Drug interactions
Amikacin + Piroxicam
Severity: Moderate
Amikacin and Piroxicam: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
NSAIDs can reduce renal clearance of aminoglycosides, which has been mainly described in preterm infants given indomethacin or ibuprofen. In adults the effect is less certain but additive nephrotoxicity is possible.
What this interaction means in plain words
Amikacin and Piroxicam can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amikacin belongs to Anti Bacterial; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID-mediated reduction in renal blood flow and glomerular filtration decreases aminoglycoside elimination, and both agents can be nephrotoxic.
What to do
Monitor serum creatinine and amikacin trough levels, and maintain hydration. Avoid the combination in patients with renal impairment where possible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Other interactions of Amikacin
- Amikacin + Cidofovir Contraindicated
- Adefovir + Amikacin Major
- Amikacin + Amphotericin b Major
- Amikacin + Amphotericin b deoxycholate Major
- Amikacin + Atracurium Major
- Amikacin + Bacitracin Major
Frequently asked questions
Can I take Amikacin with Piroxicam?
MediHelp rates the interaction as moderate. Amikacin and Piroxicam can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. NSAIDs can reduce renal clearance of aminoglycosides, which has been mainly described in preterm infants given indomethacin or ibuprofen. In adults the effect is less certain but additive nephrotoxicity is possible.
How serious is the interaction between Amikacin and Piroxicam?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum creatinine and amikacin trough levels, and maintain hydration. Avoid the combination in patients with renal impairment where possible.
What other medicines interact with Piroxicam?
MediHelp also lists interactions of Piroxicam with, for example, Ketorolac intranasal, Ketorolac, Aceclofenac. The full list is on the Piroxicam page.
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