Drug interactions
Clopidogrel + Piroxicam
Severity: Major
Clopidogrel and Piroxicam: major interaction.
Last updated Sources: US FDA label
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
Both drugs impair platelet function, and NSAIDs also damage the gastrointestinal mucosa. Together they substantially raise the risk of gastrointestinal and other bleeding.
What this interaction means in plain words
Clopidogrel and Piroxicam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Clopidogrel belongs to Cardiovascular; Piroxicam belongs to Musculoskeletal.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus COX-1 inhibition) with NSAID-induced mucosal injury.
What to do
Avoid NSAIDs in patients on clopidogrel when possible and use paracetamol instead. If necessary, add a proton pump inhibitor (avoiding omeprazole and esomeprazole) and monitor for bleeding.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Clopidogrel
Frequently asked questions
Can I take Clopidogrel with Piroxicam?
MediHelp rates the interaction as major. Clopidogrel and Piroxicam can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs impair platelet function, and NSAIDs also damage the gastrointestinal mucosa. Together they substantially raise the risk of gastrointestinal and other bleeding.
How serious is the interaction between Clopidogrel and Piroxicam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid NSAIDs in patients on clopidogrel when possible and use paracetamol instead. If necessary, add a proton pump inhibitor (avoiding omeprazole and esomeprazole) and monitor for bleeding.
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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