Drug interactions
Piroxicam + Spironolactone
Severity: Major
Piroxicam and Spironolactone: 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 diuretic and antihypertensive effect of spironolactone and impair renal function. They also raise the risk of hyperkalemia, which is most important in older patients and those with kidney disease or heart failure.
What this interaction means in plain words
Piroxicam and Spironolactone 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.
Piroxicam belongs to Musculoskeletal; Spironolactone belongs to Cardiovascular.
Why it happens
NSAID inhibition of renal prostaglandins reduces renal blood flow, sodium excretion and renin-aldosterone drive, impairing potassium excretion alongside aldosterone antagonism.
What to do
Monitor serum potassium and creatinine within the first week or so and periodically afterward. Avoid the combination in patients with renal impairment or on other potassium-raising drugs.
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 Spironolactone
- Amiloride + Spironolactone Contraindicated
- Eplerenone + Spironolactone Contraindicated
- Spironolactone + Triamterene Contraindicated
- Abiraterone + Spironolactone Major
- Aceclofenac + Spironolactone Major
- Acemetacin + Spironolactone Major
Frequently asked questions
Can I take Piroxicam with Spironolactone?
MediHelp rates the interaction as major. Piroxicam and Spironolactone 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 diuretic and antihypertensive effect of spironolactone and impair renal function. They also raise the risk of hyperkalemia, which is most important in older patients and those with kidney disease or heart failure.
How serious is the interaction between Piroxicam and Spironolactone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and creatinine within the first week or so and periodically afterward. Avoid the combination in patients with renal impairment or on other potassium-raising drugs.
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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