CELEBIB 200

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Acute pain
• Dysmenorrhea
• Ankylosing spondylitis

Dosage

Children: Refer to the BNF for Children for specific dosing information in pediatric populations.

Adults: Refer to the BNF for specific dosing information based on the condition being treated.

Mechanism of action

Celecoxib selectively inhibits cyclooxygenase-2 (COX-2), an enzyme that is responsible for the synthesis of prostaglandins. By blocking COX-2, celecoxib reduces the levels of prostaglandins, leading to decreased inflammation and pain. Unlike traditional NSAIDs that inhibit both COX-1 and COX-2, celecoxib's selective action helps minimize gastrointestinal side effects typically associated with non-selective NSAIDs.

Pharmacodynamics

The analgesic and anti-inflammatory effects of celecoxib are due to its ability to decrease prostaglandin synthesis. This results in reduced vasodilation, decreased vascular permeability, and less inflammatory cell infiltration at the site of injury or inflammation. The drug provides symptomatic relief from pain and reduces the inflammatory response, which can improve joint function and mobility in patients with inflammatory conditions.

Pharmacokinetics

Celecoxib is well absorbed after oral administration, with peak plasma concentrations occurring approximately 3 hours post-dose. It has a high protein binding rate, primarily to albumin. Celecoxib is metabolized in the liver via cytochrome P450 enzymes, particularly CYP2C9, and has a half-life of approximately 11 hours. The drug is excreted mainly in the urine, with a small fraction eliminated in the feces. Dose adjustments may be necessary in patients with liver impairment.

Contra-indications

• Hypersensitivity to celecoxib or any of its excipients
• Active peptic ulcer disease or gastrointestinal bleeding
• Severe hepatic impairment
• History of allergic reactions to sulfonamides
• Severe renal impairment

Adverse effects

• Gastrointestinal disturbances (nausea, diarrhea, dyspepsia)
• Cardiovascular events (myocardial infarction, stroke)
• Renal toxicity (acute kidney injury)
• Hypertension
• Skin reactions (rash, pruritus)
• Hepatic enzyme elevations

Interactions

• Anticoagulants (increased risk of bleeding)
• Other NSAIDs (increased risk of gastrointestinal adverse effects)
• Diuretics (may reduce efficacy and increase renal toxicity)
• ACE inhibitors (may reduce antihypertensive effect)
• Lithium (increased lithium levels)

Precautions

• Use with caution in patients with cardiovascular disease
• Monitor renal function in long-term use
• Assess liver function prior to treatment
• Use in the elderly may require dosage adjustments
• Consider potential drug-drug interactions

Pregnancy

Celecoxib is not recommended during pregnancy, particularly in the third trimester due to the risk of premature closure of the ductus arteriosus and other complications.

Breast-feeding

Celecoxib is excreted in breast milk; caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Capsules (100 mg, 200 mg)