Piroxicam is used to treat rheumatoid arthritis and osteoarthritis. It is in a class of medications known as non-steroidal anti-inflammatory drugs (NSAIDs).
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Interactions with Dietary Supplements

Potassium
An 85-year-old man developed higher than normal blood levels of potassium following several months of treatment with piroxicam.1 Until more is known, people taking piroxicam for long periods should have their blood checked regularly for high potassium levels and may need to avoid high potassium intake with the guidance of a health practitioner.

Folic acid
Piroxicam may prevent inflammation by blocking the activity of enzymes that depend on folic acid.2 However, other studies show that people taking NSAIDs such as aspirin have lower than normal levels of folic acid in their red blood cells.3 Further research is needed to determine whether supplemental folic acid prevents a deficiency of the vitamin or indirectly reduces the beneficial effects of piroxicam.

Lithium
Lithium is a mineral that is present in some supplements and is also used in large amounts to treat mood disorders such as bipolar disorder (manic depression). Blood levels of lithium may increase in people taking NSAIDs and lithium supplements together (compared with lithium alone),4 possibly resulting in unwanted side effects such as diarrhea, nausea, muscle weakness, and lack of coordination. More research is needed to determine whether piroxicam specifically increases lithium blood levels. Until more is known, people should avoid lithium supplementation except when it is prescribed by a doctor.
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Interactions with Herbs

Willow (Salix alba)
Willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. Taking aspirin significantly lowers blood levels of piroxicam and increases the potential for adverse side effects.5 Though no studies have investigated interactions between willow bark and piroxicam, people taking the drug should avoid the herb until more information is available.
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Food
Taking piroxicam with a meal may delay the speed, but not the overall amount, of drug absorption.6 Therefore, it may be taken with food if stomach upset occurs when taking the drug on an empty stomach.