Описание
Celecoxib may increase methotrexate exposure by reducing its renal clearance, raising the risk of toxicity in patients on MTX-based regimens.
Механизм
COX-2 inhibition reduces renal prostaglandin-mediated vasodilation, impairing tubular secretion of methotrexate; the effect is less pronounced than with non-selective NSAIDs.
Клиническое значение
MTX levels can increase modestly; the clinical impact is greatest with higher MTX doses or in patients with renal impairment.
Тактика ведения
Monitor CBC, renal function, and MTX levels; use the minimum celecoxib dose for the shortest duration. Hydrate adequately.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.