Drug interactions
Fluoxetine + Piroxicam
Severity: Moderate
Fluoxetine 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
Fluoxetine increases the risk of upper GI bleeding when combined with NSAIDs. Fluoxetine also inhibits CYP2C9 and may raise piroxicam levels, adding to the risk.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Piroxicam belongs to Musculoskeletal.
Why it happens
SSRI platelet serotonin depletion adds to NSAID effects, and CYP2C9 inhibition by fluoxetine may reduce piroxicam clearance.
What to do
Use gastroprotection with a proton pump inhibitor in at-risk patients and the lowest effective piroxicam dose. Monitor for GI bleeding.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Piroxicam?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine increases the risk of upper GI bleeding when combined with NSAIDs. Fluoxetine also inhibits CYP2C9 and may raise piroxicam levels, adding to the risk.
How serious is the interaction between Fluoxetine 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: Use gastroprotection with a proton pump inhibitor in at-risk patients and the lowest effective piroxicam dose. Monitor for GI 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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