Drug Index

Celecoxib

 
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Mechanism :

Celecoxib is a nonsteroidal anti-inflammatory drug that exhibits anti-inflammatory, analgesic, and antipyretic activities. The mechanism of action is believed to be due to inhibition of prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2. It does not inhibit the cyclooxygenase-1 (COX-1) isoenzyme.


Indication :

• For relief of the signs and symptoms of juvenile rheumatoid arthritis in patients 2 years and older


Contraindications :

Contraindicated in patients with known hypersensitivity to celecoxib, in patients who have demonstrated allergic-type reactions to sulfonamides, in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients. Contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.


Dosing :

<2 years: Safety and efficacy not established.

≥2 years: 10 kg to 25 kg: 50 mg capsule twice daily.

>25 kg: 100 mg capsule twice daily.


Adverse Effect :

Headache, hypertension, upper abdominal pain, nausea, diarrhea and vomiting.


Interaction :

General: Celecoxib metabolism is predominantly mediated via cytochrome P450 2C9 in the liver. Co-administration of celecoxib with drugs that are known to inhibit 2C9 should be done with caution.
ACE-inhibitors: NSAIDs may diminish the antihypertensive effect of Angiotensin Converting Enzyme (ACE) inhibitors. This interaction should be given consideration in patients taking Celebrex concomitantly with ACE-inhibitors.
Aspirin: Concomitant administration of aspirin increases the rate of GI ulceration or other complications.
Fluconazole: Concomitant administration of fluconazole at 200 mg QD resulted in a two-fold increase in celecoxib plasma concentration.
Furosemide: NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis.
Lithium: Patients on lithium treatment should be closely monitored when Celecoxib is introduced or withdrawn.
Methotrexate: In an interaction study of rheumatoid arthritis patients taking methotrexate, Celecoxib did not have a significant effect on the pharmacokinetics of methotrexate.
Warfarin: Anticoagulant activity should be monitored, particularly in the first few days, after initiating or changing Celecoxib therapy in patients receiving warfarin or similar agents.


08/06/2019 12:25:29 Celecoxib
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