Can you take celebrex whilst on warfarin medication?

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22 Sep 2010

Applies to: warfarin, Celebrex (celecoxib)

MONITOR: Coadministration with celecoxib may infrequently enhance the hypoprothrombinemic effect of warfarin. The proposed mechanism is competitive inhibition of the CYP450 2C9 metabolism of warfarin by celecoxib, as both drugs are substrates of this isoenzyme. A study involving 24 healthy volunteers found no effect of celecoxib (200 mg twice daily) on the prothrombin time or steady-state pharmacokinetics of warfarin. However, there have been isolated post-marketing case reports of elderly patients stabilized on warfarin who developed INR increases and/or bleeding complications following the addition of celecoxib. It is possible that patients with variant alleles resulting in reduced CYP450 2C9 metabolism (i.e., CYP450 2C9 poor metabolizers) may be at increased risk for this interaction, since they have reduced clearance of both celecoxib and warfarin.

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