Zobrex Drug Interactions

General: Celecoxib metabolism is predominantly mediated via CYP2C9 in the liver. Co-administration of celecoxib with drugs that are known to inhibit CYP2C9 should be done with caution. In vitro studies indicate that celecoxib, although not a substrate, is an inhibitor of CYP2D6. Therefore, there is a potential for an in vivo drug interaction with drugs that are CYP2D6.
ACE inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of angiotensin converting enzyme (ACE) inhibitors. This interaction should be given consideration in patients taking celecoxib concomitantly with ACE inhibitors.
Furosemide: Clinical studies have shown that NSAIDs can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis.
Aspirin: Concomitant administration of aspirin with celecoxib may result in an increased rate of GI ulceration or other complications, compared to use celecoxib alone.
Fluconazole: Concomitant administration of fluconazole at 200 mg four times daily resulted in a 2-fold increase in celecoxib plasma concentration. Celecoxib should be introduced at the lowest recommended dose in patients receiving fluconazole.
Lithium: In a study conducted in healthy subject, mean steady-state lithium plasma levels increased approximately 17% in subjects receiving lithium 450 mg twice a day with celecoxib 200 mg twice a day as compared to subjects receiving lithium alone. Patients on lithium treatment should be closely monitored when celecoxib is introduced or withdrawn.
Warfarin: Celecoxib did not alter the anticoagulant effect of warfarin as determined by prothrombin time. However, caution should be used when administering celecoxib with warfarin since these patients are at increased risk of bleeding complications.