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COX-2 Inhibitor (NSAID)

Celecoxib

Brand names: Celebrex

Celecoxib is a COX-2-selective non-steroidal anti-inflammatory drug (NSAID) used for pain and inflammation, including in osteoarthritis and rheumatoid arthritis.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Use the lowest effective dosage for shortest duration consistent with individual patient treatment goals. ( 2.1 ) OA: 200 mg once daily or 100 mg twice daily. ( 2.2 , 14.1 ) RA: 100 mg to 200 mg twice daily. ( 2.3 , 14.2 ) JRA: 50 mg twice daily in patients 10 kg to 25 kg. 100 mg twice daily in patients more than 25 kg. ( 2.4 , 14.3 ) AS: 200 mg once daily single dose or 100 mg twice daily. If no effect is observed after 6 weeks, a trial of 400 mg (single or divided doses) may be of benefit. ( 2.5 , 14.4 ) AP and PD: 400 mg initially, followed by 200 mg dose if needed on first day. On subsequent days, 200 mg twice daily as needed. ( 2.6 , 14.5 ) Hepatic Impairment: Reduce daily dose by 50% …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2023-08-24. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It selectively inhibits cyclo-oxygenase-2, reducing prostaglandin-mediated inflammation with relatively less effect on COX-1 (and so less gastrointestinal injury than non-selective NSAIDs).

Prescribing in practice

  • Lower gastrointestinal risk than non-selective NSAIDs does not remove cardiovascular and renal risk — avoid in established cardiovascular disease and significant renal impairment, and use the lowest effective dose for the shortest time.
  • It does not provide the antiplatelet protection of aspirin.
  • It is a sulfonamide — use caution in sulfonamide allergy.

Monitoring

With longer use or in at-risk patients monitor renal function and blood pressure.

Counselling the patient

  • Report indigestion, black stools or reduced urine output.
  • Avoid combining it with other NSAIDs.

Evidence & guidelines

A COX-2-selective NSAID with lower gastrointestinal risk, balanced against cardiovascular risk and used selectively (NICE osteoarthritis/RA guidance).

Reference: CLASS trial; EMA NSAID Safety Review; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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