CelecoxibRx

Trade Names: Celebrex

Drug Class: COX-2 selective NSAID

Preparations
Capsules: 100 and 200 mg
Dose: 100 to 200 mg once or twice daily

Clinical Pharmacology: Well absorbed after oral administration; hepatic metabolism (CYP2C9) and renal excretion of metabolites; half-life 11 hours

Comments: COX-2 selective NSAIDs are no more effective than traditional NSAIDs that inhibit both COX-1 and COX-2, but they are less likely to cause GI complications. A traditional NSAID with a proton pump inhibitor has similar GI toxicity as COX-2 selective drugs in  observational studies.  Either is a reasonable strategy for patients who have a high risk of GI complications and are unable to do without an NSAID. Therapy with low-dose aspirin and a COX-2–selective drug may abrogate the GI benefits of the COX-2 selectivity. Increased risk of cardiovascular events including myocardial infarction and stroke. Celecoxib is avoided if possible in patients allergic to sulfonamides. Fluconazole and other drugs that inhibit CYP2C9 increase concentrations of celecoxib.

See NSAIDs for Indications, Mechanism of Action, Contraindications, Precautions, Monitoring, Pregnancy Risk, Adverse Effects, Interactions, and Patient Instructions.

Cost: $$$

BIBLIOGRAPHY

FitzGerald GA, Patrono C. The coxibs, selective inhibitors of cyclooxygenase-2. N Engl J Med 2001;345:433–442.PMID:11496855