Celecoxib

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Drugs Dictionary: Celecoxib

Celecoxib

Trade Name

Celebrex (primary brand name); generic celecoxib

Classification

Nonsteroidal anti-inflammatory drug (NSAID); COX-2 selective inhibitor

Dosage/Route

* Dosage: Capsules: 50 mg, 100 mg, 200 mg, 400 mg
* Route: Oral (PO)

Usual Dosage

* Osteoarthritis: 200 mg PO daily or 100 mg BID
* Rheumatoid Arthritis: 100-200 mg PO BID; max 400 mg/day
* Acute Pain/Primary Dysmenorrhea: 400 mg PO initially, then 200 mg BID PRN
* Ankylosing Spondylitis: 200 mg PO daily or BID; max 400 mg/day
* Children (JRA, ≥2 years): 50 mg BID (10-25 kg); 100 mg BID (>25 kg)
* Reduce dose in hepatic impairment; avoid in severe renal disease

Mechanism of Action

Selectively inhibits cyclooxygenase-2 (COX-2) enzyme, reducing prostaglandin synthesis. Decreases inflammation, pain, and fever with less GI irritation than non-selective NSAIDs (minimal COX-1 inhibition, sparing gastric mucosa)

Side Effects & Adverse Effects

* Side Effects: Headache, dyspepsia, diarrhea, edema
* Adverse Effects:
- – Cardiovascular risk (boxed warning; MI, stroke, esp. long-term/high dose).
- – GI bleeding/ulceration (boxed warning; lower risk than ibuprofen, but still possible).
- – Renal impairment (reduced renal blood flow; AKI risk).
- – Hypersensitivity (sulfa allergy; celecoxib contains sulfonamide)

Nursing Management (Implications & Teachings)

* Implications:
- – Monitor BP (hypertension risk), renal function (CrCl, urine output), GI symptoms (bleeding signs)
- – Assess for sulfa allergy (contraindicated)
- – Give with food/milk if GI upset occurs; swallow capsules whole
- – Avoid in post-CABG patients (CV risk)
* Teachings:
- – Take same time daily; with food if stomach upset
- – Report black stools, chest pain, or swelling
- – Avoid alcohol, other NSAIDs (increases GI/CV risk)
- – Stop and seek help for rash, breathing issues (allergy)