Metoprolol Celecoxib

Werner U, Werner D, Rau T, et al. Celecoxib inhibits metabolism of cytochrome P4502D6 substrate metoprolol in humans. Clin Pharmacol Ther 2003 74 130-137. 

CYP2D6 5 25 S-metoprolol Carvedilol Dextromethorphan Nortriptyline Propanolol Odansetron Chlorpromazine Codeine Flecainide Fluoxetine Haloperidol Amiodarone Fluoxetine Methadone Celecoxib Doxorubicin ... 

There is evidence that most NSAIDs can increase blood pressure in patients taking antihypertensives, although some studies have not found the increase to be clinically relevant In various small studies, indometacin reduced the antihypertensive effects of the beta biockers. There is some evidence that piroxicam usually interacts similarly. Ibuprofen and naproxen have reduced the effect of beta blockers in some small studies but not others. Two isolated cases of hypertension have been reported with naproxen and ibuprofen in patients treated with propranolol and pindolol, respectively. Celecoxib, but not rofecoxib, inhibits the metabolism of metoprolol. Limited information su ests that normally di-... 

In an open, randomised crossover study in 12 healthy subjects, celecoxib 200 mg twice daily for 7 days increased the AUC of a single 50-mg dose of metoprolol by 64%. In contrast, rofecoxib 25 mg daily for 7 days did not significantly affect the pharmacokinetics of metoprolol. 

Celecoxib, but not rofecoxib, inhibits the metabolism of metoprolol by the cytochrome P450 isoenzyme CYP2D6. "... 

Although celecoxib increased levels of metoprolol, increases in plasma metoprolol levels of this size are unlikely to be clinically relevant. 

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