Products
Celecoxib is commercially available in capsule form (Celebrex, generic). It was approved in many countries in 1999 as the first member of the selective COX-2 inhibitors. Generic versions went on sale in 2014.
Structure and properties
Celecoxib (C17H14F3N3O2S, Mr = 381.37 g/mol) is a benzenesulfonamide and a substituted diaryl pyrazole. It has a V-shaped structure with which it fits into the active site of the enzyme COX-2.
Effects
Celecoxib (ATC M01AH01, ATC L01XX33) has analgesic, anti-inflammatory, and antipyretic properties. The effects are due to selective inhibition of the enzyme cyclooxygenase-2 and inhibition of prostaglandin synthesis. The half-life is 8 to 12 hours.
Indications
For symptomatic treatment of inflammation and pain in:
- Osteoarthritis
- Chronic polyarthritis (rheumatoid arthritis)
- Ankylosing spondylitis
- Juvenile idiopathic arthritis
Dosage
According to the professional information. The drug is taken once or twice a day, regardless of meals. Because of the risk for cardiovascular disease, the duration of treatment should be kept as short as possible and the dose as low as possible.
Contraindications
Numerous precautions and drug-drug interactions must be observed when treating with COX-2 inhibitors. Full details can be found in the drug label.
Interactions
Celecoxib is an inhibitor of CYP2D6 and CYP2C19 and is predominantly metabolized by CYP2C9.
Adverse effects
The most common potential adverse effects include abdominal pain, diarrhea, dyspepsia, flatulence, edema, injury, dizziness, central disorders, and respiratory disorders. COX-2 inhibitors may increase the risk of serious and life-threatening cardiovascular disease, such as heart attack and stroke. Like NSAIDs, COX-2 inhibitors can cause numerous side effects over the longer term, even though they were actually developed as better-tolerated NSAIDs.
