The bioavailability of oral celecoxib (celebrex) is not known, but peak plasma levels occur at 2-4 hours postdose. Celecoxib is bound extensively to plasma proteins. Little drug is excreted unchanged; most is excreted as carboxylic acid and glucuronide metabolites in the urine and feces. The elimination t122 is -11 hours. The drug commonly is given once or twice per day during chronic treatment. Renal insufficiency is associated with a modest, clinically insignificant decrease in plasma concentration. Celecoxib has not been studied in patients with severe renal insufficiency. Plasma concentrations are increased by -40% and 180% in patients with mild and moderate hepatic impairment, respectively, and dosages should be reduced by at least 50% in patients with moderate hepatic impairment. Significant interactions occur with fluconazole and lithium but not with ketoconazole or methotrexate. Celecoxib is metabolized predominantly by
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