PiroxicamSkip to the navigation
Common brand names:Feldene
Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss.1 Iron supplements can cause GI irritation.2 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.
Reduce Side Effects
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.3 DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.4
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.5 More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Potential Negative Interaction
An 85-year-old man developed higher than normal blood levels of potassium following several months of treatment with piroxicam.6 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.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
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.7 Though no studies have investigated interactions between willow bark and piroxicam, people taking the drug should avoid the herb until more information is available.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
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.
3. 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.
4. 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.
5. 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.
6. Miller KP, Lazar EJ, Fotino S. Severe hyperkalemia during piroxicam therapy. Arch Int Med 1984;144:2414-5.
7. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2342-4.
Last Review: 03-18-2015
Copyright © 2016 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. The Healthnotes knowledgebase does not contain every possible interaction.
The information presented by 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 June 2017.
PeaceHealth endeavors to provide comprehensive health care information, however some topics in this database describe services and procedures not offered by our providers or within our facilities because they do not comply with, nor are they condoned by, the ethics policies of our organization.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.