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Celecoxib Dosage

Applies to the following strength(s): 50 mg ; 100 mg ; 200 mg ; 400 mg

The information at Drugs.com is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Pain

Day 1: 400 mg orally once followed by an additional 200 mg orally if needed
Usual dose: 200 mg orally twice a day as needed

Comment: The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.

Use: For the management of acute pain.

Usual Adult Dose for Dysmenorrhea

Day 1: 400 mg orally once followed by an additional 200 mg orally if needed
Usual dose: 200 mg orally twice a day as needed

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the treatment of primary dysmenorrhea.

Usual Adult Dose for Osteoarthritis

Usual dose: 200 mg orally once a day OR 100 mg orally twice a day

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the relief of the signs and symptoms of osteoarthritis.

Usual Adult Dose for Rheumatoid Arthritis

Usual dose: 100 or 200 mg orally twice a day

Comment: Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the relief of the signs and symptoms of rheumatoid arthritis.

Usual Adult Dose for Ankylosing Spondylitis

Usual dose: 200 mg orally once a day OR 100 mg orally twice a day
-If no effect after 6 weeks, consider increasing dose to 400 mg orally daily
Maximum dose: 400 mg per day

Comments:
-If no effect is observed after 6 weeks at 400 mg per day, alternative treatments should be considered as a response is not likely.
-Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Use: For the relief of the signs and symptoms of ankylosing spondylitis.

Usual Pediatric Dose for Juvenile Rheumatoid Arthritis

Age: 2 years or older:

Weight: 10 kg to 25 kg: 50 mg orally twice a day
Weight: Greater than 25 kg: 100 mg orally twice a day

Comments:
-The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-For pediatric patients who are poor metabolizers of CYP450 2C9, consider alternative treatment.

Use: For the relief of the signs and symptoms of juvenile rheumatoid arthritis in patients 2 years or older.

Renal Dose Adjustments

Advanced Renal Disease: Use is not recommended
Mild to moderate renal impairment: No dose adjustment recommended

Liver Dose Adjustments

Severe hepatic impairment: Use not recommended
Moderate hepatic impairment (Child-Pugh Class B): Reduce dose by 50%
Mild hepatic impairment: No dose adjustment recommended

Dose Adjustments

CYP450 2C9 Poor Metabolizers (known or suspected based on genotype or previous history or experiences with other CYP450 2C9 substrates):
-Adults: Consider initiating treatment at one-half the lowest recommended dose
-Pediatrics: Consider alternative treatment

Elderly: Weight greater than 50 kg: No dose adjustment recommended
Elderly, Weight less than 50 kg: Initiate therapy at the lowest recommended dose

Precautions

US BOXED WARNINGS: CARDIOVASCULAR AND GASTROINTESTINAL RISKS
-Cardiovascular Risk: This drug may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. All NSAIDs may have a similar risk. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. This drug is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.
-Gastrointestinal Risk: NSAIDs, including this drug, cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:
-May take with or without food

For Patients with Difficulty Swallowing Capsules:
-Carefully sprinkle the entire contents of the capsule onto a level teaspoon of cool or room temperature applesauce and ingest immediately with water.

Storage requirements:
-The sprinkled capsule contents on applesauce are stable for up to 6 hours when stored in the refrigerator [36F to 46F (2C to 8C)].

General:
-Prior to initiating treatment, the potential benefits and risks of this drug should be weighed against other treatment options.
-The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.
-This drug is contraindicated for the treatment of perioperative pain in the setting of coronary artery bypass graft (CABG) surgery.

Monitoring:
-Blood pressure should be monitored closely during initiation and throughout course of therapy.
-Monitor for signs/symptoms of gastrointestinal bleeding.
-Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.
-Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:
-Patients should seek medical advice for signs and symptoms of cardiovascular events, gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.
-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding.
-Patients should talk to their health care provider before they use over the counter analgesics.

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