Article Contents ::

Details About Generic Salt ::  Celecoxi

Main Medicine Class:: COX-2 inhibitor   

(sel-eh-cox-ib)
Celebrex
Capsules: 100 mg
Capsules: 200 mg
Class: COX-2 inhibitor

 Indications Relief of symptoms of osteoarthritis; relief of symptoms of rheumatoid arthritis in adults; management of acute pain in adults; treatment of primary dysmenorrhea; reduction of the number of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an adjunct to usual care (eg, endoscopic surveillance, surgery).

 Contraindications Allergy to celecoxib or any of its ingredients; allergy to sulfonamides; aspirin triad (eg, asthma, nasal polyps, allergy to aspirin); previous allergic reactions following aspirin or other NSAID use (eg, asthma, hives, rash).

 Route/Dosage

OSTEOARTHRITIS: ADULTS: PO 200 mg/day administered as a single dose or as 100 mg bid. Rheumatoid Arthritis: ADULTS: PO 100 to 200 mg bid. Acute Pain, Primary Dysmenorrhea: ADULTS: PO 400 mg initially followed by an additional 200 mg dose on day 1, if needed, then 200 mg twice daily as needed. FAP: ADULTS: PO Continue usual medical care for FAP patients while on celecoxib. To reduce the number of adenomatous colorectal polyps in patients with FAP, the recommended dose is 400 mg (2 × 200 mg capsules) bid. Take with food.

 Interactions

ACE Inhibitors: NSAIDs may diminish the antihypertensive effect of ACE inhibitors. Aspirin: Coadministration with celecoxib may result in an increased rate of GI ulceration or other complications. Fluconazole: Increase in celecoxib plasma concentration may occur because of inhibition of celecoxib metabolism. Furosemide: NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients. Lithium: Mean steady-state lithium plasma levels increased about 17% in subjects receiving lithium with celecoxib. P450 2C9 Inhibitors: There is a potential for an in vivo drug interaction with drugs that are metabolized by P450 2D6. Warfarin: Monitor anticoagulant activity, particularly in the first few days, after initiating or changing celecoxib therapy in patients receiving warfarin or similar agents because these patients are at an increased risk of bleeding complications.

 Lab Test Interferences None well documented.

 Adverse Reactions

CARDIOVASCULAR: Aggravated hypertension; angina pectoris; coronary artery disorder; MI; palpitations; tachycardia. CNS: Dizziness; insomnia; fatigue; migraine; anxiety; anorexia; increased appetite; depression; nervousness; somnolence. DERMATOLOGIC: Rash; alopecia; dermatitis; nail disorder; photosensitivity; pruritus; erythematous rash; maculopapular rash; skin disorder; dry skin; increased sweating; urticaria; contact dermatitis; injection site reaction; skin nodule; cellulitis. EENT: Rhinitis; sinusitis; esophagitis; deafness; ear abnormality; earache; tinnitus; laryngitis; taste perversion; blurred vision; cataracts; conjunctivitis; eye pain; glaucoma. GI: Abdominal pain; diarrhea; dyspepsia; flatulence; constipation; diverticulitis; dysphagia; eructation; gastritis; gastroenteritis; gastroesophageal reflux; hemorrhoids; hiatal hernia; melena; dry mouth; stomatitis; tenesmus; tooth disorder; vomiting. GU: Breast fibroadenosis; breast neoplasm; breast pain; dysmenorrhea; menstrual disorder; vaginal hemorrhage; vaginitis; prostatic disorder; albuminuria; cystitis; dysuria; hematuria; micturition frequency; renal calculus; urinary incontinence; urinary tract infection. HEMATOLOGIC: Ecchymosis; epistaxis; thrombocythemia; anemia. HEPATIC: Abnormal hepatic function; elevated AST and ALT. METABOLIC: Increased BUN, CPK, creatinine, nonprotein nitrogen, and alkaline phosphotase; diabetes mellitus; hypercholesterolemia; hypokalemia; weight gain. RESPIRATORY: Pharyngitis; upper respiratory tract infection; bronchitis; bronchospasm; aggravated bronchospasm; coughing; dyspnea; pneumonia. OTHER: Peripheral edema; accidental injury; allergic reaction; asthenia; chest pain; generalized edema; facial edema; fever; hot flushes; flu-like symptoms; pain; peripheral pain; leg cramps; hypertonia; hypesthesia; neuralgia; neuropathy; paresthesia; vertigo; arthralgia; arthrosis; bone disorder; accidental fracture; myalgia; neck stiffness; synovitis; tendonitis.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and effectiveness in patients under 18 yr not established. Elderly: Initiate therapy with lowest recommended dose. Asthma: Use with caution in patients with pre-existing asthma. GI effects: Serious GI toxicity (eg, bleeding, ulcerations, perforations) can occur at any time, with or without warning symptoms.

PATIENT CARE CONSIDERATIONS


 Administration/Storage

  • Store at room temperature 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F).
  • Do not administer to patient who has experienced asthma, urticaria, or hypersensitity reactions after taking aspirin or other NSAIDs.
  • Do not administer to pregnant women or nursing mothers.
  • Administer the lowest therapeutic dose possible as prescribed for each patient.
  • Do not administer to patients with hypersensitivity to sulfonamides, NSAIDs, aspirin, celecoxib, or any of their ingredients.
  • Administer to adults older than 18 yr.

 Assessment/Interventions

  • Assess for signs and symptoms of hypersensitivity.
  • Take a complete drug history and monitor potential drug/drug interactions and contraindications that should be reported to the primary care provider.
  • Monitor for signs of GI bleeding, adverse CNS symptoms, and any other adverse events.
  • Monitor for signs of skin rash.
  • Monitor for the following signs and symptoms of decreased renal function: serum creatinine, BUN, unexpected weight gain, edema.
  • Monitor for signs of hypophosphatemia and hyperchloremia.
  • Monitor hepatic function, as decreased hepatic function may require a reduced dose.
OVERDOSAGE: SIGNS & SYMPTOMS
  Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding, hypertension, acute renal failure, respiratory depression, coma

 Patient/Family Education

  • Instruct patient to take medication as prescribed.
  • Advise patient to inform primary care provider if taking or planning to take any OTC medications, as there is potential for drug interactions.
  • Advise patient with sensitive stomach to take medication with food to help avoid GI distress.
  • Instruct patient to promptly report signs or symptoms of GI ulceration or bleeding, skin rash, unexplained weight gain, or edema to primary care provider.
  • Inform patient of the warning signs and symptoms of hepatotoxicity (eg, nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant tenderness, flu-like symptoms) and to stop therapy and contact the primary care provider should any of these occur.
  • Instruct patient to seek immediate emergency help in case of an anaphylactoid reaction.
  • Warn women with childbearing potential to avoid becoming pregnant and apprise them of the potential hazard to the fetus, especially in the third trimester.
  • Warn nursing mothers of the danger of transferring the drug to the baby through the mother’s milk. Make a decision to discontinue the drug or nursing in collaboration with the primary health care provider.
  • Instruct patient to report any unusual reaction or concern to the primary care provider.

 

Drugs Class ::

(sel-eh-cox-ib)
Celebrex
Capsules: 100 mg
Capsules: 200 mg
Class: COX-2 inhibitor

Indications for Drugs ::

 Indications Relief of symptoms of osteoarthritis; relief of symptoms of rheumatoid arthritis in adults; management of acute pain in adults; treatment of primary dysmenorrhea; reduction of the number of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an adjunct to usual care (eg, endoscopic surveillance, surgery).

Drug Dose ::

 Route/Dosage

OSTEOARTHRITIS: ADULTS: PO 200 mg/day administered as a single dose or as 100 mg bid. Rheumatoid Arthritis: ADULTS: PO 100 to 200 mg bid. Acute Pain, Primary Dysmenorrhea: ADULTS: PO 400 mg initially followed by an additional 200 mg dose on day 1, if needed, then 200 mg twice daily as needed. FAP: ADULTS: PO Continue usual medical care for FAP patients while on celecoxib. To reduce the number of adenomatous colorectal polyps in patients with FAP, the recommended dose is 400 mg (2 × 200 mg capsules) bid. Take with food.

Contraindication ::

 Contraindications Allergy to celecoxib or any of its ingredients; allergy to sulfonamides; aspirin triad (eg, asthma, nasal polyps, allergy to aspirin); previous allergic reactions following aspirin or other NSAID use (eg, asthma, hives, rash).

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and effectiveness in patients under 18 yr not established. Elderly: Initiate therapy with lowest recommended dose. Asthma: Use with caution in patients with pre-existing asthma. GI effects: Serious GI toxicity (eg, bleeding, ulcerations, perforations) can occur at any time, with or without warning symptoms.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Aggravated hypertension; angina pectoris; coronary artery disorder; MI; palpitations; tachycardia. CNS: Dizziness; insomnia; fatigue; migraine; anxiety; anorexia; increased appetite; depression; nervousness; somnolence. DERMATOLOGIC: Rash; alopecia; dermatitis; nail disorder; photosensitivity; pruritus; erythematous rash; maculopapular rash; skin disorder; dry skin; increased sweating; urticaria; contact dermatitis; injection site reaction; skin nodule; cellulitis. EENT: Rhinitis; sinusitis; esophagitis; deafness; ear abnormality; earache; tinnitus; laryngitis; taste perversion; blurred vision; cataracts; conjunctivitis; eye pain; glaucoma. GI: Abdominal pain; diarrhea; dyspepsia; flatulence; constipation; diverticulitis; dysphagia; eructation; gastritis; gastroenteritis; gastroesophageal reflux; hemorrhoids; hiatal hernia; melena; dry mouth; stomatitis; tenesmus; tooth disorder; vomiting. GU: Breast fibroadenosis; breast neoplasm; breast pain; dysmenorrhea; menstrual disorder; vaginal hemorrhage; vaginitis; prostatic disorder; albuminuria; cystitis; dysuria; hematuria; micturition frequency; renal calculus; urinary incontinence; urinary tract infection. HEMATOLOGIC: Ecchymosis; epistaxis; thrombocythemia; anemia. HEPATIC: Abnormal hepatic function; elevated AST and ALT. METABOLIC: Increased BUN, CPK, creatinine, nonprotein nitrogen, and alkaline phosphotase; diabetes mellitus; hypercholesterolemia; hypokalemia; weight gain. RESPIRATORY: Pharyngitis; upper respiratory tract infection; bronchitis; bronchospasm; aggravated bronchospasm; coughing; dyspnea; pneumonia. OTHER: Peripheral edema; accidental injury; allergic reaction; asthenia; chest pain; generalized edema; facial edema; fever; hot flushes; flu-like symptoms; pain; peripheral pain; leg cramps; hypertonia; hypesthesia; neuralgia; neuropathy; paresthesia; vertigo; arthralgia; arthrosis; bone disorder; accidental fracture; myalgia; neck stiffness; synovitis; tendonitis.

Drug Mode of Action ::  

(sel-eh-cox-ib)
Celebrex
Capsules: 100 mg
Capsules: 200 mg
Class: COX-2 inhibitor

Drug Interactions ::

 Interactions

ACE Inhibitors: NSAIDs may diminish the antihypertensive effect of ACE inhibitors. Aspirin: Coadministration with celecoxib may result in an increased rate of GI ulceration or other complications. Fluconazole: Increase in celecoxib plasma concentration may occur because of inhibition of celecoxib metabolism. Furosemide: NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients. Lithium: Mean steady-state lithium plasma levels increased about 17% in subjects receiving lithium with celecoxib. P450 2C9 Inhibitors: There is a potential for an in vivo drug interaction with drugs that are metabolized by P450 2D6. Warfarin: Monitor anticoagulant activity, particularly in the first few days, after initiating or changing celecoxib therapy in patients receiving warfarin or similar agents because these patients are at an increased risk of bleeding complications.

Drug Assesment ::

 Assessment/Interventions

  • Assess for signs and symptoms of hypersensitivity.
  • Take a complete drug history and monitor potential drug/drug interactions and contraindications that should be reported to the primary care provider.
  • Monitor for signs of GI bleeding, adverse CNS symptoms, and any other adverse events.
  • Monitor for signs of skin rash.
  • Monitor for the following signs and symptoms of decreased renal function: serum creatinine, BUN, unexpected weight gain, edema.
  • Monitor for signs of hypophosphatemia and hyperchloremia.
  • Monitor hepatic function, as decreased hepatic function may require a reduced dose.
OVERDOSAGE: SIGNS & SYMPTOMS
  Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding, hypertension, acute renal failure, respiratory depression, coma

Drug Storage/Management ::

 Administration/Storage

  • Store at room temperature 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F).
  • Do not administer to patient who has experienced asthma, urticaria, or hypersensitity reactions after taking aspirin or other NSAIDs.
  • Do not administer to pregnant women or nursing mothers.
  • Administer the lowest therapeutic dose possible as prescribed for each patient.
  • Do not administer to patients with hypersensitivity to sulfonamides, NSAIDs, aspirin, celecoxib, or any of their ingredients.
  • Administer to adults older than 18 yr.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to take medication as prescribed.
  • Advise patient to inform primary care provider if taking or planning to take any OTC medications, as there is potential for drug interactions.
  • Advise patient with sensitive stomach to take medication with food to help avoid GI distress.
  • Instruct patient to promptly report signs or symptoms of GI ulceration or bleeding, skin rash, unexplained weight gain, or edema to primary care provider.
  • Inform patient of the warning signs and symptoms of hepatotoxicity (eg, nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant tenderness, flu-like symptoms) and to stop therapy and contact the primary care provider should any of these occur.
  • Instruct patient to seek immediate emergency help in case of an anaphylactoid reaction.
  • Warn women with childbearing potential to avoid becoming pregnant and apprise them of the potential hazard to the fetus, especially in the third trimester.
  • Warn nursing mothers of the danger of transferring the drug to the baby through the mother’s milk. Make a decision to discontinue the drug or nursing in collaboration with the primary health care provider.
  • Instruct patient to report any unusual reaction or concern to the primary care provider.

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