Drug interactions
Parecoxib + Piroxicam
Severity: Major
Parecoxib 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 a nonselective NSAID with a COX-2 inhibitor offers no added benefit and increases gastrointestinal, renal, cardiovascular and bleeding risks.
What this interaction means in plain words
Parecoxib 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.
Why it happens
Duplicate cyclooxygenase inhibition produces additive adverse effects on mucosa, kidney and platelets.
What to do
Avoid concurrent use. Use a single NSAID at the lowest effective dose.
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
Frequently asked questions
Can I take Parecoxib with Piroxicam?
MediHelp rates the interaction as major. Parecoxib 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 a nonselective NSAID with a COX-2 inhibitor offers no added benefit and increases gastrointestinal, renal, cardiovascular and bleeding risks.
How serious is the interaction between Parecoxib 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. Use a single NSAID at the lowest effective dose.
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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