Acelex
Generic Name
Celecoxib
Manufacturer
Renata Limited
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| acelex 250 mg capsule | ৳ 6.60 | ৳ 66.00 |
Description
Overview of the medicine
Acelex 250 mg Capsule contains Celecoxib, a non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2) enzyme. It is used to relieve pain and inflammation in conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, and primary dysmenorrhea.
Uses & Indications
Dosage
Adults
Osteoarthritis and Ankylosing Spondylitis: 250 mg once daily. Rheumatoid Arthritis and Acute Pain: 250 mg twice daily, as directed by physician. Maximum recommended daily dose is 500 mg.
Elderly
Use the lowest effective dose. Initiate therapy with the lowest recommended dose and monitor for adverse effects.
Renal_impairment
No specific dosage adjustment recommended for mild-to-moderate renal impairment. Use with caution in severe renal impairment.
Hepatic_impairment
Moderate hepatic impairment (Child-Pugh Class B): Reduce dose by 50%. Severe hepatic impairment (Child-Pugh Class C): Not recommended.
How to Take
Acelex capsules should be taken orally with or without food. Taking with food may improve absorption or reduce gastrointestinal upset in some patients.
Mechanism of Action
Celecoxib selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, leading to reduced synthesis of prostaglandins, which are mediators of pain and inflammation. Unlike non-selective NSAIDs, it exhibits less inhibition of COX-1, potentially reducing gastrointestinal side effects.
Pharmacokinetics
Onset
Pain relief can begin within hours of administration.
Excretion
Mainly excreted via feces (57%) and urine (27%) as metabolites; less than 3% is excreted as unchanged drug.
Half life
The elimination half-life is approximately 8-12 hours.
Absorption
Well absorbed from the gastrointestinal tract. Peak plasma concentrations are achieved in approximately 2-3 hours.
Metabolism
Extensively metabolized in the liver primarily by cytochrome P450 2C9 (CYP2C9) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to celecoxib, aspirin, other NSAIDs, or sulfonamides
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
- In the setting of coronary artery bypass graft (CABG) surgery
- Advanced renal disease
- Severe hepatic impairment
- Third trimester of pregnancy
Drug Interactions
Lithium
May increase lithium plasma concentrations; monitor lithium levels.
Warfarin
Increased risk of bleeding when co-administered. Monitor INR closely.
Fluconazole
Increases celecoxib plasma concentrations; reduce celecoxib dose by half.
Cyclosporine
May increase the nephrotoxic effect of cyclosporine.
Methotrexate
May increase methotrexate toxicity.
ACE Inhibitors/ARBs
May reduce the antihypertensive effect and increase the risk of renal impairment.
Diuretics (e.g., Furosemide, Thiazides)
May reduce the natriuretic effect.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of NSAID overdose typically include lethargy, drowsiness, nausea, vomiting, and epigastric pain. Gastrointestinal bleeding can occur. Supportive and symptomatic management is recommended. Gastric lavage and activated charcoal may be considered if ingestion is recent.
Pregnancy & Lactation
Pregnancy: Avoid in the third trimester due to risk of premature closure of ductus arteriosus. Use only if potential benefit outweighs risk in early pregnancy. Lactation: Celecoxib is excreted in breast milk in small amounts; use with caution or consider alternatives.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture.
Availability
Available in pharmacies
Approval Status
Approved by regulatory authorities
Patent Status
Off-patent
Clinical Trials
Celecoxib has undergone extensive clinical trials demonstrating its efficacy and safety profile for its approved indications. Studies have compared its effects to other NSAIDs and placebo in various patient populations.
Lab Monitoring
- Complete Blood Count (CBC) periodically
- Renal function tests (BUN, creatinine) periodically, especially with long-term use
- Liver function tests (ALT, AST) periodically
- Blood pressure monitoring
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor patients for signs and symptoms of cardiovascular and gastrointestinal adverse events.
- Evaluate renal and hepatic function periodically, especially in patients with pre-existing impairment or on long-term therapy.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Report any signs of gastrointestinal bleeding (black, tarry stools; vomit resembling coffee grounds) immediately.
- Report any symptoms of cardiovascular events (chest pain, shortness of breath, sudden weakness) to your doctor.
- Avoid alcohol and smoking while taking this medication.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Celecoxib may cause dizziness or drowsiness. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a healthy diet and engage in regular, moderate exercise (if appropriate for your condition).
- Avoid excessive alcohol consumption.
- Manage stress effectively.
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