RA including juvenile idiopathic arthritis, OA & ankylosing spondylitis. Adjunctive treatment of adenomatous colorectal polyps. Management of acute pain & dysmenorrhea.
AdultOA 200 mg daily as a single dose or in 2 divided doses. May be increased up to 200 mg bid if necessary. RA 100-200 mg bid. Ankylosing spondylitis Initially 200 mg daily as single dose or in 2 divided doses. Pain & dysmenorrhea Initially 400 mg followed by an additional 200 mg on the 1st day, then 200 mg bid thereafter. Adenomatous colorectal polyps in patient w/ familial adenomatous polyposis 400 mg bid. Juvenile idiopathic arthritisChildn ≥2 yr weighing >25 kg 100 mg bid, 10-25 kg 50 mg bid.
History of ischaemic heart disease, peripheral arterial or cerebrovascular disease; significant risk factors for CV disease eg, HTN, hyperlipidaemia & DM. Discontinue use if signs or symptoms of organ toxicity develop; if skin rash & signs of hypersensitivity appear. Potential GI (gastric & liver) & renal toxicities. Allergy to NSAIDs & asthma. Avoid smoking. Dehydrated patients. Not to be used w/ severe hepatic impairment (Child-Pugh C).
May result in changes in plasma conc w/ drugs that inhibit or induce or are metabolized by CYP450 isoenzyme CYP2C9. Increased plasma conc w/ fluconazole. Potential effect on drugs metabolized by isoenzyme CYP2D6.
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