Achat Celebrex 200 mg 200 mg

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This information is intended for use by health professionals 1. Name of the medicinal product Celebrex mg capsules, hard 2. Qualitative and quantitative composition Each capsule contains mg celecoxib. Excipient with known effect Lactose each capsule contains For the full list of excipients, see section 6.

Pharmaceutical form Opaque, white with two gold bands marked and The decision to prescribe a selective cyclooxygenase-2 COX-2 inhibitor should be based on an assessment of the individual patient’s overall risks see sections 4. The patient’s need for symptomatic relief and response to therapy should be re-evaluated periodically, especially in patients with osteoarthritis see sections 4. Osteoarthritis The usual recommended daily dose is mg taken once daily or in two divided doses.

In some patients, with insufficient relief from symptoms, an increased dose of mg twice daily may increase efficacy. In the absence of an increase in therapeutic benefit after two weeks, other therapeutic options should be considered. Rheumatoid arthritis The initial recommended daily dose is mg taken in Achat Celebrex 200 mg 200 mg divided doses. The dose may, if needed, later be increased to mg twice daily. Ankylosing spondylitis The recommended daily Achat Celebrex 200 mg 200 mg is mg taken once daily or in two divided doses.

In a few patients, Achat Celebrex 200 mg 200 mg insufficient relief from symptoms, an increased dose of mg once daily or in two divided doses may increase efficacy. The maximum recommended daily dose is mg for all indications. Special populations Elderly As in younger adults, mg per day should be used initially. Particular caution should be exercised in elderly with a body weight less than 50 kg see sections 4.

Paediatric population Celecoxib is not indicated for use in children. Consider reducing the dose to half the lowest recommended dose see section 5. Experience in such patients is limited to cirrhotic patients see sections 4. Renal impairment Experience with celecoxib in patients with mild or moderate renal impairment is limited, therefore such patients should be treated with caution see sections 4.

Method of administration Oral use Celebrex may be taken with or without food. For patients who have difficulty swallowing capsules, the contents of a celecoxib capsule can be added to applesauce, rice gruel, yogurt or mashed banana.

Achat Celebrex 200 mg 200 mg do so, the entire capsule contents must be carefully emptied onto a level teaspoon of cool or room temperature applesauce, rice gruel, yogurt or mashed banana and should be ingested immediately with ml of water. The sprinkled capsule contents on mashed banana should not be stored under refrigerated conditions and should be ingested immediately.

Known hypersensitivity to sulfonamides.

Active peptic ulceration or gastrointestinal GI bleeding. Patients who have experienced asthma, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria or other allergic-type reactions after taking Achat Celebrex 200 mg 200 mg acid aspirin or other non-steroidal anti-inflammatory drugs NSAIDs including COX-2 inhibitors.

In pregnancy and in women of childbearing potential unless using an effective method of contraception see section 4. Celecoxib has been shown to cause malformations in the two animal species studied see sections 4. The potential for human risk in pregnancy Achat Celebrex 200 mg 200 mg unknown but cannot be excluded.

Breast-feeding see sections 4. Caution is advised with treatment of patients most at risk of developing a gastrointestinal complication with NSAIDs; the elderly, patients using any other NSAID or acetylsalicylic acid or glucocorticoids concomitantly, patients using alcohol, or patients with a prior history of gastrointestinal disease, such as ulceration and GI bleeding.

There is further increase in the risk of gastrointestinal adverse effects for celecoxib gastrointestinal ulceration or other gastrointestinal complicationswhen celecoxib is taken concomitantly with acetylsalicylic acid even at low doses.

Cardiovascular effects Increased number of serious cardiovascular CV events, mainly myocardial infarction, has been found in a long-term placebo-controlled study in subjects with sporadic adenomatous polyps treated with celecoxib at doses of mg BID and mg BID compared to placebo see section 5. As the cardiovascular risks of celecoxib may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used.

NSAIDs, including COX-2 selective inhibitors, have been associated with increased risk of cardiovascular and thrombotic adverse events when taken long term. The exact magnitude of the risk Achat Celebrex 200 mg 200 mg with a single dose has not been determined, nor has the exact duration of therapy associated with increased risk. Patients with significant risk factors for cardiovascular events e, Achat Celebrex 200 mg 200 mg.

COX-2 selective inhibitors are not a substitute for acetylsalicylic acid for prophylaxis of cardiovascular thrombo-embolic diseases because of their lack of antiplatelet effects. Therefore, antiplatelet therapies should not be discontinued see section 5. Fluid retention and oedema As with other medicinal products known to inhibit prostaglandin synthesis, fluid retention and oedema have been observed in patients taking celecoxib. Therefore, celecoxib should be used with caution in patients with history of cardiac failure, left ventricular dysfunction or hypertension, and in patients with pre-existing oedema from any other reason, since prostaglandin inhibition may result in deterioration of renal function and fluid retention.

Caution is also required in patients taking diuretic treatment or otherwise at risk of hypovolaemia. Hypertension As with all NSAIDS, celecoxib can lead to the onset of new hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of cardiovascular events. Therefore, blood pressure should be monitored closely during the initiation of therapy with celecoxib and throughout the course of therapy.

Hepatic and renal effects Compromised renal or hepatic function and especially cardiac dysfunction are more likely in the elderly and therefore medically appropriate supervision should be maintained, Achat Celebrex 200 mg 200 mg. NSAIDs, including celecoxib, may cause renal toxicity.

Clinical trials with celecoxib have shown renal effects similar to those observed with comparator NSAIDs. Patients at greatest risk for renal toxicity are those with impaired renal function, heart failure, liver dysfunction, those taking diuretics, ACE-inhibitors, angiotensin II receptor antagonists, and the elderly see section 4. Such patients should be carefully monitored while receiving treatment with celecoxib. Some cases of severe hepatic reactions, including fulminant hepatitis some with fatal outcomeAchat Celebrex 200 mg 200 mg, liver necrosis and, hepatic failure some with fatal outcome or requiring liver transplanthave been reported with celecoxib.

Among the cases that reported time to onset, most of the severe adverse hepatic events developed within one month after initiation of celecoxib treatment see section 4.

If during treatment, patients deteriorate in any of the organ system functions described above, Achat Celebrex 200 mg 200 mg, appropriate measures should be taken and discontinuation of celecoxib therapy should be considered. Although it is not a strong inhibitor of this enzyme, a dose reduction may be necessary for individually dose-titrated medicinal products that are metabolised by CYP2D6 see section 4.

Skin and systemic hypersensitivity reactions Serious skin reactions, some of them fatal, Achat Celebrex 200 mg 200 mg, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, have been reported very rarely in association with the use of celecoxib see section 4.

Patients appear to be at highest risk for these reactions early in the course of therapy: Serious hypersensitivity reactions including anaphylaxis, angioedema and drug rash with eosinophilia and systemic symptoms DRESSor hypersensitivity syndromehave been reported in patients receiving celecoxib see section 4. Patients with a history of sulfonamide allergy or any drug allergy may be at greater risk of serious skin reactions or hypersensitivity reactions see section 4.

Celecoxib should be discontinued at the first appearance of skin rash, mucosal lesions, or any other sign of hypersensitivity. General Celecoxib may mask fever and other signs of inflammation, Achat Celebrex 200 mg 200 mg. Use with oral anticoagulants In patients on concurrent therapy with warfarin, serious bleeding events, some of them fatal, have been reported.

Increased prothrombin time INR with concurrent therapy has been reported. Caution should be exercised when combining celecoxib with warfarin or other oral anticoagulants, including novel anticoagulants e. Excipients Celebrex mg and mg capsules contain lactose Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Therefore, patients receiving oral anticoagulants should be closely monitored for their prothrombin time INR, particularly in the first few days when therapy with celecoxib is initiated or the dose of celecoxib is changed see section 4. Bleeding events in association with increases in prothrombin time have been reported, predominantly in the elderly, in patients receiving celecoxib concurrently with warfarin, some of them fatal.

As for NSAIDs, the risk of acute renal insufficiency, which is usually reversible, may be increased in some patients with compromised renal function e.

Therefore, the combination should be administered with caution, especially in the elderly. Patients should be adequately hydrated and consideration should be given to monitoring of renal function after initiation of concomitant therapy, and periodically thereafter. In a day clinical study in patients with lisinopril-controlled Achat Celebrex 200 mg 200 mg I and II hypertension, administration of celecoxib mg BID resulted in no clinically significant increases, when compared to placebo treatment, in mean daily systolic or diastolic blood pressure as determined using hour ambulatory blood pressure monitoring.

Ciclosporin and tacrolimus Co-administration of NSAIDs and ciclosporin or tacrolimus may increase the nephrotoxic effect of ciclosporin or tacrolimus, respectively. Renal function should be Achat Celebrex 200 mg 200 mg when celecoxib and any of these medicinal products are combined. Acetylsalicylic acid Celecoxib can be used with low-dose acetylsalicylic acid but is not a substitute for acetylsalicylic acid for CV prophylaxis. In the submitted studies, as with other NSAIDs, an increased risk of gastrointestinal ulceration or other gastrointestinal complications compared to use of celecoxib alone was shown for concomitant administration of low-dose acetylsalicylic acid see section 5.

The plasma concentrations of medicinal products that are substrates of this enzyme may be increased when celecoxib is used concomitantly. Examples of medicinal products which are metabolised by CYP2D6 are antidepressants tricyclics and SSRIsneuroleptics, anti-arrhythmic medicinal products, etc. The dose of individually dose-titrated CYP2D6 substrates may need to be reduced when treatment with celecoxib is initiated or increased if treatment with celecoxib is terminated.

Concomitant Achat Celebrex 200 mg 200 mg of celecoxib mg twice daily resulted in 2. These increases are due to celecoxib inhibition of the CYP2D6 substrate metabolism. The clinical significance of this in vitro finding is unknown. Examples of medicinal products which are metabolised by CYP2C19 are diazepam, Achat Celebrex 200 mg 200 mg, citalopram and imipramine.

Methotrexate In patients with rheumatoid arthritis celecoxib had no statistically significant effect on the pharmacokinetics plasma or renal clearance of methotrexate in rheumatologic doses.

However, adequate monitoring for methotrexate-related toxicity should be considered when combining these two medicinal products. Therefore, patients on lithium treatment should be closely monitored when celecoxib is introduced or withdrawn. Effects of other medicinal products on celecoxib Achat Celebrex 200 mg 200 mg poor metabolisers In individuals who are CYP2C9 poor metabolisers and demonstrate increased systemic exposure to celecoxib, concomitant treatment with CYP2C9 inhibitors such as fluconazole could result in further increases in celecoxib exposure.

Such combinations should be avoided in known CYP2C9 poor metabolisers see sections 4. CYP2C9 inhibitors and inducers Since celecoxib is predominantly metabolised by CYP2C9 it should be used at half the recommended dose in patients receiving fluconazole.

CELEBREX 200MG CAPSULES

Concomitant use of inducers of CYP2C9 such as rifampicin, carbamazepine and barbiturates may reduce plasma concentrations of celecoxib. Ketoconazole and antacids Ketoconazole or antacids have not been observed to affect the pharmacokinetics of celecoxib. Paediatric population Interaction studies have only been performed in adults.

Inhibition of prostaglandin synthesis might adversely affect pregnancy. Data from epidemiological studies suggest an increased risk of spontaneous abortion after use of prostaglandin synthesis inhibitors in early pregnancy. Celecoxib, as with other medicinal products inhibiting Achat Celebrex 200 mg 200 mg synthesis, may cause uterine inertia and premature closure of the ductus arteriosus during the last trimester.

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During the second or third trimester of pregnancy, NSAIDs including celecoxib may cause fetal renal dysfunction which may result in reduction of amniotic fluid volume or oligohydramnios in severe cases. Such effects may occur shortly after treatment initiation and are usually reversible. Celecoxib is contraindicated in pregnancy and in women who can become pregnant see sections 4. When supernet-interior.000webhostapp.com take your medicine with you.

Not all possible interactions are listed here. If you take too many capsules contact your doctor, administration of celecoxib mg BID resulted in no clinically significant increases.

Pharmaceutical form Opaque, or hypersensitivity syndrome. When CELEBREX is used in patients with preexisting asthma without known aspirin Prix Bas Topamax Acheter signs and symptoms of asthma.

Therefore, Achat Celebrex 200 mg 200 mg, monitor patients for changes in the signs and symptoms of asthma, Achat Celebrex 200 mg 200 mg, Achat Celebrex 200 mg 200 mg, pharmacist or hospital and take cathysherin.000webhostapp.com medicine with you.

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