Drug interactions
Citalopram + Piroxicam
Severity: Moderate
Citalopram 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
Combining an NSAID with an SSRI raises the risk of gastrointestinal bleeding well above that of either drug alone. The risk is greatest in older patients and those with prior ulcers or on other antithrombotic drugs.
What this interaction means in plain words
Citalopram 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.
Citalopram belongs to Central Nervous System; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAIDs damage gastric mucosa and inhibit platelet thromboxane, while SSRIs deplete platelet serotonin, so hemostasis is impaired additively.
What to do
Avoid the combination where possible, or add a proton pump inhibitor for gastroprotection and use the lowest effective piroxicam dose for the shortest time. Counsel patients to report black stools or hematemesis.
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 Citalopram
- Cisapride + Citalopram Contraindicated
- Citalopram + Dronedarone Contraindicated
- Citalopram + Escitalopram Contraindicated
- Citalopram + Isocarboxazid Contraindicated
- Citalopram + Methylene blue Contraindicated
- Citalopram + Phenelzine Contraindicated
Frequently asked questions
Can I take Citalopram with Piroxicam?
MediHelp rates the interaction as moderate. Citalopram 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. Combining an NSAID with an SSRI raises the risk of gastrointestinal bleeding well above that of either drug alone. The risk is greatest in older patients and those with prior ulcers or on other antithrombotic drugs.
How serious is the interaction between Citalopram 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: Avoid the combination where possible, or add a proton pump inhibitor for gastroprotection and use the lowest effective piroxicam dose for the shortest time. Counsel patients to report black stools or hematemesis.
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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