Drug Interaction Report

MONITOR: Coadministration with inhibitors of CYP450 2C9 may increase the plasma concentrations of celecoxib, which is primarily metabolized by the isoenzyme. The possibility of prolonged and/or increased pharmacologic effects of celecoxib should be considered.

MANAGEMENT: Clinical monitoring for altered effects of celecoxib is recommended following initiation or discontinuation of a CYP450 2C9 inhibitor. Dosage adjustments may be required if an interaction is suspected. Patients should be advised to notify their physician if they experience potential signs and symptoms of celecoxib toxicity such as abdominal pain, black or tarry stools, nausea, vomiting, lethargy, fluid retention, swelling of legs, and worsening heart failure.

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.