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1. Adult (impaired renal function)
No dose adjustment is required in patients with mild or moderate renal insufficiency, and celecoxib is not recommended in patients with severe renal insufficiency [1-3].
2. Adult (impaired liver function)
For patients with moderate hepatic impairment (Child-Pugh class B), the dose should be reduced by 50% to a maximum recommended dose of 60 mg (2.4 mL). Celecoxib was used in patients.
The use of calibrated measuring equipment is recommended to accurately measure prescribed doses of medication, not a household teaspoon or tablespoon [1-3].
3. Child usage
Domestic usage:
There are no data on the efficacy and safety of celecoxib in children younger than 18 years [1].
FDA usage:
This product is indicated for the relief of signs and symptoms of juvenile rheumatoid arthritis (JRA) in patients 2 years of age and older.
For JRA, the dose for pediatric patients (2 years of age and older) is based on body weight. For patients weighing ≥10 kg to ≤25 kg, the recommended dose is 50 mg twice daily. For a 25 kg patient, the recommended dose is 100 mg twice daily [2].
The safety and efficacy of celecoxib have not been studied in children for more than 6 months. Long-term cardiovascular toxicity in children exposed to celecoxib has not been evaluated, and it is unclear whether the long-term risk in children is similar to findings in adults [2].
Safety and efficacy in pediatric patients have not been established. Studies have shown that disseminated intravascular coagulation has occurred in pediatric patients [3].
4. Elderly usage
Older patients are at greater risk for serious cardiovascular, gastrointestinal, and/or renal adverse reactions associated with nonsteroidal anti-inflammatory drugs (NSAIDs) than younger patients.
If the expected benefit in older patients outweighs the potential risk, start with the lowest dose in the dose range and monitor patients for adverse effects [1-3].
5. Medication during pregnancy
Use of NSAIDs, including celecoxib, can lead to premature closure of the ductus arteriosus and fetal renal dysfunction, which can lead to premature closure of the ductus arteriosus and fetal renal dysfunction. > Oligohydramnios and, in some cases, kidney impairment in neonates.
Because of these risks, the dose and duration of this product should be limited around 20-30 weeks of pregnancy and celecoxib should be avoided around 30 weeks and later in pregnancy .
1. Premature closure of the fetal ductus arteriosus
The use of NSAIDs, including celecoxib, at about 30 weeks of pregnancy or later in pregnancy increases the risk of premature closure of the ductus arteriosus in the fetus.
2. Oligohydramnios/neonatal renal impairment
NSAID use around 20 weeks or later in pregnancy has been associated with cases of fetal renal dysfunction resulting in oligohydramnios and, in some cases, neonatal renal impairment [1] -2].
6. Lactation medication
Three published medical reports (including a total of 12 breastfeeding women) showed low levels of celecoxib in breast milk.
The average daily dose for infants is calculated to be 10-40 μg/kg/day, which is less than 1% of the weight-based therapeutic dose for two-year-old children. Reports of two breastfed infants (17 and 22 months of age) showed no adverse events in these infants.
Celecoxib should be administered with caution to nursing women. Consider the developmental and health benefits of breastfeeding, the maternal clinical need for celecoxib, and any potential adverse effects of celecoxib on the breastfed infant [1-3].
References:
[1]Drug Information: Celecoxib Capsules, approved by Chinese medicine J20140072; 2018/11/20.
[2]Product Information:CELECOXIB capsule,Actavis Pharma,Inc.,Updated September 1,2021.
[3]Product Information:ELYXYB-celecoxib solution,Dr.Reddys Laboratories,Inc,Updated May 13,2020.
This article was first published: Clinical Pharmacy Channel in the Medical Community
The author of this article: Jie Xiaoyao
Editor in charge: Xiao Dangdang
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