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| Interactions: | Aspirin
Adverse Effect: Increased risk of GI ulceration and other complications # Clinical Management: Avoid concomitant use if possible.
Fluconazole
Adverse Effect: Significant increase in the plasma concentration of Valdecoxib due to the inhibitory effect of Fluconazole on CYP 3A4 and 2C9, which are responsible for the metabolism of Valdecoxib # Clinical Management: Monitor for the therapeutic effects and adjust the dosage accordingly.
Frusemide
Adverse Effect: Reduction in the natriuretic effect of Frusemide # Clinical Management: Monitor for the therapeutic effects and adjust the dose accordingly.
Ketoconazole
Adverse Effect: Significant increase in the plasma concentration of Valdecoxib due to the inhibitory effect of Ketoconazole on CYP 3A4 and 2C9, which are responsible for the metabolism of Valdecoxib # Clinical Management: Monitor for the therapeutic effects and adjust the dosage accordingly.
Lithium
Adverse Effect: Elevation of plasma Lithium levels and a reduction in renal Lithium clearance # Clinical Management: Monitor for signs of Lithium toxicity when the drugs are administered concomitantly.
Warfarin
Adverse Effect: Significant increase in plasma exposures of R-warfarin andS-warfarin, and in the pharmacodynamic effects of Warfarin # Clinical Management: Anticoagulant therapy should be monitored, particularly during the first few weeks, after initiating therapy with Valdecoxib in patients receiving Warfarin or similar agents |
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