<p>A large part of celecoxib metabolism is mediated by cytochrome P450 2C9 in the liver with some contribution from CYP3A4 and CYP2C8 and possible contributions from CYP2D6.<sup class="text-reference-group"><a class="reference-popover-link" data-content="Gong L, Thorn CF, Bertagnolli MM, Grosser T, Altman RB, Klein TE: Celecoxib pathways: pharmacokinetics and pharmacodynamics. Pharmacogenet Genomics. 2012 Apr;22(4):310-8. doi: 10.1097/FPC.0b013e32834f94cb. (PubMed ID 22336956)" href="#reference-A34124">7</a>,<a class="reference-popover-link" data-content="Siu YA, Hao MH, Dixit V, Lai WG: Celecoxib is a substrate of CYP2D6: Impact on celecoxib metabolism in individuals with CYP2C9*3 variants. Drug Metab Pharmacokinet. 2018 Oct;33(5):219-227. doi: 10.1016/j.dmpk.2018.06.001. Epub 2018 Jun 19. (PubMed ID 30219715)" href="#reference-A181379">21</a>,<a class="reference-popover-link" data-content="Daily EB, Aquilante CL: Cytochrome P450 2C8 pharmacogenetics: a review of clinical studies. Pharmacogenomics. 2009 Sep;10(9):1489-510. doi: 10.2217/pgs.09.82. (PubMed ID 19761371)" href="#reference-A38563">20</a>,<a class="reference-popover-link" data-content="Brandon Cohen; Charles V. Preuss (2019). Celecoxib, NIH StatPearls. StatPearls." href="#reference-T647">22</a></sup> It is metabolized by biotransformation to carboxylic acid and glucuronide metabolites.<sup class="text-reference-group"><a class="reference-popover-link" data-content="Ahmad SR, Kortepeter C, Brinker A, Chen M, Beitz J: Renal failure associated with the use of celecoxib and rofecoxib. Drug Saf. 2002;25(7):537-44. doi: 10.2165/00002018-200225070-00007. (PubMed ID 12093311)" href="#reference-A4983">12</a></sup> Three metabolites, a primary alcohol, a carboxylic acid, and a glucuronide conjugate, have been found in human plasma after celecoxib administration.<sup class="text-reference-group"><a class="reference-popover-link" data-content="Gong L, Thorn CF, Bertagnolli MM, Grosser T, Altman RB, Klein TE: Celecoxib pathways: pharmacokinetics and pharmacodynamics. Pharmacogenet Genomics. 2012 Apr;22(4):310-8. doi: 10.1097/FPC.0b013e32834f94cb. (PubMed ID 22336956)" href="#reference-A34124">7</a></sup> These are considered inactive metabolites in regards to COX enzyme inhibition. Patients who are known or suspected to have decreased cytochrome P450 2C9 activity or function, based on their previous history, should be administered celecoxib with caution as they may have abnormally high serum concentrations resulting from decreased metabolism celecoxib.<sup class="text-reference-group"><a class="reference-popover-link" data-content="FDA Approved Drug Products: CELEBREX (celecoxib) oral capsules" href="#reference-L7646">31</a></sup></p><p class="d-none d-sm-block"><strong>Hover over products below to view reaction partners</strong></p>