Overview
Celecoxib is a selective COX-2 inhibitor, representing a specialized class of nonsteroidal anti-inflammatory drugs (NSAIDs). It was developed to provide robust pain and inflammation relief while significantly minimizing the gastrointestinal toxicity associated with traditional non-selective NSAIDs.

Mechanism of Action
By selectively targeting and inhibiting the COX-2 enzyme, which is induced during inflammation, celecoxib reduces the production of inflammatory prostaglandins. Crucially, it largely spares the COX-1 enzyme, which is responsible for protecting the gastric mucosa and maintaining normal platelet function.

Dosage and Administration
It is primarily indicated for the management of osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain. The typical adult dosage for arthritis management is 100 mg twice daily or 200 mg once daily. For acute pain, an initial dose of 400 mg may be used, followed by 200 mg twice daily as needed.

Side Effects
While celecoxib substantially reduces the risk of endoscopic gastric ulcers compared to non-selective NSAIDs, it is not entirely devoid of gastrointestinal risks. More critically, long-term use of COX-2 inhibitors is associated with an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke.

Contraindications
Celecoxib is strictly contraindicated in patients with known hypersensitivity to sulfonamides, aspirin, or other NSAIDs. It is also contraindicated in patients with severe hepatic impairment, severe renal disease, or those who have recently undergone coronary artery bypass graft (CABG) surgery.

Pregnancy and Lactation
Its use is not recommended during pregnancy, particularly in the third trimester, due to the risk of premature closure of the ductus arteriosus. It is excreted in breast milk in small amounts; therefore, a decision should be made whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.