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Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e. However, as with other NSAIDs, including those that selectively inhibit COX-2, there have been more spontaneous post-marketing reports of fatal GI events and The daily recommended dose of CELEBREX capsules in patients with moderate hepatic impairment (Child-Pugh Class B) should be reduced by 50%.

WARNINGS AND CELEBREX is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. During concomitant use of CELEBREX and digoxin, monitor serum digoxin levels. This increase is due to the inhibition of celecoxib metabolism via P450 2C9 by fluconazole [see The effects of celecoxib on the pharmacokinetics and/or pharmacodynamics of ], phenytoin, and tolbutamide have been studied in vivo and clinically important interactions have not been found. All pregnancies have a background risk of , loss, or other adverse outcomes. At doses of 100 mg twice daily or 200 mg twice daily the effectiveness of CELEBREX was shown to be similar to that of naproxen 500 mg twice daily.

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The pharmacokinetics of celecoxib have not been evaluated in subjects with other CYP2C9 polymorphisms, such as *2, *5, *6, *9 and *11. Celecoxib 100 mg twice daily was non- 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 To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest for the shortest duration possible. Forced , alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.

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