What are the documented precautions with celecoxib?
Celecoxib is contraindicated in patients who have had an allergic-type reaction to sulfonamide drugs. This agent is not recommended for patients with severe hepatic insufficiency or advanced renal disease. In postmarketing studies, patients receiving celecoxib concurrently with warfarin experienced bleeding events in association with an increase in prothrombin time. Therefore, if celecoxib therapy is initiated or changed, the international normalized ratio (INR) should be monitored, especially in the first few days. In addition, the clinician should be aware of the potential interaction with lithium and cytochrome P450 inhibitors when patients are taking celecoxib.