Celecoxib with Capecitabine Interaction Details
Brand Names Associated with Celecoxib
- Celebrex®
- Celecoxib
- Consensi® (as a combination product containing Amlodipine, Celecoxib)
- Elyxyb®
Brand Names Associated with Capecitabine
- Capecitabine
- Xeloda®
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Dec 22, 2023
Interaction Effect
Increased celecoxib exposure and an increased risk of celecoxib-related adverse effects
Interaction Summary
Coadministration of capecitabine with celecoxib (a CYP2C9 substrate) may increase celecoxib exposure which may increase the risk of adverse reactions related to celecoxib. Closely monitor for adverse reactions of celecoxib where minimal concentration changes may lead to serious adverse reactions when used concomitantly with capecitabine. Concomitant use of capecitabine and celecoxib has significantly increased the exposure of celecoxib compared with celecoxib alone (Cmax increased by 24% to 39%; AUC(0 to 8 hours) increased by 28% to 41%) in a pharmacokinetic study in 16 patients with advanced solid malignancies that was terminated after an interim analysis demonstrated a drug interaction. Reported adverse events were attributed to capecitabine .
Severity
Major
Onset
Unspecified
Evidence
Probable
How To Manage Interaction
Coadministration of capecitabine with celecoxib (a CYP2C9 substrate) may increase celecoxib exposure which may increase the risk of adverse reactions related to celecoxib. Closely monitor for adverse reactions of celecoxib where minimal concentration changes may lead to serious adverse reactions when used concomitantly with capecitabine.
Mechanism Of Interaction
Inhibition of CYP2C9-mediated metabolism of celecoxib
Literature Reports
A) Concomitant administration of multiple doses of capecitabine (1000 mg/m(2) twice daily for 14 days) increased celecoxib AUC by 28%, Cmax by 24%, and Ctrough by 30% .
B) Concomitant use of capecitabine and celecoxib has significantly increased the exposure of celecoxib compared with celecoxib alone in a pharmacokinetic study in 16 patients with advanced solid malignancies that was terminated after an interim analysis demonstrated a drug interaction. Celecoxib Cmax increased from 1109 to 1377 nanograms (ng)/mL at steady-state after 7 days of coadministration (geometric mean ratio (GMR), 1.24 [90% CI, 1.04 to 1.49) and AUC (0 to 8 hours) increased from 5199 to 6656 ng x hr/mL (GMR, 1.28 [90% CI, 1.11 to 1.47]). After continued concomitant use followed by a 7-day washout period of capecitabine on day 21, there was an even greater increase in celecoxib Cmax (GMR, 1.39 [90% CI, 1.16 to 1.66) as well as the AUC(0 to 8 hours) (GMR, 1.41 [90% CI, 1.19 to 1.68]). Reported adverse events were attributed to capecitabine. Patient received celecoxib 200 mg orally twice daily with or without capecitabine 1000 mg/m(2) orally twice daily for 14 days on/7 days off for 21-day cycles .
Celecoxib Overview
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Celecoxib is used to relieve pain, tenderness, swelling and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints), rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), and ankylosing spondylitis (arthritis that mainly affects the spine). Celecoxib is also used to treat juvenile rheumatoid arthritis (a type of arthritis that affects children) in children 2 years of age and older. Celecoxib is also used to treat painful menstrual periods and to relieve other types of short-term pain including pain caused by injuries, surgery and other medical or dental procedures, or medical conditions that last for a limited time. Celecoxib is in a class of NSAIDs called COX-2 inhibitors. It works by stopping the body's production of a substance that causes pain and inflammation.
Capecitabine Overview
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Capecitabine is used in combination with other medications to treat breast cancer that has come back after treatment with other medications. It is also used alone to treat breast cancer that has not improved after treatment with other medications. Capecitabine is also used to treat colon or rectal cancer (cancer that begins in the large intestine) that has gotten worse or spread to other parts of the body. It is also used to prevent colon cancer from spreading in people who have had surgery to remove the tumor. Capecitabine is in a class of medications called antimetabolites. It works by stopping or slowing the growth of cancer cells.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.