Contains celecoxib and tramadolStrong evidence

Is Celecoxib and Tramadol (Seglentis) affected by genetics?

Yes. All 2 active ingredients have pharmacogenetic evidence.

Genes CYP2C9 CYP2D6

Celecoxib and tramadol is affected by pharmacogenetics through the CYP2C9 and CYP2D6 genes. Your genotype for these genes can change how well Celecoxib and tramadol works for you or how well you tolerate it. The strongest evidence level on this page is Strong, from the published guidelines shown below.

Also sold as Seglentis.

Pharmacogenetic guidelines are written for one ingredient at a time, so the guidance below is for each ingredient on its own. What your genes mean for a combination product is less clear, because the dose and the other ingredients can change things. If you take Celecoxib and tramadol, it's worth talking over with your prescriber or pharmacist. How we handle combination products.

What's in Celecoxib and tramadol

Celecoxib Affected by CYP2C9

Affected by CYP2C9. Guidance from CPIC, FDA, strong evidence.

Read the full celecoxib genetics guide

Tramadol Affected by CYP2D6

Affected by CYP2D6. Guidance from CPIC, FDA, strong evidence.

Read the full tramadol genetics guide

Celecoxib phenotype recommendations

Published guidance from CPIC and FDA on how celecoxib should be dosed or substituted based on your CYP2C9 phenotype.

Phenotype	What it means	Recommendation	Evidence
Normal MetabolizerCYP2C9	Your body processes this drug normally, so the usual starting dose applies.	CPIC Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. FDA Initiate therapy with recommended starting dose.	Strong
Intermediate MetabolizerCYP2C9	Your body slows the drug down slightly, but usually the normal starting dose is fine.	CPIC Initiate therapy with recommended starting dose. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. CPIC Initiate therapy with lowest recommended starting dose. Titrate dose upward to clinical effect or maximum recommended dose with caution. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Carefully monitor adverse events, such as blood pressure and kidney function, during course of therapy. FDA Initiate therapy with recommended starting dose.	Moderate
Poor MetabolizerCYP2C9	Your body clears this drug very slowly, so it can build up. A much lower starting dose, or a different drug, is suggested.	CPIC + CPIC Initiate therapy with 25 to 50% of the lowest recommended starting dose. Titrate dose upward to clinical effect or 25 to 50% of the maximum recommended dose with caution. In accordance with the prescribing information, use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Upward dose titration should not occur until after steady-state is reached (at least 8 days for celecoxib and 5 days for ibuprofen, flurbiprofen, and lornoxicam after first dose in PMs). Carefully monitor adverse events such as blood pressure and kidney function during course of therapy. Alternatively, consider an alternate therapy not metabolized by CYP2C9 or not significantly impacted by CYP2C9 genetic variants in vivo. FDA Reduce the starting dose to half of the lowest recommended dose. Consider alternative therapy in poor metabolizers with juvenile rheumatoid arthritis.	Strong
IndeterminateCYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2C9	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated

Sources: CPIC, FDA

Tramadol phenotype recommendations

Published guidance from CPIC and FDA on how tramadol should be dosed or substituted based on your CYP2D6 phenotype.

Phenotype	What it means	Recommendation	Evidence
Ultrarapid MetabolizerCYP2D6	Your body turns this drug into its active form too fast, which raises the risk of serious side effects. A different pain medicine is advised.	CPIC Avoid tramadol use because of potential for toxicity. If opioid use is warranted, consider a non-codeine opioid. FDA Avoid use. Use an alternative analgesic that is not metabolized by CYP2D6. Contraindicated in children under 12 and adolescents following tonsillectomy/adenoidectomy. Breastfeeding is not recommended.	Strong
Normal MetabolizerCYP2D6	Your body processes this drug normally, so the usual dose should work.	CPIC Use tramadol label recommended age- or weight-specific dosing. FDA Initiate therapy with recommended starting dose.	Strong
Intermediate MetabolizerCYP2D6	Your body processes tramadol somewhat slowly, but you can usually use standard doses. If it doesn't work well, you might need a different pain medication.	CPIC Use tramadol label recommended age- or weight-specific dosing. If no response and opioid use is warranted, consider non-codeine opioid. FDA Initiate therapy with recommended starting dose.	Optional
Poor MetabolizerCYP2D6	Your body can't turn this drug into its active form well, so it may not relieve your pain. A different pain medicine is advised.	CPIC Avoid tramadol use because of possibility of diminished analgesia. If opioid use is warranted, consider a non-codeine opioid. FDA The FDA notes reduced efficacy but gives no dosing change. Monitor for adequate pain relief.	Strong
IndeterminateCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated
Not availableCYP2D6	The impact of your genotype on response to this drug is unknown.	CPIC + FDA Initiate therapy with recommended starting dose.	Not rated

Sources: CPIC, FDA

The genes behind the guidance

CYP2C9 Cytochrome P450 2C9

CYP2C9 metabolizes warfarin, phenytoin, celecoxib, and some NSAIDs. Variants that reduce its activity are most consequential for warfarin, where even small changes in drug clearance translate into very different doses (and a real bleeding risk if missed).

Poor metabolizers need substantially lower warfarin doses to hit the same INR target.

See all drugs affected by CYP2C9

CYP2D6 Cytochrome P450 2D6

CYP2D6 is the most clinically important pharmacogene. It metabolizes around a quarter of all prescription drugs, including many antidepressants, opioids, and stimulants. The gene is unusually variable: roughly 7 percent of people are poor metabolizers (they barely activate CYP2D6), and another 1 to 3 percent are ultrarapid metabolizers (their enzyme is overactive).

The v4 report preserves the activity score used in its interpretation. Some medicines use a combined CYP2D6/CYP2C19 recommendation. CYP2D6 inhibitors can change functional metabolism; a genotype alone does not capture that effect.

See all drugs affected by CYP2D6

Browse the full drug class: Pain medications.

Related medications

Find out how your genetics affect Celecoxib and tramadol

This page describes the general pharmacogenetics. A Gene2Rx report analyzes your own DNA to tell you which metabolizer group you fall into, across every medication.

Get my report Look up another medication

Informational only, not medical advice. Pharmacogenetic guidance describes population-level patterns; your individual response depends on many factors. Never start, stop, or change a medication without talking to your prescribing clinician.