Drug interactions
Piroxicam + Siponimod
Severity: Minor
Piroxicam and Siponimod: minor 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 is metabolized by CYP2C9 and may compete with siponimod for this pathway, though it is not a notable CYP2C9 inhibitor. Any rise in siponimod exposure is likely small. Piroxicam is mainly a substrate rather than an inhibitor, so the legacy concern is largely theoretical.
What this interaction means in plain words
Piroxicam and Siponimod have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Piroxicam belongs to Musculoskeletal; Siponimod belongs to Central Nervous System.
Why it happens
Possible competition for CYP2C9 metabolism; piroxicam is not an established CYP2C9 inhibitor.
What to do
No routine adjustment is needed; confirm the patient's CYP2C9 genotype is not *3/*3 as required by siponimod labeling. Monitor for siponimod adverse effects such as bradycardia and lymphopenia.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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 Siponimod
- Cladribine + Siponimod Contraindicated
- Fingolimod + Siponimod Contraindicated
- Fluconazole + Siponimod Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Siponimod Contraindicated
- Ponesimod + Siponimod Contraindicated
- Siponimod + Thioridazine Contraindicated
Frequently asked questions
Can I take Piroxicam with Siponimod?
MediHelp rates the interaction as minor. Piroxicam and Siponimod have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Piroxicam is metabolized by CYP2C9 and may compete with siponimod for this pathway, though it is not a notable CYP2C9 inhibitor. Any rise in siponimod exposure is likely small. Piroxicam is mainly a substrate rather than an inhibitor, so the legacy concern is largely theoretical.
How serious is the interaction between Piroxicam and Siponimod?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine adjustment is needed; confirm the patient's CYP2C9 genotype is not *3/*3 as required by siponimod labeling. Monitor for siponimod adverse effects such as bradycardia and lymphopenia.
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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