Drug Interactions between celecoxib / tramadol and Xylon 10
This report displays the potential drug interactions for the following 2 drugs:
- celecoxib/tramadol
- Xylon 10 (hydrocodone/ibuprofen)
Interactions between your drugs
ibuprofen celecoxib
Applies to: Xylon 10 (hydrocodone / ibuprofen) and celecoxib / tramadol
GENERALLY AVOID: Concomitant use of COX-2 inhibitors with other nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the potential for serious gastrointestinal toxicity including inflammation, bleeding, ulceration, and perforation. The risk is dependent on both dosage and duration of therapy.
MANAGEMENT: Concomitant use of COX-2 inhibitors with non-aspirin NSAIDs should generally be avoided. Some authorities consider this combination to be contraindicated due to the absence of any evidence demonstrating synergistic benefits and the potential for additive adverse reactions (AU,UK).
References (4)
- (2001) "Product Information. Celebrex (celecoxib)." Searle
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- Cerner Multum, Inc. "Australian Product Information."
- Cerner Multum, Inc (2015) "ANVISA Bulário Eletrônico."
HYDROcodone traMADol
Applies to: Xylon 10 (hydrocodone / ibuprofen) and celecoxib / tramadol
GENERALLY AVOID: Concomitant use of tramadol with other central nervous system (CNS) depressants including other opioids may result in profound sedation, respiratory depression, coma, and death. The risk of hypotension and seizures may also be increased. In patients who have been previously dependent on or chronically using opioids, tramadol can reinitiate physical dependence or precipitate withdrawal symptoms.
MANAGEMENT: Concomitant use of tramadol with other opioids should generally be avoided. If coadministration is necessary, the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect. Patients should be monitored closely for development of seizures, respiratory depression and sedation, and advised to avoid driving or operating hazardous machinery until they know how these medications affect them. Cough medications containing opioids (e.g., codeine, hydrocodone) should not be prescribed to patients on tramadol. In addition, tramadol should not be used in opioid-dependent patients, and use in patients who are chronically on opioids is also not recommended. Tramadol is contraindicated in patients with acute opioid intoxication.
References (1)
- (2001) "Product Information. Ultram (tramadol)." McNeil Pharmaceutical
HYDROcodone celecoxib
Applies to: Xylon 10 (hydrocodone / ibuprofen) 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)
- (2001) "Product Information. Celebrex (celecoxib)." Searle
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)
- (2001) "Product Information. Celebrex (celecoxib)." Searle
Drug and food interactions
HYDROcodone food
Applies to: Xylon 10 (hydrocodone / ibuprofen)
GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including hydrocodone. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.
GENERALLY AVOID: Consumption of alcohol while taking some sustained-release formulations of hydrocodone may cause rapid release of the drug, resulting in high systemic levels of hydrocodone that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. In study subjects, the rate of absorption of hydrocodone from an extended-release formulation was found to be affected by coadministration with 40% alcohol in the fasted state, as demonstrated by an average 2.4-fold (up to 3.9-fold in one subject) increase in hydrocodone peak plasma concentration and a decrease in the time to peak concentration. Alcohol also increased the extent of absorption by an average of 1.2-fold (up to 1.7-fold in one subject).
GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of hydrocodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of hydrocodone by certain compounds present in grapefruit. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.
MANAGEMENT: Patients taking sustained-release formulations of hydrocodone should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as hydrocodone should not be combined with alcohol. Patients should also avoid consumption of grapefruit or grapefruit juice during treatment with hydrocodone.
References (1)
- (2013) "Product Information. Zohydro ER (hydrocodone)." Zogenix, Inc
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)
- Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
- 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.
- (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
- (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
ibuprofen food
Applies to: Xylon 10 (hydrocodone / ibuprofen)
GENERALLY AVOID: The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
MANAGEMENT: Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
References (1)
- (2002) "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn
Therapeutic duplication warnings
Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.
Nonsteroidal anti-inflammatories
Therapeutic duplication
The recommended maximum number of medicines in the 'nonsteroidal anti-inflammatories' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'nonsteroidal anti-inflammatories' category:
- celecoxib/tramadol
- Xylon 10 (hydrocodone/ibuprofen)
Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.
See also
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| 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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