CELECOXIB

(cel-e-cox'ib)
Celebrex
Classifications: CENTRAL NERVOUS SYSTEM AGENT, ANALGESIC, NSAID,
CYCLOOXYGENASE-2 INHIBITOR, ANTIPYRETIC
Pregnancy Category: C first and second trimesters; D third trimester

Availability
100 mg, 200 mg, 400 mg capsules

Actions
NSAID that exhibits antiinflammatory, analgesic, and antipyretic activities. Unlike
ibuprofen, inhibits prostaglandin synthesis by inhibiting cyclooxygenase-2 (COX-2), but
does not inhibit cyclooxygenase-1 (COX-1).

Therapeutic Effects
Reduces or eliminates the pain of rheumatoid and osteoarthritis.

Uses
Relief of S&S of osteoarthritis and rheumatoid arthritis. Treatment of acute pain and
primary dysmenorrhea. Reduction of polyp formation in Familial Adenomatous
Polyposis (FAP)

Contraindications
Severe hepatic impairment; hypersensitivity to celecoxib; asthmatic patients with aspirin
triad; advanced renal disease; concurrent use of diuretics and ACE inhibitors; anemia;
pregnancy (category D) in third trimester; lactation.

Cautious Use
Patients who are P450 2C9 poor metabolizers; patients who weigh <50 kg; moderate
hepatic impairment; renal insufficiency; aspirin use; prior history of GI bleeding or peptic
ulcer disease; asthmatics; pregnancy (category C) in first and second trimesters, and
(category D) in third trimester; elevated liver function tests; heart failure; kidney disease;
hypertension; fluid retention.

Route & Dosage

Arthritis
Adult: PO 100–200 mg b.i.d. or 200 mg q.d.

Acute Pain, Dysmenorrhea

Adult: PO 400 mg 1st dose, then 200 mg same day if needed, then 200 mg b.i.d. prn

FAP
Adult: PO 400 mg b.i.d.

Administration
Oral

• Give 2 h before/after magnesium or aluminum-containing antacids.

• Store in tightly closed container and protect from light.

Adverse Effects ( 1%)

Body as a Whole: Back pain, peripheral edema. GI: Abdominal pain, diarrhea,
dyspepsia, flatulence, nausea. CNS: Dizziness, headache, insomnia. Respiratory:
Pharyngitis, rhinitis, sinusitis, URI. Skin: Rash.

Interactions
Drug: May diminish effectiveness of ACE INHIBITORS; fluconazole increases celecoxib
concentrations; may increase lithium concentrations; may increase INR in older patients
on warfarin.

Pharmacokinetics
Peak: 3 h. Distribution: 97% protein bound; crosses placenta. Metabolism: Metabolized
in liver by cytochrome P450 2C9 enzymes. Elimination: Excreted primarily in feces
(57%), 27% excreted in urine. Half-Life: 11.2 h.

NURSING IMPLICATIONS
Assessment & Drug Effects

• Therapeutic effectiveness is indicated by relief of joint pain.

• Lab tests: Periodically monitor Hct and Hgb, liver functions, BUN and creatinine,
and serum electrolytes.
• Monitor closely lithium levels when the two drugs are given concurrently.
• Monitor closely PT/INR when used concurrently with warfarin.
• Monitor for fluid retention and edema especially in those with a history of
hypertension or CHF.
Patient & Family Education

• Avoid using celecoxib during the third trimester of pregnancy.

• Promptly report any of the following: unexplained weight gain, edema, skin rash.
• Stop taking celecoxib and promptly report to physician if any of the following
occurs: S&S of liver dysfunction including nausea, fatigue, lethargy, itching,
jaundice, abdominal pain, and flulike symptoms; S&S of GI ulceration including
black, tarry stools and upper GI distress.
• Do not breast feed while taking this drug.

Common adverse effects in italic, life-threatening effects underlined: generic names in bold; classifications
in SMALL CAPS; Canadian drug name; Prototype drug

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