Who should not take a Non-Steroidal Anti-Inflammatory Drug (NSAID)/ Rox?

Can Rox be used with Lisinopril?

No. Rox should be avoided with lisinopril. It is important to note that piroxicam decreases the effectiveness of the antihypertensive medication like lisinopril when given together leading to failure of antihypertensive therapy. Inform your doctor if you are taking antihypertensive medications before starting Rox.

What is the difference between Rox and nimesulide?

Both Rox and nimesulide are pain killers. However, Rox is a non-selective COX (cyclooxygenase -an enzyme responsible for inflammation and pain) inhibitor whereas nimesulide is selective to the COX-2 enzyme. This selectivity of nimesulide is supposed to decrease the side effects as compared to piroxicam. It should not be used in children below 12 years of age.

Can Rox be used in the treatment of allergy?

No. Rox is not a drug to treat allergy. It is a pain killer.

What are the contraindications for Rox?

Contraindications to piroxicam are an allergy, bleeding tendency, duodenal/gastric/peptic ulcer, stomatitis, Systemic Lupus Erythematosus (SLE), ulcerative colitis, upper GI disease, late pregnancy, cardiac disease, hepatic impairment, renal impairment.

Can Rox be used with calcium channel blocker?

Yes. Rox can be taken with calcium channel blocker. NSAIDs have been observed to reduce the effectiveness of all antihypertensive drugs except calcium channel blockers (ref: White 2007)

What is the difference between Rox and naproxen?

Both Rox and naproxen are pain killers. Both are non-selective COX (cyclooxygenase - an enzyme responsible for inflammation and pain). Research studies have shown both are equally effective. However, gastric side effects are lesser with naproxen as compared to Rox.

Can you get high by using Rox?

No. Rox is not known to cause high. It is a non-narcotic painkiller.

What increases the chances of getting a gastric ulcer when I am already taking Rox?

The chances of gastric ulceration increases if you take medicines like corticosteroids and anticoagulants. Long term use, alcohol, smoking and old age are few other factors which can increase the chances of ulceration.

Can Rox lead to difficulty in conception?

Yes. Rox can sometimes cause reversible infertility. Piroxicam by its mechanism of action may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women. Consult your doctor before starting this medication.

Can I use Rox if I have asthma?

Some patients with asthma are hypersensitive to non-steroidal anti-inflammatory (NSAID) drugs like aspirin which can lead to acute attacks of asthma. Consult your doctor before starting this medication.

Can Rox lead to skin reactions?

Yes. Rox is known to cause skin reactions which can be very severe such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. These serious events may occur without warning. You should inform your doctor if you feel you have a mild rash and immediately discontinue the drug.

Are there any alternatives of Rox?

Yes. There are alternatives to Rox. Pain killers are prescribed according to the disease condition. Consult your doctor before starting piroxicam or changing it to other medication.

What are the serious side effects of Rox?

GI discomfort and, rarely, serious GI side effects, such as ulcers and bleeding, serious skin side effects such as exfoliative, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis, liver failure, renal damage.

Can I use Rox for a migraine?

Rox is not approved for the treatment of migraine. Research studies have shown that Rox is effective in significantly decreasing the pain associated with migraine without aura.

Can I use Rox if I have a deranged renal function?

No. Rox should not be taken if you have a abnormal renal function because long-term administration of NSAIDs has resulted in renal papillary necrosis and another renal injury.

Can I use Rox if I am pregnant?

No. Rox should not be taken in pregnancy. It causes premature closure of the ductus arteriosus which can lead to fetal heart failure and death of the baby.

Can Rox be used with lithium?

No. Rox should not be used with lithium. Rox leads to an elevation of plasma lithium levels and a reduction in renal lithium clearance. This is because of inhibition of renal prostaglandin synthesis by the NSAID. Consult and inform your doctor before starting this medication.

Can Rox be used with warfarin?

No. Rox should be avoided with warfarin as they both lead to increase in bleeding tendencies. Inform your doctor if you are taking any of the medications. If given together then the therapy should be monitored closely.

Is Rox affective in gout management?

Yes. Rox can be given for the treatment of acute gout. Research studies have shown Rox to be highly effective in the treatment of acute gout.

Can I use Rox if I am a diabetic?

Rox in a diabetic patient can only be taken only by consulting a doctor because these medicines have the propensity to cause renal failure when taken for a long period. Diabetes itself causes renal Rox so taking piroxicam can lead to increased risk of renal failure by many folds.

Can Rox be used with diuretics?

No. Rox should not be used with diuretics. Rox reduces the natriuretic effect of furosemide and thiazides diuretics in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis.

Can Rox be used with Tizanidine?

Yes, Rox can be combined with tizanidine. Piroxicam is a pain killer and tizanidine is a skeletal muscle relaxant. It is used in the condition like a backache.

Can Rox be used along with dexamethasone?

No. Rox should not be used with dexamethasone. They both increase each others toxicity. There is an increased risk of GI ulceration.

Can Rox be used with methocarbamol?

Yes. Methocarbamol can be used with Rox as no serious side effects are known. Inform your doctor before starting any of the medication.

Can Rox be used along with paracetamol?

Yes. Paracetamol can be used with Rox as no serious side effects are known. Inform your doctor before starting any of the medication.

Are Rox and aspirin same?

No. Rox and aspirin are not same. They belong to the same class of drugs known as COX (cyclooxygenase) inhibitors. They both are anti-inflammatory and analgesic.

Can Rox be used in the treatment of chikungunya?

Usually, the platelet count does not dip in cases of chikungunya and painkillers like piroxicam can lead to the risk of increased bleeding tendency. So refrain from taking Rox or any painkiller in the case of any fever with joint pain. Consult your doctor before starting Rox.

How long does Rox work?

Rox is a long acting drug. Once the daily dose is enough for the relief of pain but it depends from person to person as the effectiveness of piroxicam increases when given for few weeks.

Is Rox a blood thinner?

No. Rox is not a blood thinner. It is a pain killer. It should be avoided in a patient with a bleeding disorder.

Why is beta cyclodextrin added to Rox?

Yes. Rox can be combined with beta-cyclodextrin. Research has shown that combining Rox with beta-cyclodextrin leads to faster onset of action of piroxicam and reduced gastric side effects.

Is Rox a sulfa drug?

Rox is a sulphur containing compound. Rox can cause serious adverse events in sensitive individuals. It can cause severe skin reactions like Steven Johnson Syndrome. Do inform your doctor if you have any kind of allergies.

Is Rox a NSAID?

Yes. Rox is a non-steroidal anti-inflammatory drug (NSAID).

What is the difference between Rox and tramadol?

Rox is a COX (cyclooxygenase -an enzyme responsible for inflammation and pain) whereas Tramadol is a narcotic-like painkiller. Tramadol is a habit forming medicine.

What is the difference between Rox and meloxicam?

Both Rox and meloxicam are pain killers. Both are non-selective COX (cyclooxygenase - an enzyme responsible for inflammation and pain). Research studies have shown both are equally effective. However, acute gastric side effects are lesser with meloxicam as compared to Rox.

What is the difference between Rox and ketoprofen?

Both Rox and ketoprofen are pain killers. Both are non-selective COX (cyclooxygenase -an enzyme responsible for inflammation and pain). Research studies have shown ketoprofen topical gel is better and effective as compared to Rox. Ketoprofen gel also showed excellent tolerability.

Is Rox a narcotic?

No. Rox is not a narcotic. It is a pain killer which acts on COX (cyclooxygenase -an enzyme responsible for inflammation and pain) enzyme to decrease the pain and inflammation.

Can Rox be used along with Losartan?

No. Rox should not be combined with Losartan. It is important to note that Rox decreases the effectiveness of the antihypertensive medication like losartan when given together leading to failure of antihypertensive therapy. Inform your doctor if you are taking antihypertensive medications before starting Rox.