Drug interactions
Celecoxib + Warfarin
Severity: Major
Celecoxib and Warfarin: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Celecoxib can increase the INR in patients on warfarin and adds its own risk of gastrointestinal bleeding. Serious bleeding has been reported with the combination, particularly in older patients.
What this interaction means in plain words
Celecoxib and Warfarin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Celecoxib belongs to Musculoskeletal; Warfarin belongs to Cardiovascular.
Why it happens
Celecoxib weakly inhibits CYP2C9, which metabolizes S-warfarin, and the NSAID adds mucosal injury and some platelet effects that increase bleeding risk.
What to do
Check INR within several days of starting or stopping celecoxib and adjust warfarin as needed. Use the lowest celecoxib dose for the shortest time and consider gastroprotection or a non-NSAID analgesic.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Celecoxib
- Celecoxib + Ketorolac Contraindicated
- Celecoxib + Ketorolac intranasal Contraindicated
- Aceclofenac + Celecoxib Major
- Acemetacin + Celecoxib Major
- Amiloride + Celecoxib Major
- Apixaban + Celecoxib Major
Other interactions of Warfarin
- Defibrotide + Warfarin Contraindicated
- Ketorolac + Warfarin Contraindicated
- Abciximab + Warfarin Major
- Acetylsalicylic acid + Warfarin Major
- Adagrasib + Warfarin Major
- Amiodarone + Warfarin Major
Frequently asked questions
Can I take Celecoxib with Warfarin?
MediHelp rates the interaction as major. Celecoxib and Warfarin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Celecoxib can increase the INR in patients on warfarin and adds its own risk of gastrointestinal bleeding. Serious bleeding has been reported with the combination, particularly in older patients.
How serious is the interaction between Celecoxib and Warfarin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check INR within several days of starting or stopping celecoxib and adjust warfarin as needed. Use the lowest celecoxib dose for the shortest time and consider gastroprotection or a non-NSAID analgesic.
What other medicines interact with Celecoxib?
MediHelp also lists interactions of Celecoxib with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Celecoxib page.
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