Biocoxib Drug Interactions

Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin II Antagonists (AIIAs): NSAIDs may decrease the antihypertensive of ACEI and/or AIIAs. The co-administration medication may be the risk of nephrotoxicity increased. Consider discontinuation of BIOCOXIB (90 mg) if patient is uncontrolled blood pressure. Periodically measure renal function during concomitant use.
Azole antifungals (Fluconazole, Ketoconazole): Increase in BIOCOXIB (90 mg) plasma concentration may occur, increasing the pharmacologic effect and adverse reactions.
Corticosteroid oral (Prednisone): The risk of GI bleeding may be increased. Use corticosteroid oral and BIOCOXIB (90 mg) with caution.
Antiplatelet therapy (Clopidogrel, Prasugrel): The risk of bleeding may be increased. Use antiplatelet and BIOCOXIB (90 mg) with caution.
Anticoagulant (Warfarin): Coadministration with BIOCOXIB (90 mg) may increase the risk of anticoagulant-induced bleeding (eg. GI bleeding). Monitor prothrombin time and International Normalized Ratio (INR) and patients closely, especially the first few days.
Beta-blockers: The antihypertensive effect of beta-blockers with BIOCOXIB (90 mg) may be impaired, possibly because of BIOCOXIB (90 mg) as the NSAIDs inhibition of renal prostaglandin synthesis, thereby allowing unopposed pressure systems. Monitor blood pressure and adjust beta-blocker dose as needed to treat.
Cyclosporin and tacrolimus: Coadministration with BIOCOXIB (90 mg) may increase nephrotoxicity. Monitor renal function frequently and consider avoiding concurrent use.
Diuretics (Thiazides, Potassium-sparing diuretics, Loop diuretics): The effects of diuretics may be decreased, the risk of acute renal failure may be increased when co-administered. Closely monitor renal function if coadministration cannot be avoided. If renal function decreases, consider stopping one or both drugs.
Lithium: Concomitant administration with BIOCOXIB (90 mg) may increase plasma lithium levels. This interaction should be given consideration in patients taking BIOCOXIB (90 mg) concomitantly with lithium.
Methotrexate: Concomitant administration with BIOCOXIB (90 mg) may increase risk of methotrexate toxicity (eg. stomatitis, bone marrow suppression, nephrotoxicity). This interaction should be given low-dose methotrexate in patients taking BIOCOXIB (90 mg) concomitantly.