Warfarin Institute of America
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PIROXICAM INTERACTIONS WITH WARFARIN
Brand Name: Feldene
Rhodes et al. report the case of a person who experienced a warfarin-piroxicam drug interaction. The person was taking warfarin and piroxicam and had the piroxicam discontinued. He then had to have his warfarin dose increased. Twice over the next ten months, the piroxicam was restarted and stopped. Each time it was restarted, his warfarin dose had to be lowered and each time it was stopped his warfarin dose had to be increased.
There is also a case reported where a woman taking piroxicam was spreading a warfarin-like rat poison weekly. She did not use gloves, nor wash her hands afterwards. She developed a brain hemorrhage.
A report from Hong Kong also lists two cases of bleeding associated with prioxicam. They also mention a piroxicam gel which is not available in the United States.
References:
Rhodes RS et at. A warfarin-piroxicam drug interaction. Drug Intell Clin Pharm 1985;19:556-558.
Abell TL et al. Cutaneous exposure to warfarin-like anticoagulant causing an intracerebral hemorrhage:a case report. J Toxicol Clin Toxicol 1994;32:69-73.
Chan TY. Drug interactions as a cause of overanticoagulation and bleedings in Chinese patients receiving warfarin. Int J Clin Pharmacol Ther 1998;36:403-405.
Please Note: I do not recommend this combination because of the likelihood of gastrointestinal irritation by the piroxicam. If a bleed does get started, it may become excessive because of the warfarin.
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Last updated November 15, 2004