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Celebrex Drug Interactions

by on April 21, 2012

There are quite a number of medications that can potentially interact with Celebrex. Usually, these drugs interfere with the metabolism of Celebrex. More specifically, these drugs inhibit the action of an enzyme called CYP2C9, which is mainly responsible for the metabolism of celecoxib in the liver.

Significant Celebrex Drug Interactions

Caution must be taken when using Celebrex along with the following drugs:

  • Warfarin - Patients taking warfarin together with Celebrex must be monitored for signs of bleeding. Although clinical trials suggest that Celebrex does not interfere with the anticoagulant effect of warfarin, there are reported cases of serious bleeding events in patients, mostly older adults, taking these drugs together. Regular diagnostic tests may be recommended to prevent this unwanted adverse effect.
  • Lithium - Celebrex is thought to increase the concentration of lithium in the blood by 17%. Patients taking Celebrex must be closely monitored for untoward side effects during the initiation or withdrawal of this medication.
  • Aspirin - Although Celebrex does not seem to interact with low-dose aspirin, concomitant use of these drugs increases the risk for stomach or intestinal ulceration as well as other complications.
  • In addition, Celebrex should not be used as a substitute for aspirin for prevention of heart attack or management of heart conditions.
  • ACE-inhibitors and Angiotensin II Antagonists - NSAIDs, including Celebrex, reduce the antihypertensive effect of ACE inhibitors and angiotensin II antagonists. Dose adjustments may be necessary in patients taking these drugs together.  These include  valsartan (Diovan), losartan (Cozaar), Enalapril (Vasotec), Lisinopril.
  • Fluconazole - Fluconazole tends to increase by two times celecoxib plasma concentration as well as its effects. Fluconazole is thought to interfere with the metabolism of celecoxib, particularly in the P450 2C9 pathway. Patients taking fluconazole should be given the lowest possible Celebrex dose.
  • Diuretics - NSAIDs, including Celebrex, can reduce the diuretic effect of furosemide and thiazides in some patient. This effect has been associated to the inhibitory effect of celecoxib in prostanglandin production.
  • Other NSAIDs and NSAID-Containing Medications - Celebrex increases the risk for adverse reactions when taken along with non-aspirin NSAID. It is important to avoid using medications that contain NSAID while taking Celebrex.

There are also several nutritional and herbal supplements that can increase the risk of bleeding. Some of these supplements include feverfew, garlic, gingko biloba, ginseng, St. John’s Wort, and some fish oil supplements.

This information guide does not contain all medications that can potentially interact with Celebrex. Make sure that you inform your healthcare provider of all the drugs (including prescription and over-the-counter medications as well as vitamins, nutritional and herbal supplements) that you normally take. Most importantly, avoid taking any medication without consulting your healthcare provider or pharmacist.

Other Drugs That Can Potentially Interact With Celebrex

Beta blockers, such as:

  • acebutolol (Sectral)
  • atenolol (Tenormin)
  • betaxolol (Kerlone)
  • bisoprolol (Zebeta)
  • carvedilol (Coreg, Coreg CR)
  • emolol (Brevibloc)
  • labetalol (Trandate)
  • metoprolol (Lopressor, Toprol-XL)
  • nadolol (Corgard)
  • nebivolol (Bystolic)
  • penbutolol (Levatol)
  • propranolol (Inderal, Inderal LA, InnoPran XL)
  • sotalol (Betapace)
  • timolol

Corticosteroids, including but not limited to:

  • betamethasone (Celestone)
  • cortisone
  • dexamethasone (Decadron)
  • fludrocortisone (Florinef)
  • hydrocortisone (Cortef)
  • methylprednisolone (Depo-Medrol, Medrol)
  • prednisone
  • triamcinolone (Kenalog, Aristospan)

Anti-depressants/Antipsychotics

  • lithium (Eskalith, Lithobid)
  • Citalopram (Celexa)
  • Duloxetine (Cymbalta)
  • Desvenlafaxine (Pristiq)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac, Sarafem, Selfemra)
  • Fluvoxamine (Luvox, Luvox CR)
  • Milnacipran (Savella)
  • Paroxetine (Paxil, Paxil CR, Pexeva)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor, Effexor XR)

Anti-coagulant drugs or “blood thinners”

  • aspirin (Bayer and others)
  • clopidogrel (Plavix)
  • dabigatran (Pradaxa)
  • eptifibatide (Integrilin)
  • fondaparinux (Arixtra)

Other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as:

  • diclofenac (Cambia, Cataflam, Flector, and others)
  • etodolac (Lodine, Lodine XL)
  • ibuprofen (Motrin, Advil, Nuprin)
  • indomethacin (Indocin, Indocin SR)
  • ketoprofen (Orudis, Actron, Oruvail)
  • ketorolac (Toradol)
  • meloxicam (Mobic)
  • nabumetone (Relafen)
  • naproxen (Naprosyn, Aleve, Anaprox, Naprelan)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)

Anti-inflammatory medications

  • methotrexate (Rheumatrex, Trexall)
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