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Nonsteroidal anti-inflammatory drugs (standard or coxibs) - prescribing issues - Management
What should I do for a person who requires probenecid and an NSAID?
- Avoid the concurrent use of probenecid and ketorolac:
- Probenecid reduces excretion of ketorolac, resulting in an increased plasma concentration of ketorolac.
- Closely monitor people who are concurrently receiving probenecid and indometacin because some may develop indometacin toxicity (headache, dizziness, light-headedness, nausea). This is particularly likely in people with impaired renal function:
- Reduce the indometacin dose as necessary.
- Concurrent use of probenecid and other nonsteroidal anti-inflammatory drugs (NSAIDs) is unlikely to result in an interaction, but it is prudent to be alert for any evidence of increased adverse effects:
- In the event of an interaction, reduce the NSAID dose as necessary.
Basis for recommendation
- These recommendations are based on an authoritative reference manual on drug interactions and the British National Formulary [Baxter, 2006; BNF 55, 2008].
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