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Drug Interactions between antithrombin (recombinant) and celecoxib / tramadol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

traMADol celecoxib

Applies to: celecoxib / tramadol and celecoxib / tramadol

MONITOR: Coadministration with celecoxib may increase the plasma concentrations of drugs that are substrates of the CYP450 2D6 isoenzyme. The mechanism is decreased clearance due to inhibition of CYP450 2D6 activity by celecoxib.

MANAGEMENT: Caution is advised if celecoxib must be used concurrently with medications that undergo metabolism by CYP450 2D6, particularly those with a narrow therapeutic range. Dosage adjustments as well as clinical and laboratory monitoring may be appropriate for some drugs whenever celecoxib is added to or withdrawn from therapy.

References (1)
  1. (2001) "Product Information. Celebrex (celecoxib)." Searle
Moderate

celecoxib antithrombin recombinant

Applies to: celecoxib / tramadol and antithrombin (recombinant)

MONITOR: Anticoagulants, antiplatelet agents, and thrombolytics may potentiate the risk of gastrointestinal bleeding complications associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) including COX-2 inhibitors. A retrospective epidemiologic study of patients aged 65 years or older reported a nearly 13-fold increase in the risk of developing hemorrhagic peptic ulcer disease in concurrent users of oral anticoagulants and NSAIDs compared with nonusers of either drug. Fatalities have been reported.

MANAGEMENT: Although COX-2 inhibitors are often preferred over traditional, nonselective NSAIDs in patients who have increased risk for gastrointestinal toxicity, caution is advised during coadministration with anticoagulants or antiplatelet agents. Gastroprotective agents such as proton pump inhibitors or misoprostol may be appropriate in high risk patients.

References (13)
  1. Ku LL, Ward CO, Durgin SJ (1970) "A clinical study of drug interaction and anticoagulant therapy." Drug Intell Clin Pharm, 4, p. 300-6
  2. Koch-Weser J, Sellers EM (1971) "Drug interactions with coumarin anticoagulants (second of two parts)." N Engl J Med, 285, p. 547-58
  3. Loftin JP, Vesell ES (1979) "Interaction between sulindac and warfarin: different results in normal subjects and in an unusual patient with a potassium-losing renal tubular defect." J Clin Pharmacol, 19, p. 733-42
  4. Self TH, Evans WE, Ferguson T (1975) "Drug enhancement of warfarin activity." Lancet, 2, p. 557-8
  5. Kaufman DW, Kelly JP, Sheehan JE, Laszlo A, Wiholm BE, Alfredsson L, Koff RS, Shapiro S (1993) "Nonsteroidal anti-inflammatory drug use in relation to major upper gastrointestinal bleeding." Clin Pharmacol Ther, 53, p. 485-94
  6. Wells PS, Holbrook AM, Crowther NR, Hirsh J (1994) "Interactions of warfarin with drugs and food." Ann Intern Med, 121, p. 676-83
  7. Serlin MJ, Breckenridge AM (1983) "Drug interactions with warfarin." Drugs, 25, p. 610-20
  8. Brouwers JRBJ, Desmet PAGM (1994) "Pharmacokinetic-pharmacodynamic drug interactions with nonsteroidal anti-inflammatory drugs." Clin Pharmacokinet, 27, p. 462-85
  9. Gabb GM (1996) "Fatal outcome of interaction between warfarin and a non-steroidal anti-inflammatory drug." Med J Aust, 164, p. 700-1
  10. Knijff-Dutmer EA, Schut GA, van de Laar MA (2003) "Concomitant coumarin-NSAID therapy and risk for bleeding." Ann Pharmacother, 37, p. 12-6
  11. Shorr RI, Ray WA, Daugherty JR, Griffin MR (1993) "Concurrent use of nonsteroidal anti-inflammatory drugs and oral anticoagulants places elderly persons at high risk for hemorrhagic peptic ulcer disease." Arch Intern Med, 153, p. 1665-70
  12. Penning-van Beest F, Erkens J, Petersen KU, Koelz HR, Herings R (2005) "Main comedications associated with major bleeding during anticoagulant therapy with coumarins." Eur J Clin Pharmacol, 61, p. 439-44
  13. (2023) "Product Information. CeleBREX (celecoxib)." Viatris Specialty LLC

Drug and food interactions

Moderate

traMADol food

Applies to: celecoxib / tramadol

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References (4)
  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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