Drug interactions
Piroxicam + Ramipril
Severity: Moderate
Piroxicam and Ramipril: 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
Piroxicam may weaken the blood pressure lowering effect of ramipril. Together they can also reduce renal function in vulnerable patients and cause hyperkalemia.
What this interaction means in plain words
Piroxicam and Ramipril 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.
Piroxicam belongs to Musculoskeletal; Ramipril belongs to Cardiovascular.
Why it happens
NSAID inhibition of vasodilatory renal prostaglandins opposes ACE inhibitor effects and reduces glomerular perfusion.
What to do
Monitor blood pressure, serum creatinine and potassium, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
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 Ramipril
- Aliskiren + Ramipril Contraindicated
- Protein a column + Ramipril Contraindicated
- Ramipril + Sacubitril / valsartan Contraindicated
- Ramipril + Sacubitril-valsartan Contraindicated
- Amifostine + Ramipril Major
- Amiloride + Ramipril Major
Frequently asked questions
Can I take Piroxicam with Ramipril?
MediHelp rates the interaction as moderate. Piroxicam and Ramipril 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. Piroxicam may weaken the blood pressure lowering effect of ramipril. Together they can also reduce renal function in vulnerable patients and cause hyperkalemia.
How serious is the interaction between Piroxicam and Ramipril?
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 blood pressure, serum creatinine and potassium, and keep the patient well hydrated. Use the lowest effective NSAID dose for the shortest time or choose a non-NSAID analgesic.
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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