Class: Cyclooxygenase-2 Inhibitor
Dosage Forms. Capsule: 50 mg, 100 mg, 200 mg, 400 mg
Common FDA Label Indication and Dosing.
1. Familial multiple polyposis syndrome: 400 mg po bid
2. Osteoarthritis: 100 mg po bid or 200 mg po daily
3. Rheumatoid arthritis: Adults, 100-200 mg po bid; Children 2 y and older, 10-25 kg, 50 mg po bid
4. Ankylosing spondylitis: 100 mg po bid
1. Coronary stent stenosis, prophylaxis: 100 mg po daily
MOA. Inhibition of the COX-2 enzyme isoform is thought to be responsible for the anti-inflammatory effects of NSAIDs, whereas inhibition of COX-1 results in GI and possibly other side effects.
Drug Characteristics: Celecoxib
Medication Safety Issues: Celecoxib
Drug Interactions: Celecoxib
Adverse Reactions: Celecoxib
Efficacy Monitoring Parameters. Decreased pain and improved range of motion, regression of colonic polyps on colonoscopy.
Toxicity Monitoring Parameters. CBC, liver function tests, SCr, fecal occult blood tests, blood pressure, severe skin rash, black tarry stools, swelling or weight gain, severe pain, yellowing of eyes of skin, change in urination.
Key Patient Counseling Points. Take with food or milk to decrease GI upset. May open capsule and pour into a teaspoon of applesauce.
Clinical Pearls. Elderly patients are at increased risk of GI ulceration. Patients with underlying cardiac dysfunction are at increased risk for cardiovascular effects. Celecoxib has less risk of GI effects than other NSAIDs, but increased cardiovascular toxicity.