Interactions - summary

Celecoxib + Cytochrome inhibitors

Excercise caution. Interfere with metabolism.

Celecoxib + Lithium

increase plasma levels of lithium when combined with celecoxib

Celecoxib +Fluconazole

two increase in celecoxib plasma conc.

Celecoxib + Furosemide,

potential to interact. Observe caution

Symptomatic relief of rheumatoid arthiritis

Ankylosing spondylitis

Osteoarthiritis

Abdominal pain, diarrhoea, flatulance, dyspepsia,

nausea, backpain, peripheral edema.

dizziness, rhinitis, sinusitis,

upper respiratory tract interactions, rash.

Hypersensitivity

Allergic-Type reactions to sulfonamides. Not to given to patients who have asthma, urticaria, or allergic type reactions after taking aspirin or NSAIDs.

Special precautions:

Safety for use below 18 years not established.

Not recommended in advanced kidney disease.

Pregnancy and lactation, heptic insufficiency.

Patients with long term use- check haemoglobin or hematocrit value.

Date of Approval     2000

Indication-

Symptomatic relief of rheumatoid arthiritis

Ankylosing spondylitis

Osteoarthiritis

Dosage-

Adults: 200mg per day administered as a single dose. or as twice a day

For Availability/supplies 

EVIDENCE BASED MEDICINE (MIMS -April 2003)

Pain of Osteoarthiritis

Comparative effectiveness of various interventions

Beneficial

1. Systemic simple analgesics (eg paracetamol for short term pain relief, and improvement in function)

2. Systemic NSAIDs (short term pain relief and improvement in function)

3. Topical agents (short term pain relief)

Likely to be beneficial

1. Education, dietary advice,empowerment and support ( improved knowledge of disease and pain relief)

2. Physical support (pain relief and improvement in function)

KEY POINTS

1. There is no good evidence that NSAIDs were superior to simple analgesics such as paracetamol or to suggest that any one of the many available NSAIDs had greater efficacy in relieving pain of osteoarthritis.

2. One systematic review of randomised controlled trials has found that topical agents provide pain relief in patients with osteoarthritis and offer a non-toxic alternative to systemic drug treatment. However there is no evidence to indicate whether the prescribed agents were superior to less expensive, non-prescribtion drugs over the counter (OTC) alternatives, or to other local treatments such as hot or cold packs.

Pregnacy and lactation.

Caution in patients with consideration dehydration

Pharmacology:

Celecoxib is NSAID agent which exerts its anti-inflammatory and analgesic effect by targetting COX-2. The specific inhibition of COX-2 isoenzyme confers the molecule the ability to exert potent anti-inflammatory activity, analgesic and anti-pyretic effect with minimal side effects.

Pharmacokinetics:

Peak plasma levels of Celecoxib are acheived in approximately 3 hrs after an oral dose. When celecoxib capsules are taken with a high fat meal, peak plasma levels were delayed for about an 1 to 2 hours. Celecoxib is eliminated predominantly by hepatic metabolism with little unchanged drug recovered in the urine and faces.

Dose for QA/RA may be given with or without meals, but for FAP must be given with meals

Avoid during pregnancy and lactation