Drug interactions
Piroxicam + Sacubitril / valsartan
Severity: Major
Piroxicam and Sacubitril / valsartan: 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
NSAIDs can blunt the blood pressure lowering effect of sacubitril/valsartan and increase the risk of acute kidney injury and hyperkalemia, especially in elderly, volume-depleted or renally impaired patients.
What this interaction means in plain words
Piroxicam and Sacubitril / valsartan 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
NSAID inhibition of vasodilatory renal prostaglandins reduces glomerular perfusion while angiotensin receptor blockade removes efferent arteriolar compensation, also promoting potassium retention.
What to do
Avoid regular NSAID use where possible; if needed, monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration.
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 Piroxicam with Sacubitril / valsartan?
MediHelp rates the interaction as major. Piroxicam and Sacubitril / valsartan 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. NSAIDs can blunt the blood pressure lowering effect of sacubitril/valsartan and increase the risk of acute kidney injury and hyperkalemia, especially in elderly, volume-depleted or renally impaired patients.
How serious is the interaction between Piroxicam and Sacubitril / valsartan?
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 regular NSAID use where possible; if needed, monitor blood pressure, serum creatinine and potassium, and ensure adequate hydration.
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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