Amiloride
Adverse Effect: Reduced diuretic effectiveness, hyperkalemia, or possible nephrotoxicity Clinical Management: When administering Celecoxib and Amiloride concurrently, monitor the patient for decreased effectiveness of the diuretic and hyperkalemia. Monitor blood pressure, weight changes, urine output, potassium levels, and creatinine levels.
Amlodipine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Ardeparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving Ardeparin and Celecoxib should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to Ardeparin . Celecoxib should be discontinued several days prior to surgery.
Aspirin
Adverse Effect: an increased risk of gastrointestinal bleeding Clinical Management: Patients who receive more than low-dose aspirin therapy should be closely monitored for signs of gastrointestinal bleeding. Alternative therapy may be warranted.
Atenolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Benazepril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Betaxolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Bisoprolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Bumetanide
Adverse Effect: decreased diuretic and antihypertensive efficacy Clinical Management: When administering Bumetanide and Celecoxib concurrently, monitor blood pressure and weight. Also, follow the patient for decreased urine output and increased edema.
Captopril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Captopril Comb.
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Carvedilol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Celiprolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Chlorpropamide
Adverse Effect: a possible increased risk of hypoglycemia Clinical Management: When Celecoxib is coadministered with Chlorpropamide, patients should be monitored more closely for hypoglycemia. Dose of Chlorpropamide may need to be reduced when Celecoxib is added to therapy.
Chlorthalidone
Adverse Effect: Decreased diuretic and antihypertensive efficacy Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently, monitor blood pressure and weight. Also, follow the patient for decreases in urine output and increased edema.
Clopamide
Adverse Effect: Decreased diuretic and antihypertensive efficacy Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently, monitor blood pressure and weight. Also, follow the patient for decreases in urine output and increased edema.
Dalteparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Diltiazem
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Enalapril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Enalapril Comb.
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Enoxaparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Esmolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Felodipine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Fluconazole
Adverse Effect: increased celecoxib plasma concentrations Clinical Management: Caution should be used when prescribing fluconazole for patients on concurrent celecoxib therapy. When initiating celecoxib therapy in a patient already receiving fluconazole, celecoxib should be introduced at the lowest recommended dose. Alternative antifungal therapy may be warranted.
Flunarizine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Frusemide
Adverse Effect: decreased diuretic and antihypertensive efficacy Clinical Management: When administering Frusemide and Celecoxib concurrently, monitor blood pressure and weight. Also, follow the patient for decreased urine output and increased edema.
Glibenclamide
Adverse Effect: A possible increased risk of hypoglycemia Clinical Management: When Celecoxib is coadministered with Glibenclamide , patients should be monitored more closely for hypoglycemia. Dose of Glibenclamide may need to be reduced when Celecoxib is added to therapy.
Gliclazide
Adverse Effect: a possible increased risk of hypoglycemia Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug, patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Glimepiride
Adverse Effect: a possible increased risk of hypoglycemia Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug, patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Glipizide
Adverse Effect: a possible increased risk of hypoglycemia Clinical Management: When Celecoxib is coadministered with Glipizide , patients should be monitored more closely for hypoglycemia. Doses of Glipizide may need to be reduced when Celecoxib is added to therapy.
Indapamide
Adverse Effect: Decreased diuretic and antihypertensive efficacy Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently, monitor blood pressure and weight. Also, follow the patient for decreases in urine output and increased edema.
Ketorolac
Adverse Effect: enhanced gastrointestinal adverse effects (peptic ulcers, gastrointestinal bleeding and/or perforation) Clinical Management: Concomitant use of ketorolac and other nonsteroidal antiinflammatory agents is contraindicated.
Labetalol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lacidipine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Levobunolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lisinopril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Lithium
Adverse Effect: Increased lithium plasma concentrations and an increased risk of lithium toxicity (weakness, tremor, excessive thirst, confusion) Clinical Management: Closely monitor plasma lithium concentrations when celecoxib therapy is initiated or withdrawn.
Methotrexate
Adverse Effect: methotrexate toxicity (leukopenia, thrombocytopenia, anemia, nephrotoxicity, mucosal ulcerations) Clinical Management: In general, do not administer NSAIDS within 10 days of high-dose methotrexate (ie, doses used in cancer therapy).
Metoprolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nadroparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Nifedipine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Nimodipine
Adverse Effect: an increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent Celecoxib and Nimodipine should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Nitrendipine
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Ofloxacin
Adverse Effect: an increased risk of seizures Clinical Management: Ofloxacin should be used cautiously in patients receiving other medications which may lower the seizure threshold, including nonsteroidal antiinflammatory drugs (NSAIDs). Alternative therapy should be considered, especially in patients who are predisposed to seizure activity.
Oxprenolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Perindopril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Pindolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Propranolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ramipril
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Ramipril Comb.
Adverse Effect: Decreased antihypertensive and natriuretic effects Clinical Management: Caution should be used if a nonsteroidal antiinflammatory agent (NSAID) is to be coadministered with an angiotensin converting enzyme (ACE) inhibitor, especially in patients predisposed to or with preexisting nephropathy. Monitor blood pressure and cardiovascular function for a reduction in the efficacy of the ACE inhibitor. Also monitor patient for hyperkalemia or acute renal failure.
Reviparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Sotalol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Spironolactone
Adverse Effect: Reduced diuretic effectiveness, hyperkalemia, or possible nephrotoxicity Clinical Management: When administering Celecoxib and Spironolactone concurrently, monitor the patient for decreased effectiveness of the diuretic and hyperkalemia. Monitor blood pressure, weight changes, urine output, potassium levels, and creatinine levels.
Timolol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Tinzaparin
Adverse Effect: an increased risk of bleeding and an increased risk of hematoma when neuraxial anesthesia is employed Clinical Management: Patients receiving a low molecular weight heparin and a nonsteroidal antiinflammatory agent (NSAID) concurrently should be monitored closely for bleeding, which may be serious. Gastrointestinal bleeding is a particular concern with this combination, as is the development of a spinal or epidural hematoma in patients who receive epidural/spinal anesthesia or spinal puncture prior to low molecular weight heparin therapy. NSAID therapy should be discontinued several days prior to surgery.
Tolbutamide
Adverse Effect: a possible increased risk of hypoglycemia Clinical Management: When nonsteroidal antiinflammatory agents (NSAIDs) are coadministered with a sulfonylurea drug, patients should be monitored more closely for hypoglycemia. Doses of the sulfonylurea may need to be reduced when NSAIDs are added to therapy.
Verapamil
Adverse Effect: An increased risk of gastrointestinal hemorrhage Clinical Management: Patients who are receiving concurrent NSAID and calcium channel blocker therapy should be monitored for signs of gastrointestinal hemorrhage, such as weakness, nausea, and blood in the stool.
Warfarin
Adverse Effect: An increased risk of bleeding Clinical Management: Prothrombin time should be closely monitored, especially in the first few days after initiating or changing celecoxib therapy, in patients also receiving warfarin.
Xipamide
Adverse Effect: Decreased diuretic and antihypertensive efficacy Clinical Management: When administering thiazide diuretics and nonsteroidal antiinflammatory agents (NSAIDs) concurrently, monitor blood pressure and weight. Also, follow the patient for decreases in urine output and increased edema. |