Medications and Drugs
Medical Author: Omudhome Ogbru, Pharm.D.
Medical Editor: Jay Marks, M.D.
GENERIC NAME: celecoxib
BRAND NAME: Celebrex
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.
Persons taking the anticoagulant (blood thinner) warfarin (Coumadin) should
have their blood tested when initiating or changing celecoxib treatment,
particularly in the first few days, for any changes in the effects of the
anticoagulant.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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