Uses of Celestal 200

Celestal 200 is a non-steroidal anti-inflammatory drug, commonly indicated in anti-inflammatory, pain relief in patients with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. Users need to follow the instructions exactly to achieve the best results.

Celestal 200 has the main active ingredient is Celecoxib, the drug is made in the form of a capsule with a content of 200mg. Celecoxib is a non-steroidal anti-inflammatory drug, which selectively inhibits the isoenzyme Cyclooxygenase-2 (COX-2), reducing the formation of prostaglandins. Celecoxib has anti-inflammatory, antipyretic and analgesic effects.
Celecoxib does not inhibit the isoenzyme cyclooxygenase-1 (COX-1). Because Celecoxib does not inhibit COX-1, there is less risk of side effects such as bleeding, prolongation of bleeding time, and stomach ulcers. However, the drug can still cause kidney side effects similar to other non-steroidal anti-inflammatory drugs.
Celecoxib may increase the risk of vascular thrombosis, because it inhibits Prostaglandin synthesis (antithrombotic agent) and does not affect thromboxane A2 (prothrombotic substance).

2.1 Indications Celestal 200 is mainly indicated in anti-inflammatory, pain relief in patients with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis.
In addition, the drug is also used to support the treatment of reducing the number of polyps in conventional therapy, treating familial adenomatous colorectal polyps. The drug is effective in treating acute pain, including pain after surgery, tooth extraction, primary dysmenorrhea.
2.2. Contraindications Hypersensitivity or allergy to Celecoxib, Sulfonamide or any of its ingredients. Progressive peptic ulcer disease, gastrointestinal bleeding. Myocardial ischemia, peripheral vascular disease, cerebrovascular disease. Severe heart failure. Hepatic impairment (serum albumin <25 g/l or Child-Pugh score ≥10) severe renal impairment. Inflammatory bowel disease such as Crohn's disease, ulcerative colitis. History of asthma, urticaria or other allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs. Children, pregnant women and lactating women, as safety has not been proven.

Celestal 200 is used by mouth and patients only use it according to the doctor's prescription. Celestal 200 should be administered at the lowest effective dose for the shortest duration suitable for therapeutic purposes. Accordingly, children are not recommended to take this drug.
Dosage of Celestal 200 is as follows:
Osteoarthritis: 200 mg/day x 1 time/day. Rheumatoid arthritis: 100-200 mg x 2 times/day. Using higher doses does not have a better effect. Ankylosing spondylitis in adults: 200 mg/day x 1 time/day. If there is no response after 6 weeks of treatment, the dose may be increased to a maximum of 400 mg/day. After 6 weeks of no response, another drug must be switched. Overdose and management:
Overdosage of Celestal 200 can cause lethargy, somnolence, nausea, vomiting, and epigastric pain. More rarely: gastrointestinal bleeding, coma, hypertension, acute renal failure, respiratory depression, anaphylactic reactions.
Treatment of overdose with Celestal 200 includes: symptomatic and supportive treatment; There is no specific antidote. Within the first 4 hours after an overdose of Celestal, emetic therapy or activated charcoal can be used.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause serious gastrointestinal side effects such as bleeding, ulceration or perforation of the stomach with or without warning symptoms. The drug should be used with caution in patients with a history of peptic ulcer or gastrointestinal bleeding, although Celecoxib is not considered to cause gastrointestinal events due to selective COX-2 inhibition.
History of asthma, allergy when taking Aspirin or NSAIDs: anaphylaxis may occur. Elderly, debilitated: easy gastrointestinal bleeding, kidney function is often impaired. NSAIDs increase the limit of one or more liver and enzyme tests (AST, ALT). Monitor carefully for symptoms of liver dysfunction and liver enzymes when taking Celecoxib. Celestal 200 should not be used in patients with moderate or severe hepatic impairment. Celecoxib should not be used as a substitute for corticosteroids or for the treatment of corticosteroid insufficiency. Celecoxib has anti-inflammatory and antipyretic pharmacological effects, which may mask valuable markers in detecting infectious complications of painful conditions. Celecoxib may cause nephrotoxicity, renal papillary necrosis, and other renal lesions. Especially when maintaining blood flow through the kidneys requires the help of renal prostaglandins. The patient has extracellular water loss. In this case, dehydration should be treated before using Celestal 200. Anemia may occur during treatment with Celecoxib. Check the blood count (HGB and HCT) in patients on long-term Celecoxib who have signs of anemia. Monitor the risk of cardiovascular complications (myocardial ischemia, myocardial infarction). Celecoxib does not have intrinsic antiplatelet activity, does not protect against ischemic events, especially with prolonged high doses (400-800 mg/day). Patients with significant risk factors for cardiovascular events (eg, hypertension, hyperlipidemia, diabetes, smoking) should only be treated with Celecoxib after careful consideration. dual. As with all NSAIDS, Celecoxib may lead to the onset of new hypertension or the exacerbation of pre-existing hypertension, either of which may contribute to an increased frequency of adverse events. cardiovascular effort. Therefore, blood pressure should be closely monitored during initiation of celecoxib therapy and throughout treatment. Driving and operating machines: The drug may cause fatigue and drowsiness. Celestal should not be used if the patient experiences this side effect. Pregnancy: There are currently no adequate studies of Celecoxib in pregnant women. Celecoxib is contraindicated in the third trimester of pregnancy, as synthesis inhibitors may have adverse effects on the fetal cardiovascular system. The drug should only be used when the potential benefit outweighs the possible risk to the fetus and mother. Lactation: It is not known whether Celestal passes into breast milk. However, Celecoxib causes serious unwanted side effects in young children. The benefits and risks of using Celestal in lactating women should be assessed, considering whether to discontinue nursing or discontinue the drug.

Undesirable effects when using Celestal 200 are usually mild and mainly related to the gastrointestinal tract. The symptoms that caused patients to stop taking the drug the most were dyspepsia and abdominal pain (about 7.1%).
Digestion: indigestion, abdominal pain, diarrhea, flatulence, nausea. Less common: intestinal obstruction, intestinal perforation, gastrointestinal bleeding, hemorrhagic colitis, pancreatitis. Respiratory: rhinitis, sinusitis, pharyngitis. Central nervous system: insomnia, dizziness, headache. Skin: rash. Uncommon: erythema multiforme, Stevens-Johnson syndrome. Cardiovascular (rare): Syncope, congestive heart failure, ventricular fibrillation, pulmonary embolism, cerebrovascular accident, thrombophlebitis, vasculitis. Hepatobiliary: jaundice, hepatitis, liver failure, gallstones. Hematologic: thrombocytopenia, leukopenia, pancytopenia, non-regenerative anemia. Metabolism: decreased blood glucose. Renal: acute renal failure, interstitial nephritis. Celestal 200 is generally well tolerated when used in normal and short-term doses. If kidney damage occurs while taking Celestal, the patient should stop taking the drug. Renal function usually returns to pre-treatment levels after discontinuation of the drug. Liver enzymes may be increased to 3 times the upper limit of normal. If there are signs of acute hepatitis (jaundice, liver failure, etc.), the drug should be stopped immediately.

Celecoxib - the main active ingredient of the drug Celestal 200, metabolism mediated by Cytochrome P450 2C9 in the liver. Therefore, caution should be exercised when combining Celestal 200 with a P450 2C9 inhibitor. In addition, Celecoxib also inhibits cytochrome P4502D6, so Celestal 200 is likely to interact with drugs metabolized by P4502D6. Angiotensin-converting enzyme (ACE) inhibitors: drugs that may reduce the antihypertensive effect of ACE inhibitors. Furosemide and Thiazides: NSAIDs may reduce the diuretic effect of the drug. Aspirin: Concomitant use of aspirin with celecoxib may increase the incidence of gastrointestinal ulceration or other complications. Fluconazole: doubled the plasma concentration of celecoxib. Warfarin: bleeding complications, increased prothrombin time may occur in some patients (mainly elderly) when Celecoxib is used concurrently with Warfarin. Monitor coagulation tests and prothrombin time, especially during the first few days after starting or changing therapy. Celestal 200 is a non-steroidal anti-inflammatory drug, often indicated in anti-inflammatory, pain relief in patients with osteoarthritis, rheumatoid arthritis, ankylosing spondylitis. To ensure the effectiveness of use, patients need to use the drug according to the prescription, prescribed by the doctor and pharmacist.
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