Drug interactions between Celebrex and metoprolol
Results for the following 2 drugs: |
|
|---|---|
| Celebrex (celecoxib) | |
| metoprolol | |
Interactions between your selected drugs
metoprolol ⇔ celecoxib
Applies to: metoprolol and Celebrex (celecoxib)
MONITOR: Coadministration with celecoxib may increase the plasma concentrations of metoprolol. The mechanism is celecoxib inhibition of metoprolol metabolism via CYP450 2D6. In 12 healthy male volunteers, pretreatment with celecoxib (200 mg orally twice daily for 7 days) increased the mean peak plasma concentration (Cmax) and area under the concentration-time curve (AUC) of metoprolol (50 mg single dose) by 38% and 64%, respectively, compared to administration of metoprolol alone. One patient had a 204% increase in metoprolol AUC following celecoxib pretreatment. The magnitude of the interaction was significantly greater in subjects with 2 fully functional alleles associated with CYP450 2D6 activity (i.e., homozygous extensive metabolizers (EMs) of CYP450 2D6) than in subjects with only 1 fully functional allele (i.e., heterozygous EMs). The relative increase in metoprolol AUC by celecoxib was 103% and 36%, respectively, while relative decrease in metoprolol oral clearance by celecoxib was 46% and 25%, respectively, in homozygous EMs versus heterozygous EMs. Poor metabolizers of CYP450 2D6 were excluded from the study.
MANAGEMENT: Although metoprolol has a wide therapeutic range, caution is advised during coadministration with celecoxib because hemodynamic effects of metoprolol may be related to plasma concentration. Patients should be monitored for increased pharmacologic effects that may result in bradycardia or hypotension.
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