Hofxib 90 Drug Interactions

Anticoagulant (Warfarin): Co-administration with etoricoxib may increase the risk of anticoagulant-induced bleeding (eg, GI bleeding). Monitor Prothrombin Time (PTT) and International Normalized Ratio (INR) and patients closely, especially the first few days and instruct patients to watch for signs and symptoms of bleeding.
Rifampin: Rifampin is a potent inducer of CYP isoenzymes. Co-administration with etoricoxib has produced decreased plasma concentration of etoricoxib.
Methotrexate: Concomitant administration with etoricoxib may increase risk of methotrexate toxicity (eg, stomatitis, bone marrow suppression, nephrotoxicity).
Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin II Antagonists (AIIAs): Nonsteroidal anti-inflammatory drugs (NSAIDS) may decrease the antihypertensive effects of ACEI and/or AIIAs.
Co-administration may increase the risk of nephrotoxicity. Consider discontinuation of etoricoxib if blood pressure is uncontrolled. Periodically measure renal function during concomitant use.
Diuretics (Thiazides, Potassium-sparing diuretics, Loop diuretics): Co-administration may decrease effects of diuretic and increase the risk of acute renal failure. Closely monitor renal function. If renal function decreases, consider stopping one or both drugs.
Lithium: Concomitant use with etoricoxib may increase serum lithium levels. Monitor for signs of lithium toxicity in patient closely.
Aspirin: The potential for GI side effects, including bleeding may be increased with regular use of full-dose. Etoricoxib can be used concomitantly with low-dose aspirin at doses of cardiovascular prophylaxis.
Cyclosporin and Tacrolimus: Co-administration with etoricoxib may increase nephrotoxicity. Renal function should be monitored when etoricoxib and either of these drugs are used in combination.
Oral contraceptive: Etoricoxib is an inhibitor of human sulfotransferase activity and has been shown to increase the plasma concentration of ethinylestradiol and exposure increase incidence of adverse events associated with oral contraceptive.
Prednisone: The risk of GI bleeding may be increased. Use with caution when concomitantly used.
Azole antifungal (Fluconazole, ketoconazole): Increase etoricoxib plasma concentration may occur, increasing the pharmacologic effects and adverse reaction.
Beta-blocker: The antihypertensive effect of beta-blocker with etoricoxib may be impaired, possibly because of etoricoxib as the NSAIDs inhibition of renal prostaglandin synthesis, thereby allowing unopposed pressure system. Monitor blood pressure and adjust beta-blocker dose as needed to treat.
Effect of etoricoxib on drugs metabolised by sulfotransferases: Etoricoxib is an inhibitor of human sulfotransferase activity, particularly SULT1E1 and has been shown to increase the serum concentration of ethinylestradiol. While knowledge about effects of multiple sulfotransferases in presently limited and the clinical consequences for many drugs are still being examined, it may be prudent to exercise care when administering etoricoxib concurrently with other drugs primarily metabolised by human sulfotransferases (e.g. oral salbutamol and minoxidil).