Selected NSAIDs/Selected CYP2C9 Inhibitors Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

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: drug-interactions-table-substrates-inhibitors-and-inducers. Updated 11/14/2017.
  • 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. May, 2019.
  • 4.Diflucan (fluconazole) US prescribing information. Pfizer Inc. March, 2020.
  • 5.Arthrotec (diclofenac sodium/misoprostol) US prescribing information. Pfizer, Inc. May, 2016.
  • 6.Dynastat (parecoxib) UK summary of product characteristics. Pfizer Limited June 26, 2020.
  • 7.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.
  • 8.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.
  • 9.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.
  • 10.Vfend (voriconazole) US prescribing information. Pfizer Inc. January, 2021.
  • 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 May, 2016.
  • 13.Feldene (piroxicam) US prescribing information. Pfizer Inc. May, 2019.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.