Drug

Piroxicam

Common brand names:

Feldene

Piroxicam is used to treat rheumatoid arthritis and osteoarthritis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).

Summary of Interactions with Vitamins, Herbs, & Foods

  • Negative Interactions

    1

    • Piroxicam

      Potassium

      Potential Negative Interaction

      An 85-year-old man developed higher than normal blood levels of potassium following several months of treatment with piroxicam. Until more is known, people taking piroxicam for long periods should have their blood checked regularly for high potassium levels and may need to avoid high potassium intake with the guidance of a health practitioner.

      Potassium
      Piroxicam
      ×
      1. Miller KP, Lazar EJ, Fotino S. Severe hyperkalemia during piroxicam therapy. Arch Int Med 1984;144:2414-5.

  • Supportive Interactions

    3

    • Piroxicam

      Iron

      Replenish Depleted Nutrients

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.

      Iron
      Piroxicam
      ×
      1. Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidal anti-inflammatory drugs. Pharmacol Ther 1994;62:145-57.
      2. Threlkeld DS, ed. Blood Modifiers, Iron-Containing Products. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1998, 62-9a.

    • Piroxicam

      Stinging Nettle

      Support Medicine

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.

      Stinging Nettle
      Piroxicam
      ×
      1. Chrubasik S, Enderlein W, Bauer R, Grabner W. Evidence for antirheumatic effectiveness of Herba Urticae dioicae in acute arthritis: a pilot study. Phytomedicine 1997;4:105-8.

    • Piroxicam

      Licorice

      Reduce Side Effects

      This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.

      The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.

      Licorice
      Piroxicam
      ×
      1. Rees WDW, Rhodes J, Wright JE, et al. Effect of deglycyrrhizinated liquorice on gastric mucosal damage by aspirin. Scand J Gastroenterol 1979;14:605-7.
      2. Morgan AG, McAdam WAF, Pacsoo C, Darnborough A. Comparison between cimetidine and Caved-S in the treatment of gastric ulceration, and subsequent maintenance therapy. Gut 1982;23:545-51.

  • Explanation Required

    1

    • Piroxicam

      White Willow

      Needs Explanation

      Willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. Taking aspirin significantly lowers blood levels of piroxicam and increases the potential for adverse side effects. Though no studies have investigated interactions between willow bark and piroxicam, people taking the drug should avoid the herb until more information is available.

      White Willow
      Piroxicam
      ×
      1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2342-4.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

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