Celecoxib 200 mg Tablet – Quick Reference
| Topic | Key Points |
|-------|------------|
| Drug Class | COX‑2 selective non‑steroidal anti‑inflammatory drug (NSAID). |
| Indications | • Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other inflammatory joint conditions.
• Acute pain (e.g., postoperative, dental, low back).
• Dysmenorrhea (menstrual cramps). |
| Typical Dosage | • 200 mg once or twice daily (max 400 mg/day).
• Dose may be adjusted (often 100 mg BID or 200 mg BID) based on pain severity and patient response. |
| Administration | Take with a full glass of water. Can be taken with or without food; taking with food may reduce gastric discomfort. |
| Mechanism of Action | Inhibits cyclo‑oxygenase‑2 (COX‑2) enzyme, reducing prostaglandin synthesis → ↓ pain, inflammation, fever. COX‑2 selectivity lowers GI irritation compared to non‑selective NSAIDs. |
| Common Side Effects | • Gastrointestinal: dyspepsia, heartburn, abdominal pain.
• Central nervous system: headache, dizziness, insomnia.
• Cardiovascular: edema, hypertension, increased risk of myocardial infarction or stroke (especially at higher doses or in patients with pre‑existing CV disease). |
| Serious Risks & Precautions | • Cardiovascular: contraindicated in patients with uncontrolled hypertension, recent MI, or uncontrolled heart failure.
• Gastro‑intestinal: risk of ulcers, bleeding, perforation—avoid in patients with a history of GI ulcers or bleeding.
• Renal: may impair kidney function, especially in volume‑depleted states (e.g., dehydration, heart failure).
• Liver: rare hepatotoxicity; monitor liver function if prolonged use or in patients with liver disease. |
| Drug Interactions | • Anticoagulants (warfarin, DOACs): ↑ bleeding risk.
• Other NSAIDs or steroids: additive GI and renal toxicity.
• ACE inhibitors/ARBs: potential additive renal impairment.
• SSRIs/SNRIs: increased bleeding risk.
• Methotrexate: possible elevation of methotrexate levels; monitor. |
| Contraindications | • Known hypersensitivity to celecoxib or sulfonamide drugs.
• Active or history of GI ulcer or bleeding.
• Uncontrolled hypertension or significant heart disease.
• Severe hepatic or renal impairment (dose adjustment or avoidance). |
| Pregnancy & Lactation | • Pregnancy: Category C (potential fetal risk). Use only if benefits outweigh risks; avoid in 3rd trimester due to risk of premature ductus arteriosus closure.
• Breastfeeding: low excretion; generally avoided unless no better option. |
| Overdose | Symptoms: GI distress (nausea, vomiting), dizziness, headache, confusion. Treat with supportive care; activated charcoal if within 1 h. No specific antidote. |
| Monitoring | • Blood pressure (especially if patient has HTN).
• Renal function (creatinine, GFR).
• Liver enzymes if prolonged use.
• Signs of GI bleeding (black stools, hematemesis). |
| Patient Counseling Tips | • Take with food or milk to reduce GI upset.
• Avoid alcohol (increases GI bleeding risk).
• Report any new chest pain, shortness of breath, swelling of legs/face, or unexplained GI bleeding.
• If taking other NSAIDs or steroids, discuss with healthcare provider. |
Bottom Line:
Celecoxib 200 mg is a widely used COX‑2 selective NSAID for pain and inflammation. While it offers a lower GI side‑effect profile than non‑selective NSAIDs, it carries cardiovascular and renal risks that warrant careful patient selection, monitoring, and counseling. Always use under a healthcare provider’s guidance.