Drug interactions
Fluconazole + Parecoxib
Severity: Moderate
Fluconazole and Parecoxib: moderate interaction.
Last updated
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
Fluconazole can raise exposure to valdecoxib, the active metabolite of parecoxib, because both are handled by CYP2C9. Higher levels may increase the risk of gastrointestinal, renal and cardiovascular adverse effects.
What this interaction means in plain words
Fluconazole and Parecoxib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Fluconazole inhibits CYP2C9, reducing the metabolism of valdecoxib (active metabolite of parecoxib), and CYP3A4 also contributes to its clearance.
What to do
Start parecoxib at the lowest recommended dose (reduce the dose in patients receiving fluconazole, as labeling advises). Monitor for signs of NSAID toxicity such as GI bleeding, fluid retention and renal impairment.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fluconazole
- Dihydroergotamine intranasal + Fluconazole Contraindicated
- Dihydroergotamine + Fluconazole Contraindicated
- Dofetilide + Fluconazole Contraindicated
- Domperidone + Fluconazole Contraindicated
- Dronedarone + Fluconazole Contraindicated
- Erythromycin + Fluconazole Contraindicated
Frequently asked questions
Can I take Fluconazole with Parecoxib?
MediHelp rates the interaction as moderate. Fluconazole and Parecoxib can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Fluconazole can raise exposure to valdecoxib, the active metabolite of parecoxib, because both are handled by CYP2C9. Higher levels may increase the risk of gastrointestinal, renal and cardiovascular adverse effects.
How serious is the interaction between Fluconazole and Parecoxib?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start parecoxib at the lowest recommended dose (reduce the dose in patients receiving fluconazole, as labeling advises). Monitor for signs of NSAID toxicity such as GI bleeding, fluid retention and renal impairment.
What other medicines interact with Fluconazole?
MediHelp also lists interactions of Fluconazole with, for example, Dihydroergotamine intranasal, Dihydroergotamine, Dofetilide. The full list is on the Fluconazole page.
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