Celecoxib with Nadolol Interaction Details
Brand Names Associated with Celecoxib
- Celebrex®
- Celecoxib
- Consensi® (as a combination product containing Amlodipine, Celecoxib)
- Elyxyb®
Brand Names Associated with Nadolol
- Corgard®
- Corzide® (as a combination product containing Bendroflumethiazide, Nadolol)
- Nadolol
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 15, 2023
Interaction Effect
Reduced antihypertensive effect
Interaction Summary
Coadministration of NSAIDs and beta-adrenergic blockers may increase blood pressure and interfere with blood pressure control. This effect was reported for flurbiprofen (400 mg daily), ibuprofen (more than 400 mg daily), indomethacin (more than 50 mg daily), naproxen (1000 mg daily), and piroxicam . Sulindac may not antagonize the antihypertensive effects of beta-blockers . Monitor blood pressure when concomitant use of NSAIDs and beta blockers is required .
Severity
Moderate
Onset
Delayed
Evidence
Probable
How To Manage Interaction
The antihypertensive efficacy of beta blockers may be decreased when used concomitantly with NSAIDs. Monitor blood pressure when coadministration is required.
Mechanism Of Interaction
Decreased production of renal prostaglandins
Literature Reports
A) Ibuprofen 400 mg orally every 8 hours, acetaminophen, or placebo was given to hypertensive patients receiving their usual medications. At the end of the 3-week trial, patients given ibuprofen showed increases of approximately 6 mmHg in various blood pressure measures. Acetaminophen had no demonstrable effect on blood pressure. The mechanism may involve attenuation of the effectiveness of antihypertensive agents secondary to interference with production of vasodilator and natriuretic prostaglandins that are stimulated by antihypertensive agents. A reduction in sodium excretion may have been involved in exacerbating hypertension .
B) The effect of naproxen and sulindac on blood pressure response was studied in 28 patients with mild to moderate essential hypertension well controlled by atenolol. The results of the 5-week, double-blind, placebo-controlled trial indicated that 1 week of therapy with naproxen 500 mg twice daily significantly increased systolic blood pressure (mean 4 mmHg), but did not alter diastolic blood pressure. Sulindac 200 mg twice daily for 1 week did not alter either blood pressure parameter .
C) The effects of indomethacin in 16 patients with essential hypertension treated with oxprenolol have been examined. Both indomethacin and oxprenolol, as well as the 2 drugs combined, inhibited plasma renin activity. When the 2 drugs were given in combination, blood pressure decreased (systolic: -5.9 mmHg; diastolic: -4 mmHg; mean: -4.6 mmHg), but the changes induced in blood pressure were reduced by about 50% when compared with those in the oxprenolol-alone period .
D) Concomitant administration of oral naproxen 500 mg twice daily or oral sulindac 200 mg twice daily resulted in no effect on blood pressure control in patients with mild to moderate hypertension controlled with oral propranolol 10 mg to 240 mg daily in a single-blind study. The serum levels of propranolol were not determined and patients with preexisting renal disease, heart failure, or cirrhosis were not studied .
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.
Nadolol Overview
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Nadolol is used alone or in combination with other medications to treat high blood pressure. It is also used to prevent angina (chest pain). Nadolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing heart rate to improve blood flow and decrease blood pressure.
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High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys, and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.
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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.