Celecoxib (cancer chemoprevention context — APC duodenal polyposis)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-CELECOXIB-CHEMOPREVENTION |
|---|---|
| Type | Drug |
| Aliases | CelebrexCelecoxib (cancer chemoprevention)Целекоксиб (хіміопрофілактика раку — поліпоз APC) |
| Status | reviewed 2026-05-18 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-COLON-2025 SRC-USPSTF-CRC-2021 |
Drug Facts
| Class | COX-2 selective non-steroidal anti-inflammatory drug (coxib) |
|---|---|
| Mechanism | Selective inhibitor of cyclooxygenase-2 (COX-2; ~10-20-fold selectivity over COX-1 at therapeutic concentrations), suppressing prostaglandin- driven inflammation, proliferation, and angiogenesis with relatively spared platelet COX-1 (no antiplatelet effect at standard doses) and reduced gastric mucosal COX-1 (less GI bleeding than non-selective NSAIDs). Cancer-prevention rationale: COX-2 is upregulated in adenomas and many tumors; inhibition reduces PGE2-driven proliferation and immune escape. In FAP, celecoxib reduced duodenal polyp burden (Steinbach NEJM 2000) — formerly FDA-approved for FAP-related polyposis (orphan designation), withdrawn 2011 by sponsor after post-marketing study did not confirm benefit. |
| Typical dosing | FAP duodenal polyposis chemoprevention (historical FDA indication pre-2011): 400 mg PO BID (= 800 mg/day). Adjunct to surveillance endoscopy and polypectomy — not a replacement. General CV-risk caveat: lowest effective dose for shortest duration. Take with food; avoid in CrCl <30 mL/min, severe hepatic impairment. CYP2C9 poor metabolizers — consider half dose. |
| Ukraine registered | True |
| NSZU reimbursed | False |
| Ukraine last verified | 2026-05-18 |
Warnings
- Cardiovascular thrombotic events (MI, stroke) — increased risk with all NSAIDs including COX-2 selective; contraindicated in CABG perioperative period
- GI bleeding, ulceration, perforation — risk lower than non-selective NSAIDs but not absent; can occur without warning
Notes
STUB — v0.2 chemoprevention-workstream authoring; pending two-Clinical- Co-Lead signoff per CHARTER §6.1 dev-mode. ORPHAN / HISTORICAL FAP indication. Celecoxib was FDA-approved (1999) for reducing duodenal polyp number in FAP based on Steinbach NEJM 2000 (6-month, 28% polyp burden reduction at 400 mg BID); approval withdrawn at sponsor request in 2011 after PreSAP/APC trials showed CV-risk signal outweighed benefit in adenoma-prevention populations. NCCN Genetic Familial High-Risk Assessment guidelines retain celecoxib as adjunct option in selected FAP patients (post-colectomy surveillance, retained rectum, duodenal disease) under specialist hereditary-CRC team. Engine should NOT auto-recommend; reserved for specialist hereditary- cancer center management with explicit CV risk discussion. Strict ASA / sulfa allergy screen.
Used By
No reverse references found in the YAML corpus.