Celecoxib (Celebrex) is a non-opioid analgesic used for the management of acute pain and acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis

Generic Name

celecoxib

(sell ah cocks’ ib)

Brand Name

Celebrex

Drug classes

• NSAID
• Analgesic (nonopioid)
• Specific COX-2 enzyme blocker

Therapeutic actions

Analgesic and anti-inflammatory activities related to inhibition of the COX-2 enzyme, which is activated in inflammation to cause the signs and symptoms associated with inflammation; does not affect the COX-1 enzyme, which protects the lining of the GI tract and has blood clotting and renal functions.

Indications

• Acute and long-term treatment of signs and symptoms of rheumatoid arthritis and osteoarthritis
• Reduction of the number of colorectal polyps in familial adenomatous polyposis (FAP)
• Management of acute pain
• Treatment of primary dysmenorrhea

Contraindications and cautions

• Contraindicated with allergies to sulfonamides, celecoxib, NSAIDs, or aspirin; significant renal impairment; pregnancy (third trimester); lactation.
• Use cautiously with impaired hearing, hepatic, and CV conditions.

Available forms

Capsules—100, 200 mg

Dosages

ADULTS

• Initially, 100 mg PO bid; may increase to 200 mg/day PO bid as needed.
• Acute pain, dysmenorrhea: 400 mg, then 200 mg PO bid.
• FAP: 400 mg PO bid.

PEDIATRIC PATIENTS

Safety and efficacy have not been established.

PATIENTS WITH HEPATIC IMPAIRMENT

Reduce dosage by 50%.

Adverse effects

• CNS: Headache, dizziness, somnolence, insomnia, fatigue, tiredness, dizziness, tinnitus, ophthamologic effects
• Dermatologic: Rash, pruritus, sweating, dry mucous membranes, stomatitis
• GI: Nausea, abdominal pain, dyspepsia, flatulence, GI bleed
• Hematologic: Neutropenia, eosinophilia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis, granulocytopenia, aplastic anemia, decreased hemoglobin or hematocrit, bone marrow depression,menorrhagia
• Other: Peripheral edema, anaphylactoid reactions to anaphylactic shock.

Interactions

Drug-drug

• Increased risk of bleeding if taken concurrently with warfarin. Monitor patient closely and reduce warfarin dose as appropriate
• Increased lithium levels and toxicity
• Increased risk of GI bleeding with long-term alcohol use, smoking

Nursing considerations

Name confusion has occurred between Celebrex (celecoxib), Celexa (citalopram), Xanax (alprazolam), and Cerebyx (fosphenytoin); use caution.

Interventions

• Administer drug with food or after meals if GI upset occurs.
• Establish safety measures if CNS, visual disturbances occur.
• Arrange for periodic ophthalmologic examination during long-term therapy.
• WARNING: If overdose occurs, institute emergency procedures—gastric lavage, induction of emesis, supportive therapy.
• Provide further comfort measures to reduce pain (eg, positioning, environmental control), and to reduce inflammation (eg, warmth, positioning, rest).

Patient teaching points

• Take drug with food or meals if GI upset occurs.
• Take only the prescribed dosage.
• You may experience these side effects: Dizziness, drowsiness (avoid driving or the use of dangerous machinery while using this drug).
• Report sore throat, fever, rash, itching, weight gain, swelling in ankles or fingers; changes in vision.