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NSAID — Selective COX-2 Inhibitor

Celecoxib (Rheumatology)

Brand names: Celebrex

This is celecoxib, a selective COX-2 inhibitor non-steroidal anti-inflammatory drug, used in rheumatology to relieve pain and inflammation in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

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.

Clinical monograph

How it works

It selectively inhibits cyclo-oxygenase-2, reducing prostaglandin-mediated inflammation and pain while sparing COX-1, which lessens gastrointestinal mucosal injury.

Prescribing in practice

  • Like other NSAIDs it carries cardiovascular thrombotic risk and is contraindicated in established ischaemic heart disease, cerebrovascular and peripheral arterial disease, so it is used at the lowest effective dose for the shortest period.
  • It is contraindicated in sulfonamide allergy and used with caution with renal impairment, hypertension and heart failure.
  • Although gastrointestinal-sparing relative to non-selective NSAIDs, serious gastrointestinal events can still occur, particularly in older patients or with concomitant antithrombotics.

Monitoring

Monitor blood pressure, renal function and for gastrointestinal or cardiovascular symptoms, particularly with prolonged use or in at-risk patients.

Counselling the patient

  • Report indigestion, black stools, breathlessness or ankle swelling.
  • Take with food and use the lowest effective dose for the shortest time.

Evidence & guidelines

Efficacy and the relative gastrointestinal profile are supported by randomised controlled trials, with NICE and MHRA guidance on cardiovascular risk.

Reference: CONDOR Trial (Lancet 2010); PRECISION Trial (NEJM 2016); NICE TA27 (COX-2 inhibitors); 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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