| Indication | Celecoxib Order Written For | Convert to Following Naproxen Dose |
|---|---|---|
| Osteoarthritis Symptoms | 200 mg PO as a single dose OR 100 mg PO twice daily |
Naproxen 250 mg, 375 mg, or 500 mg PO twice daily (May increase to 1500 mg/day)* |
| Rheumatoid Arthritis Symptoms | 100 mg - 200 mg PO twice daily | Naproxen 250 mg, 375 mg, or 500 mg PO twice daily (May increase to 1500 mg/day)* |
| Acute Pain | Day 1: 400 mg PO initially, followed by an additional 200 mg PO if needed. Subsequent Days: 200 mg PO twice daily as needed |
Naproxen 500 mg PO initially, followed by 250 mg every 6-8 hours as needed (Maximum Daily Dose: 1250 mg)* |
| Post-operative Pain | Day 1: 400 mg PO initially, followed by an additional 200 mg PO if needed. Subsequent Days: 200 mg PO twice daily as needed |
Naproxen 500 mg PO initially, followed by 250 mg every 6-8 hours as needed (Maximum Daily Dose: 1250 mg)* Additional pain medications may be warranted. |
* Patients at risk of developing NSAID-induced gastric ulcers (e.g., history of ulcers and symptoms, age >65 years, aspirin/anticoagulant use) should receive oral esomeprazole (Nexium ® ) 20 mg orally once daily (or an equivalent dose of the current preferred Formulary proton pump inhibitor) concomitantly with naproxen to prevent gastrointestinal bleeding.