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Cox B200 mg
Beximco Pharmaceuticals Ltd.
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Celecoxib: Brands, Price & Uses in Bangladesh
Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor NSAID with the following evidence-based indications: Established / FDA-approved uses Osteoarthritis (OA): relief of signs and symptoms.
About Celecoxib
Indications of Celecoxib
Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor NSAID with the following evidence-based indications:
Established / FDA-approved uses
- Osteoarthritis (OA): relief of signs and symptoms.
- Rheumatoid arthritis (RA): relief of signs and symptoms in adults.
- Ankylosing spondylitis: relief of signs and symptoms.
- Acute pain in adults (e.g. post-surgical or musculoskeletal pain).
- Primary dysmenorrhea: management of menstrual pain.
- Juvenile rheumatoid arthritis (JRA) in children 2 years of age and older (relief of signs and symptoms).
Guideline-supported / adjunct uses
- Adjunctive reduction of adenomatous colorectal polyps in familial adenomatous polyposis (FAP), as an addition to usual care (surgery, endoscopic surveillance), not as a replacement for these.
Celecoxib is not indicated for minor aches or short-term self-limited pain when safer alternatives are appropriate, and should always be used at the lowest effective dose for the shortest duration needed.
Dosage & Administration of Celecoxib
| Indication | Adult Dose |
|---|---|
| Osteoarthritis | 200 mg once daily, or 100 mg twice daily |
| Rheumatoid arthritis | 100–200 mg twice daily |
| Ankylosing spondylitis | 200 mg once daily, or in two divided doses; may increase to 400 mg/day if needed after 6 weeks |
| Acute pain / Primary dysmenorrhea | 400 mg initially, followed by an additional 200 mg dose on day 1 if needed; then 200 mg twice daily as needed |
Pediatric dosing (Juvenile Rheumatoid Arthritis, age 2 years and older)
| Body weight | Dose |
|---|---|
| 10 kg to 25 kg | 50 mg twice daily |
| Greater than 25 kg | 100 mg twice daily |
Administration
Celecoxib capsules may be taken with or without food. Capsules may be swallowed whole, or opened and the entire contents sprinkled onto a small amount of applesauce and consumed immediately with water. Use the lowest effective dose for the shortest duration consistent with individual treatment goals.
Dose adjustment
- Hepatic impairment: reduce dose by approximately 50% in moderate hepatic impairment (Child-Pugh Class B); not recommended in severe hepatic impairment.
- Renal impairment: use with caution in mild-to-moderate impairment; not recommended in severe renal impairment.
- Known or suspected CYP2C9 poor metabolizers: consider starting at half the lowest recommended dose.
Side Effects of Celecoxib
Common side effects (occurring in more than 2% of patients) associated with Celecoxib include:
- Abdominal pain, dyspepsia, diarrhea, flatulence, nausea
- Headache, dizziness
- Peripheral edema
- Upper respiratory tract infection symptoms
- Rash
- Insomnia
Serious but less common effects requiring immediate medical attention include signs of GI bleeding (black/bloody stools, vomiting blood), signs of cardiovascular events (chest pain, shortness of breath, weakness on one side of the body, slurred speech), severe skin reactions (blistering, peeling rash), signs of liver injury (jaundice, dark urine), and hypersensitivity reactions (facial swelling, difficulty breathing).
Contraindications of Celecoxib
Celecoxib is contraindicated in the following situations (true absolute contraindications only):
- Known hypersensitivity to Celecoxib, sulfonamides (Celecoxib contains a sulfonamide chemical moiety), or any component of the formulation.
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs (due to cross-reactivity risk).
- Use in the setting of coronary artery bypass graft (CABG) surgery, including the immediate perioperative period.
- Third trimester of pregnancy (risk of premature closure of the fetal ductus arteriosus).
Frequently Asked Questions about Celecoxib
What is Celecoxib used for?
Celecoxib is used to relieve pain, swelling, and stiffness from conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, and to manage acute pain and menstrual pain (primary dysmenorrhea). In children aged 2 years and older, it may be used for juvenile rheumatoid arthritis. Always use it as prescribed by your physician.
Can Celecoxib cause heart or stomach problems?
Yes. Celecoxib carries boxed warnings for an increased risk of serious cardiovascular events such as heart attack and stroke, and for serious gastrointestinal problems such as bleeding, ulcers, and perforation of the stomach or intestines. These risks can occur without warning symptoms, so use the lowest effective dose for the shortest time needed and seek urgent care for chest pain, weakness on one side, black or bloody stools, or vomiting blood.
Is Celecoxib safe during pregnancy or breastfeeding?
Celecoxib should generally be avoided during pregnancy, especially from 20 weeks onward, and is contraindicated in the third trimester due to risks to the baby's heart and kidney development. It should only be used earlier in pregnancy if clearly needed and the potential benefit justifies the potential risk to the fetus, and only under a physician's guidance. Celecoxib passes into breast milk in small amounts, so discuss the risks and benefits with your physician before use while breastfeeding.
Who should not take Celecoxib?
Celecoxib should not be taken by anyone with a known allergy to Celecoxib, sulfonamide (sulfa) drugs, aspirin, or other NSAIDs, especially if that allergy caused asthma, hives, or swelling. It must not be used around the time of coronary artery bypass graft (CABG) heart surgery, and must not be used during the third trimester of pregnancy.
Can I take Celecoxib with other pain relievers or blood thinners?
Combining Celecoxib with aspirin, other NSAIDs, or corticosteroids increases the risk of stomach bleeding and should generally be avoided. If you take warfarin or another blood thinner, Celecoxib can increase bleeding risk and your doctor may need to monitor your blood clotting tests more closely. Always tell your physician or pharmacist about all medicines you take before starting Celecoxib.
What should I do if I miss a dose or take too much Celecoxib?
If you miss a dose of Celecoxib, take it as soon as you remember unless it is almost time for your next dose — do not double up. If you or someone else has taken too much Celecoxib and has symptoms like severe stomach pain, vomiting, drowsiness, or breathing difficulty, seek immediate medical attention or contact a poison control center right away.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.