Torixib Drug Interactions

Warfarin: The administration of etoricoxib 120mg daily was associated with an approximate 13% increase in prothrombin time International Normalized Ratio (INR). Standard monitoring of INR values should be conducted when therapy with etoricoxib is initiated or changed, particularly in the first few days, in patients receiving warfarin or similar agents.
Rifampin: Co-administration of etoricoxib with rifampin, a potent inducer of hepatic metabolism, produced a 65% decrease in etoricoxib plasma area under the curve (AUC). This interaction should be considered when etoricoxib is co-administered with rifampin.
Methotrexate: Monitoring for methotrexate-related toxicity should be considered when etoricoxib at doses greater than 90mg daily and methotrexate are administered concomitantly.
Diuretics, Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin II Antagonists (AllAs): Selective COX-2 inhibitors may diminish the antihypertensive effect of diuretics, ACE inhibitors and AllAs. This interaction should be given consideration in patients taking etoricoxib concomitantly with these products.
In some patients with compromised renal function (e.g., elderly patients or patients who are volume-depleted, including those on diuretic therapy) who are being treated with NSAIDs, including selective COX-2 inhibitors, the co-administration of ACE inhibitors or AllAs may result in a further deterioration of renal function, including possible acute renal failure. These effects are usually reversible. Therefore, the combination should be administered with caution, especially in the elderly.
Lithium: Non-selective NSAIDS and selective COX-2 inhibitors may increase plasma lithium levels. This interaction should be given consideration in patients taking etoricoxib concomitantly with lithium.
Aspirin: Etoricoxib can be used concomitantly with low-dose aspirin at doses for cardiovascular prophylaxis. At steady state, etoricoxib 120mg once daily had no effect on the anti-platelet activity of low-dose aspirin (81mg once daily). However, concomitant administration of low-dose aspirin with etoricoxib increases the rate of Gl ulceration or other complications compared to use of etoricoxib alone.
Oral Contraceptives: An increase in ethinyl estradiol (EE) concentration should be considered when selecting an appropriate oral contraceptive for use with etoricoxib. An increase in EE exposure can increase the incidence of adverse events associated with oral contraceptives (e.g., venous thromboembolic events in women at risk).
Hormone Replacement Therapy: The increases in estrogenic concentration should be taken into consideration when selecting post-menopausal hormone therapy for use with etoricoxib.
Other: Etoricoxib did not have clinically important effects on the pharmacokinetics of prednisone/prednisolone or digoxin. Antacids and ketoconazole (a potent inhibitor of CYP3A4) did not have clinically important effects on the pharmacokinetics of etoricoxib.