Celebrex 200mg viatris medicine for osteoarthritis, rheumatoid arthritis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Celecoxib
Ingredient Dysmenorrhea, osteoarthritis, joint spondylitis, arthritis, rheumatoid arthritis

Ingredient

Composition information	Content
Celecoxib	200mg

Uses

Indications

Celebrex 200 mg drug is indicated in the following cases:

Treatment of symptoms of osteoarthritis (OA) and rheumatoid arthritis (out). The initial prostaglandin synthesis through inhibition of cyclooxygenase enzyme - 2 (COX - 2). At human treatment concentration, Celecoxib does not inhibit cyclooxygenase enzyme - 1 (COX - 1). COX - 2 is created to respond to inflammatory agents. This leads to the synthesis and accumulation of inflammatory prostanoids, especially prostaglandin E2, causing inflammation, edema and pain.

Celecoxib has an anti -inflammatory, analgesic and cooling effect on animals due to the prevention of the production of inflammatory prostanoids through COX -2 inhibition. In the treatment dose, Celecoxib does not work on Prostanoids that are synthesized by COX -1 activation, therefore, does not affect normal physiological processes related to COX - 1 in p>.

pharmacokinetic

absorption

When used at Celecoxib, it is easy to be absorbed and reaches the peak concentration in plasma after about 2-3 hours. Oral bioavailability capsules is 99% compared to the type of translation (the optimal oral form is available). Using drugs with food (rich in fat) slows down the absorption shown through TMAX achieved after about 4 hours and bioavailability increases 20%.

Distribution

The ratio of cohesion with plasma proteins is about 97% at plasma treatment concentrations and Celecoxib is not given priority associated with red blood cells. The average stable distribution integral is about 500L/70 kg in healthy adults showing a wide distribution of Celecoxib into tissues. Pre -clinical studies have identified the drug to overcome the bloody barrier.

Metabolism

Celecoxib is metabolized mainly through Cytocrom P450 2C9. Three metabolic products have no effect inhibiting COX - 1 or COX - 2 identified in human plasma as the best alcohol, the corresponding carboxylic acid and the form associated with its glucuronic. The activity of Cytocrom P450 2C9 decreases in people with polymorphism and this leads to a decrease in enzyme activity, for example, a contractor for polymorphism CYP2C9*3.

Elimination

Eliminating Celecoxib is mainly due to the metabolism through the liver with less than 1% of the dosage excreted in the urine. After multi -dose use, the sale time is 8 - 12 hours and the clearance rate is about 500 ml/min. With multiple doses, the concentration of drugs in plasma is stable before the 5th day.

Before taking Celebrex 200mg viatris medicine for osteoarthritis, rheumatoid arthritis (3 blisters x 10 tablets)

How to use

Celecoxib capsules can be used with food or not. Due to the cardiovascular risks of Celecoxib may increase with the dose and time of drug use, the lowest dose should be used in the shortest possible time.

For patients with difficulty swallowing capsules, it is possible to put the amount of pills in the juice of apple smoothie, porridge, yogurt or crushed bananas to drink. At that time, the entire amount of drugs must be added to about a small teaspoon of apple smoothie, porridge, yogurt or crushed bananas at room temperature and must drink immediately with water. The amount of drug mixed with apple smoothie, porridge or yogurt is stable for about 6 hours when stored in the refrigerator (2 ° C - 80C/35 ° F - 45 ° F). Do not be stored in the refrigerator amount mixed with crushed bananas and must be taken immediately.

Dosage

Adults

Symptomatic treatment in osteoarthritis (OA): Celecoxib's recommendations are 200 mg used for single or 100 mg, 2 times daily.

Symptomatic treatment in rheumatoid arthritis (output): Celecoxib's recommendations are 100 mg or 200 mg 2 times daily.

Againized spondylitis (AS): Celecoxib's recommendations are 200 mg of single or 100 mg twice doses daily. Some patients may be better if they use a total daily dose of 400 mg.

Acute pain control: The starting dose as recommended by Celecoxib is 400 mg, taking an additional 200 mg dose on the first day if necessary. In the following days, the recommended dose is 200 mg 2 times daily when needed.

Treatment of primary menstrual dysmenorrhea: The starting dose as recommended by Celecoxib is 400 mg, taking an additional 200 mg dose on the first day if necessary. In the following days, the recommended dose is 200 mg 2 times daily when needed.

People with poor metabolism CYP2C9: Patients who know or suspect poor metabolism through CYP2C9 based on a history of experience with other substrates of CYP2C9 should be cautious when using Celecoxib. Start treatment with the lowest recommended dose.

Elderly: generally do not have to adjust the dose. However, for elderly patients weighing less than 50 kg, it is advisable to start treatment with the lowest recommended dose.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when using overdose? In case of suspicion of overdose, appropriate medical support measures should be taken. The fertilizer is not an effective measure to eliminate drugs because the drug is strongly connected to the protein.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Celebrex 200 mg, you may experience unwanted effects (ADR).

Uncommon, 1/1000

Eye disorders: conjunctivitis.

Systemic disorders and medication: chest pain.

Rare 1/1000

Mental disorders: illusion.

Respiratory disorders, chest and mediastinum: pulmonary embolism, pneumonia.

Gastrointestinal disorders: digestive bleeding.

Hepatitis: Hepatitis.

Skin and subcutaneous tissue disorders: light -sensitive reactions.

Renal and urinary disorders: acute renal failure, hypoglyc sodium.

Reproduction disorders: Menstrual disorders.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Celebrex 200 mg drug is contraindicated in the following cases:

Patients with a history of hypersensitivity to Celecoxib or any component of the drug.

Patients with a history of hypersensitivity to sulfonamid. Artificial ring (CABG).

Precautions when using

Effects on the heart

Cardiovascular thrombosis: Celecoxib can increase the risk of serious cardiovascular thrombosis, myocardial infarction, and stroke, which can be fatal. To minimize the risk of the lowest dosage effectively and in the shortest possible time.

Celecoxib is not a substitute for acetylsalicylic acid in preventing cardiovascular blockage due to lack of platelet function. Because Celecoxib does not inhibit platelet aggression, platelet resistance should not be stopped (for example, acetylsalicylic acid) while using Celecoxib.

Hypertension: Need to monitor blood pressure closely when starting treatment with Celecoxib as well as during treatment. Caution should be careful when using Celecoxib in patients who have suffered from heart, edema or other conditions may be worse due to fluid and edema, including patients taking diuretics or risk of blood volume.

Effects on the gastrointestinal tract: Patients are at risk of these gastrointestinal complications when taking NSAID drugs mostly elderly people, patients with cardiovascular diseases, patients who are taking aspirin, glucocorticoids, or other NSAIDs, patients using alcohol, or patients with a history or suffering from progressive gastrointestinal diseases such as ulcers, blood inflammation or digestive tract.

Effects on the kidneys: Patients with the highest risk of kidney toxicity are those who fail kidney function, heart failure, liver and elderly. Careful monitoring for these patients when treated with Celecoxib. Be careful when starting treatment for dehydration patients. First, it is necessary to rehydration for patients and then start treatment with Celecoxib. Need to closely monitor kidney function in patients with renal disease progressive treatment with Celecoxib.

Anaphylactic reaction: Like NSAID drugs in general, anaphylactic reactions occur in patients using Celecoxib.

Serious skin reactions: Patients are often at high risk for these events in the early stage of the treatment process, most of these cases occur mainly in the first month of treatment. Celecoxib should be stopped as soon as skin redness appears, mucosal damage or any hypersensitivity signs.

Effects on the liver: There is no study in patients with severe liver failure (Child - PUGH group C). Do not use Celecoxib in patients with severe liver failure. Caution should be used when using Celecoxib in medium liver failure patients (Child - Pugh Group B) and should start at half the recommended dose.

The ability to drive and operate machinery

There has been no research on the effects of Celecoxib on driving and operating machinery, but based on the pharmacological properties and the general description of the safety of the drug, it can be considered as non -influential drugs.

Pregnancy

Celecoxib can cause helplessness and early aortic muscle, so avoid using Celecoxib in the third quarter of pregnancy. Celecoxib should only be used during pregnancy if the potential benefits are changed to the mother outstanding potential risk to the fetus. Prostaglandin synthesis inhibitors can cause disadvantages for pregnant women.

Breastfeeding period

In nursing women using Celecoxib, very few Celecoxibs are transferred into milk. Because of the unwanted effects of Celecoxib on breastfeeding children, depending on the desired benefit of the drug for the mother, should consider stopping the medicine or stop breastfeeding.

Drug interaction

Celecoxib mainly transformed through Cytocrom P450 (CYP) 2C9 in the liver. The simultaneous use of Celecoxib with CYP2C9 inhibitors increases the concentration of Celecoxib in plasma. The simultaneous use of Celecoxib with CYP2C9 induction substances such as Rifampicin, Carbamazepin and Barbiturat reduces the concentration of plasma Celecoxib. In addition, there may be in vivo interaction with drugs metabolized by CYP2D6.

Lithium: In healthy objects, plasma lithium concentrations increase by about 17% when used simultaneously lithium and Celecoxib. Need to closely monitor patients being treated with lithium when starting or stopping using simultaneously with Celecoxib.

Aspirin: Celecoxib does not affect the anti -platelet effect of low -dose aspirin.

Prostaglandin inhibitor can reduce the anti -hypertension effect of angiotensin transferring enzyme inhibitors (Acei) and/or Angiotensin II antagonists, diuretics and beta receptor blockers.

Cyclosporin: Because NSAIDs work on kidney prostaglandin, these drugs may increase the risk of cyclosporin kidney poisoning.

Fluconazole and Ketoconazole: simultaneously use Fluconazole at a dose of 200mg, 1 time/day double the plasma celecoxib concentration due to fluconazole that has the effect of inhibiting enzymes metabolism of Celecoxib CYP P450 2C9. Ketoconazole, a CYP3A4 inhibitor, has no significant celecoxib metabolism inhibitors.

dextromethorphan and metoprolol: simultaneous use of Celecoxib 200mg twice a day increases 2.6 times and 1.5 times the concentration of dextromethorphan and metoprolol in plasma (substrates of CYP2D6). This is because Celecoxib inhibits metabolism of substrates of CYP2D6.

Diuretics: Clinical studies show that in some patients, NSAIDs can reduce the effect of increasing sodium exhaust through the urine of Furosemid and Thiazid by inhibiting the synthesis of prostaglandin in the kidney.

Storage

Store at conditions not exceeding 30 ° C.

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