Drug interactions
Piroxicam + Ticagrelor
Severity: Major
Piroxicam and Ticagrelor: 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
Taking an NSAID with ticagrelor raises the risk of bleeding, especially from the gastrointestinal tract. The antiplatelet effects of both drugs are additive.
What this interaction means in plain words
Piroxicam and Ticagrelor 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; Ticagrelor belongs to Cardiovascular.
Why it happens
Additive platelet inhibition (P2Y12 blockade plus COX inhibition) together with NSAID gastric mucosal injury.
What to do
Avoid regular NSAID use in patients on ticagrelor and use paracetamol instead. If an NSAID is essential, use gastroprotection and monitor for bleeding.
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 Ticagrelor
- Itraconazole + Ticagrelor Contraindicated
- Ketoconazole + Ticagrelor Contraindicated
- Levoketoconazole + Ticagrelor Contraindicated
- Abciximab + Ticagrelor Major
- Abrocitinib + Ticagrelor Major
- Acalabrutinib + Ticagrelor Major
Frequently asked questions
Can I take Piroxicam with Ticagrelor?
MediHelp rates the interaction as major. Piroxicam and Ticagrelor 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. Taking an NSAID with ticagrelor raises the risk of bleeding, especially from the gastrointestinal tract. The antiplatelet effects of both drugs are additive.
How serious is the interaction between Piroxicam and Ticagrelor?
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 in patients on ticagrelor and use paracetamol instead. If an NSAID is essential, use gastroprotection and monitor for bleeding.
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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