Celebrex

Celebrex

Celecoxib capsules
PFIZERCOX-2 inhibitor approved for ankylosing spondylitis

This NSAID is believed to exert its therapeutic effect through inhibition of prostaglandin synthesis, primarily via inhibition of cyclooxygenase-2 (COX-2). Celecoxib was approved on July 29, 2005, for the relief of the signs and symptoms of ankylosing spondylitis (AS).

Safety. As with all NSAIDs, celecoxib may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use, and patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk. Celecoxib, like all NSAIDs, may lead to the onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of cardiovascular events. NSAIDs, including celecoxib, 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. Celecoxib should not be given to patients who have demonstrated allergic-type reactions to sulfonamides or to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Fluid retention and edema have been observed in some patients taking NSAIDs, including celecoxib. Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury. Celecoxib therapy is not recommended in patients with advanced renal disease or severe hepatic impairment. Celecoxib can cause serious skin adverse events such as exfoliative dermatitis, Stevens Johnson syndrome, and toxic epidermal necrolysis, which can be fatal. Celecoxib should be administered with caution in patients with pre-existing asthma. The most common adverse events reported with celecoxib include abdominal pain, diarrhea, dyspepsia, headache, sinusitis, and upper respiratory tract infection.

Dosing. The recommended dose of celecoxib for the management of the signs and symptoms of AS is 200 mg daily as a single dose or divided into 2 doses. If no effect is observed after 6 weeks, a trial of 400 mg daily may be beneficial. If no effect is observed after 6 weeks of 400 mg daily, a response is not likely and consideration should be given to alternate treatment options.