What is the appropriate dosing for Celebrex (celecoxib)?

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Last updated: February 12, 2025 • View editorial policy

From the Guidelines

Celebrex (celecoxib) dosing is typically 100-200 mg twice daily.

Important Considerations

  • The dosing of Celebrex can vary depending on the specific condition being treated, with 100 mg twice daily being a common dose for many indications 1.
  • For acute gout, a dose of 800 mg once, followed by 400 mg on day 1, then 400 mg twice daily for a week has been suggested as an option for carefully selected patients with contraindications or intolerance to NSAIDs 2.
  • It is essential to consider the individual patient's risk for cardiovascular events and other risks commonly associated with NSAIDs when prescribing Celebrex 3.
  • The American Heart Association recommends that physicians consider alternative therapy or use the smallest effective dose of Celebrex, taking into account the patient's individual risk for cardiovascular events 3.

Key Points

  • Celebrex is a cyclooxygenase-2 (COX-2) inhibitor, which may have a better safety profile than nonselective NSAIDs (nsNSAIDs) for patients at high risk for gastrointestinal (GI) complications.
  • However, the cardiovascular risk conferred by Celebrex and other COX-2 inhibitors remains unclear, and additional large outcome trials are needed to definitively answer these questions 4.
  • Patients should be advised to use Celebrex in strict accordance with the label directions, and if use is needed for longer than 10 days, a physician should be consulted 3.

From the FDA Drug Label

2. Dosage and Administration
  1. 1 General Dosing Instructions Carefully consider the potential benefits and risks of celecoxib capsules and other treatment options before deciding to use celecoxib capsules. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals [see Warnings and Precautions (5)]. These doses can be given without regard to timing of meals.
  2. 2 Osteoarthritis For OA, the dosage is 200 mg per day administered as a single dose or as 100 mg twice daily. 2.3 Rheumatoid Arthritis For RA, the dosage is 100 mg to 200 mg twice daily.
  3. 4 Juvenile Rheumatoid Arthritis For JRA, the dosage for pediatric patients (age 2 years and older) is based on weight. For patients ≥10 kg to ≤25 kg the recommended dose is 50 mg twice daily. For patients >25 kg the recommended dose is 100 mg twice daily.
  4. 5 Ankylosing Spondylitis For AS, the dosage of celecoxib capsules are 200 mg daily in single (once per day) or divided (twice per day) doses. If no effect is observed after 6 weeks, a trial of 400 mg daily may be worthwhile. If no effect is observed after 6 weeks on 400 mg daily, a response is not likely and consideration should be given to alternate treatment options.
  5. 6 Management of Acute Pain and Treatment of Primary Dysmenorrhea For management of Acute Pain and Treatment of Primary Dysmenorrhea, the dosage is 400 mg initially, followed by an additional 200 mg dose if needed on the first day. On subsequent days, the recommended dose is 200 mg twice daily as needed.
  6. 7 Special Populations Hepatic Impairment In patients with moderate hepatic impairment (Child-Pugh Class B), reduce the dose by 50%. The use of celecoxib capsules in patients with severe hepatic impairment is not recommended [see Warnings and Precautions (5.5), Use in Specific Populations (8.6), and Clinical Pharmacology (12. 3)]. Poor Metabolizers of CYP2C9 Substrates In adult patients who are known or suspected to be poor CYP2C9 metabolizers based on genotype or previous history/experience with other CYP2C9 substrates (such as warfarin, phenytoin), initiate treatment with half of the lowest recommended dose In patients with JRA who are known or suspected to be poor CYP2C9 metabolizers, consider using alternative treatments [see Use in Specific populations (8.8) and Clinical Pharmacology (12.5)].

The appropriate dosing for Celebrex (celecoxib) varies by condition:

  • Osteoarthritis (OA): 200 mg per day as a single dose or 100 mg twice daily
  • Rheumatoid Arthritis (RA): 100 mg to 200 mg twice daily
  • Juvenile Rheumatoid Arthritis (JRA): + For patients ≥10 kg to ≤25 kg: 50 mg twice daily + For patients >25 kg: 100 mg twice daily
  • Ankylosing Spondylitis (AS): 200 mg daily in single or divided doses, with a possible increase to 400 mg daily if no effect is observed after 6 weeks
  • Acute Pain and Primary Dysmenorrhea: 400 mg initially, followed by an additional 200 mg dose if needed on the first day, and 200 mg twice daily as needed on subsequent days
  • Special Populations: + Hepatic Impairment: reduce dose by 50% in patients with moderate hepatic impairment (Child-Pugh Class B) + Poor Metabolizers of CYP2C9 Substrates: initiate treatment with half of the lowest recommended dose in adult patients, and consider alternative treatments in patients with JRA 5

From the Research

Dosing Information for Celebrex (Celecoxib)

  • The usual recommended daily dosage of celecoxib is 200 mg (in one or two intakes per day), to be increased up to 400 mg (two intakes per day) if necessary 6.
  • Celecoxib 100 and 200 mg and naproxen 500 mg twice daily were similarly efficacious and superior to placebo in patients with osteoarthritis of the knee 7.
  • All dosages of celecoxib (100 to 400 mg twice daily) and naproxen 500 mg twice daily produced significant anti-inflammatory and analgesic effects in patients with active rheumatoid arthritis 7.
  • The recommended dosages of celecoxib are 200 or 400 mg/day for the symptomatic treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis in adults 8.
  • A single oral dose of celecoxib 200 mg is effective for postoperative pain relief, with a number-needed-to-treat of 4.5 (CI 3.3 to 7.2) compared with placebo 9.
  • Dosing regimens of celecoxib 200 mg QD and 100 mg BID are equally effective and well tolerated in patients with osteoarthritis of the knee 10.

Key Considerations

  • The dosage of celecoxib should be individualized based on the patient's response and tolerance 6, 7, 8.
  • Celecoxib should be used at the lowest effective dosage for the shortest possible duration after a careful evaluation of the GI, cardiovascular, and renal risks of the individual patient 8.
  • Concomitant administration of celecoxib with low-dose cardioprotective aspirin may negate the GI-sparing advantages of celecoxib over NSAIDs 8.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.