Cross-sensitivity may exist with other NSAIDs, including aspirin;
History of allergic-type reactions to sulfonamides;
History of asthma, urticaria, or allergic-type reactions to aspirin or other NSAIDs, including the aspirin triad (asthma, nasal polyps, and severe hypersensitivity reactions to aspirin);
Advanced renal disease;
Severe hepatic dysfunction;
Peri-operative pain from coronary artery bypass graft (CABG) surgery;
OB: Should not be used in late pregnancy (may cause premature closure of the ductus arteriosus).
Use Cautiously in:
Cardiovascular disease or risk factors for cardiovascular disease (may ↑ risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, especially with prolonged use or use of higher doses);
Pre-existing renal disease, heart failure, liver dysfunction, concurrent diuretic, or ACE inhibitor therapy (↑ risk of renal impairment);
Serious dehydration (correct deficits before administering);
Patients who are known or suspected to be poor CYP2C9 metabolizers (↓ initial dose by 50%);
Pedi: Safety not established in children <2 yr or for longer than 6 mo;
Geri: Concurrent therapy with corticosteroids or anticoagulants, long duration of NSAID therapy, history of smoking, alcoholism, geriatric patients, or poor general health status (↑ risk of GI bleeding);
Distribution: 97% bound to plasma proteins; extensive tissue distribution.
Metabolism and Excretion: Mostly metabolized by the hepatic CYP2C9 isoenzyme; the CYP2C9 enzyme system exhibits genetic polymorphism; poor metabolizers may have significantly ↑ celecoxib concentrations and an ↑ risk of adverse effects; <3% excreted unchanged in urine and feces.