COX-2 Inhibitor·Analgesia - Simple & NSAIDs

Celecoxib

Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis, acute pain

Authority requiredPBSNSAIDCelebrex100 mg+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

400 mg/day

Half-life

11 h

GI Bleed

LOWER RISK

Caution: CV Risk

MONITOR

Cautions

Avoid / Cautions

Severe Ischemic Heart Disease, prior stroke/MI, active GI bleeding, severe heart failure. Pregnancy Category B3 (Avoid in 3rd trimester).

Where it stands

Rapid Summary

Overview

Highly selective COX-2 inhibitor ('Coxib'). Designed to provide the anti-inflammatory power of an NSAID while sparing the stomach lining from ulceration.

Clinical Focus

Much safer for the GI tract, but carries a higher risk of pro-thrombotic cardiovascular events (MI/Stroke) than non-selective agents like Naproxen.

Bottom Line

Celecoxib is a selective COX-2 inhibitor with lower GI bleeding risk than traditional NSAIDs, but carries the same cardiovascular risk and is contraindicated in sulfonamide allergy.

Formulation & Access

Brand Names

Celebrex

Oral Routes

Capsules (100 mg, 200 mg).

Prescribing & PBS

Authority Required (PBS) for chronic arthritis.

Indications & Use

Primary

PBSTGA

Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis, acute pain.

Clinical Place

The NSAID of choice for patients with a history of peptic ulcer disease who absolutely require anti-inflammatory therapy.

Quick reference

Class & Role

COX-2 Inhibitor — Highly selective COX-2 inhibitor ('Coxib').

Route / Formulation

Capsules (100 mg, 200 mg). (Celebrex)

Usual Dose & Max

PO 100-200 mg OD or divided BD. Max 400 mg/day (e.g., 200 mg BD).

Key Indication Doses

Osteoarthritis / RA: PO 100-200 mg OD or divided BD. Acute Pain / Dysmenorrhoea: PO 400 mg STAT on Day 1, then 200 mg BD. Renal / Hepatic: Halve dose in moderate hepatic impairment. Avoid entirely if eGFR < 30.

Best Uses

Celecoxib is a selective COX-2 inhibitor with lower GI bleeding risk than traditional NSAIDs, but carries the same cardiovascular risk and is contraindicated in sulfonamide allergy.

Key Risks

Cardiovascular: Increased risk of myocardial infarction, stroke, heart failure, and hypertension. (Selectively blocking COX-2 drops prostacyclin—a vasodilator—while leaving COX-1 thromboxane—a clot promoter—unopposed). Renal: AKI, fluid retention, hyperkalemia. (COX-2 selectivity does NOT protect the kidneys. The renal risk is identical to Ibuprofen). Gastrointestinal: Ulcers and bleeding are significantly reduced compared to standard NSAIDs, but risk is not zero.

Key Interactions

Fluconazole (Inhibits CYP2C9, massively spiking Celecoxib levels. Halve Celecoxib dose). ACEi + Diuretic + Celecoxib = AKI.

Monitoring

Monitor BP regularly. Fluid retention can easily tip an elderly patient into heart failure. Check U&E and eGFR.

Clinical Pearl

Early COX-2 inhibitors (Rofecoxib/Vioxx) were pulled from the market globally because they caused massive fatal heart attacks. Celecoxib survived because its COX-2 selectivity is much weaker. However, the cardiac risk is still very real in high-risk patients.

Access

Authority requiredCelebrex100 mg

Brand: Celebrex
PBS status: Authority required
Formulation: Capsules (100 mg, 200 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

COX-2 Inhibitor·Analgesia - Simple & NSAIDs

Celecoxib

Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis, acute pain

Authority requiredPBSNSAIDCelebrex100 mg+2

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

400 mg/day

Half-life

11 h

GI Bleed

LOWER RISK

Caution: CV Risk

MONITOR

Cautions

Avoid / Cautions

Severe Ischemic Heart Disease, prior stroke/MI, active GI bleeding, severe heart failure. Pregnancy Category B3 (Avoid in 3rd trimester).

Where it stands

Rapid Summary

Overview

Highly selective COX-2 inhibitor ('Coxib'). Designed to provide the anti-inflammatory power of an NSAID while sparing the stomach lining from ulceration.

Clinical Focus

Much safer for the GI tract, but carries a higher risk of pro-thrombotic cardiovascular events (MI/Stroke) than non-selective agents like Naproxen.

Bottom Line

Celecoxib is a selective COX-2 inhibitor with lower GI bleeding risk than traditional NSAIDs, but carries the same cardiovascular risk and is contraindicated in sulfonamide allergy.

Formulation & Access

Brand Names

Celebrex

Oral Routes

Capsules (100 mg, 200 mg).

Prescribing & PBS

Authority Required (PBS) for chronic arthritis.

Indications & Use

Primary

PBSTGA

Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis, acute pain.

Clinical Place

The NSAID of choice for patients with a history of peptic ulcer disease who absolutely require anti-inflammatory therapy.

Quick reference

Class & Role

COX-2 Inhibitor — Highly selective COX-2 inhibitor ('Coxib').

Route / Formulation

Capsules (100 mg, 200 mg). (Celebrex)

Usual Dose & Max

PO 100-200 mg OD or divided BD. Max 400 mg/day (e.g., 200 mg BD).

Key Indication Doses

Best Uses

Celecoxib is a selective COX-2 inhibitor with lower GI bleeding risk than traditional NSAIDs, but carries the same cardiovascular risk and is contraindicated in sulfonamide allergy.

Key Risks

Key Interactions

Fluconazole (Inhibits CYP2C9, massively spiking Celecoxib levels. Halve Celecoxib dose). ACEi + Diuretic + Celecoxib = AKI.

Monitoring

Monitor BP regularly. Fluid retention can easily tip an elderly patient into heart failure. Check U&E and eGFR.

Clinical Pearl

Access

Authority requiredCelebrex100 mg

Brand: Celebrex
PBS status: Authority required
Formulation: Capsules (100 mg, 200 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.