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Consider using alternative management in JRA patients who are poor metabolizers.
Physicians and patients should remain alert for the development of such events, even in the absence of previous CV symptoms.
Patients should be informed about the signs and symptoms of serious skin manifestations and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity.
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For the management of the signs and symptoms of AS, the recommended dose of Celebrex is 200 mg daily in single once per day or divided twice per day doses.
Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, use of alcohol, older age, and poor general health status.
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To minimize the potential risk for an adverse CV event in patients treated with Celebrex, the lowest effective dose should be used for the shortest duration consistent with individual patient treatment goals.
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The concurrent use of aspirin and Celebrex does increase the risk of serious GI events see Warnings and Precautions 5.
Blood pressure should be monitored closely during the initiation of therapy with Celebrex and throughout the course of therapy.
These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs.
The increases in both celecoxib dose groups versus placebotreated patients were mainly due to an increased incidence of myocardial infarction see Clinical Studies 14.
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Most spontaneous reports of fatal GI events are in elderly or debilitated patients and therefore special care should be taken in treating this population.
The use of Celebrex in patients with severe hepatic impairment is not recommended see Warnings and Precautions 5.