Name Celecoxib
Classes Analgesic / Pain Killer
Central Nervous System Agent
NSAID
COX-2 inhibitor
Diseases Arthritis
Inflammatory Disease
Pain

Celecoxib

Etoricoxib is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities. The mechanism of action of Etoricoxib, like that of other NSAIDs, is not completely understood but may be related to prostaglandin synthetase inhibition. It is a selective COX-2 inhibitor.

Etoricoxib is indicated for symptomatic relief of-

  • osteoarthritis
  • rheumatoid arthritis
  • ankylosing spondylitis 
  • Minor pain
  • Dental pain
  • gouty arthritis
  • primary dysmenorrhea
  • Osteoarthritis:  For relief of the signs and symptoms of osteoarthritis the recommended oral dose is 200 mg  per day administered as a single dose or as 100 mg twice per day.  
  • Rheumatoid arthritis:  For relief of the signs and symptoms of rheumatoid arthritis the recommended oral dose is 100 to 200 mg twice per day.
  • Ankylosing Spondylitis (AS):  For the management of the signs and symptoms of AS, the recommended dose of Celecoxib is 200 mg daily single (once per day) or divided (twice per day) doses.  If no effect is observed after 6 weeks, a trial of 400 mg daily may be worthwhile.  If no effect is observed after 6 weeks on 400 mg daily, a response is not likely and consideration should be given to alternate treatment options.  
  • Management of Acute Pain and Treatment of Primary Dysmenorrhea: The recommended dose of Celecoxib is 400 mg initially, followed by an additional 200 mg dose if needed on the first day. On subsequent days, the recommended dose is 200 mg twice daily as needed. 
  • Psychiatric disorders: insomnia, confusion, hallucinations, depression, restlessness.
  • Immune system disorders: hypersensitivity reactions, anaphylactic/anaphylactoid reactions including shock.
  • Metabolism and nutrition disorders: hyperkalaemia.
  • Nervous system disorders: dysgeusia, somnolence.
  • Cardiac disorders: congestive heart failure, palpitations, angina, arrhythmia.
  • Respiratory, thoracic and mediastinal disorders: bronchospasm, dyspnoea. 
  • Gastrointestinal disorders: abdominal pain, melaena, oral ulcers, peptic ulcers including perforation and bleeding (mainly in elderly patients).
  • Skin and subcutaneous tissue disorders: angioedema, rash, pruritus, erythema, Stevens Johnson syndrome, toxic epidermal necrolysis, urticaria, fixed drug eruption.
  • Renal and urinary disorders: renal insufficiency, including renal failure 
  • Hepatobiliary disorders: hepatitis, jaundice, hepatic failure. Blood and lymphatic system disorders: thrombocytopenia. 

Cardiovascular effects

Clinical trials suggest that the selective COX-2 inhibitor class of drugs may be associated with an increased risk of serious thrombotic events (especially MI and stroke), relative to placebo and some NSAIDs.  Long term safety data beyond one year are not currently available for celecoxib compared to placebo or NSAIDs other than diclofenac.

  • COX-2 selective inhibitors are not a substitute for aspirin for cardiovascular prophylaxis because of their lack of effect on platelets.  Because celecoxib, a member of this class, does not inhibit platelet aggregation, antiplatelet therapies should not be discontinued.  
  • In rare cases, patients using celecoxib may develop peptic ulcers or experience gastrointestinal bleeding.
  • Patients in their advanced years should be closely monitored.
  • Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal injury.
  • As with other drugs known to inhibit prostaglandin synthesis, fluid retention, oedema and hypertension have been observed in patients taking celecoxib. 

Contraindication

  • Contraindicated in patients who have shown hypersensitivity to any component of this product.
  • Celecoxib should not be given to patients who have experienced asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs, such as-

Contraindicated in-

  • congestive heart failure
  • established ischaemic heart disease, peripheral arterial disease and/or cerebrovascular disease (including patients who have recently undergone coronary artery bypass graft surgery or angioplasty).