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Nonsteroidal anti-inflammatory drugs (standard or coxibs) - prescribing issues - Management
What should I do for a person who requires a quinolone and an NSAID?
- The risk of convulsions may be increased when a quinolone is used concomitantly with a nonsteroidal anti-inflammatory drug (NSAID).
- Normally, no interaction seems to occur with most quinolones and NSAIDs; therefore, the concomitant use of a quinolone and an NSAID is acceptable.
- One possible exception to this is in people with epilepsy on an NSAID (e.g. in people taking ciprofloxacin and phenytoin, phenytoin levels should be closely monitored). In these people, it may be best to avoid the concomitant use of a quinolone and an NSAID.
Basis for recommendation
- These recommendations are based on information in an authoritative reference manual and the British National Formulary [Baxter, 2006; BNF 55, 2008]. They also reflect advice from the Commission on Human Medicines (formerly Committee on Safety of Medicines) that the risk of convulsions is increased when quinolones and nonsteroidal anti-inflammatory drugs are used concomitantly [CSM, 1991; BNF 55, 2008].
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