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celecoxib + tramadol HCl (MR308 / Velyntra / Seglentis)

✓ Approved

Kowa · OPRM1 · Small Molecule

What is celecoxib + tramadol HCl?

celecoxib + tramadol HCl is a small molecule developed by Kowa. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesMR308, Velyntra, Seglentis
CompanyKowa
Drug ClassSmall Molecule
Molecular TargetOPRM1, PTGS2, SLC6A2, SLC6A4
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Kowa

Mechanism of Action

Molecular Targets

celecoxib + tramadol HCl acts on 4 molecular targets:

OPRM1opioid receptor mu 1 (MOP, M-OR-1)
PTGS2prostaglandin-endoperoxide synthase 2 (PHS-2, PGG/HS)
SLC6A2solute carrier family 6 member 2 (NAT1, NET)
SLC6A4solute carrier family 6 member 4 (SERT1, 5-HTTLPR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

celecoxib + tramadol HCl is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Gastrointestinal disordersAbdominal pain✓ Approved
Injury, poisoning and procedural complicationsProcedural painPhase III

Related Research Articles

PubMedIn vitro models2026-09-20

Anti-biofilm and anti-virulence properties of Ricinus communis and Catharanthus roseus leaves against Pseudomonas aeruginosa PAO1.

Gebaly Eman El EE, Taha Mostafa N MN, Ashour Hossam M HM, Khairalla Ahmed S AS

Pseudomonas aeruginosa remains a major concern in clinical microbiology owing to its intrinsic multidrug resistance and its elaborate regulatory networks that enable evasion of host immune responses, particularly through robust biofilm development and the secretion of diverse virulence factors. These pathogenic behaviors are tightly governed by quorum-sensing (QS) systems, prompting increasing interest in exploiting plant-derived compounds as potential anti-virulence therapeutics. In this study, leaf extracts from Ricinus communis and Catharanthus roseus were examined for their capacity to modulate biofilm formation and QS-regulated virulence gene expression in the P. aeruginosa PAO1 strain. The production of key virulence factors was evaluated using multiple standardized assays, including the crystal violet binding assay (biofilm), azocasein assay (protease), chloroform-HCl extraction (pyocyanin), and the orcinol assay (rhamnolipids), while gene expression was quantified via quantitative real-time polymerase chain reaction (qPCR). The findings indicated that the extracts, rich in tannins and flavonoids, did not affect the planktonic growth of PAO1; however, both significantly (P < 0.05) suppressed biofilm formation and attenuated the production of pyocyanin, protease, and rhamnolipids. Additionally, qPCR analysis revealed pronounced downregulation of central QS regulatory genes, lasI, lasR, and rhlR, highlighting the potential of these phytochemicals to disrupt quorum-sensing-mediated pathogenicity.

PMID 42763502
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PubMedMedicine2026-09-19

Efficacy of celecoxib and methotrexate-vinblastine regimen in desmoid-type fibromatosis: A retrospective cohort study.

Kawano Masanori M, Kubota Yuta Y, Itonaga Ichiro I, Kaku Nobuhiro N et al.

Desmoid tumors are classified as borderline malignancies and are characterized by a high rate of local recurrence despite the absence of distant metastasis. Low-dose methotrexate combined with vinblastine, known as the methotrexate and vinblastine (MV) regimen, has been reported as an effective treatment for desmoid-type fibromatosis (DF). At our institution, we adopt a treatment strategy beginning with celecoxib as the first-line therapy, escalating to the MV regimen only in cases showing disease progression. This study evaluates treatment outcomes based on this protocol. At our institution, 10 patients diagnosed with DF between 2003 and 2025 received surgical resection and/or pharmacotherapy. The standard approach involved initiating treatment with oral celecoxib; if no clinical improvement was observed, therapy was escalated to the MV regimen. Treatment response was assessed using Response Evaluation Criteria in Solid Tumors 1.1 criteria. Of the 10 cases, 1 achieved complete response, 5 showed partial response, 2 maintained stable disease, and 2 exhibited progressive disease, yielding a response rate of 60%. Among patients treated with the MV regimen, extended dosing intervals did not lead to tumor progression, and sustained suppression was observed in several cases. No grade 3 or 4 adverse events were reported. Celecoxib and the MV regimen appear to be effective and well-tolerated options for DF. Given its low toxicity and favorable tolerability, celecoxib should be considered the first-line treatment, especially since tumor control was achieved in half of the cases. Although tumor progression occurred in the remaining cases, disease control was subsequently achieved by introducing the MV regimen. These findings support recent trends favoring nonsurgical management and suggest that the celecoxib followed by the MV regimen strategy should be considered a primary therapeutic approach.

PMID 42760667
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PubMedBMC anesthesiology2026-09-19

Postoperative analgesic outcomes of fascia iliaca compartment block versus pericapsular nerve group block in hip fracture surgery: a retrospective observational study.

Karataş Sevim Şenol SŞ, Öner Sait Fatih SF

Hip fracture surgery is associated with substantial postoperative pain, delayed mobilization, and increased opioid requirements, particularly in older adults. Ultrasound-guided regional nerve blocks are increasingly used as components of multimodal analgesia. This study compared postoperative analgesic outcomes between fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) block in patients undergoing hemiarthroplasty for hip fracture. This retrospective single-center cohort study included all 186 eligible adult patients who underwent hemiarthroplasty for hip fracture under spinal anesthesia between October 2022 and October 2024. Patients received either ultrasound-guided FICB (n = 90) or PENG block (n = 96) before surgery. The primary outcome was postoperative visual analogue scale (VAS) score at 6 h. Secondary outcomes included VAS score at 24 h, cumulative tramadol consumption during the first postoperative 24 h, quality of recovery assessed using the QoR-15, hospital length of stay, and intraoperative hemodynamic parameters. Separate multivariable linear regression models were used to adjust for age, sex, and ASA physical status. Baseline characteristics were comparable between groups. Patients receiving PENG block had significantly lower postoperative VAS scores at 6 h (3.42 ± 0.90 vs. 5.04 ± 1.24; mean difference - 1.63, 95% CI - 1.94 to - 1.32; p < 0.001) and at 24 h (5.29 ± 0.86 vs. 6.40 ± 0.91; mean difference - 1.11, 95% CI - 1.36 to - 0.85; p < 0.001). Cumulative 24-hour tramadol consumption was significantly lower in the PENG group (243.98 ± 54.27 mg vs. 347.89 ± 65.87 mg; mean difference - 103.91 mg, 95% CI - 121.32 to - 86.49; p < 0.001). QoR-15 scores were significantly higher following PENG block (91 [88-93] vs. 83 [80-85]; p < 0.001). After adjustment for age, sex, and ASA physical status, PENG block remained independently associated with lower VAS scores at 6 and 24 h and lower 24-hour tramadol consumption. Compared with FICB, PENG block was associated with lower postoperative opioid requirements, lower early postoperative pain scores, and improved patient-reported quality of recovery following hemiarthroplasty for hip fracture. The reduction in postoperative tramadol consumption appears to represent the most clinically relevant finding. Prospective randomized multicenter studies are warranted to confirm these observations.

PMID 42760509
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PubMedFood science of animal resources2026-09-19

Comparative evaluation of the gastroprotective effects of lactic acid bacteria strains against ethanol/HCl-induced gastric injury.

Kim Kiyeop K, Pyeon Minsu M, Shin Saeyoun S, Lee Jiwon J et al.

This study aimed to evaluate the comparative protective effects of lactic acid bacteria (LAB) strains against ethanol/HCl-induced gastric injury in rats and to identify strains with gastroprotective potential. Rats were orally administered three LAB strains for 14 days prior to the induction of gastric injury using 0.15 M HCl in 60% ethanol. Gastric tissues were collected for histopathological and molecular analyses. Pretreatment with the LAB strains significantly reduced the extent of mucosal damage compared with the EtOH/HCl-treated group. At the transcriptional level, ethanol/HCl exposure markedly decreased the expression of the mucus-associated gene Muc5ac and the anti-inflammatory gene Il10, while increasing the expression of pro-inflammatory genes including Tnf, Il6, and Ptgs2. In contrast, LAB administration restored Muc5ac and Il10 expression and suppressed the expression of pro-inflammatory genes. These findings were consistent with histological observations showing comparatively preserved gastric tissue architecture and less prominent inflammatory cell infiltration in LAB-treated groups. Notably, differences in protective efficacy were observed among the LAB strains, indicating strain-specific functional properties. These findings suggest that selected LAB strains are promising probiotic candidates for maintaining gastric health by preserving gastric mucosal integrity and regulating inflammatory responses.

PMID 42762417
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PubMedAllergologia et immunopathologia2026-09-19

Systematic allergological evaluation enables NSAID allergy delabeling and identification of safe alternatives in adults.

Guzmán Avilán Rosa I RI, Avilés Vargas Silvia Rosario SR, González Díaz Sandra N SN, Ortega Natalhie Acuña NA et al.

Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are a frequent reason for allergy referral and a major diagnostic challenge. In everyday practice, overdiagnosis contributes to unnecessary drug avoidance, restricting therapeutic access to first-line analgesic and anti-inflammatory treatments and impacting clinical care. To determine the true prevalence of confirmed NSAID hypersensitivity in adults with suspected reactions through systematic allergological evaluation and assess its clinical impact on therapeutic access through safe delabeling and identification of alternative agents. We conducted a prospective, cross-sectional study including adults ≥18 years with suspected NSAID hypersensitivity evaluated at a tertiary referral center in Mexico between March and November 2025. All patients underwent standardized assessment including detailed clinical history, skin testing (prick and intradermal), and controlled drug provocation tests (DPTs) with acetylsalicylic acid, the implicated NSAID, and celecoxib. Clinical phenotypes were classified according to EAACI/ENDA guidelines. Associations between clinical variables and confirmed hypersensitivity were analyzed. Thirty-three patients were included; 72.7% were women, and 42.4% were aged 18-30 years. Atopy was present in 63.6%. Urticaria/angioedema predominated (69.7%). Ibuprofen and diclofenac were most frequently implicated (45.5%). Skin testing showed low diagnostic yield (6.1% prick; 21.2% intradermal). DPT was positive in 24.2%, mainly inducing urticaria. Celecoxib was tolerated in all patients with multiple hypersensitivity. Overall, 48.5% had no confirmed hypersensitivity and were successfully delabeled, restoring access to NSAID therapy. Multiple hypersensitivity occurred in 39.4% and selective reactions in 12.1%, with NIUAA as the predominant phenotype (33.4%). Atopy (p = 0.002) and recurrent episodes (p < 0.001) were associated with multiple hypersensitivity. Nearly half of adults labeled as NSAID-allergic were not truly hypersensitive. These prospective Mexican data demonstrate the clinical impact of systematic evaluation in reducing overdiagnosis and improving therapeutic access.

PMID 42760878
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PubMedAesthetic plastic surgery2026-09-19

Postoperative Analgesic Efficacy of a Novel Surgical Modified Serratus Anterior Plane Block in Reduction Mammaplasty: A Prospective Randomized Controlled Trial.

Sonmez Ayhan A, Kokten Alperen Can AC, Kayikci Ebru E, Bulbuloglu Ismail I et al.

Postoperative analgesia after reduction mammaplasty remains challenging, particularly given the extent and distribution of surgical dissection. While ultrasound-guided interfascial plane blocks are commonly used, their timing and reliability may be influenced by surgical duration and tissue manipulation. We investigated whether a surgically administered serratus anterior plane block, applied under direct visualization immediately before wound closure, could enhance postoperative analgesia. In this prospective randomized controlled trial, patients undergoing reduction mammaplasty were assigned to receive either a bilateral surgical serratus anterior plane block in addition to standardized multimodal analgesia or standard analgesia alone. The block was performed intraoperatively by the surgeon without ultrasound guidance. The primary endpoint was cumulative tramadol consumption within the first 24 postoperative hours. Secondary outcomes included postoperative pain intensity, time to first analgesic request, and opioid-related adverse effects. Fifty-six patients completed the study. Patients receiving the surgical serratus anterior plane block demonstrated lower pain scores in the early postoperative period, while pain intensity became comparable between groups later during follow-up. Despite this convergence, opioid consumption remained consistently lower in the block group throughout the first 24 hours, with a 43% reduction in cumulative tramadol use at 24 hours. In addition, the time to first postoperative analgesic demand was significantly prolonged in the block group. No block-related complications were observed. A surgically performed serratus anterior plane block applied immediately before wound closure was associated with a sustained opioid-sparing effect after reduction mammaplasty. This intraoperative approach may offer a practical alternative to ultrasound-guided techniques; however, further studies are required to refine the technique and define its role within enhanced recovery pathways. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID 42760357
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