Celecoxib 100 mg Capsule, 100-count — NDC 23155-964-01 (Billing 23155-0964-01) · Product 23155-964
NDC 23155-964-01 (billing 23155-0964-01) is a package of 100 capsules of Celecoxib 100 mg Capsule from Avet Pharmaceuticals Inc., marketed since Mar 2026 and currently FDA-listed; retail pharmacies pay about $0.0614 per capsule (NADAC). It is the main listing for product NDC 23155-964, which comes in 2 package sizes.
Other active recalls for Celecoxib (different manufacturers) — 2 · tap to view
Identity & classification
Regulatory identifiers FDA, NLM and CMS codes for this package
Drug-database identifiers Medi-Span GPI and First Databank GCN / HICL / AHFS classification
- GSN (GCN sequence number): 041285
- GCN: 42001
- HICL (First Databank): 018979
- AHFS class code: 28:08.04.08
- RxCUI (RxNorm): 205322
- 11-digit billing NDC: 23155096401
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 1, 2026
- RxNorm (NLM RxNav) · catalog refreshed Sep 24, 2026
- Medi-Span GPI (licensed)
- First Databank (licensed) · refreshed Oct 1, 2026
RxNorm drug class
This medicine belongs to the Nonsteroidal Anti-inflammatory Drug class.
Where does this data come from?
- RxClass (NLM) · catalog refreshed Sep 24, 2026
Clinical
Celecoxib is used to relieve pain, tenderness, swelling and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Celecoxib is also used to treat juvenile rheumatoid arthritis (a type of arthritis that affects children) in children 2 years of age and older. Celecoxib is also used to treat painful menstrual periods and to relieve other types of short-term pain including pain caused by injuries, surgery...
Read the full MedlinePlus article ↗- It depends on the product. Celebrex and generic capsules are used for several types of arthritis, acute pain and painful periods. Vyscoxa liquid is for certain arthritis types. ELY...
- For capsules, usual doses can be taken with or without food, but higher doses are taken with food. Vyscoxa suspension must be taken on an empty stomach, at least 2 hours before or...
- The most common ones are stomach upset, indigestion, diarrhea, gas, swelling, dizziness, cold-like symptoms and rash. Call your doctor if they bother you or don't go away.
- Get emergency help for chest pain, shortness of breath, weakness on one side, slurred speech, black or bloody stools, vomiting blood, or swelling of the face or throat. Stop it and...
Patient education
Supplement & herbal interactions
Some supplements/herbs that may interact with Celecoxib — tap one for details:
Celecoxib may be associated with lower levels of 1 nutrient — worth a chat with your pharmacist, not a cause for alarm.
Where does this data come from?
- MedlinePlus (NLM) · refreshed Oct 1, 2026
- FDA label on DailyMed · label index refreshed Oct 1, 2026
Ask a licensed pharmacist directly — free, answered by our team.
Pricing
A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.
| Price system | Per ea | Per package |
|---|---|---|
| Retail pharmacies payNADAC · weekly | $0.061 | $6.14 / 100 capsules |
| Medicaid paysCMS SDUD · 12 mo | No recent Medicaid claims on file for this NDC — rare and low-volume NDCs are suppressed in the public data. | |
| Medicare drug plans payPart D · Q2 2026 | $0.2958 | $29.58 / 100 capsules |
Where does this data come from?
- CMS NADAC weekly file · file of Sep 30, 2026
- CMS ASP pricing files · refreshed Sep 20, 2026
- CMS Medicaid State Drug Utilization Data · refreshed Oct 1, 2026
- CMS Part D plan pricing files · refreshed Sep 24, 2026
- VA National Acquisition Center price file
Packaging — all sizes for this product
| Package NDC | Description | Per unit | Per pack | Marketing start | Marketing end | Status |
|---|---|---|---|---|---|---|
| 23155-0964-01 23155-964-01 You're viewing this Main listing | 100 CAPSULE in 1 BOTTLE (23155-964-01) | $0.0614 / ea | $6.14 | 2026-03-25 | — | Active |
| 23155-0964-05 23155-964-05 | 500 CAPSULE in 1 BOTTLE (23155-964-05) | $0.0614 / ea | $30.70 | 2026-03-25 | — | Active |
You're viewing the smallest of 2 pack sizes for this product.
This pack has the lowest per-ea cost of the 2 priced pack sizes ($0.0614 NADAC).
Pack size FAQ
What quantity is in NDC 23155-0964-01?
What is the difference between NDC 23155-0964-01 and NDC 23155-0964-05?
What NDC number is used to bill for this package of Celecoxib 100 mg Capsule?
Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.
Therapeutic equivalents
| Product | Labeler | Pack | NADAC/unit | TE | Status | Price vs. this |
|---|---|---|---|---|---|---|
| Celecoxib 100 mg 00591-3983-01 | Actavis | 100 capsules | $0.061 | AB | Discontinued | — |
| Celecoxib 100 mg 00904-7550-61 | Major | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 11788-0113-01 | AiPing | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 16714-0732-01 | NorthStar | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mgthis 23155-0964-01 | Avet | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 27808-0296-01 | Cranbury | 100 capsules | $0.061 | AB | Availability likely | — |
| celecoxib 100 mg 33342-0156-11 | Macleods | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 42571-0143-01 | Micro | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 50228-0157-01 | ScieGen | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 50268-0168-15 | AvPAK | 50 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 60505-3848-01 | Apotex | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 60687-0436-01 | American | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 62135-0021-60 | Chartwell | 60 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 65862-0908-01 | Aurobindo | 100 capsules | $0.061 | AB | Availability likely | — |
| celecoxib 100 mg 68180-0396-01 | Lupin | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 69367-0301-01 | Westminster | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 75834-0237-01 | NIVAGEN | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 82009-0068-05 | Quallent | 500 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 83301-0011-01 | Mullan | 100 capsules | $0.061 | AB | Availability likely | — |
| Celecoxib 100 mg 42806-0721-01 | EPIC | 100 capsules | $0.062 | AB | Availability likely | +1% |
| celecoxib 100 mg 13668-0441-01 | Torrent | 100 capsules | $0.090 | AB | FDA listed | +46% |
| Celebrex 100 mg 58151-0083-01 | Viatris | 100 capsules | $9.534 | AB | Availability likely | +15428% |
| Celecoxib 100 mg 00615-8572-39 | NCS | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 29300-0158-01 | Unichem | 100 capsules | — | — | FDA listed | — |
| Celecoxib 100 mg 46708-0268-10 | Alembic | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 50090-6380-00 | A-S | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 51655-0059-52 | Northwind | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 51655-0436-25 | Northwind | 60 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 55700-0613-30 | Quality | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 57582-0212-01 | Tianjin | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 60290-0017-01 | Umedica | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 60760-0649-60 | ST. | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 60760-0995-15 | St. | 15 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 62332-0141-08 | Alembic | 80 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 63187-0301-30 | Proficient | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 63187-0643-30 | Proficient | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 68788-4095-03 | Preferred | 30 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 68788-7286-03 | Preferred | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 68788-8206-03 | Preferred | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 69097-0422-02 | Cipla | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 69117-0021-01 | Yiling | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 70247-0007-10 | Qingdao | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 70518-3424-00 | REMEDYREPACK | 30 capsules | — | AB | Discontinued | — |
| Celecoxib 100 mg 70518-3826-00 | REMEDYREPACK | 90 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 70518-4009-00 | REMEDYREPACK | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 70518-4508-00 | REMEDYREPACK | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71205-0020-30 | Proficient | 30 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 71205-0439-30 | Proficient | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71209-0055-03 | Cadila | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71335-0292-01 | Bryant | 30 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 71335-0936-01 | Bryant | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71335-1804-01 | Bryant | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71335-2019-01 | Bryant | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 71335-2222-01 | Bryant | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 72162-2254-05 | Bryant | 500 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 72189-0123-30 | Direct | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 72189-0662-60 | Direct_Rx | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 72241-0023-03 | Modavar | 60 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 76420-0243-01 | Asclemed | 1 capsule | — | AB | FDA listed | — |
| Celecoxib 100 mg 76420-0727-01 | Asclemed | 1 capsule | — | AB | FDA listed | — |
| Celecoxib 100 mg 76420-0843-00 | Asclemed | 1000 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 77771-0157-01 | Radha | 100 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 80425-0142-01 | Advanced | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 80425-0167-01 | Advanced | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 80425-0321-01 | Advanced | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 80425-0323-01 | Advanced | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 82804-0151-60 | Proficient | 60 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 85509-1237-01 | PHOENIX | 120 capsules | — | AB | FDA listed | — |
| celecoxib 100 mg 85534-0014-00 | HAWAII | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 85534-0067-00 | HAWAII | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 55154-0160-00 | Cardinal | 10 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 50090-8031-00 | A-S | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 72189-0685-72 | Direct_Rx | 120 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 50090-8036-00 | A-S | 30 capsules | — | AB | FDA listed | — |
| Celecoxib 100 mg 60760-0942-60 | St. | 60 capsules | — | AB | FDA listed | — |
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- FDA Orange Book · refreshed Sep 3, 2026
- CMS NADAC weekly file · file of Sep 30, 2026
Availability & generic status
This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.
Where does this data come from?
- FDA Orange Book · refreshed Sep 3, 2026
What it looks like
Where does this data come from?
- FDA label on DailyMed · label index refreshed Oct 1, 2026
Inactive Ingredients / Excipients
Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.
💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.
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UNII M28OL1HH48
Croscarmellose sodium is a plant-based substance derived from cellulose. It acts as a disintegrant, helping tablets and capsules break down quickly in the digestive system so the medicine can be absorbed.
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UNII H3R47K3TBD
FD&C Blue No. 1 is a synthetic blue dye approved for use in foods and medicines. It serves as a colorant to give the medication its distinctive appearance and help with product identification.
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UNII PN2ZH5LOQY
A synthetic red dye approved by the FDA for use in foods, medicines, and cosmetics. It serves as a colorant to make tablets, capsules, and liquids visually distinctive for product identification.
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UNII XM0M87F357
A dark iron oxide compound that gives medicines their black or dark color. It's used as a colorant in tablets and capsules to help identify the product and make it visually distinctive.
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UNII 2G86QN327L
Gelatin is a protein derived from animal collagen, commonly used in medicines as a gelling agent and capsule material. It helps create soft or hard capsule shells that hold and release medication, and can also thicken liquid formulations.
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UNII EWQ57Q8I5X
Lactose monohydrate is a natural sugar derived from milk. It serves as a filler and binder in tablets and capsules, helping create the proper size, texture, and consistency of the medicine.
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UNII 70097M6I30
Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
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UNII WZH3C48M4T
Potassium hydroxide is a strong alkaline chemical used in medicines to adjust and maintain the pH level of liquid formulations, helping keep the product stable and the active ingredients effective.
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UNII U725QWY32X
Povidone K30 is a synthetic polymer made from petroleum. It acts as a binder to hold tablet ingredients together and as a disintegrant to help the tablet break apart in the stomach so the medicine can be absorbed.
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UNII 6DC9Q167V3
Propylene glycol is a clear liquid derived from petroleum or vegetable sources. It acts as a solvent, humectant, and preservative in medicines, helping dissolve active ingredients and maintain product stability.
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UNII 46N107B71O
Shellac is a natural resin secreted by the lac beetle. It's used as a coating on tablets and capsules to control how quickly the medicine dissolves and to improve appearance and stability.
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UNII 368GB5141J
A detergent and foaming agent derived from coconut or palm oil. In medications, it helps break down and mix oil and water-based ingredients, aids in tablet disintegration, and improves how the drug dissolves and spreads in the mouth or digestive system.
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UNII 15FIX9V2JP
Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.
13 inactive ingredients listed in the exact product block matched to this NDC.
Where does this data come from?
ingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.- FDA label on DailyMed · label index refreshed Oct 1, 2026
- FDA openFDA NDC Directory · synced Oct 1, 2026
Inactive ingredient FAQ
Are inactive ingredients the same for every manufacturer?
Why might an inactive ingredient be missing?
Can inactive ingredients matter?
Manufacturer & labeler
Where does this data come from?
- FDA openFDA NDC Directory · synced Oct 1, 2026
- Drugs@FDA
Full prescribing information FDA SPL
🚨 Boxed Warning ▾
WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Cardiovascular Thrombotic Events Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction, and stroke, which can be fatal. This risk may occur early in the treatment and may increase with duration of use. [see Warnings and Precautions (5.1) ] Celecoxib capsules are contraindicated in the setting of coronary artery bypass graft (CABG) surgery. [see Contraindications (4) and Warnings and Precautions (5.1) ] Gastrointestinal Bleeding, Ulceration, and Perforation NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.
These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. [see Warnings and Precautions (5.2) ] WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS See full prescribing information for complete boxed warning. Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
This risk may occur early in the treatment and may increase with duration of use. (5.1) Celecoxib is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. (4, 5.1) NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal.
These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events. (5.2)
🎯 Indications and Usage ▾
1. INDICATIONS AND USAGE Celecoxib capsules are indicated Celecoxib capsule is a nonsteroidal anti-inflammatory drug indicated for: Osteoarthritis (OA) (1.1) Rheumatoid Arthritis (RA) (1.2) Juvenile Rheumatoid Arthritis (JRA) in patients 2 years and older (1.3) Ankylosing Spondylitis (AS) (1.4) Acute Pain (AP) (1.5) Primary Dysmenorrhea (PD) (1.6)
1.1Osteoarthritis (OA) For the management of the signs and symptoms of OA [ see Clinical Studies (14.1) ]
1.2Rheumatoid Arthritis (RA) For the management of the signs and symptoms of RA [ see Clinical Studies (14.2) ]
1.3Juvenile Rheumatoid Arthritis (JRA) For the management of the signs and symptoms of JRA in patients 2 years and older [ see Clinical Studies (14.3) ]
1.4Ankylosing Spondylitis (AS) For the management of the signs and symptoms of AS [ see Clinical Studies (14.4) ]
1.5Acute Pain For the management of acute pain in adults [ see Clinical Studies (14.5) ]
1.6Primary Dysmenorrhea For the management of primary dysmenorrhea [ see Clinical Studies (14.5) ]
⏱️ Dosage and Administration ▾
2. DOSAGE AND ADMINISTRATION Use the lowest effective dosage for shortest duration consistent with individual patient treatment goals (2.1) OA: 200 mg once daily or 100 mg twice daily (2.2, 14.1) RA: 100 mg to 200 mg twice daily (2.3, 14.2) JRA: 50 mg twice daily in patients 10 kg to 25 kg. 100 mg twice daily in patients more than 25 kg (2.4, 14.3) AS: 200 mg once daily single dose or 100 mg twice daily.
If no effect is observed after 6 weeks, a trial of 400 mg (single or divided doses) may be of benefit (2.5, 14.4) AP and PD: 400 mg initially, followed by 200 mg dose if needed on first day. On subsequent days, 200 mg twice daily as needed (2.6, 14.5) Hepatic Impairment: Reduce daily dose by 50% in patients with moderate hepatic impairment (Child-Pugh Class B). (2.7, 8.6, 12.3) Poor Metabolizers of CYP2C9 Substrates: Consider a dose reduction by 50% (or alternative management for JRA) in patients who are known or suspected to be CYP2C9 poor metabolizers, (2.7, 8.8, 12.3).
2.1General Dosing Instructions Carefully consider the potential benefits and risks of celecoxib capsules and other treatment options before deciding to use celecoxib capsules. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals [ see Warnings and Precautions (5) ]. These doses can be given without regard to timing of meals.
2.2Osteoarthritis For OA, the dosage is 200 mg per day administered as a single dose or as 100 mg twice daily.
2.3Rheumatoid Arthritis For RA, the dosage is 100 mg to 200 mg twice daily.
2.4Juvenile Rheumatoid Arthritis For JRA, the dosage for pediatric patients (age 2 years and older) is based on weight. For patients ≥10 kg to ≤25 kg the recommended dose is 50 mg twice daily. For patients >25 kg the recommended dose is 100 mg twice daily.
For patients who have difficulty swallowing capsules, the contents of a celecoxib capsule can be added to applesauce. The entire capsule contents are carefully emptied onto a level teaspoon of cool or room temperature applesauce and ingested immediately with water. The sprinkled capsule contents on applesauce are stable for up to 6 hours under refrigerated conditions (2°C to 8°C/ 35°F to 45°F).
2.5Ankylosing Spondylitis For AS, the dosage of celecoxib capsules is 200 mg daily in single (once per day) or divided (twice per day) doses. If no effect is observed after 6 weeks, a trial of 400 mg daily may be worthwhile. If no effect is observed after 6 weeks on 400 mg daily, a response is not likely and consideration should be given to alternate treatment options.
2.6Management of Acute Pain and Treatment of Primary Dysmenorrhea For management of Acute Pain and Treatment of Primary Dysmenorrhea, the dosage is 400 mg initially, followed by an additional 200 mg dose if needed on the first day. On subsequent days, the recommended dose is 200 mg twice daily as needed.
2.7Special Populations Hepatic Impairment In patients with moderate hepatic impairment (Child-Pugh Class B), reduce the dose by 50%. The use of celecoxib capsules in patients with severe hepatic impairment is not recommended [ see Warnings and Precautions (5.3), Use in Specific Populations (8.6) and Clinical Pharmacology (12.3) ]. Poor Metabolizers of CYP2C9 Substrates In adult patients who are known or suspected to be poor CYP2C9 metabolizers based on genotype or previous history/experience with other CYP2C9 substrates (such as warfarin, phenytoin), initiate treatment with half of the lowest recommended dose.
In patients with JRA who are known or suspected to be poor CYP2C9 metabolizers, consider using alternative treatments. [ see Use in Specific populations (8.8), and Clinical Pharmacology (12.5) ].
💊 Dosage Forms and Strengths ▾
3. DOSAGE FORMS AND STRENGTHS Celecoxib capsules: 50 mg hard capsule Capsule cap: pink opacity, capsule body: white opacity. Imprinted Y181 in black ink on the capsule cap and no mark on the capsule body 100 mg hard capsule Capsule cap: standard blue opacity, capsule body: white opacity.
Imprinted Y182 in black ink on the capsule cap and no mark on the capsule body. 200 mg hard capsule Capsule cap: buff opacity, capsule body: white opacity. Imprinted Y183 in black ink on the capsule cap and no mark on the capsule body.
400 mg hard capsule Capsule cap: powder blue opacity, capsule body: white opacity. Imprinted Y184 in black ink on the capsule cap and no mark on the capsule body. Celecoxib capsules: 50 mg, 100 mg, 200 mg and 400 mg(3)
⛔ Contraindications ▾
4. CONTRAINDICATIONS Celecoxib capsules are contraindicated in the following patients: Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to celecoxib, any components of the drug product [ see Warnings and Precautions (5.7, 5.9) ]. History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs.
Severe, sometimes fatal, anaphylactic reactions to NSAIDs, have been reported in such patients [see Warnings and Precautions (5.7, 5.8) ]. In the setting of CABG surgery [see Warnings and Precautions (5.1) ]. In patients who have demonstrated allergic-type reactions to sulfonamides [ see Warnings and Precautions (5.7) ].
Known hypersensitivity to celecoxib, or any components of the drug product or sulfonamides (4) History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs (4) In the setting of CABG surgery (4)
⚠️ Warnings and Cautions ▾
5. WARNINGS AND PRECAUTIONS
5.1Cardiovascular Thrombotic Events Clinical trials of several cyclooxygenase-2 ( COX-2 )selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal. Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease.
However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment. The increase in CV thrombotic risk has been observed most consistently at higher doses.
In the APC (Adenoma Prevention with Celecoxib) trial, there was about a threefold increased risk of the composite endpoint of cardiovascular death, MI, or stroke for the celecoxib capsules 400 mg twice daily and celecoxib capsules 200 mg twice daily treatment arms compared to placebo. The increases in both celecoxib dose groups versus placebo-treated patients were mainly due to an increased incidence of myocardial infarction [see Clinical Studies (14.7)]. A randomized controlled trial entitled the Prospective Randomized Evaluation of Celecoxib Integrated Safety vs.
Ibuprofen Or Naproxen (PRECISION) was conducted to assess the relative cardiovascular thrombotic risk of a COX-2 inhibitor, celecoxib, compared to the non-selective NSAIDs naproxen and ibuprofen. Celecoxib 100 mg twice daily was non-inferior to naproxen 375 to 500 mg twice daily and ibuprofen 600 to 800 mg three times daily for the composite endpoint of the Antiplatelet Trialists’ Collaboration (APTC), which consists of cardiovascular death (including hemorrhagic death), non-fatal myocardial infarction, and non-fatal stroke [See Clinical Studies (14.6)].
To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms. Patients should be informed about the symptoms of serious CV events and the steps to take if they occur.
There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as celecoxib, increases the risk of serious gastrointestinal (GI) events [see Warnings and Precautions (5.2)]. Status Post Coronary Artery Bypass Graft (CABG) Surgery Two large, controlled clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10 to 14 days following CABG surgery found an increased incidence of myocardial infarction and stroke.
NSAIDs are contraindicated in the setting of CABG [see Contraindications (4)]. Post-MI Patients Observational studies conducted in the Danish National Registry have demonstrated that patients treated with NSAIDs in the post-MI period were at increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment. In this same cohort, the incidence of death in the first year post-MI was 20 per 100 person years in NSAID-treated patients compared to 12 per 100 person years in non-NSAID exposed patients.
Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next four years of follow-up. Avoid the use of celecoxib capsules in patients with a recent MI unless the benefits are expected to outweigh the ris… [Excerpted — this section continues on DailyMed.]
🤒 Adverse Reactions ▾
6. ADVERSE REACTIONS The following adverse reactions are discussed in greater detail in other sections of the labeling: Cardiovascular Thrombotic Events [see Warnings and Precautions (5.1) ] GI Bleeding, Ulceration and Perforation [see Warnings and Precautions (5.2) ] Hepatotoxicity [see Warnings and Precautions (5.3) ] Hypertension [see Warnings and Precautions (5.4) ] Heart Failure and Edema [see Warnings and Precautions (5.5) ] Renal Toxicity and Hyperkalemia [see Warnings and Precautions (5.6) ] Anaphylactic Reactions [see Warnings and Precautions (5.7) ] Serious Skin Reactions [see Warnings and Precautions (5.9) ] Hematologic Toxicity [see Warnings and Precautions (5.12) ] Most common adverse reactions in arthritis trials (>2% and >placebo) are: abdominal pain, diarrhea, dyspepsia, flatulence, peripheral edema, accidental injury, dizziness, pharyngitis, rhinitis, sinusitis, upper respiratory tract infection, rash.
(6.1) To report SUSPECTED ADVERSE REACTIONS, contact Avet Pharmaceuticals Inc. at 1-866-901-DRUG (3784) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The adverse reaction information from clinical trials does, however, provide a basis for identifying the adverse events that appear to be related to drug use and for approximating rates. Of the celecoxib-treated patients in the pre-marketing controlled clinical trials, approximately 4,250 were patients with OA, approximately 2,100 were patients with RA, and approximately 1,050 were patients with post-surgical pain.
More than 8,500 patients received a total daily dose of celecoxib of 200 mg (100 mg twice daily or 200 mg once daily) or more, including more than 400 treated at 800 mg (400 mg twice daily). Approximately 3,900 patients received celecoxib at these doses for 6 months or more; approximately 2,300 of these have received it for 1 year or more and 124 of these have received it for 2 years or more. Pre-marketing Controlled Arthritis Trials Table 1 lists all adverse events, regardless of causality, occurring in 2% of patients receiving celecoxib from 12 controlled studies conducted in patients with OA or RA that included a placebo and/or a positive control group.
Since these 12 trials were of different durations, and patients in the trials may not have been exposed for the same duration of time, these percentages do not capture cumulative rates of occurrence. Table 1: Adverse Events Occurring in 2% of Celecoxib Patients from Premarketing Controlled Arthritis Trials CBX N=4146 Placebo N=1864 NAP N=1366 DCF N=387 IBU N=345 Gastrointestinal Abdominal Pain Diarrhea Dyspepsia Flatulence Nausea 4.1% 5.6% 8.8% 2.2% 3.5% 2.8% 3.8% 6.2% 1.0% 4.2% 7.7% 5.3% 12.2% 3.6% 6.0% 9.0% 9.3% 10.9% 4.1% 3.4% 9.0% 5.8% 12.8% 3.5% 6.7% Body as a whole Back Pain Peripheral Edema Injury-Accidental 2.8% 2.1% 2.9% 3.6% 1.1% 2.3% 2.2% 2.1% 3.0% 2.6% 1.0% 2.6% 0.9% 3.5% 3.2% Central, Peripheral Nervous system Dizziness Headache 2.0% 15.8% 1.7% 20.2% 2.6% 14.5% 1.3% 15.5% 2.3% 15.4% Psychiatric Insomnia 2.3% 2.3% 2.9% 1.3% 1.4% Respiratory Pharyngitis Rhinitis Sinusitis Upper Respiratory Infection 2.3% 2.0% 5.0% 8.1% 1.1% 1.3% 4.3% 6.7% 1.7% 2.4% 4.0% 9.9% 1.6% 2.3% 5.4% 9.8% 2.6% 0.6% 5.8% 9.9% Skin Rash 2.2% 2.1% 2.1% 1.3% 1.2% CBX = Celecoxib 100 mg to 200 mg twice daily or 200 mg once daily; NAP = Naproxen 500 mg twice daily; DCF = Diclofenac 75 mg twice daily; IBU = Ibuprofen 800 mg three times daily.
In placebo- or active-controlled clinical trials, the discontinuation rate due to adverse events was 7.1% for patients receiving celecoxib and 6.1% for patients receiving placebo. Among the most common reasons for discontinuation due to adverse events in the celecoxib treatment groups were dysp… [Excerpted — this section continues on DailyMed.]
🔄 Drug Interactions ▾
7. DRUG INTERACTIONS See Table 3 for clinically significant drug interactions with celecoxib. Table 3: Clinically Significant Drug Interactions with Celecoxib Drugs That Interfere with Hemostasis Clinical Impact: Celecoxib and anticoagulants such as warfarin have a synergistic effect on bleeding.
The concomitant use of Celecoxib and anticoagulants have an increased risk of serious bleeding compared to the use of either drug alone. Serotonin release by platelets plays an important role in hemostasis Case-control and cohort epidemiological studies showed that concomitant use of drugs that interfere with serotonin reuptake and an NSAID may potentiate the risk of bleeding more than an NSAID alone. Intervention: Monitor patients with concomitant use of celecoxib with anticoagulants (e.g., warfarin), antiplatelet drugs (e.g., aspirin), SSRIs, and SNRIs for signs of bleeding [see Warnings and Precautions (5.12) ].
Aspirin Clinical Impact: Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of the NSAID alone [see Warnings and Precautions (5.2) ]. In two studies in healthy volunteers, and in patients with osteoarthritis and established heart disease respectively, celecoxib (200 mg to 400 mg daily) has demonstrated a lack of interference with the cardioprotective antiplatelet effect of aspirin (100mg to 325 mg).
Intervention: Concomitant use of celecoxib and analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding [see Warnings and Precautions (5.12) ]. Celecoxib is not a substitute for low dose aspirin for cardiovascular protection. ACE Inhibitors, Angiotensin Receptor Blockers , and Beta-Blockers Clinical Impact: NSAIDs may diminish the antihypertensive effect of ACE inhibitors, ARBs, or beta-blockers (including propranolol).
In patients who are elderly, volume-depleted (including those on diuretic therapy), or have renal impairment, co-administration of an NSAID with ACE inhibitors or ARBs may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Intervention: During concomitant use of celecoxib and ACE-inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained.
During concomitant use of celecoxib and ACE-inhibitors or ARBs in patients who are elderly, volume-depleted, or have impaired renal function, monitor for signs of worsening renal function [see Warnings and Precautions (5.6) ]. When these drugs are administered concomitantly, patients should be adequately hydrated. Assess renal function at the beginning of the concomitant treatment and periodically thereafter.
Diuretics Clinical Impact: Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients. This effect has been attributed to the NSAID inhibition of renal prostaglandin synthesis. Intervention: During concomitant use of celecoxib with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects [ see Warnings and Precautions (5.6) ].
Digoxin Clinical Impact: The concomitant use of Celecoxib with digoxin has been reported to increase the serum concentration and prolong the half-life of digoxin. Intervention: During concomitant use of celecoxib and digoxin, monitor serum digoxin levels. Lithium Clinical Impact: NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance.
The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. This eff… [Excerpted — this section continues on DailyMed.]
👥 Use in Specific Populations ▾
8. USE IN SPECIFIC POPULATIONS Infertility : NSAIDs are associated with reversible infertility. Consider withdrawal of celecoxib capsules in women who have difficulties conceiving (8.3)
8.1Pregnancy Risk Summary Use of NSAIDs, including celecoxib, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. Because of these risks, limit dose and duration of celecoxib use between about 20 and 30 weeks of gestation and avoid celecoxib use at about 30 weeks of gestation and later in pregnancy (see Clinical Considerations, Data ). Premature Closure of Fetal Ductus Arteriosus Use of NSAIDs, including celecoxib, at about 30 weeks gestation or later in pregnancy increases the risk of premature closure of the fetal ductus arteriosus.
Oligohydramnios/Neonatal Renal Impairment Use of NSAIDs at about 20 weeks gestation or later in pregnancy has been associated with cases of fetal renal dysfunction leading to oligohydramnios, and in some cases, neonatal renal impairment. Data from observational studies regarding other potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive. In animal reproduction studies, embryo-fetal deaths and an increase in diaphragmatic hernias were observed in rats administered celecoxib daily during the period of organogenesis at oral doses approximately 6 times the maximum recommended human dose (MRHD) of 200 mg twice daily.
In addition, structural abnormalities (e.g., septal defects, ribs fused, sternebrae fused and sternebrae misshapen) were observed in rabbits given daily oral doses of celecoxib during the period of organogenesis at approximately 2 times the MRHD (see Data). Based on animal data, prostaglandins have been shown to have an important role in endometrial vascular permeability, blastocyst implantation, and decidualization. In animal studies, administration of prostaglandin synthesis inhibitors such as celecoxib, resulted in increased pre- and post-implantation loss.
Prostaglandins also have been shown to have an important role in fetal kidney development. In published animal studies, prostaglandin synthesis inhibitors have been reported to impair kidney development when administered at clinically relevant doses. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown.
All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Clinical Considerations Fetal/Neonatal Adverse Reactions Premature closure of Fetal Ductus Arteriosus: Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy, because NSAIDs, including celecoxib, can cause premature closure of the fetal ductus arteriosus ( see Data ).
Oligohydramnios/Neonatal Renal Impairment: If an NSAID is necessary at about 20 weeks gestation or later in pregnancy, limit the use to the lowest effective dose and shortest duration possible. If celecoxib treatment extends beyond 48 hours, consider monitoring with ultrasound for oligohydramnios. If oligohydramnios occurs, discontinue celecoxib and follow up according to clinical practice (see Data).
Labor or Delivery There are no studies on the effects of celecoxib during labor or delivery. In animal studies, NSAIDs, including celecoxib, inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth. Data Human Data The available data do not establish the presence or absence of developmental toxicity related to the use of celecoxib.
Premature Closure of Fetal Ductus Arteriosus: Published literature reports that the use of NSAIDs at about 30 weeks of gestation and later in pregnancy may cause premature closure of the fetal ductus arterios… [Excerpted — this section continues on DailyMed.]
🆘 Overdosage ▾
10. OVERDOSAGE Symptoms following acute NSAID overdosages have been typically limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which have been generally reversible with supportive care. Gastrointestinal bleeding has occurred.
Hypertension, acute renal failure, respiratory depression, and coma have occurred, but were rare [see Warnings and Precautions (5.2, 5.4, 5.6) ]. No overdoses of celecoxib were reported during clinical trials. Doses up to 2400 mg/day for up to 10 days in 12 patients did not result in serious toxicity.
No information is available regarding the removal of celecoxib by hemodialysis, but based on its high degree of plasma protein binding (>97%) dialysis is unlikely to be useful in overdose. Manage patients with symptomatic and supportive care following an NSAID overdosage. There are no specific antidotes.
Consider emesis and/or activated charcoal (60 to 100 grams in adults, 1 to 2 grams per kg of body weight in pediatric patients) and/or osmotic cathartic in symptomatic patients seen within four hours of ingestion or in patients with a large overdosage (5 to 10 times the recommended dosage). Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding. For additional information about overdosage treatment contact a poison control center (1-800-222-1222).
🧬 Clinical Pharmacology ▾
12. CLINICAL PHARMACOLOGY
12.1Mechanism of Action Celecoxib has analgesic, anti-inflammatory, and antipyretic properties. The mechanism of action of celecoxib is believed to be due to inhibition of prostaglandin synthesis, primarily via inhibition of COX-2. Celecoxib is a potent inhibitor of prostaglandin synthesis in vitro .
Celecoxib concentrations reached during therapy have produced in vivo effects. Prostaglandins sensitize afferent nerves and potentiate the action of bradykinin in inducing pain in animal models. Prostaglandins are mediators of inflammation.
Since celecoxib is an inhibitor of prostaglandin synthesis, its mode of action may be due to a decrease of prostaglandins in peripheral tissues.
12.2Pharmacodynamics Platelets In clinical trials using normal volunteers, celecoxib at single doses up to 800 mg and multiple doses of 600 mg twice daily for up to 7 days duration (higher than recommended therapeutic doses) had no effect on reduction of platelet aggregation or increase in bleeding time. Because of its lack of platelet effects, celecoxib is not substitute for aspirin for cardiovascular prophylaxis. It is not known if there are any effects of celecoxib on platelets that may contribute to the increased risk of serious cardiovascular thrombotic adverse events associated with the use of celecoxib.
Fluid Retention Inhibition of PGE2 synthesis may lead to sodium and water retention through increased reabsorption in the renal medullary thick ascending loop of Henle and perhaps other segments of the distal nephron. In the collecting ducts, PGE2 appears to inhibit water reabsorption by counteracting the action of antidiuretic hormone.
12.3Pharmacokinetics Celecoxib exhibits dose-proportional increase in exposure after oral administration up to 200 mg twice daily and less than proportional increase at higher doses. It has extensive distribution and high protein binding. It is primarily metabolized by CYP2C9 with a half-life of approximately 11 hours.
Absorption Peak plasma levels of celecoxib occur approximately 3 hours after an oral dose. Under fasting conditions, both peak plasma levels (C max ) and area under the curve (AUC) are roughly dose-proportional up to 200 mg twice daily; at higher doses there are less than proportional increases in C max and AUC (see Food Effects) . Absolute bioavailability studies have not been conducted.
With multiple dosing, steady-state conditions are reached on or before Day 5. The pharmacokinetic parameters of celecoxib in a group of healthy subjects are shown in Table 4. Table 4 Summary of Single Dose (200 mg) Disposition Kinetics of Celecoxib in Healthy Subjects 1 Mean (%CV) PK Parameter Values C max , ng/mL T max , hr Effective t 1/2 ,hr V ss /F, L CL/F, L/hr 705 (38) 2.8 (37) 11.2 (31) 429 (34) 27.7 (28) 1 Subjects under fasting conditions (n=36, 19–52 yrs.) Food Effects When celecoxib capsules were taken with a high fat meal, peak plasma levels were delayed for about 1 to 2 hours with an increase in total absorption (AUC) of 10% to 20%.
Under fasting conditions, at doses above 200 mg, there is less than a proportional increase in C max and AUC, which is thought to be due to the low solubility of the drug in aqueous media. Coadministration of celecoxib with an aluminum- and magnesium-containing antacids resulted in a reduction in plasma celecoxib concentrations with a decrease of 37% in C max and 10% in AUC. Celecoxib, at doses up to 200 mg twice daily, can be administered without regard to timing of meals.
Higher doses (400 mg twice daily) should be administered with food to improve absorption. In healthy adult volunteers, the overall systemic exposure (AUC) of celecoxib was equivalent when celecoxib was administered as intact capsule or capsule contents sprinkled on applesauce. There were no significant alterations in C max , T max or t 1/2 after administration of capsule contents on applesauce [ see Dosage and Administration (2) ].
Distribution In healthy subjects, celecoxib… [Excerpted — this section continues on DailyMed.]
📦 How Supplied / Storage and Handling ▾
16. HOW SUPPLIED/STORAGE AND HANDLING Celecoxib capsules 50 mg are hard capsules; capsule cap: pink opacity, capsule body: white opacity. Imprinted Y181 in black ink on the capsule cap and no mark on the capsule body.
They are supplied as: NDC Number Size 23155-963-06 bottle of 60 Celecoxib capsules 100 mg are hard capsules; capsule cap: standard blue opacity, capsule body: white opacity. Imprinted Y182 in black ink on the capsule cap and no mark on the capsule body. They are supplied as: NDC Number Size 23155-964-01 23155-964-05 bottle of 100 bottle of 500 Celecoxib capsules 200 mg are hard capsules; capsule cap: buff opacity, capsule body: white opacity.
Imprinted Y183 in black ink on the capsule cap and no mark on the capsule body. They are supplied as: NDC Number Size 23155-965-01 23155-965-05 bottle of 100 bottle of 500 Celecoxib capsules 400 mg are hard capsules; capsule cap: powder blue opacity, capsule body: white opacity. Imprinted Y184 in black ink on the capsule cap and no mark on the capsule body.
They are supplied as: NDC Number Size 23155-964-06 bottle of 60 Storage Store at 20°C to 25°C (68°F to 77°F) [See USP Controlled Room Temperature].
📋 Description ▾
11. DESCRIPTION Celecoxib capsule is a nonsteroidal anti-inflammatory drug, available as capsules containing 50 mg, 100 mg, 200 mg and 400 mg celecoxib for oral administration. The chemical name is 4-[5-(4-methylphenyl)-3- (trifluoromethyl) -1H-pyrazol-1-yl] benzenesulfonamide and is a diaryl-substituted pyrazole.
The molecular weight is 381.38. Its molecular formula is C 17 H 14 F 3 N 3 O 2 S, and it has the following chemical structure: Celecoxib, USP is a white to off-white powder with a pKa of 11.1 (sulfonamide moiety). Celecoxib is hydrophobic (log P is 3.5) and is practically insoluble in aqueous media at physiological pH range.
The inactive ingredients in celecoxib capsules include: croscarmellose sodium, lactose monohydrate, magnesium stearate, povidone K30 and sodium lauryl sulfate. The involatile ingredients in imprinting ink for all strengths (i.e. 50 mg, 100 mg, 200 mg and 400 mg) include: shellac, propylene glycol, potassium hydroxide and ferrosoferric oxide (black iron oxide).
The ingredients in capsule shell of the 50 mg strength include: gelatin, titanium dioxide, Erythrosine (FD&C Red #3) and Brilliant Blue FCF (FD&C Blue #1). The ingredients in capsule shell of the 100 mg strength include: gelatin, titanium dioxide, Erythrosine (FD&C Red #3) and Brilliant Blue FCF (FD&C Blue #1). The ingredients in capsule shell of the 200 mg strength include: gelatin, titanium dioxide, Sunset Yellow FCF (FD&C Yellow #6) and Brilliant Blue FCF (FD&C Blue #1).
The ingredients in capsule shell of the 400 mg strength include: gelatin, titanium dioxide and Brilliant Blue FCF (FD&C Blue #1). structure
💬 Information for Patients ▾
17. PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-approved patient labeling (Medication Guide) that accompanies each prescription dispensed. Inform patients, families, or their caregivers of the following information before initiating therapy with celecoxib capsules and periodically during the course of ongoing therapy.
Cardiovascular Thrombotic Events Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their health care provider immediately [see Warnings and Precautions (5.1) ]. Gastrointestinal Bleeding, Ulceration, and Perforation Advise patients to report symptoms of ulcerations and bleeding, including epigastric pain, dyspepsia, melena, and hematemesis to their health care provider. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, inform patients of the increased risk for and the signs and symptoms of GI bleeding [see Warnings and Precautions (5.2) ].
Hepatotoxicity Inform patients of the warning signs and symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, pruritus, diarrhea jaundice, right upper quadrant tenderness, and "flu-like" symptoms). If these occur, instruct patients to stop celecoxib capsules and seek immediate medical therapy [see Warnings and Precautions (5.3), Use in Specific Populations (8.6) ]. Heart Failure and Edema Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur [see Warnings and Precautions (5.5) ].
Anaphylactic Reactions Inform patients of the signs of an anaphylactic reaction (e.g., difficulty breathing, swelling of the face or throat). Instruct patients to seek immediate emergency help if these occur [see Contraindications (4) and Warnings and Precautions (5.7) ]. Serious Skin Reactions, including DRESS Advise patients to stop taking celecoxib capsules immediately if they develop any type of rash or fever and to contact their healthcare provider as soon as possible [see Warnings and Precautions (5.9,5.10)].
Female Fertility Advise females of reproductive potential who desire pregnancy that NSAIDs, including celecoxib capsules, may be associated with a reversible delay in ovulation [see Use in Specific Populations (8.3) ]. Fetal Toxicity Inform pregnant women to avoid use of Celecoxib Capsule and other NSAIDs starting at 30 weeks of gestation because of the risk of the premature closing of the fetal ductus arteriosus. If treatment with celecoxib is needed for a pregnant woman between about 20 to 30 weeks gestation, advise her that she may need to be monitored for oligohydramnios, if treatment continues for longer than 48 hours [see Warnings and Precautions (5.11) and Use in Specific Populations (8.1) ].
Avoid Concomitant Use of NSAIDs Inform patients that the concomitant use of celecoxib capsules with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy [see Warnings and Precautions (5.2) and Drug Interactions (7) ]. Alert patients that NSAIDs may be present in "over the counter" medications for treatment of colds, fever, or insomnia. Use of NSAIDS and Low-Dose Aspirin Inform patients not to use low-dose aspirin concomitantly with celecoxib capsules until they talk to their healthcare provider [see Drug Interactions (7) ].
Manufactured by: Yiling Pharmaceutical Ltd No.36 Zhujiang Road, Shijiazhuang, 050035, China Distributed by: Avet Pharmaceuticals Inc. East Brunswick, NJ 08816 1 .866.901 .DRUG (3784) Rev. 12/2025 AVET logo
💬 Medication Guide ▾
Medication Guide for Nonsteroidal Anti-inflammatory Drugs (NSAIDs) What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)? NSAIDs can cause serious side effects , including: Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase: ○ with increasing doses of NSAIDs ○ with longer use of NSAIDs Do not take NSAIDs right before or after a heart surgery called a "coronary artery bypass graft (CABG)." Avoid taking NSAIDs after a recent heart attack, unless your healthcare provider tells you to.
You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack. Increased risk of bleeding, ulcers , and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines: ○ anytime during use ○ without warning symptoms ○ that may cause death The risk of getting an ulcer or bleeding increases with: ○ past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs ○ taking medicines called "corticosteroids", "antiplatelet drugs", "anticoagulants", "SSRIs" or SNRIs ○ increasing doses of NSAIDs ○ older age ○ longer use of NSAIDs ○ poor health ○ smoking ○ advanced liver disease ○ drinking alcohol ○ bleeding problems NSAIDs should only be used: ○ exactly as prescribed ○ at the lowest dose possible for your treatment ○ for the shortest time needed What are NSAIDs?
NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain. Who should not take NSAIDs? Do not take NSAIDs : if you have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs. right before or after heart bypass surgery.
Before taking NSAIDS, tell your healthcare provider about all of your medical conditions , including if you: have liver or kidney problems have high blood pressure have asthma are pregnant or plan to become pregnant. Talk to your healthcare provider if you are considering taking NSAIDs during pregnancy. You should not take NSAIDs after 29 weeks of pregnancy are breastfeeding or plan to breast feed.
Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins or herbal supplements. NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first.
What are the possible side effects of NSAIDs? NSAIDs can cause serious side effects , including: See "What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)? new or worse high blood pressure heart failure liver problems including liver failure kidney problems including kidney failure low red blood cells (anemia) life-threatening skin reactions life-threatening allergic reactions Other side effects of NSAIDs include : stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness.
Get emergency help right away if you get any of the following symptoms: • shortness of breath or trouble breathing • slurred speech • chest pain • swelling of the face or throat • weakness in one part or side of your body Stop taking your NSAID and call your healthcare provider right away if you get any of the following symptoms : •nausea •vomit blood •more tired or weaker than usual •there is blood in your bowel movement or it is black and sticky like tar •diarrhea •unusual weight gain •itching •skin rash or blisters with fever •your skin or eyes look yellow •swelling of the arms, legs, hands and feet •indigestion or stomach pain •flu-like symptoms If you take too much of your NSAID, call your healthcare provider or get medical help right away.
These are not all the possible side effects of N… [Excerpted — this section continues on DailyMed.]
🔬 Clinical Studies ▾
14. CLINICAL STUDIES
14.1Osteoarthritis Celecoxib has demonstrated significant reduction in joint pain compared to placebo. Celecoxib was evaluated for treatment of the signs and the symptoms of OA of the knee and hip in placebo- and active controlled clinical trials of up to 12 weeks duration. In patients with OA, treatment with celecoxib 100 mg twice daily or 200 mg once daily resulted in improvement in WOMAC (Western Ontario and McMaster Universities) osteoarthritis index, a composite of pain, stiffness, and functional measures in OA.
In three 12-week studies of pain accompanying OA flare, celecoxib doses of 100 mg twice daily and 200 mg twice daily provided significant reduction of pain within 24–48 hours of initiation of dosing. At doses of 100 mg twice daily or 200 mg twice daily the effectiveness of celecoxib was shown to be similar to that of naproxen 500 mg twice daily. Doses of 200 mg twice daily provided no additional benefit above that seen with 100 mg twice daily.
A total daily dose of 200 mg has been shown to be equally effective whether administered as 100 mg twice daily or 200 mg once daily.
14.2Rheumatoid Arthritis Celecoxib has demonstrated significant reduction in joint tenderness/pain and joint swelling compared to placebo. Celecoxib was evaluated for treatment of the signs and symptoms of RA in placebo- and active-controlled clinical trials of up to 24 weeks in duration. Celecoxib was shown to be superior to placebo in these studies, using the ACR20 Responder Index, a composite of clinical, laboratory, and functional measures in RA.
Celecoxib doses of 100 mg twice daily and 200 mg twice daily were similar in effectiveness and both were comparable to naproxen 500 mg twice daily. Although celecoxib 100 mg twice daily and 200 mg twice daily provided similar overall effectiveness, some patients derived additional benefit from the 200 mg twice daily dose. Doses of 400 mg twice daily provided no additional benefit above that seen with 100 mg to 200 mg twice daily.
14.3Juvenile Rheumatoid Arthritis (NCT 00652925) In a 12-week, randomized, double-blind active-controlled, parallel-group, multicenter, non-inferiority study, patients from 2 years to 17 years of age with pauciarticular, polyarticular course JRA or systemic onset JRA (with currently inactive systemic features), received one of the following treatments: celecoxib 3 mg/kg (to a maximum of 150 mg) twice daily; celecoxib 6 mg/kg (to a maximum of 300 mg) twice daily; or naproxen 7.5 mg/kg (to a maximum of 500 mg) twice daily.
The response rates were based upon the JRA Definition of Improvement greater than or equal to 30% (JRA DOI 30) criterion, which is a composite of clinical, laboratory, and functional measures of JRA. The JRA DOI 30 response rates at week 12 were 69%, 80% and 67% in the celecoxib 3 mg/kg twice daily, celecoxib 6 mg/kg twice daily, and naproxen 7.5 mg/kg twice daily treatment groups, respectively. The efficacy and safety of celecoxib for JRA have not been studied beyond six months.
The long-term cardiovascular toxicity in children exposed to celecoxib has not been evaluated and it is unknown if the long-term risk may be similar to that seen in adults exposed to celecoxib or other COX-2 selective and non-selective NSAIDs [( see Boxed Warning, Warnings and Precautions (5.1, 5.15) ].
14.4Ankylosing Spondylitis Celecoxib was evaluated in AS patients in two placebo- and active-controlled clinical trials of 6 and 12 weeks duration. Celecoxib at doses of 100 mg twice daily, 200 mg once daily and 400 mg once daily was shown to be statistically superior to placebo in these studies for all three co-primary efficacy measures assessing global pain intensity (Visual Analogue Scale), global disease activity (Visual Analogue Scale) and functional impairment (Bath Ankylosing Spondylitis Functional Index). In the 12-week study, there was no difference in the extent of improvement between the 200 mg and 400 mg celecoxib doses in a comparison of mean c… [Excerpted — this section continues on DailyMed.]
🧪 Nonclinical Toxicology ▾
13. NONCLINICALTOXICOLOGY
13.1Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis Celecoxib was not carcinogenic in Sprague-Dawley rats given oral doses up to 200 mg/kg for males and 10 mg/kg for females (approximately 2-to 4-times the human exposure as measured by the AUC 0-24 at 200 mg twice daily) or in mice given oral doses up to 25 mg/kg for males and 50 mg/kg for females (approximately equal to human exposure as measured by the AUC 0-24 at 200 mg twice daily) for two years. Mutagenesis Celecoxib was not mutagenic in an Ames test and a mutation assay in Chinese hamster ovary (CHO) cells, nor clastogenic in a chromosome aberration assay in CHO cells and an in vivo micronucleus test in rat bone marrow.
Impairment of Fertility Celecoxib had no effect on male or female fertility or male reproductive function in rats at oral doses up to 600 mg/kg/day (approximately 11-times human exposure at 200 mg twice daily based on the AUC 0-24 ). At ≥50 mg/kg/day (approximately 6-times human exposure based on the AUC 0-24 at 200 mg twice daily) there was increased preimplantation loss.
13.2Animal Toxicology An increase in the incidence of background findings of spermatocele with or without secondary changes such as epididymal hypospermia as well as minimal to slight dilation of the seminiferous tubules was seen in the juvenile rat. These reproductive findings while apparently treatment-related did not increase in incidence or severity with dose and may indicate an exacerbation of a spontaneous condition. Similar reproductive findings were not observed in studies of juvenile or adult dogs or in adult rats treated with celecoxib.
The clinical significance of this observation is unknown.
📄 Recent Major Changes ▾
Warnings and Precautions (5.9) 11/2024
📄 Package Label / Principal Display Panel ▾
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-963-06 60 Capsules Celecoxib Capsules 50mg Rx only 50mg-60
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-964-01 100 Capsules Celecoxib Capsules 100mg Rx only 100mg-100
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-964-05 500 Capsules Celecoxib Capsules 100mg Rx only 100mg-500
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-965-01 100 Capsules Celecoxib Capsules 200mg Rx only 200mg-100
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-965-05 500 Capsules Celecoxib Capsules 200mg Rx only 200mg-500
PACKAGE/LABEL PRINCIPAL DISPLAY PANEL NDC 23155-966-06 60 Capsules Celecoxib Capsules 400mg Rx only 400mg-60