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CYCLOOXYGENASE- 2 INHIBITORS
CYCLOOXYGENASE- 2 INHIBITORS
CELECOXIB
Guidelines for Use
- The patient should have a current documented diagnosis of osteoarthritis, rheumatoid arthritis, or acute pain in which other medication for pain control are contraindicated.
- One
of the following criteria should be present and documented:
- Medically necessary concomitant use of low dose aspirin, warfarin or methotrexate
- Concomitant use of an NSAID and an H-2 Antagonist or proton pump inhibitor for the past 3 months
- Past history of peptic ulcer disease or a gastrointestinal bleed
- Concomitant use of an NSAID and two or more antihypertensive drugs in a patient with poorly controlled hypertension
- Failure with or intolerance of 4 non-selective NSAIDS
Dose:
(100mg, 200mg cap)
Osteoarthritis - 100 mg BID or 200mg QD
Rheumatoid Arthritis - 100 - 200 mg BID
MONITOR:
- Labs: hemogram; fecal occult blood, serum sodium, potassium, blood urea nitrogen and creatinine; urinalysis; and SGPT (ALT).
- Adverse effects: signs and symptoms of bleeding; 3 fold increase in SGPT (ALT) from baseline
- Hypertension or cardiac conditions aggravated by fluid retention and edema
- Anemia
- Sulfa allergy contraindicates the use of Celecoxib
- Avoid in late pregnancy and history of moderate/severe hypersensitivity to NSAIDS
- Use with caution with history of liver dysfunction; pre-existing infection; history of GI ulceration, bleeding, or perforation; renal dysfunction
Outpatient prescribing: Medicaid recipients 64 years of age and under will require Prior Authorization ((PA) A prior Authorization request form must be filled out and signed by the physician.
OUTCOME:
Improvement in symptons and functions of systems
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