Acicox

Indications

Celecoxib is a painkiller and anti-inflammatory medicine used to relieve pain, swelling and stiffness in:

• osteoarthritis;
• rheumatoid arthritis;
• ankylosing spondylitis (long-term inflammation of the spine);
• short-term pain, such as after dental work or minor surgery, and painful periods.

How It Works

Celecoxib is a COX-2 inhibitor, a type of NSAID (non-steroidal anti-inflammatory drug). It blocks the COX-2 enzyme, which makes prostaglandins, chemicals that cause pain and inflammation. Because it affects the stomach-protecting COX-1 enzyme less, it causes fewer stomach ulcers than older NSAIDs, although the risk is not zero.

Dosage and Administration

Adults, osteoarthritis: 200 mg once a day, or 100 mg twice a day.

Adults, rheumatoid arthritis and ankylosing spondylitis: 100 mg to 200 mg twice a day.

Short-term pain and painful periods: as prescribed by your doctor; the dose should not exceed 400 mg in a day unless a doctor advises.

Use the lowest dose that works for the shortest time. Take with water, with or without food (with food if it upsets your stomach). Moderate liver problems and older people who weigh less may need a lower dose. Children: only as prescribed by a specialist.

Interactions

• Warfarin and other blood thinners, Aspirin, and other NSAIDs (such as Ibuprofen or Diclofenac): higher risk of bleeding and stomach ulcers. Do not take with other NSAIDs.
• Blood pressure medicines (ACE inhibitors, ARBs, diuretics): Celecoxib may reduce their effect and harm the kidneys, especially in older or dehydrated people.
• Lithium and Methotrexate: blood levels may rise.
• Fluconazole raises Celecoxib levels; a lower dose may be needed.
• Antidepressants such as SSRIs and steroids increase the risk of stomach bleeding.

Contraindications

• Allergy to Celecoxib or to sulfonamide (sulfa) medicines
• Asthma, hives or allergic reactions after taking Aspirin or other NSAIDs
• Active stomach or duodenal ulcer or bleeding
• Heart failure, coronary heart disease, stroke or blocked arteries in the legs
• Severe liver or kidney disease
• Pain around heart bypass surgery
• The last 3 months of pregnancy

Side Effects

Common: indigestion, stomach pain, diarrhoea, wind, headache, dizziness, swelling of the ankles, raised blood pressure, and cold-like symptoms.

Get medical help at once for chest pain, sudden breathlessness, weakness on one side of the body or slurred speech (possible heart attack or stroke); black or bloody stools or vomiting blood; swelling of the face, lips or throat; a blistering or peeling skin rash; or yellowing of the skin or eyes.

Pregnancy and Lactation

Do not use in the last 3 months of pregnancy, as it can harm the baby's heart and kidneys and delay labour. Avoid earlier in pregnancy unless your doctor decides it is needed. NSAIDs may also make it harder to become pregnant. Small amounts pass into breast milk; use while breastfeeding only if your doctor advises.

Precautions and Warnings

• Like all NSAIDs, Celecoxib can raise the risk of heart attack and stroke, especially at high doses or with long use.
• Take extra care with high blood pressure, high cholesterol, diabetes, smoking, past stomach ulcers, kidney or liver problems, and in older people.
• Drink enough fluids; stop and see a doctor if you become dehydrated from vomiting or diarrhoea.
• Your doctor may check blood pressure, kidney function and liver tests during long-term use.

Overdose

Overdose may cause drowsiness, nausea, vomiting, stomach pain and, rarely, stomach bleeding or kidney problems. Contact a doctor or go to hospital; treatment is supportive.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID), selective COX-2 inhibitor.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.