk of GI irritation or bleeding. Check for signs and symptoms of bleeding.
Effects on diagnostic tests
None reported.
Contraindications
Contraindicated in patients with hypersensitivity to drug, sulfonamides, aspirin, or other NSAIDs and in those with severe hepatic impairment; also contraindicated in pregnant women in third trimester.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING