Drug interactions
Enoxaparin + Piroxicam
Severity: Major
Enoxaparin 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
Piroxicam inhibits platelet function and can injure the gastric mucosa, which adds to the bleeding tendency produced by enoxaparin. The risk of gastrointestinal and other hemorrhage is increased.
What this interaction means in plain words
Enoxaparin 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.
Enoxaparin belongs to Cardiovascular; Piroxicam belongs to Musculoskeletal.
Why it happens
Additive hemostatic impairment: NSAID inhibition of platelet cyclooxygenase-dependent aggregation combined with anticoagulation by factor Xa inhibition, plus NSAID mucosal injury.
What to do
Avoid the combination where possible and choose a non-NSAID analgesic. If unavoidable, use the lowest NSAID dose for the shortest time and monitor for bleeding and hemoglobin changes.
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 Enoxaparin
- Defibrotide + Enoxaparin Contraindicated
- Enoxaparin + Ketorolac Contraindicated
- Enoxaparin + Mifepristone Contraindicated
- Abciximab + Enoxaparin Major
- Aceclofenac + Enoxaparin Major
- Acetylsalicylic acid + Enoxaparin Major
Frequently asked questions
Can I take Enoxaparin with Piroxicam?
MediHelp rates the interaction as major. Enoxaparin 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. Piroxicam inhibits platelet function and can injure the gastric mucosa, which adds to the bleeding tendency produced by enoxaparin. The risk of gastrointestinal and other hemorrhage is increased.
How serious is the interaction between Enoxaparin 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 the combination where possible and choose a non-NSAID analgesic. If unavoidable, use the lowest NSAID dose for the shortest time and monitor for bleeding and hemoglobin changes.
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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