Warfarin Institute of America
Dedicated To Your Health
VALDECOXIB INTERACTIONS WITH WARFARIN
The package insert for Bextra cautions that, in pre-marketing studies when valdecoxib was added to warfarin, it caused an increase in warfarin plasma levels of 12 to 15%. This may or may not affect the INR to any significant amount. As of November 2004, I can find no medical journal articles showing that anyone was harmed by this interaction.
My recommendation is to get the INR checked about one week after valdecoxib is added to warfarin. If a person had an INR at the upper edge of the therapeutic range, a 15% increase could put them high enough to warrant a downward dosage adjustment. Likewise, if valdecoxib is stopped and warfarin continued, the INR may go down. Checking the INR about one week after valdecoxib is stopped is prudent.
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Last updated November 21, 2004