Engflag

Coxid

Quick links to important sections

Coxid

There is no image.

Treatment option:

Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Coxid

Property Description
Active Ingredients Celecoxib, Rifampicin (Rifampin)
Form Capsule
Pharmacological Class Non-Steroidal Anti-Inflammatory Drug (NSAID) and Antimycobacterial Agent
General Purpose Dual management of inflammation and specific microbial activity
Origin Synthetic / Semi-synthetic

What Type of Medicine is Coxid and What Does it Contain?

Coxid is a medicine formulated as a fixed-dose combination product designed for oral administration, typically supplied in a capsule. Its identity is derived from its two distinct Active Pharmaceutical Ingredients (APIs): Celecoxib and Rifampicin (Rifampin). The product is largely synthetic or semi-synthetic in origin, combining a modern anti-inflammatory agent with a derivative of the natural product Rifamycin. This co-formulation is clinically recognized for addressing conditions where both systemic anti-bacterial action and targeted inflammation control are necessary.

Coxid's Pharmacological Class and Dual Action Principle

The medicine’s identity is defined by the unique pairing of its components' pharmacological classes, establishing a dual action principle. Celecoxib is classified as a Non-Steroidal Anti-Inflammatory Drug (NSAID) and is specifically a selective Cyclooxygenase-2 (COX-2) inhibitor, belonging to the Coxib subclass. Rifampicin is designated as an Antimycobacterial and Antibacterial Agent, known for its ability to prevent susceptible bacteria from creating necessary proteins by inhibiting microbial RNA synthesis. Pharmacological studies confirm this principle, establishing Coxid as a product whose high-level classification involves both inflammation management and systemic microbial suppression.

General Purpose: Combined Support for Inflammation and Infection

The overarching, general purpose of Coxid is the simultaneous support required by certain medical conditions that involve both inflammatory processes and the presence of a Rifampicin-sensitive microbial activity. A typical neutral use scenario for such a product involves the co-management of infections requiring Rifampicin where associated inflammatory pain requires selective NSAID support. This specific formulation is designed to deliver both the selective reduction of inflammatory symptoms—such as pain and swelling—and the systematic action required to inhibit the basic life processes of targeted bacteria.

Regulatory References

  1. Regulatory Knowledge Guide for Combination Products
  2. Rifampin: MedlinePlus Drug Information

What side effects are possible with Coxid?

Possible Side Effects and Safety Information

The medicine's safety profile is defined by the known risks of its two active components: the Non-Steroidal Anti-Inflammatory Drug (NSAID), celecoxib, and the Antimycobacterial Agent, rifampicin. Officially documented adverse effects are classified by frequency and system-organ class.

Commonly Documented Adverse Reactions

Adverse reactions classified as common in regulatory documents include hypertension, peripheral oedema, headache, and gastrointestinal effects such as dyspepsia, diarrhoea, and abdominal pain (celecoxib). Rifampicin commonly causes thrombocytopenia and chromaturia, which is a reddish discoloration of body fluids.

Serious Adverse Reactions

Official labeling documents the risk of serious, potentially fatal events across several systems. These include cardiovascular thrombotic events (e.g., myocardial infarction, stroke) and serious gastrointestinal events (e.g., bleeding, ulceration, and perforation) associated with the NSAID component. Rifampicin is associated with risks of drug-induced liver injury and severe haematological reactions. Rare, but serious, severe cutaneous reactions (e.g., Stevens-Johnson syndrome) are also documented.

Time- and Population-Specific Safety Notes

Safety notes specify that the risk of serious cardiovascular events may begin as early as the first weeks of treatment. Furthermore, the highest risk for severe skin reactions is often documented during the first month of treatment. Specific safety considerations are required for older adults due to their increased risk for serious gastrointestinal events, and for patients with impaired hepatic or renal function. Use of celecoxib is restricted during late-stage pregnancy due to risk of premature closure of the fetal ductus arteriosus.

Regulatory constraints define contraindications based on a patient's history, including those with a history of asthma or allergic-type reactions to NSAIDs or sulfonamides, or those having undergone CABG surgery.

Overdose and Emergency Response

Overdose with Coxid, a fixed-dose combination product, is a scenario with the potential for serious or life-threatening systemic outcomes, requiring immediate medical attention. Documented clinical manifestations include gastrointestinal symptoms like nausea, vomiting, epigastric distress, and severe abdominal pain, alongside neurological effects such as lethargy, drowsiness, dizziness, and headache.

Overdose manifestations carry documented risks of acute renal failure, hepatotoxicity (including liver enlargement and jaundice), and severe gastrointestinal complications like bleeding or perforation. The celecoxib component also carries the documented risk of cardiovascular thrombotic events, such as myocardial infarction and stroke. A unique finding of Rifampicin toxicity is the characteristic red-orange or reddish-brown discoloration of bodily fluids.

Immediate medical attention must be sought for any suspected overdose. Emergency services must be contacted immediately if the individual has collapsed, had a seizure, has trouble breathing, or cannot be awakened. Treatment is strictly symptomatic and supportive, as no specific antidote is known or documented in regulatory labeling. Hospital monitoring is required, with close observation of hepatic and renal function mandated. Elderly or debilitated patients face an increased risk for serious gastrointestinal adverse events.

Therapeutic Uses of Coxid

What Coxid Treats: Main Uses and Benefits

Coxid is commonly used in clinical settings that require a combined therapeutic approach: addressing Rifampicin-sensitive microbial activity alongside the management of associated inflammatory symptoms. This combination may be part of the systematic support generally required for conditions characterized by systemic discomfort, such as tuberculosis, where the anti-infective treatment may be paired with management of inflammatory manifestations. This approach assists in the management of the underlying condition while simultaneously managing symptoms that interfere with daily functioning.

The medication helps manage symptom clusters related to inflammatory or irritative states, including pain, stiffness, swelling, and tenderness that arise from chronic or acute processes. It is relevant for conditions where functional stability becomes affected, such as specific infectious joint diseases and inflammatory arthritides. The symptomatic relief contributes to easing discomfort and supports maintenance of routine activities.

Quick Fact: Support for Symptoms Related to Inflammatory Pain

Coxid may assist with managing symptoms related to inflammatory pain and physical tenderness associated with the underlying disease activity, providing supportive relief when symptoms interfere with routine activities.

Eligibility and Restrictions for Use

Eligibility Map: Who Can and Cannot Use Coxid (Celecoxib) — Official Regulatory Information

Official regulatory documents define strict criteria for using Coxid (celecoxib), focusing on patient status, allergies, and organ function. The medication is contraindicated and must not be used by specific populations due to serious safety risks.

Absolute Contraindications (Must Not Use):

  • Patients with known hypersensitivity to celecoxib, any component of the formulation, or sulfonamide drugs.
  • Individuals with aspirin-sensitive asthma or other allergic-type reactions to aspirin or other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).
  • Patients in the setting of coronary artery bypass graft (CABG) surgery.
  • Pregnant women at or after 30 weeks gestation.

Restrictions and Conditional Use:

  • Age: Use is approved for adults and pediatric patients 2 years of age and older for Juvenile Rheumatoid Arthritis. Safety is not established for children under 2.
  • Organ Function: Use is not recommended in patients with severe hepatic impairment (Child-Pugh Class C) or severe renal impairment. Patients with moderate hepatic impairment (Child-Pugh Class B) must adhere to a 50% dose reduction to be eligible.
  • Other Conditions: Contraindicated in patients with active gastrointestinal ulceration or bleeding. Use is not recommended for patients with severe heart failure.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Official regulatory documents detail specific interactions for Coxid (a selective COX-2 inhibitor) that primarily involve effects on drug concentration and additive risks. These interactions are categorized based on their mechanism and resulting clinical requirement.

Pharmacokinetic and Pharmacodynamic Interactions

Interacting Product Category Basis of Interaction Constraint or Regulatory Requirement
CYP2C9 Inhibitors (e.g., Fluconazole) Decreased metabolism of Coxid via CYP2C9, increasing systemic exposure. May necessitate a dose adjustment for Coxid.
Anticoagulants (e.g., Warfarin) Increased risk of serious bleeding events. Requires close monitoring of anticoagulant activity (e.g., INR) upon initiation or change of Coxid dosage.
ACE Inhibitors / ARBs Diminution of their antihypertensive effect. Potential for acute renal function deterioration, especially in the elderly. Requires monitoring of blood pressure and renal function.
Lithium or Digoxin Increased serum concentrations of these drugs. Requires monitoring of serum Lithium or Digoxin levels.
Other Non-Aspirin NSAIDs Potential for increased risk of adverse reactions. Concomitant use should be generally avoided.
Aspirin (Analgesic Dose) Increased risk of serious gastrointestinal events. Concomitant use is generally not recommended.

Summary of Interaction Constraints

The interaction profile mandates avoiding concomitant use with other non-aspirin NSAIDs to manage the risk of adverse events. For agents like Warfarin, the regulatory constraint requires intensive monitoring of blood clotting parameters. The need for close monitoring of serum levels is specified when co-administered with narrow-therapeutic-index drugs such as Lithium and Digoxin due to increased exposure.

Mechanism of Action

Modulation of Host Inflammatory Signaling

The Celecoxib component operates by selectively inhibiting the Cyclooxygenase-2 ( COX-2) enzyme, which is primarily responsible for synthesizing inflammatory prostaglandins, such as PGE2 . This targeted mechanism interrupts the Arachidonic Acid Cascade, resulting in the modulation of nociceptive signaling factors and localized vasodilation. The physiological consequence is a reduction in the intensity of the localized inflammatory cascade and its downstream effects.

Blockade of Microbial Gene Expression

The Rifampicin component engages a separate, essential domain by rapidly binding to the beta subunit of bacterial DNA-dependent RNA Polymerase . This action physically prevents the initiation of RNA synthesis, which arrests the microbe's production of essential proteins required for replication and metabolic function. This interference with microbial genetic processes culminates in a systemic loss of metabolic function in susceptible microorganisms.

Mechanistic Constraint on Anti-inflammatory Action

A key aspect of this combination product is the interaction between the two mechanisms. Rifampicin acts as an agonist for the human Pregnane X Receptor (PXR), which increases the expression of hepatic drug-metabolizing enzymes, notably CYP2C9. This induction accelerates the inactivation of Celecoxib, imposing a mechanistic constraint on the duration of its COX-2 inhibitory concentration.

Dosage and Administration Information

Administration Guidelines for Coxid

The official guidance for administering Coxid (a non-steroidal anti-inflammatory drug, or NSAID) mandates the lowest effective dose for the shortest duration consistent with individual treatment goals, a principle applicable to all NSAIDs.

Route and Timing

The drug is taken orally. Standard capsule doses (up to 200 mg twice daily) may be taken with or without food. For higher doses, such as 400 mg twice daily, the medication should be administered with food to improve drug absorption. If a patient has difficulty swallowing capsules, the contents may be sprinkled onto a level teaspoon of cool or room temperature applesauce and swallowed immediately with water.

Dosing Schedule

Dosage is determined by the specific condition being managed:

Condition Typical Adult Dosing Schedule
Osteoarthritis 200 mg once daily OR 100 mg twice daily
Rheumatoid Arthritis 100 mg to 200 mg twice daily
Acute Pain 400 mg initial dose, followed by 200 mg if needed on Day 1, then 200 mg twice daily as needed
Ankylosing Spondylitis 200 mg once daily. If no response after 6 weeks, the dose may be increased to 400 mg daily.

Special Dosing Considerations

  • Juvenile Rheumatoid Arthritis (JRA): For children aged 2 years and older, dosing is based on weight: 50 mg twice daily for patients 10 kg to 25 kg, and 100 mg twice daily for patients over 25 kg.
  • Hepatic Impairment: The daily dose must be reduced by 50% in patients with moderate hepatic impairment (Child-Pugh Class B). Use in severe hepatic impairment (Child-Pugh Class C) is not recommended.
  • CYP2C9 Poor Metabolizers: Treatment for known or suspected poor metabolizers of CYP2C9 should be initiated at half of the lowest recommended dose for adults.

Missed Dose

If a dose is missed, take it as soon as possible. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the patient should return to the regular dosing schedule. Do not double the dose.

This instruction set consolidates the official, regulated requirements for Coxid administration, detailing the oral route, specific dose frequencies, and mandatory dose adjustments for various patient populations. It emphasizes a procedural framework centered on individualized dosing and adherence to the lowest effective therapeutic amount.

Recent Clinical Evidence

Research evidence / Overview of Studies for Coxid

Evidence for Use in Infections with Associated Inflammation

Research has explored the co-administration of a Coxib, such as celecoxib, with anti-infective treatment in conditions that require anti-bacterial action alongside symptom management. This involved Randomized Controlled Trials (RCTs) and Systematic Reviews examining the combined approach in adult patients diagnosed with specific infections, including tuberculosis. Studies monitored both microbial outcomes and patient-reported outcomes describing perceived discomfort. Findings related to the influence of the anti-inflammatory component were inconsistent across different study settings. The evidence contributes to the broader landscape, but the certainty remains low regarding the contribution of the anti-inflammatory component in these complex infection treatments.

Studies on Drug Exposure and Interaction (Pharmacokinetics)

Pharmacokinetic (PK) studies and bioavailability studies were conducted in healthy adult volunteers to understand how the body handles the two drugs when they are combined. Research examined the concentrations of both celecoxib and rifampicin in the bloodstream to characterize the drug exposure characteristics of the fixed-dose product. Data show patterns related to an interaction where the rifampicin component was observed to influence the systemic exposure of celecoxib. The clinical relevance of this measured drug-drug interaction on patient-reported outcomes during an active infection is an area where certainty remains low.

Long-Term Evidence and Research Gaps

Studies exploring outcomes over extended periods are generally limited, particularly regarding the long-term use of the celecoxib component within this combination. Research has explored short-term changes but less often the maintenance of observed patterns once the study follow-up is complete. Evidence for specific populations, such as older adults or individuals with co-morbidities, is often derived from small subgroups. The overall body of evidence highlights what is known—and what is still uncertain—about this combination product.

Frequently Asked Questions (FAQ)

Common questions about Coxid (FAQ)

Q: What is Coxid used for?

A: Coxid is a type of medicine known as a selective COX-2 inhibitor (sometimes called a coxib). It belongs to the class of non-steroidal anti-inflammatory drugs (NSAIDs).

It is primarily used to relieve pain and inflammation caused by:

  • Osteoarthritis (OA)
  • Rheumatoid arthritis (RA)
  • Ankylosing spondylitis (a type of arthritis affecting the spine)
  • Short-term treatment of acute pain

Q: How does Coxid work?

A: Coxid works by selectively blocking an enzyme called cyclooxygenase-2 (COX-2). This enzyme is responsible for producing prostaglandins, which are chemical substances in the body that cause inflammation, pain, and fever.

By blocking COX-2, Coxid reduces the production of these inflammatory prostaglandins, thereby relieving the symptoms of pain and swelling.

Unlike traditional NSAIDs, which block both COX-1 and COX-2, Coxid's selectivity for COX-2 may potentially reduce the risk of certain gastrointestinal side effects.

Q: What is the typical dosing for Coxid?

A: The dosage of Coxid depends on the condition being treated and the patient's individual response. It is typically taken by mouth as a tablet.

  • For Osteoarthritis, the usual dose is 100 mg once daily.
  • For Rheumatoid Arthritis and Ankylosing Spondylitis, the dose may be increased to 200 mg once daily.
  • For acute pain or flare-ups, a higher short-term dose may be prescribed.

Always take the exact dose prescribed by your healthcare provider. Do not change your dose or stop taking the medication without consulting them first. It can be taken with or without food.

Q: How long does it take for Coxid to start working?

A: Most patients will begin to feel the effects of Coxid, such as reduced pain and swelling, within 24 hours of taking the first dose.

For chronic conditions like arthritis, the full benefit in terms of pain management and reduced joint stiffness may take up to two weeks of continuous treatment.

If you do not notice an improvement in your symptoms after a few weeks, you should discuss this with your healthcare provider.

Q: What are the potential side effects of Coxid?

A: Like all medicines, Coxid can cause side effects, although not everyone experiences them. Common side effects may include:

  • Stomach pain or indigestion (dyspepsia)
  • Diarrhea
  • Nausea
  • Headache
  • Swelling of the ankles, feet, or hands (peripheral edema)

Less common but serious side effects can include:

  • Cardiovascular risks: Increased risk of heart attack or stroke, especially with long-term use or higher doses.
  • Gastrointestinal bleeding/ulcers
  • Allergic reactions (e.g., rash, difficulty breathing)
  • Liver or kidney problems

Seek immediate medical attention if you experience chest pain, sudden weakness, shortness of breath, black/tarry stools, or persistent severe stomach pain.

Q: Can I take Coxid with other pain relievers?

A: Generally, you should avoid taking Coxid with other NSAIDs, including over-the-counter pain relievers like ibuprofen or naproxen, or with other selective COX-2 inhibitors.

Taking Coxid with other NSAIDs significantly increases the risk of side effects, particularly gastrointestinal bleeding and ulcers, without providing greater pain relief.

Acetaminophen (paracetamol) is usually considered a safe alternative for pain relief while taking Coxid, but you should still check with your doctor or pharmacist before combining any medications.

How should Coxid be stored and disposed of?

How to Store and Dispose of Celecoxib (Coxid)

Official regulatory documents define specific requirements for the storage, stability, and disposal of this medicine.

Storage Conditions

Requirement Details
Temperature Store in a closed container at room temperature (e.g., 20 C to 25 C or 68 F to 77 F).
Protection Keep away from heat, moisture, freezing, and direct light.
Child Safety Keep out of the reach of children.
Stability A dose mixed with applesauce is stable for up to 6 hours when refrigerated (2 C to 8 C or 35 F to 45 F).

Disposal Instructions

Outdated or unneeded medicine must be disposed of. The preferred method is using a drug take-back program or a prepaid mail-back envelope. If these options are unavailable, do not flush the medicine. Instead, mix the product with an unappealing substance, such as dirt or used coffee grounds, place the mixture into a sealed container, and discard it in the household trash.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Equivalent of Coxid found in:

A-Z Index: