Drug interactions
Indomethacin + Piroxicam
Severity: Major
Indomethacin and Piroxicam: major 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
Taking two NSAIDs together adds no proven benefit and increases the risk of gastrointestinal ulceration, bleeding and renal injury. Hyperkalemia and fluid retention are also more likely.
What this interaction means in plain words
Indomethacin 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.
Indomethacin belongs to Musculoskeletal; Piroxicam belongs to Musculoskeletal.
Why it happens
Both drugs inhibit cyclooxygenase, producing additive loss of gastroprotective prostaglandins, platelet inhibition and renal prostaglandin suppression.
What to do
Avoid concurrent use of two systemic NSAIDs and choose a single agent at the lowest effective dose. If a switch is made, stop one agent before starting the other.
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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Other interactions of Indomethacin
- Indomethacin + Ketorolac Contraindicated
- Indomethacin + Ketorolac intranasal Contraindicated
- Aceclofenac + Indomethacin Major
- Acemetacin + Indomethacin Major
- Acetylsalicylic acid + Indomethacin Major
- Alteplase + Indomethacin 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 Indomethacin with Piroxicam?
MediHelp rates the interaction as major. Indomethacin 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. Taking two NSAIDs together adds no proven benefit and increases the risk of gastrointestinal ulceration, bleeding and renal injury. Hyperkalemia and fluid retention are also more likely.
How serious is the interaction between Indomethacin 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 concurrent use of two systemic NSAIDs and choose a single agent at the lowest effective dose. If a switch is made, stop one agent before starting the other.
What other medicines interact with Indomethacin?
MediHelp also lists interactions of Indomethacin with, for example, Ketorolac, Ketorolac intranasal, Aceclofenac. The full list is on the Indomethacin page.
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