Recommended Dosages of Celebrex (Celecoxib) for Various Conditions
The FDA-approved dosages of Celebrex vary by condition, with osteoarthritis requiring 200 mg daily (either as a single dose or 100 mg twice daily), rheumatoid arthritis requiring 100-200 mg twice daily, and ankylosing spondylitis requiring 200 mg daily (single or divided doses). 1
Condition-Specific Dosing Recommendations
Osteoarthritis
- 200 mg per day administered as:
- 200 mg once daily OR
- 100 mg twice daily
- Both regimens provide comparable efficacy with similar safety profiles 1, 2
- Once-daily dosing may improve patient adherence
Rheumatoid Arthritis
- 100 mg to 200 mg twice daily 1
- Higher doses within this range may provide better symptom control for more severe disease
Ankylosing Spondylitis
- Initial dose: 200 mg daily in single or divided doses
- If no effect after 6 weeks, may increase to 400 mg daily
- If no response after 6 weeks at 400 mg daily, consider alternative treatment 1
- Studies show celecoxib 200 mg twice daily is comparable to diclofenac 75 mg twice daily for pain reduction 3
Juvenile Rheumatoid Arthritis (age 2 years and older)
- Weight-based dosing:
- 10-25 kg: 50 mg twice daily
25 kg: 100 mg twice daily 1
Acute Pain and Primary Dysmenorrhea
- Initial dose: 400 mg
- Additional 200 mg on first day if needed
- Subsequent days: 200 mg twice daily as needed 1
Chronic Non-Bacterial Osteitis (CNO)
- 200-400 mg daily in divided doses 4
Special Populations
Hepatic Impairment
- Moderate impairment (Child-Pugh Class B): Reduce dose by 50%
- Severe impairment: Not recommended 1
Poor CYP2C9 Metabolizers
- Start with half of the lowest recommended dose
- For JRA patients who are poor CYP2C9 metabolizers, consider alternative treatments 1
Administration Considerations
- Can be taken without regard to timing of meals 1
- For patients who have difficulty swallowing capsules, contents can be added to applesauce and consumed immediately with water 1
- Sprinkled contents remain stable for up to 6 hours under refrigeration (2-8°C) 1
Safety Considerations
- Use lowest effective dose for shortest duration to minimize cardiovascular and gastrointestinal risks 1
- Celecoxib has a better GI safety profile than traditional NSAIDs, with studies showing lower incidence of gastrointestinal adverse events (16.7% for celecoxib vs 28.4% for diclofenac) 3
- Exercise caution in patients with cardiovascular risk factors 5
- Avoid in patients with congestive heart failure 5
- Monitor kidney function when using any NSAID, including Celebrex 5
- Use caution with concomitant anticoagulants due to increased bleeding risk 5
Efficacy Considerations
- Celecoxib 200 mg once daily is as effective as naproxen 500 mg twice daily in Hispanic patients with knee OA 6
- Long-term therapy with celecoxib does not appear to accelerate progression of osteoarthritis of the knee or hip 7
By following these dosing guidelines and considering patient-specific factors, Celebrex can be effectively and safely used to manage various inflammatory and painful conditions.