Locoa Drug Interactions

Contraindications for concomitant administration: Enoxacin hydrate, Lomefloxacin, Norfloxacin, Prulifloxacin: Concomitant use may induce convulsions due to enhancing GABA inhibition by new quinolone antibiotics.
Precautions for concomitant administration: New quinolone antibiotics (Ofloxacin, etc.) [Note that enoxacin hydrate, lomefloxacin, norfloxacin and prulifloxacin are contraindicated for concomitant administration]: Concomitant use may induce convulsions due to enhancing GABA inhibition by new quinolone antibiotics.
Coumarin anticoagulants (Warfarin): Care such as dose adjustment should be taken to avoid possible increase in effect of coumarin anticoagulants (warfarin). Esflurbiprofen may compete with warfarin in plasma protein binding, increasing free warfarin.
Methotrexate: Care such as dose adjustment should be taken to avoid possible poisoning symptoms (e.g., anaemia and thrombocytopenia) due to increase in the effect of methotrexate.
Inhibition of prostaglandin synthesis by esflurbiprofen may reduce renal blood flow, resulting in decreased renal excretion and thus increased blood levels of methotrexate.
Lithium products (Lithium carbonate): Careful measures such as adequate monitoring of lithium blood levels should be taken during the use of lithium products, since concomitant use may increase blood levels of lithium, which may cause lithium poisoning symptoms. Inhibition of prostaglandin synthesis by esflurbiprofen may reduce renal excretion of sodium and lithium clearance, thus increasing lithium blood levels.
Thiazide diuretics (Hydrochlorothiazide, etc.) and loop diuretics (Furosemide, etc.): The effect of these diuretics may decrease. Inhibition of prostaglandin synthesis by esflurbiprofen may produce water and salt retention in the body.
Corticosteroids (Methylprednisolone, etc.): Concomitant use may mutually increase gastrointestinal reactions (peptic ulcer, gastrointestinal bleeding, etc.). Concomitant use may increase gastrointestinal reactions to both drugs.
Pharmacokinetic interaction with CYP2C9 inhibitors (Fluconazole, etc.): Esflurbiprofen is mainly metabolized by hepatic enzyme CYP2C9. Esflurbiprofen blood levels may increase, since metabolism of esflurbiprofen is inhibited by concomitant use of CYP2C9 inhibitors.