NSAIDs Rifampicin

NSAIDs RIFAMPICIN Rifampicin i diclofenac, celecoxib, etoricoxib and parecoxib levels Rifampicin T CYP2C9-mediated metabolism of these NSAIDs Monitor analgesic effects consider using alternative NSAIDs... 

Polypharmacy For example, NSAIDs if used with other hepatotoxic drugs increase the risk of hepatotoxicity. Isoniazid with rifampicin or pyrazinamide... 

Slc22a7) Drugs NSAIDs, AZT, MTX, zalcitabine Drugs p-lactam antibiotics, NSAIDs, bumetanide, enalapril, glibenclamide, rifampicin, verapamil... 

Tubulointerstitial nephritis can be either acute or chronic in nature. Acute interstitial nephritis is characterized by an acute renal interstitial inflammatory response with urinary eosinophils and nonoliguric acute renal failure. The more common drugs that induce acute interstitial nephritis include penicillins, rifampicin, sulfonamides, and cimetadine. Chronic tubulointerstitial nephritis is most commonly associated with the long term use of large amounts of analgesics and antiinflammatory agents (e.g., NSAIDs). 

Rifampicin is a potent inducer of hepatic enzymes, and it is likely that it increased the metabolism of these NSAIDs. 

Although information is limited, these pharmacokinetic interactions appear to be established. Their clinical relevance remains to be determine, but it seems likely that the efficacy of these NSAIDs will be reduced by rifampicin. Combined use should be well monitored, and the NSAID dosage increased if necessary. See also NSAIDs Parecoxib -i- Miscellane-ous%p.l60. The clinical relevance ofthe increase in rifampicin maximum levels with metamizole is uncertain. 

The serum levels of the active metabolite of leflunomide are reduced by activated charcoal, and colestyramine. The manufacturers advise against the concurrent use of alcohol because of the potential for hepatotoxicity. Methotrexate may also increase leflunomide hepatotoxicity, so in general the combination is not recommended. A case of fatal fulminant hepatic failure has been reported in a patient taking leflunomide and itraconazole. A case of peripheral neuropathy has been reported in a patient taking leflunomide and tegafiir/uraciL The manufacturers predict interactions between leflunomide and phenytoin or tolbutamide, and advise caution with rifampicin as it may increase leflunomide metabolite levels. No clinically relevant interaction occurs with cime-tidine, corticosteroids or NSAIDs. 

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