Celebrex (celecoxib)

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

Celecoxib may be taken with low-dose (75mg daily) aspirin. However, the combination may carry an increased risk of ulceration or bleeding in the stomach or intestines compared to taking celecoxib on its own. Celecoxib should not be taken with higher daily doses of aspirin. For more information and advice ask your doctor or pharmacist.

This medicine should not be taken with other non-steroidal anti-inflammatory drugs (NSAIDs), eg ibuprofen, diclofenac, as using more than one NSAID together may also increase the risk of side effects on the gut.

There may be an increased risk of bleeding if celecoxib is taken by people taking anti-blood-clotting medicines (anticoagulants) such as warfarin. If you are taking an anticoagulant you should have your blood clotting time (INR) monitored while taking celecoxib, particularly in the first few days after starting treatment or if your dose is changed.

This medicine may oppose the effect of diuretics and medicines for high blood pressure (antihypertensives).

There may be an increased risk of side effects on the kidney if celecoxib is taken with any of the following medicines. Your kidney function should be monitored if you are taking any of these medicines in combination with celecoxib, particularly if you are elderly:

- ACE inhibitors, eg enalapril
- angiotensin II antagonists, eg losartan
- ciclosporin
- diuretics, eg bendroflumethiazide, furosemide
- tacrolimus.

Celecoxib may increase the blood level of lithium. Your lithium blood level should be monitored if you are starting, changing dose, or stopping celecoxib while taking lithium.

Other NSAIDs can reduce the removal of the medicine methotrexate from the body. This has not been reported with celecoxib, but people taking methotrexate should be well monitored for any side effects of methotrexate while taking celecoxib.

There is a possibility that celecoxib may increase the blood levels of the following medicines:

- dextromethorphan
- antidepressants (tricyclics, eg amitriptyline and SSRIs, eg fluoxetine)
- antipsychotic medicines (eg haloperidol)
- anti-arrhythmic medicines (eg flecainide).

The antifungal medicine fluconazole may increase the blood level of celecoxib. Your dose of celecoxib should be halved if you also take fluconazole. Ask your pharmacist for further advice.

There is a possibility that the following medicines may reduce the blood level of celecoxib:

- rifampicin
- carbamazepine
- barbiturates.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain celecoxib as the active ingredient.

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