Cox 100 mg Capsule

COX-2 selective NSAID for:

• Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis
• Acute pain and period pain (some countries)
• Juvenile rheumatoid arthritis (2 years and over, specialist)

Osteoarthritis: 200 mg once daily or 100 mg twice daily (maximum 400 mg/day).

Rheumatoid arthritis: 100–200 mg twice daily.

Ankylosing spondylitis: 200 mg daily (up to 400 mg).

Acute pain/period pain: 400 mg initially, then 200 mg once or twice daily as needed.

• With or without food. Lowest effective dose for the shortest time.
• Moderate liver impairment: halve the dose.

• Allergy to sulphonamides, celecoxib, aspirin or NSAIDs (asthma, hives)
• Active peptic ulcer or GI bleeding
• Ischaemic heart disease, cerebrovascular disease, peripheral arterial disease, heart failure (NYHA II–IV)
• Severe kidney or liver impairment
• Immediately after coronary bypass surgery
• Last 3 months of pregnancy

Common: indigestion, abdominal pain, diarrhoea, wind, swelling, raised blood pressure, dizziness, insomnia, upper respiratory infections, rash.

Serious: heart attack and stroke (dose- and duration-related), GI bleeding/ulcer (less than traditional NSAIDs), kidney injury, liver injury, severe skin reactions, anaphylaxis.

• Cardiovascular risk factors (hypertension, smoking, diabetes, high cholesterol): use only after careful assessment.
• Elderly, kidney disease, dehydration: caution.
• Asthma: caution.

Avoid in the first 6 months unless advised; contraindicated in the last 3 months. Small amounts in milk — short-term use may be acceptable.

• Warfarin (bleeding, INR rise), antiplatelets, SSRIs
• Low-dose aspirin (more GI bleeding)
• ACE inhibitors, ARBs, diuretics (kidney injury)
• Lithium (toxicity)
• Fluconazole (doubles celecoxib levels — halve the dose)
• Metoprolol, dextromethorphan (celecoxib raises their levels)

Drowsiness, nausea, vomiting, epigastric pain; rarely kidney failure. Supportive care.

Store below 30°C.