Drug Interaction Report
1 potential interaction and/or warning found for the following 2 drugs:
- carvedilol
- Vioxx (rofecoxib)
Interactions between your drugs
carvedilol rofecoxib
Applies to: carvedilol, Vioxx (rofecoxib)
MONITOR: Nonsteroidal anti-inflammatory drugs (NSAIDs) may attenuate the antihypertensive effect of beta-blockers. The proposed mechanism is NSAID-induced inhibition of renal prostaglandin synthesis, which results in unopposed pressor activity producing hypertension. In addition, NSAIDs can cause fluid retention, which also affects blood pressure. Indomethacin and piroxicam have been reported to have greater attenuating effects than other NSAIDs, and indomethacin effects may be significant in patients with eclampsia.
MANAGEMENT: Patients receiving a beta-blocker who require prolonged (greater than 1 week) concomitant therapy with an NSAID should have blood pressure monitored more closely following initiation, discontinuation, or change of dosage of the NSAID. The interaction is not expected to occur with low doses (e.g., low-dose aspirin) or intermittent short-term administration of NSAIDs.
References (9)
- Salvetti A, Pedrinelli R, Alberici P, Magagna A, Abdel-Haq B (1984) "The influence of indomethacin and sulindac on some pharmacological actions of atenolol in hypertensive patients." Br J Clin Pharmacol, 17 Suppl 1, s108-11
- Ylitalo P, Pitkajarvi T, Pyykonen ML, Nurmi AK, Seppala E, Vapaatalo H (1985) "Inhibition of prostaglandin synthesis by indomethacin interacts with the antihypertensive effect of atenolol." Clin Pharmacol Ther, 38, p. 443-9
- Radack KL, Deck CC, Bloomfield SS (1987) "Ibuprofen interferes with the efficacy of antihypertensive drugs." Ann Intern Med, 107, p. 628-35
- Wong DG, Spence JD, Lamki L, Freeman D, McDonald JW (1986) "Effect of non-steroidal anti-inflammatory drugs on control of hypertension by beta-blockers and diuretics." Lancet, 1, p. 997-1001
- Durao V, Prata MM, Goncalves LM (1977) "Modification of antihypertensive effect of beta-adrenoceptor-blocking agents by inhibition of endogenous prostaglandin synthesis." Lancet, 2, p. 1005-7
- Abate MA, Neely JL, Layne RD, D'Allessandri R (1991) "Interaction of indomethacin and sulindac with labetalol." Br J Clin Pharmacol, 31, p. 363-6
- Salvetti A, Arzilli F, Pedrinelli R, Beggi P, Motolese M (1982) "Interaction between oxprenolol and indomethacin on blood pressure in essential hypertensive patients." Eur J Clin Pharmacol, 22, p. 197-201
- Durao V, Prata MM, Concalves LM (1977) "Modification of antihypertensive effect of B-adrenoceptor-blocking agents by inhibition of endogenous prostaglandin synthesis." Lancet, 2, p. 1005-7
- Hartmann D, Stief G, Lingenfelder M, Guzelhan C, Horsch AK (1995) "Study on the possible interaction between tenoxicam and atenolol in hypertensive patients." Arzneimittelforschung, 45-1, p. 494-8
Drug and food interactions
No alcohol/food interactions were found with the drugs in your list. However, this does not necessarily mean no food interactions exist. Always consult your healthcare provider.
Therapeutic duplication warnings
No duplication 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.
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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. |
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