Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Celecoxib is a
nonsteroidal
antiinflammatory drug (NSAID) that is used to treat arthritis, pain,
menstrual
cramps, and colonic polyps. Prostaglandins are chemicals that are important
contributors to the inflammation of arthritis that causes pain, fever, swelling
and tenderness. Celecoxib blocks the enzyme that makes prostaglandins
(cyclooxygenase 2), resulting in lower concentrations of prostaglandins. As a
consequence, inflammation and its accompanying pain, fever, swelling and
tenderness are reduced. Celecoxib differs from other NSAIDs in that it causes
less inflammation and ulceration of the stomach and intestine (at least with
short-term use) and does not interfere with the clotting of blood.
NSAIDs have
been found to prevent the formation and reduce the size of polyps in patients
with the genetic disease, familial adenomatous polyposis (FAP). In FAP, patients
develop large numbers of polyps in their colons, and the polyps invariably
become malignant. The only cure of FAP is removal of the entire colon. Celecoxib
is approved as an adjunctive (secondary) treatment among patients with FAP. The
cramping and pain during menstrual periods is due to prostaglandins, and
blocking the production of prostaglandins with celecoxib reduces the cramps and
pain.
GENERIC AVAILABLE: No
PRESCRIPTION: Yes
PREPARATIONS: Capsules: 50, 100, 200, and 400 mg
STORAGE: Capsules should be stored between 15-30 C (59-86 F).
PRESCRIBED FOR: Celecoxib is used for the relief of pain, fever,
swelling, and tenderness caused by osteoarthritis, juvenile arthritis,
rheumatoid arthritis, and ankylosing spondylitis. Celecoxib does not prevent the
progression of either type of arthritis. It reduces only the symptoms and signs
of arthritis. Celecoxib is approved for patients with familial FAP who have not
had their colons removed. Celebrex also is also used for the relief of acute
pain and the pain of menstrual cramps (primary dysmenorrhea).
DOSING: The lowest effective dose should be used for each patient.
For
the management of osteoarthritis, the dose usually is 100 mg twice daily or 200
mg as a single dose.
For rheumatoid arthritis, the dose usually is 100 or 200 mg
twice daily.
For acute pain or menstrual cramps, the dose is 400 mg as a single
dose on the first day followed by an additional 200 mg if needed, then 200 mg
twice daily as needed.
For FAP, the recommended dose is 400 mg twice daily.
DRUG INTERACTIONS: Concomitant use of celecoxib with
aspirin or other
NSAIDs (for example, ibuprofen, naproxen, etc.) may increase the occurrence of stomach
and intestinal ulcers. It may be used with low dose aspirin.
Fluconazole (Diflucan) increases the concentration of celecoxib in the body
by preventing the elimination of celecoxib in the liver. Therefore, treatment
with celecoxib should be initiated at the lowest recommended doses in patients
who are taking fluconazole.
Celecoxib increases the concentration of lithium (Eskalith) in the blood by
17% and may promote lithium toxicity. Therefore, lithium therapy should be
closely monitored during and after therapy with celecoxib.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Menstrual cramps (pain in the belly and pelvic area) are experienced by women as a result of menses. Menstrual cramps are not the same as premenstrual syndrome (PMS). Menstrual cramps are common, and may be accompanied by headache, nausea, vomiting, constipation, or diarrhea. Severity of menstrual cramp pain varies from woman to woman. Treatment includes OTC or prescription pain relief medication.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Ankylosing spondylitis is a type of arthritis that causes chronic inflammation of the spine. The tendency to develop ankylosing spondylitis is genetically inherited.
Psoriatic arthritis is a disease that causes skin and joint inflammation. Symptoms include painful, stiff, and swollen joints, tendinitis, and organ inflammation. Treatment involves antiinflammatory medications and exercise.
A colon polyp is a benign tumor of the large intestine. Benign polyps do not invade nearby tissue or spread to other parts of the body. Benign polyps can easily be removed during colonoscopy and are not life threatening. If benign polyps are not removed from the large intestine, they can become malignant over time.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Juvenile arthritis (juvenile rheumatoid arthritis or JRA) annually affects one child in every thousand. There are three types of JRA: pauciarticular (less than four joints affected), polyarticular (more than four joints affected), and systemic-onset (inflamed joints with high fevers and rash). Treatment of juvenile arthritis depends upon the type the child has and should focus on treating the symptoms that manifest.
Menstruation (menstrual cycle) is also referred to as a "period." When a woman menstruates, the lining of the uterus is shed. This shedding of the uterine linking is the menstrual blood flow. The average menstrual cycle is 28 days. There can be problems with a woman's period, including heavy bleeding, pain, or skipped periods. Causes of these problems may be amenorrhea (lack fo a period), menstrual cramps (dysmenorrhea), or abnormal vaginal or uterine bleeding. There are a variety of situations in which a girl or woman should see a doctor about her menstrual cycle.
Menstrual cramps and premenstrual syndrome (PMS) symptoms include abdominal cramping, bloating, a feeling of fullness, abdominal pain, mood swings, anxiety and more. Treatment for menstrual cramps and premenstrual syndrome (PMS) symptoms include regular sleep, exercise, smoking cessation, diet changes, and OTC or prescription medication depending on the severity of the condition.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Colon polyps are fleshy growths that occur on the inside (the
lining) of the large intestine, also known as the colon. Polyps in
the colon are extremely common, and their incidence increases as
individuals get older. It is estimated that 50% of the people over
the age of 60 will harbor at least one polyp. The significance of
polyps is that we know that when certain types of polyps grow large
enough, they can become cancerous, and, moreover, colon cancer is the
second leading cause of death from cancer in the United Sates.
Therefore, screening for colon polyps and removing them before they
become cancerous should markedly reduce the incidence of colon cancer.
What types of polyps become cancerous?
The polyps that become cancerous are called adenomatous polyps or
adenomas. Adenomas account for approximately 75% of all colon
polyps. There are several subtypes of adenoma that differ prima...
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