Celecoxib (Celebrex) is a non-opioid analgesic used for the management of acute pain and acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis
(sell ah cocks’ ib)
- Analgesic (nonopioid)
- Specific COX-2 enzyme blocker
Analgesic and anti-inflammatory activities related to inhibition of the COX-2 enzyme, which is activated in inflammation to cause the signs and symptoms associated with inflammation; does not affect the COX-1 enzyme, which protects the lining of the GI tract and has blood clotting and renal functions.
- Acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis
- Reduction of the number of colorectal polyps in familial adenomatous polyposis (FAP)
- Management of acute pain
- Treatment of primary dysmenorrhea
Contraindications and cautions
- Contraindicated with allergies to sulfonamides, celecoxib, NSAIDs, or aspirin; significant renal impairment; pregnancy (third trimester); lactation.
- Use cautiously with impaired hearing, hepatic, and CV conditions.
Capsules—100, 200 mg
- Initially, 100 mg PO bid; may increase to 200 mg/day PO bid as needed.
- Acute pain, dysmenorrhea: 400 mg, then 200 mg PO bid.
- FAP: 400 mg PO bid.
Safety and efficacy have not been established.
PATIENTS WITH HEPATIC IMPAIRMENT
Reduce dosage by 50%.
- CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthamologic effects
- Dermatologic: Rash, pruritus, sweating, dry mucous membranes, stomatitis
- GI: Nausea, abdominal pain, dyspepsia, flatulence, GI bleed
- Hematologic: Neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased hemoglobin or hematocrit, bone marrow depression,menorrhagia
- Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock.
- Increased risk of bleeding if taken concurrently with warfarin. Monitor patient closely and reduce warfarin dose as appropriate
- Increased lithium levels and toxicity
- Increased risk of GI bleeding with long-term alcohol use, smoking
Name confusion has occurred between Celebrex (celecoxib), Celexa (citalopram), Xanax (alprazolam), and Cerebyx (fosphenytoin); use caution.
- Administer drug with food or after meals if GI upset occurs.
- Establish safety measures if CNS, visual disturbances occur.
- Arrange for periodic ophthalmologic examination during long-term therapy.
- WARNING: If overdose occurs, institute emergency procedures—gastric lavage, induction of emesis, supportive therapy.
- Provide further comfort measures to reduce pain (eg, positioning, environmental control), and to reduce inflammation (eg, warmth, positioning, rest).
Patient teaching points
- Take drug with food or meals if GI upset occurs.
- Take only the prescribed dosage.
- You may experience these side effects: Dizziness, drowsiness (avoid driving or the use of dangerous machinery while using this drug).
- Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision.