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NSAIDs may diminish the antihypertensive effect of angiotensin converting enzymeACEinhibitorsangiotensin receptor blockersARBsor beta-blockersincluding propranololIn patients who are elderlyvolume-depletedincluding those on diuretic therapyor Florinef order have renal impairmentco-administration of an NSAID with ACE inhibitors or ARBs may result in deterioration of renal functionincluding possible acute renal failureThese effects are usually reversible.

Because of the risk of disseminated intravascular coagulation with use of CELEBREX in pediatric patients with systemic onset JRAmonitor patients for signs and symptoms of abnormal clotting or bleedingand inform patients and their caregivers to report symptoms as soon as possible.

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NSAIDs cause an increased risk of serious gastrointestinalGIadverse events including bleedingulcerationandperforation of the stomach or intestineswhich can be fatalThese events can occur at any time during use and without warning symptomsElderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for seriousGIeventssee WARNINGS AND PRECAUTIONS]

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