If celebrex is used in patients with a recent mi, monitor patients for signs of cardiac ischemia.
Celecoxib and anticoagulants such as warfarin have a synergistic effect on bleedingThe concomitant use of Celecoxib and anticoagulants have an increased risk of serious bleeding compared to the use of either drug aloneSerotonin release by platelets plays an important role in hemostasisCase-control and cohort epidemiological studies showed that concomitant use of drugs that interfere with serotonin reuptake and an NSAID may potentiate the risk of bleeding more than an NSAID alone.
In patients with JRA who are known or suspected to be poor CYP2C9 metabolizersconsider using alternative treatmentssee Use in Specific populationsand CLINICAL PHARMACOLOGY
A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polypsseverepotentially fatal bronchospasmand/or intolerance to aspirin and other NSAIDsBecause cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patientsCELEBREX is contraindicated in patients with this form of aspirin sensitivitysee CONTRAINDICATIONSWhen CELEBREX is used in patients with preexisting asthmawithout known aspirin sensitivitymonitor patients for changes in the signs and symptoms of asthma.
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