Introduction
Cox B is a pain relieving medicine. It alleviates pain, redness, and swelling in conditions such as osteoarthritis, rheumatoid arthritis, and pain during menstruation.
Cox B can be taken with or without food. You should take it regularly as advised by your doctor. Your doctor may change the dose and time between doses according to your pain level and your needs. Do not take more or use it for longer than recommended by your doctor.
Some common side effects of this medicine includes abdominal pain, diarrhea, indigestion, flatulence, peripheral edema, and dizziness. If any of these side effects bother you or do not go away, you should let your doctor know. Your doctor may help with ways to reduce or prevent these symptoms by prescribing you an alternative medicine or by adjusting the dose.
The medicine may not be suitable for everybody. Before taking it, let your doctor know if you have any problems with your heart, kidneys, and liver. You should avoid consumption of alcohol while on this medication. Let your doctor know about all the other medicines you are taking because they may affect, or be affected by this medicine. Pregnant and breastfeeding mothers should consult their doctors before using this medicine as it can cause harmful effects to the developing baby.
Uses of Cox B
- Pain relief
- Osteoarthritis
- Rheumatoid arthritis
- Pain during menstruation
Side effects of Cox B
Common
- Stomach pain
- Diarrhea
- Flatulence
- Flu-like symptoms
- Peripheral edema
How to use Cox B
Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it. Cox B may be taken with or without food, but it is better to take it at a fixed time.
How Cox B works
Cox B is a non-steroidal anti-inflammatory drug (NSAID) called COX-2 inhibitors. It works by blocking the release of certain chemical messengers that are responsible for pain and inflammation (redness and swelling).
Indication
Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis, Dysmenorrhea, Acute pain, Familial adenomatous polyposis
Administration
May be taken with or without food. Dose for OA/RA may be given w/ or w/o meals, but doses for FAP must be given w/ meals.
Adult Dose
Oral
Osteoarthritis
Adult: 200 mg/day as a single dose or in 2 divided doses. May increase to 200 mg bid, if necessary.
Rheumatoid arthritis
Adult: 100-200 mg bid.
Dysmenorrhoea; Pain relief
Adult: Initially, 400 mg followed by 200 mg if necessary on the 1st day. Maintenance: 200 mg bid.
Ankylosing spondylitis
Adult: Initially, 200 mg/day as a single dose or in 2 divided doses. May increase to 400 mg/day after 6 wk.
Hepatic impairment: Moderate (Child-Pugh category B): Reduce dose by 50%. Severe (Child-Pugh category C or ?10 score): Contraindicated.
Child Dose
Juvenile idiopathic arthritis
Child: >2 yr >10 kg to <25 kg: 50 mg bid;
>25 kg: 100 mg bid.
Contraindication
Hypersensitivity including those in whom attacks of angioedema, rhinitis and urticaria have been precipitated by aspirin, NSAIDs or sulfonamides. Severe hepatic impairment; severe heart failure; inflammatory bowel disease; peptic ulcer; renal impairment (creatinine clearance <30 mL/min); pregnancy and lactation.
Mode of Action
Celecoxib is a selective cyclooxygenase-2 (COX-2) inhibitor primarily responsible to reduce mediators of pain and inflammation. Its action is due to inhibition of prostaglandin synthesis via inhibition of COX-2.
Precaution
History of GI bleeding; renal/hepatic insufficiency; asthma or allergic disorders; hypertension; monitor Hb or haematocrit levels for signs of anaemia. History of cerebrovascular disease or ischaemic heart disease (IHD).
Lactation: Drug enters breast milk; use caution
Side Effect
>10%
Headache (10-16%),Hypertension (13%)
1-10%
Fever (9%),Dyspepsia (8.8%),Upper respiratory tract infection (8.1%),Arthralgia (7%),Cough (7%),Vomiting (6%),Diarrhea (5.6%),Gastroesophageal reflux (5%),Sinusitis (5%),Abdominal pain (4.1%),Nausea (3.5%),Back pain (2.8%),Insomnia (2.3%),Pharyngitis (2.3%),Flatulence (2.2%),Rash (2.2%),Dizziness (2%),Peripheral edema (2%)
<1%
Anemia,Erythema multiforme,Exfoliative dermatitis,Hepatitis,Jaundice,Stevens-Johnson syndrome,Toxic epidermal necrolysis
Frequency Not Defined
Increased serum asparate aminotransferase concentration
Potentially Fatal: Serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis.
Pregnancy Category Note
Pregnancy category: C; D at >30 weeks' gestation (may cause premature closure of ductus arteriosus)
Lactation: Drug enters breast milk; use caution
Interaction
May increase plasma level w/ CYP2C9 isoenzymes (e.g. fluconazole). May increase serum level of lithium. May reduce effect of antihypertensives and diuretics. May increase anticoagulant effect of warfarin.