Powercox
Generic Name
Celecoxib
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| powercox 90 mg tablet | ৳ 12.00 | ৳ 120.00 |
Description
Overview of the medicine
Celecoxib is a non-steroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2) enzyme. It is used to treat pain and inflammation caused by various conditions like osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, acute pain, and primary dysmenorrhea.
Uses & Indications
Dosage
Adults
Osteoarthritis: 200 mg once daily or 100 mg twice daily. Rheumatoid arthritis: 100-200 mg twice daily. Ankylosing Spondylitis: 200 mg once daily or 100 mg twice daily. Acute pain/Dysmenorrhea: 400 mg initially, followed by 200 mg if needed on the first day, then 200 mg twice daily.
Elderly
Generally no dosage adjustment is required, but caution is advised in elderly patients, especially those with renal or hepatic impairment.
Renal_impairment
Mild to moderate impairment: No dosage adjustment. Severe impairment: Not recommended. If necessary, use lowest effective dose.
How to Take
Powercox capsules can be taken with or without food. However, taking it with food may help reduce gastrointestinal upset. Swallow the capsule whole with water. Do not crush or chew.
Mechanism of Action
Powercox (Celecoxib) works by selectively inhibiting the cyclooxygenase-2 (COX-2) enzyme. This inhibition reduces the synthesis of prostaglandins, which are mediators of pain and inflammation.
Pharmacokinetics
Onset
Analgesic effects typically seen within 30-60 minutes.
Excretion
Mainly excreted in the feces (57%) and urine (27%) as inactive metabolites.
Half life
Approximately 8-12 hours.
Absorption
Well absorbed after oral administration; peak plasma concentrations reached in approximately 2-3 hours.
Metabolism
Extensively metabolized in the liver, primarily via cytochrome P450 2C9 (CYP2C9) to inactive metabolites.
Side Effects
Contraindications
- Hypersensitivity to celecoxib, sulfonamides, or any component of the formulation.
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.
- Coronary artery bypass graft (CABG) surgery (peri-operative pain).
- Severe heart failure.
- Active gastrointestinal bleeding or ulceration.
- Third trimester of pregnancy.
Drug Interactions
Aspirin
Concomitant use with low-dose aspirin for cardioprotection is generally acceptable, but may increase GI adverse events.
Lithium
Increased plasma lithium levels; monitor lithium levels.
Warfarin
Increased risk of bleeding; monitor INR.
Fluconazole
Increases celecoxib plasma concentrations; reduce celecoxib dose.
Methotrexate
May increase methotrexate toxicity; monitor for adverse effects.
ACE inhibitors, Angiotensin II receptor blockers (ARBs), Diuretics
Reduced antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of celecoxib overdose may include lethargy, drowsiness, nausea, vomiting, and epigastric pain. Gastrointestinal bleeding can occur. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management involves symptomatic and supportive treatment. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester due to the risk of premature closure of the fetal ductus arteriosus. Use in early pregnancy only if the potential benefit justifies the potential risk to the fetus. Lactation: Low levels of celecoxib are excreted in breast milk. Use with caution during breastfeeding; weigh the benefits against the risks.
Side Effects
Contraindications
- Hypersensitivity to celecoxib, sulfonamides, or any component of the formulation.
- History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.
- Coronary artery bypass graft (CABG) surgery (peri-operative pain).
- Severe heart failure.
- Active gastrointestinal bleeding or ulceration.
- Third trimester of pregnancy.
Drug Interactions
Aspirin
Concomitant use with low-dose aspirin for cardioprotection is generally acceptable, but may increase GI adverse events.
Lithium
Increased plasma lithium levels; monitor lithium levels.
Warfarin
Increased risk of bleeding; monitor INR.
Fluconazole
Increases celecoxib plasma concentrations; reduce celecoxib dose.
Methotrexate
May increase methotrexate toxicity; monitor for adverse effects.
ACE inhibitors, Angiotensin II receptor blockers (ARBs), Diuretics
Reduced antihypertensive effect; increased risk of renal impairment.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach and sight of children.
Overdose
Symptoms of celecoxib overdose may include lethargy, drowsiness, nausea, vomiting, and epigastric pain. Gastrointestinal bleeding can occur. Rarely, hypertension, acute renal failure, respiratory depression, and coma may occur. Management involves symptomatic and supportive treatment. There is no specific antidote.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester due to the risk of premature closure of the fetal ductus arteriosus. Use in early pregnancy only if the potential benefit justifies the potential risk to the fetus. Lactation: Low levels of celecoxib are excreted in breast milk. Use with caution during breastfeeding; weigh the benefits against the risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Generally 24 months from the date of manufacture. Refer to the product packaging for specific dates.
Availability
Pharmacies nationwide
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Generic available
Clinical Trials
Celecoxib has undergone extensive clinical trials demonstrating its efficacy and safety for various indications. Large-scale trials have assessed its cardiovascular and gastrointestinal safety profile compared to other NSAIDs.
Lab Monitoring
- Renal function tests (e.g., serum creatinine, BUN) especially in patients with pre-existing impairment or on diuretics.
- Liver function tests (e.g., ALT, AST) periodically, especially in long-term use.
- Blood pressure monitoring, particularly in hypertensive patients.
- Complete blood count (CBC) in patients receiving long-term treatment.
Doctor Notes
- Prescribe the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
- Monitor for signs and symptoms of cardiovascular events, GI bleeding, and renal dysfunction.
- Avoid use in patients with recent myocardial infarction or high cardiovascular risk unless benefits outweigh risks.
- Consider proton pump inhibitor co-administration in patients at high risk of GI complications.
Patient Guidelines
- Do not exceed the prescribed dose or duration of treatment.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools; vomiting blood) immediately to your doctor.
- Be aware of potential cardiovascular risks (chest pain, shortness of breath, sudden weakness).
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements, you are taking.
- Do not take celecoxib if you are in the last trimester of pregnancy.
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 resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Powercox may cause dizziness, drowsiness, or blurred vision in some individuals. If you experience these side effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Maintain a healthy weight to reduce stress on joints if suffering from arthritis.
- Engage in regular, moderate exercise as advised by your healthcare provider.
- Avoid smoking and excessive alcohol consumption, as these can increase the risk of adverse effects, especially gastrointestinal issues.
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