Moderate
Amiodarone × celecoxib
Class III antiarrhythmics (Vaughan Williams)×Selective COX-2 inhibitor (coxib)
Mechanism
Celecoxib is a CYP2C9 substrate. Amiodarone weakly inhibits CYP2C9, so celecoxib AUC may rise moderately. Clinically significant amplification of celecoxib side effects is unlikely.
Symptoms
Possible typical celecoxib side effects: dyspepsia, peripheral oedema, BP rise. GI bleeding is rare.
Management
No dose adjustment needed. On long-term celecoxib, check BP and renal function every 3 months. Alternatives for rheumatologic pain: topical NSAIDs, paracetamol up to 2 g/day.