Drug interactions
Diflunisal + Piroxicam
Severity: Major
Diflunisal 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
Combining two NSAIDs increases the risk of gastrointestinal ulceration and bleeding, renal toxicity and fluid retention without improved analgesia.
What this interaction means in plain words
Diflunisal 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.
Diflunisal belongs to Musculoskeletal; Piroxicam belongs to Musculoskeletal.
Why it happens
Additive cyclooxygenase inhibition reducing protective prostaglandins in gastric mucosa, kidney and platelets.
What to do
Avoid using two NSAIDs together; select one agent at the lowest effective dose.
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 Diflunisal
- Diflunisal + Ketorolac Contraindicated
- Diflunisal + Ketorolac intranasal Contraindicated
- Acemetacin + Diflunisal Major
- Acetazolamide + Diflunisal Major
- Alteplase + Diflunisal Major
- Amiloride + Diflunisal Major
Other interactions of Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Frequently asked questions
Can I take Diflunisal with Piroxicam?
MediHelp rates the interaction as major. Diflunisal 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. Combining two NSAIDs increases the risk of gastrointestinal ulceration and bleeding, renal toxicity and fluid retention without improved analgesia.
How serious is the interaction between Diflunisal 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 using two NSAIDs together; select one agent at the lowest effective dose.
What other medicines interact with Diflunisal?
MediHelp also lists interactions of Diflunisal with, for example, Ketorolac, Ketorolac intranasal, Acemetacin. The full list is on the Diflunisal page.
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