Drug Index


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Lithium: Patients on lithium treatment should be closely monitored when Celecoxib is introduced or withdrawn.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.

Renal Dose :

Dose in Renal Impairment GFR (mL/min)
30-50Dose as in normal renal function. Use with caution
10-30Dose as in normal renal function, but avoid if possible
<10Dose as in normal renal function, but only use if on dialysis

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in normal renal function
HDUnlikely to be dialysed. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDUnknown dialysability. Dose as in GFR=10–20 mL/min

Hepatic Dose :

Moderate hepatic impairment: Reduce dose by 50%.
Severe hepatic impairment: Use is contraindicated.
11/08/2020 12:21:17 Celecoxib
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