Indications

Rheumatoid arthritis, Gout pain (sudden, painful swelling of the joints. It is caused by deposits of uric acid crystals in the joint), Osteoarthritis (disease of the joints where there is gradual breakdown of cartilage that cushions the bone ends), Ankylo

Contraindication

Hypersensitivity. Patient w/ inflammatory bowel disease, active GI ulceration or bleeding, moderate to severe heart failure (NYHA class II-IV), ischaemic heart disease, peripheral arterial disease, or cerebrovascular disease, uncontrolled HTN (persistently above 140/90 mmHg); history of bronchospasm, acute rhinitis, nasal polyps, angioneurotic oedema, urticaria or allergic-type reactions after taking aspirin, NSAIDs including COX-2 inhibitors. Renal (CrCl <30 mL/min) and severe hepatic (Child-Pugh ≥10) impairment. Childn and adolescent <16 yr. Lactation.

Special Precautions

Patient w/ significant risk factors for CV disease e.g. HTN, hyperlipidaemia and DM; pre-existing oedema; history of left ventricular dysfunction, cardiac failure; history of upper GI ulceration, perforation and bleeding. May mask fever and other signs of inflammation. Mild to moderate hepatic impairment. Elderly. Pregnancy. Monitoring Parameters Monitor BP before treatment, w/in 2 wk after initiation of therapy and periodically thereafter.

Side Effects

Constipation, diarrhoea, nausea, vomiting, oesophagitis, flatulence, gastritis, heartburn/acid reflux, dyspepsia/epigastric discomfort, oral ulcer, alveolar osteitis, oedema/fluid retention, dizziness, headache, palpitations, arrhythmia, HTN, asthenia/fatigue, flu-like disease, bronchospasm, ecchymosis, increased ALT and AST.

Drug Interactions

May increase INR w/ oral anticoagulants. May decrease effects of ACE inhibitors, angiotensin II antagonist and diuretics. May increase lithium plasma concentrations. May reduce plasma levels w/ rifampicin. Increased serum concentrations of ethinylestradiol.

Route of Administration

Oral

Dosage

As directed by the physician