Drug interactions
Levomilnacipran + Piroxicam
Severity: Moderate
Levomilnacipran 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
Both drugs impair hemostasis, so using them together raises the risk of bleeding, especially from the upper gastrointestinal tract. The risk is higher in older patients and those also taking anticoagulants or antiplatelet agents.
What this interaction means in plain words
Levomilnacipran 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.
Levomilnacipran belongs to Central Nervous System; Piroxicam belongs to Musculoskeletal.
Why it happens
Levomilnacipran depletes platelet serotonin and piroxicam inhibits platelet cyclooxygenase, giving additive impairment of platelet function, while the NSAID also damages gastric mucosa.
What to do
Monitor for signs of gastrointestinal or other bleeding and use the lowest effective NSAID dose for the shortest time. Consider gastroprotection with a proton pump inhibitor in high-risk patients.
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 Levomilnacipran
- Isocarboxazid + Levomilnacipran Contraindicated
- Levomilnacipran + Linezolid Contraindicated
- Levomilnacipran + Methylthioninium chloride Contraindicated
- Levomilnacipran + Phenelzine Contraindicated
- Levomilnacipran + Procarbazine Contraindicated
- Levomilnacipran + Rasagiline Contraindicated
Frequently asked questions
Can I take Levomilnacipran with Piroxicam?
MediHelp rates the interaction as moderate. Levomilnacipran 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. Both drugs impair hemostasis, so using them together raises the risk of bleeding, especially from the upper gastrointestinal tract. The risk is higher in older patients and those also taking anticoagulants or antiplatelet agents.
How serious is the interaction between Levomilnacipran 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 for signs of gastrointestinal or other bleeding and use the lowest effective NSAID dose for the shortest time. Consider gastroprotection with a proton pump inhibitor in high-risk patients.
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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