From the Guidelines
The equivalent dose of naproxen 220 mg twice daily (bid) in celecoxib would be approximately 100-200 mg once daily. Celecoxib is typically dosed at 100-200 mg once daily for osteoarthritis and 200 mg twice daily for rheumatoid arthritis 1. When converting from naproxen to celecoxib, it's essential to consider that these medications work differently - naproxen is a traditional non-steroidal anti-inflammatory drug (NSAID) that inhibits both COX-1 and COX-2 enzymes, while celecoxib is a selective COX-2 inhibitor. This selectivity gives celecoxib a potentially better gastrointestinal safety profile at equivalent anti-inflammatory doses. The conversion is not perfectly linear, and individual response may vary.
Some key points to consider when switching between these medications include:
- Starting with the lower recommended dose of celecoxib and adjusting based on symptom relief
- Taking celecoxib with food to improve absorption
- Avoiding celecoxib in patients with sulfonamide allergies due to potential cross-reactivity
- Being aware of the potential for gastrointestinal complications, particularly in patients with a history of NSAID-associated upper GI tract bleeding, and considering the use of a gastroprotective agent or a COX-2 selective agent in these cases 1.
It's also important to note that the evidence supports the use of NSAIDs, including celecoxib, in the treatment of knee OA, particularly in patients with an increased risk of gastrointestinal complications 1. However, the decision to switch from naproxen to celecoxib should be made on a case-by-case basis, taking into account the individual patient's medical history, current medications, and potential risks and benefits.
From the FDA Drug Label
At doses of 100 mg twice daily or 200 mg twice daily the effectiveness of celecoxib capsules was shown to be similar to that of naproxen 500 mg twice daily The equivalent dose of naproxen 220 mg bid in celecoxib is not directly stated in the label, but based on the information provided, 220 mg bid of naproxen is less than 500 mg bid of naproxen, which is comparable to 100 mg bid or 200 mg bid of celecoxib.
- However, the exact equivalent dose of naproxen 220 mg bid in celecoxib cannot be determined from the label. 2
From the Research
Equivalent Dose of Naproxen 220 mg bid in Celecoxib
- The equivalent dose of naproxen 220 mg bid in celecoxib is not directly stated in the provided studies 3, 4, 5, 6, 7.
- However, study 4 compared celecoxib 100 mg twice daily with naproxen 500 mg twice daily, and study 5 compared celecoxib 100 to 200 mg twice daily with naproxen 375 to 500 mg twice daily.
- Study 6 compared celecoxib 100 mg every 12 hours with naproxen 250 mg every 12 hours, and found that naproxen inhibited COX-2 activity to a greater degree than celecoxib.
- Based on the dosages used in these studies, it can be inferred that the equivalent dose of naproxen 220 mg bid in celecoxib may be around 100-200 mg bid, but this is not a direct conversion and should be used as a rough estimate only 4, 5, 6.
Dose Comparison
- Study 4 used a dosage of celecoxib 100 mg twice daily and naproxen 500 mg twice daily.
- Study 5 used a dosage range of celecoxib 100 to 200 mg twice daily and naproxen 375 to 500 mg twice daily.
- Study 6 used a dosage of celecoxib 100 mg every 12 hours and naproxen 250 mg every 12 hours.
- These studies suggest that the dosage of celecoxib and naproxen can vary, and the equivalent dose of naproxen 220 mg bid in celecoxib may depend on the specific study and dosage used 4, 5, 6.