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CELECOXIB Information That Patients Need to Know About Their Medication

Kelsey L. Fletcher, BS Medical Student Wake Forest School of Medicine Winston-Salem, North Carolina Mary Lynn McPherson, PharmD, BCPS, CPE Professor and Vice Chair Department of Pharmacy Practice and Science University of Maryland, School of Pharmacy Baltimore, Maryland

, cough or respiratory infections. Celecoxib may cause What is celecoxib? or worsen high blood pressure. Celecoxib (pronounced se le KOKS ib) is a nonsteroidal While taking celecoxib you should avoid drinking alco- anti-inflammatory drug (NSAID) that has been prescribed hol because it may increase your risk of stomach bleeding. by your doctor to relieve or prevent your pain. Celecoxib You should also avoid using celecoxib in combination with is available as an oral tablet. Another name you may see on other NSAIDs such as (Motrin, Advil), the prescription label is Celebrex. (Aleve), (Arthrotec, Cambia, Cataflam, Voltaren) and others. Ask your doctor or pharmacist before taking What is it used for? other cold, allergy or pain medications, as they may contain Celecoxib is used for the management of acute pain in adults, medications similar to celecoxib. pain associated with menstrual cramps, and to treat the pain Celecoxib should not be used if you have a history of of arthritis including: allergic reaction to , sulfa drugs or other NSAIDs. If • taken for long periods of time, celecoxib can cause increased • risk of cardiovascular events such as and heart attack. • Juvenile rheumatoid arthritis in children over two Celecoxib may also have serious effects on the stomach and • Ankylosing spondylosis intestines, including bleeding and ulcers. These conditions can occur without warning and can be life threatening. Your How do I take this medication? doctor will schedule a follow up appointment after you begin Ask your pharmacist and follow the instructions on the pre- taking celecoxib and routine followups afterward to check scription bottle. Take celecoxib exactly as it is prescribed by for these conditions. your doctor. Do not take in larger or smaller doses or for longer than recommended. How do I know if it’s working? Celecoxib may be taken at any time without regard to If you are taking celecoxib for pain, you should experience meals, particularly with lower doses (such as up to 200 mg relief, however, it may take up to two weeks for you to notice twice daily). Higher doses (such as 400 mg twice daily) a significant improvement. If your pain does not subside, should be taken with food to reduced stomach upset. If you you may want to call your doctor to determine if you need have difficulty swallowing tablets, the contents of a cele- a larger dose of celecoxib or a different medication. Do not coxib capsule can be emptied onto a level teaspoon of cool increase your dose of celecoxib unless your doctor advises or room temperature applesauce and ingested immediately you to do so. with water (Table). How do I know if something is wrong? Is this drug safe? You should stop taking celecoxib and seek immediate medi- You should talk to your doctor before taking celecoxib to cal attention if you experience symptoms such as chest pain, ensure that it is the right drug for you. Common side effects weakness, shortness of breath, slurred speech or difficulty of celecoxib include ankle swelling/edema, dizziness, head- with vision or balance. ache, insomnia, skin rash, stomach or abdominal upset or Celecoxib can have serious effects on the stomach and

January/February 2016 | PracticalPainManagement.com 1 Header

Table. Celecoxib Dosage Formulation Strength(s) (Brand name) Capsule (Celebrex, generic) 50, 100, 200, 400 mg

intestines. You should call your doctor dry, safe place such as a nightstand. Do time for your next dose. You should immediately if you experience black, not store celecoxib in a humid place never take extra medicine to make up bloody or tarry stools or you cough such as the kitchen or bathroom. All a missed dose. up blood or vomit that looks like cof- medications should be stored in a loca- fee grounds. You should also call your tion in your house that is out of reach Resources doctor if you experience any signs of of pets and children. an allergic reaction such as rash, hives, 1. Celebrex®Prescribing Information. G.D. Searle LLC Division of , Inc. Accessed online or swelling. What do I do if I miss a dose? at http://labeling.pfizer.com/ShowLabeling. If you are taking celecoxib on a regular aspx?id=793. How do I store my dosing schedule, take the missed dose 2. Celecoxib. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis: MO: medication? as soon as you remember. You should Wolters Kluwer Health, Inc.: July 2014. Accessed Celecoxib should be stored in a cool, skip the missed dose if it is almost January 2, 2016.

Prescriber Quick Fact Card

Name: Cautions: Celecoxib (Celebrex, generic) Do not use celecoxib in patients with history of a allergic reaction to NSAIDs or sulfonamides. Celecoxib should not Class: be used for the treatment of perioperative pain in the setting Nonsteroidal Anti-inflammatory Drug (NSAID) of a coronary artery bypass graft (CABG). Avoid in patients with active gastrointestinal (GI) bleeding. Evaluate use of Dosage Forms: celecoxib carefully due to risk of serious and potentially fatal Capsule (50 mg, 100 mg, 200 mg, 400 mg) cardiovascular events, and stroke, and serious GI events. May cause fluid retention and cause or Indications: worsen or heart failure. May result in renal Acute pain, ankylosing spondylosis, juvenile rheumatoid damage or severe dermatologic reactions. arthritis (age 2 years and older), osteoarthritis, primary , rheumatoid arthritis. Side Effects: Most common adverse effects (> 2% and > placebo) include: Directions for Use: , , dyspepsia, flatulence, peripheral Adult dose: 100-200 mg by mouth twice daily. edema, accidental injury, dizziness, pharyngitis, rhinitis, Pediatric dose (juvenile rheumatoid arthritis): sinusitis, upper respiratory tract infection, rash. Other side • Patients 10-25 kg, the dose is 50 mg by mouth twice effects include hypertension, nausea, headache, serious car- daily. diac event, GI hemorrhage, ulcer or perforation. • Patients > 25 kg, the dose is 100 mg by mouth twice daily. Monitoring: Look for signs and symptoms of cardiovascular events and GI bleeding.

2 PracticalPainManagement.com | January/February 2016