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PIROXICAM
Piroxicam is used to treat rheumatoid arthritis and osteoarthritis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).
Safetychecker Summary
for Piroxicam
(for details about the summarized interactions, read the full article)
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
Lithium* Potassium* |
Check: Other—Before taking any of these supplements or eating any of
these foods with your medication, read this article in full for details. |
Folic acid* Willow* |
| Depletion or interference |
None known |
| Side effect reduction/prevention |
None known |
| Supportive interaction |
None known |
| Reduced drug absorption/bioavailability |
None known |
Interactions with Dietary Supplements
Potassium
An 85-year-old man developed higher than normal blood levels of potassium following several
months of treatment with piroxicam.1 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.
Folic
acid
Piroxicam may prevent inflammation by blocking the activity of enzymes that depend on folic
acid.2 However, other studies show that people taking NSAIDs such as aspirin have lower than normal levels of folic acid in
their red blood cells.3 Further research is needed to determine whether
supplemental folic acid prevents a deficiency of the vitamin or indirectly reduces the
beneficial effects of piroxicam.
Lithium
Lithium is a mineral that is present in some supplements and is also used in large amounts to
treat mood disorders such as bipolar disorder
(manic depression). Blood levels of lithium may increase in people taking NSAIDs and lithium supplements together (compared with
lithium alone),4 possibly resulting in unwanted side effects such as diarrhea, nausea, muscle weakness, and lack of
coordination. More research is needed to determine whether piroxicam specifically increases
lithium blood levels. Until more is known, people should avoid lithium supplementation except
when it is prescribed by a doctor.
Interactions with Herbs
Willow
(Salix alba)
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.5 Though no studies
have investigated interactions between willow bark and piroxicam, people taking the drug
should avoid the herb until more information is available.
Interactions with Foods and Other Compounds
Food
Taking piroxicam with a meal may delay the speed, but not the overall amount, of drug
absorption.6 Therefore, it may be taken with food if stomach upset occurs when
taking the drug on an empty stomach.
References:
1. Miller KP, Lazar EJ, Fotino S. Severe hyperkalemia during piroxicam therapy. Arch Int Med 1984;144:2414–5.
2. Baggott JE, Morgan SL, Ha T, et al. Inhibition of folate-dependent enzymes by non-steroidal anti-inflammatory drugs. Biochem J 1992;282:197–202.
3. Alter HJ, Zvaifler NJ, Rath CE. Interrelationship of rheumatoid arthritis, folic acid, and aspirin. Blood 1971;38:405–16.
4. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2342–4.
5. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2342–4.
6. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2342–4.
Copyright © 2002 Healthnotes, Inc. All rights reserved. www.healthnotes.com
Please read the disclaimer about the limitations of the information provided here. Do NOT rely solely on the information in this article.
Learn more about Healthnotes, the company.
Learn more about the authors of Safetychecker.
The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2003.
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