Drug interactions
Piroxicam + Valproic acid
Severity: Moderate
Piroxicam and Valproic acid: 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
Valproate may increase piroxicam exposure, and both drugs impair platelet function, which may increase bleeding risk. Valproate can also be displaced from protein binding by NSAIDs.
What this interaction means in plain words
Piroxicam and Valproic acid 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; Valproic acid belongs to Central Nervous System.
Why it happens
Valproate inhibits CYP2C9 and both agents have additive antiplatelet effects, with possible protein binding displacement.
What to do
Monitor for bleeding and gastrointestinal symptoms, and check platelet counts if clinically relevant. Consider an alternative analgesic if prolonged therapy is needed.
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 Valproic acid
- Ertapenem + Valproic acid Contraindicated
- Imipenem / cilastatin / relebactam + Valproic acid Contraindicated
- Imipenem / cilastatin + Valproic acid Contraindicated
- Meropenem / vaborbactam + Valproic acid Contraindicated
- Meropenem + Valproic acid Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Valproic acid Major
Frequently asked questions
Can I take Piroxicam with Valproic acid?
MediHelp rates the interaction as moderate. Piroxicam and Valproic acid 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. Valproate may increase piroxicam exposure, and both drugs impair platelet function, which may increase bleeding risk. Valproate can also be displaced from protein binding by NSAIDs.
How serious is the interaction between Piroxicam and Valproic acid?
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 for bleeding and gastrointestinal symptoms, and check platelet counts if clinically relevant. Consider an alternative analgesic if prolonged therapy is needed.
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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