Drug interactions
Mefenamic acid + Piroxicam
Severity: Major
Mefenamic acid 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
Combining two NSAIDs increases the risk of gastrointestinal ulceration and bleeding and of renal injury, with no added benefit.
What this interaction means in plain words
Mefenamic acid 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.
Mefenamic acid belongs to Musculoskeletal; Piroxicam belongs to Musculoskeletal.
Why it happens
Additive cyclooxygenase inhibition causing mucosal injury, platelet inhibition and renal prostaglandin suppression.
What to do
Avoid using the two together; choose one NSAID at the lowest effective dose and shortest duration.
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 Piroxicam
- Ketorolac intranasal + Piroxicam Contraindicated
- Ketorolac + Piroxicam Contraindicated
- Aceclofenac + Piroxicam Major
- Acemetacin + Piroxicam Major
- Acetylsalicylic acid + Piroxicam Major
- Alteplase + Piroxicam Major
Other interactions of Mefenamic acid
- Ketorolac intranasal + Mefenamic acid Contraindicated
- Ketorolac + Mefenamic acid Contraindicated
- Aceclofenac + Mefenamic acid Major
- Acemetacin + Mefenamic acid Major
- Acetylsalicylic acid + Mefenamic acid Major
- Alteplase + Mefenamic acid Major
Frequently asked questions
Can I take Mefenamic acid with Piroxicam?
MediHelp rates the interaction as major. Mefenamic acid 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. Combining two NSAIDs increases the risk of gastrointestinal ulceration and bleeding and of renal injury, with no added benefit.
How serious is the interaction between Mefenamic acid 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 using the two together; choose one NSAID at the lowest effective dose and shortest duration.
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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