Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Some medicines slow down how quickly your liver processes certain non-steroidal anti-inflammatory medicines (NSAIDs).
What might happen:
The amount of the NSAID in your body may increase. This may increase your risk of having side effects from these medicines.
What you should do about this interaction:
Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. Your doctor may want to monitor you more closely or may want to lower the dose of your NSAID while you are taking your other medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.US Food and Drug Administration (FDA). Drug Development and Drug Interactions: Table of Substrates, Inhibitors and Inducers. Available at: http://www.fda.gov/Drugs/DevelopmentApprovalProcess/DevelopmentResources/D rugInteractionsLabeling/ucm093664.htm. Updated 08/05/2011.
2.Rajnarayana K, Venkatesham A, Krishna DR. Bioavailability of diclofenac sodium after pretreatment with diosmin in healthy volunteers. Drug Metabol Drug Interact 2007;22(2-3):165-74.
3.Celebrex (celecoxib) US prescribing information. Pfizer Inc. February 4, 2011.
4.Arthrotec (diclofenac sodium/misoprostol) US prescribing information. Pfizer, Inc. April, 2015.
5.Dynastat (parecoxib) UK summary of product characteristics. Pfizer Limited February 7, 2012.
6.McGinnity DF, Tucker J, Trigg S, Riley RJ. Prediction of CYP2C9-mediated drug-drug interactions: a comparison using data from recombinant enzymes and human hepatocytes. Drug Metab Dispos 2005 Nov;33(11):1700-7.
7.Hynninen VV, Olkkola KT, Leino K, Lundgren S, Neuvonen PJ, Rane A, Valtonen M, Laine K. Effect of voriconazole on the pharmacokinetics of diclofenac. Fundam Clin Pharmacol 2007 Dec;21(6):651-6.
8.Hynninen VV, Olkkola KT, Leino K, Lundgren S, Neuvonen PJ, Rane A, Valtonen M, Vyyrylainen H, Laine K. Effects of the antifungals voriconazole and fluconazole on the pharmacokinetics of s-(+)- and R-(-)-Ibuprofen. Antimicrob Agents Chemother 2006 Jun;50(6):1967-72.
9.Vfend (voriconazole) US prescribing information. Pfizer Inc. February, 2015.
10.Diflucan (fluconazole) US prescribing information. Pfizer Inc. November, 2014.
11.Hynninen VV, Olkkola KT, Bertilsson L, Kurkinen KJ, Korhonen T, Neuvonen PJ, Laine K. Voriconazole increases while itraconazole decreases plasma meloxicam concentrations. Antimicrob Agents Chemother 2009 Feb; 53(2):587-92.
12.Mobic (meloxicam) US prescribing information. Boehringer Ingelheim March 5, 2012.
13.Feldene (piroxicam) US prescribing information. Pfizer Inc. August 13, 2010.