Drug interactions
Enalapril + Piroxicam
Severity: Moderate
Enalapril 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
Piroxicam may weaken the antihypertensive effect of enalapril. Together they can also impair renal function, especially with dehydration, heart failure or pre-existing kidney disease, and may cause hyperkalemia.
What this interaction means in plain words
Enalapril 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.
Enalapril belongs to Cardiovascular; Piroxicam belongs to Musculoskeletal.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins opposes ACE inhibitor effects and reduces glomerular perfusion.
What to do
Monitor blood pressure, serum creatinine and potassium, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
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 Enalapril
- Aliskiren + Enalapril Contraindicated
- Enalapril + Protein a column Contraindicated
- Enalapril + Sacubitril / valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Amifostine + Enalapril Major
- Amiloride + Enalapril Major
Frequently asked questions
Can I take Enalapril with Piroxicam?
MediHelp rates the interaction as moderate. Enalapril 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. Piroxicam may weaken the antihypertensive effect of enalapril. Together they can also impair renal function, especially with dehydration, heart failure or pre-existing kidney disease, and may cause hyperkalemia.
How serious is the interaction between Enalapril 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 blood pressure, serum creatinine and potassium, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
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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