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The metabolism of etoricoxib is mediated by the cytochrome P450 isoenzyme CYP3A4. Use with other drugs that inhibit or induce this isoenzyme may result in changes in plasma concentration of etoricoxib. In addition, in vitro studies suggest that several other isoenzymes may also mediate the main metabolic pathway of etoricoxib. Rifampicin, a potent inducer of CYP isoenzymes, has produced decreased plasma concentrations of etoricoxib.
Etoricoxib is an inhibitor of human sulfotransferase activity and has been shown to increase the plasma concentration of ethinyl estradiol. Interactions with other drugs, such as oral salbutamol and minoxidil, also metabolized by this enzyme may be a possibility and licensed product information advises care with such combinations.
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