Celecoxib is a selective COX-2 inhibitor with anti-inflammatory and analgesic effects and minimal gastrointestinal side effects. However, attention should be paid to its cardiovascular risks and interactions with multiple drugs.

1. Effect of action

(1) Pharmacological effects

Selective inhibition of COX-2 enzyme, reduction of prostaglandin production, exerting anti-inflammatory and analgesic effects, with minimal impact on COX-1.

(2) Indications

Used for the treatment of osteoarthritis, rheumatoid arthritis, acute pain, and ankylosing spondylitis.

(3) Effective time

It takes effect within 3 hours after oral administration, and the analgesic effect can last for 24 hours. The blood drug concentration reaches a steady state within 3 days.

2. Drug interactions

(1) Anticoagulant drugs

Combined use with warfarin may increase INR values, and close monitoring of coagulation function is necessary.

(2) Antihypertensive drugs

May weaken the antihypertensive effect of ACE inhibitors/ARB drugs and require dosage adjustment.

(3) Diuretics

Combined use with furosemide may reduce diuretic effects and increase the risk of nephrotoxicity.

(4) Lithium salt

May increase blood lithium concentration, blood lithium levels need to be monitored when used in combination.

(5) CYP2C9 inhibitors

Fluconazole and other drugs may increase the blood concentration of celecoxib and should be used in moderation.

3. Special precautions

(1) Cardiovascular risk

Long term use may increase the risk of myocardial infarction, and patients with coronary heart disease should use it with caution.

(2) Gastrointestinal reactions

Although less common than traditional NSAIDs, it may still cause ulcers, and attention should be paid to gastrointestinal bleeding symptoms.

(3) Impact on renal function

It may cause retention of water and sodium, and the dosage shall be adjusted for patients with renal insufficiency.