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Drug Interactions between Celebrex and rivaroxaban

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

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Interactions between your drugs

Major

celecoxib rivaroxaban

Applies to: Celebrex (celecoxib) and rivaroxaban

MONITOR CLOSELY: Oral anticoagulants 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 oral anticoagulants. 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

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

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.

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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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