Favocox Drug Interactions

General: Celecoxib metabolism is predominantly mediated via cytochrome P-450 2C9 in the liver. Co-administration of celecoxib with drugs that are known to inhibit 2C9 should be done with caution. In vitro studies indicate that celecoxib, although not a substrate, is an inhibitor of cytochrome P-450 2D6. Therefore, there is a potential for an in vivo drug interaction with drugs that are metabolized by P-450 2D6.
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, as well as post-marketing observations, 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: Celecoxib can be used with low dose aspirin. However, concomitant administration of aspirin with Celecoxib may result in an increased rate of Gl ulceration or other complications, compared to use Celecoxib alone (see Pharmacology under Actions). Because of its lack of platelet effects, Celecoxib is not a substitute for aspirin for cardiovascular prophylaxis.
Fluconazole: Concomitant administration of fluconazole at 200 mg once daily resulted in a 2-fold increase in celecoxib plasma concentration. This increase is due to the inhibition of celecoxib metabolism via P-450 2C9 by fluconazole. Celecoxib should be introduced at the lowest recommended dose in patients receiving fluconazole.
Lithium: In a study conducted in healthy subjects, 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 Patients on lithium treatment should be closely monitored when Celecoxib is introduced or withdrawn.
Methotrexate: In an interaction study of rheumatoid arthritis patients taking methotrexate, Celecoxib did not have a significant effect on the pharmacokinetics of methotrexate.
Warfarin: The effect of celecoxib on the anticoagulant effect of warfarin was studied in a group of healthy subjects receiving daily doses of 2-4 mg of warfarin. In these subjects, 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.