Drug interactions
Fluoxetine + Parecoxib
Severity: Moderate
Fluoxetine 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
Fluoxetine plus an NSAID increases the risk of gastrointestinal bleeding because of impaired platelet function. Fluoxetine inhibits CYP2C9 and may also raise levels of valdecoxib, the active metabolite of parecoxib. COX-2 selectivity reduces but does not remove bleeding risk.
What this interaction means in plain words
Fluoxetine 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
Additive effects on bleeding risk via platelet serotonin depletion plus NSAID effects, and CYP2C9 inhibition by fluoxetine reducing valdecoxib clearance.
What to do
Use the lowest effective parecoxib dose for a short duration and monitor for bleeding. Consider gastroprotection in patients at high GI risk.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Parecoxib?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine plus an NSAID increases the risk of gastrointestinal bleeding because of impaired platelet function. Fluoxetine inhibits CYP2C9 and may also raise levels of valdecoxib, the active metabolite of parecoxib. COX-2 selectivity reduces but does not remove bleeding risk.
How serious is the interaction between Fluoxetine 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: Use the lowest effective parecoxib dose for a short duration and monitor for bleeding. Consider gastroprotection in patients at high GI risk.
What other medicines interact with Fluoxetine?
MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Methylene blue. The full list is on the Fluoxetine page.
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