Drug General Information (ID: DDIYS16AP2)
Drug Name			Piroxicam		Drug Info		Diclofenac (topical)		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Nsaids/Analgesics
Structure

Mechanism of Piroxicam-Diclofenac (topical) Interaction (Severity Level: Moderate)
Increased risk of hepatotoxicity Click to Show/Hide Mechanism Graph
Drug Name		Piroxicam				Diclofenac (topical)
Mechanism		Hepatotoxicity				Hepatotoxicity
Key Mechanism Factor 1
		Factor Name		Hepatotoxicity
		Factor Description		Combination of drugs that can induce hepatotoxicity may increase the risk of liver injury. Symptoms vary depending on the level of exposure and the total extent of liver damage, and may cause few symptoms if the damage is mild, and eventually lead to liver failure in patients with severe damage.
Mechanism Description		Increased risk of hepatotoxicity by the combination of Piroxicam and Diclofenac (topical)

Recommended Action
Management		Patients treated with topical preparations of nonsteroidal anti-inflammatory drugs should avoid or limit the use of systemic nonsteroidal anti-inflammatory drugs. Although systemic exposure is generally low following topical administration, absorption may be increased with frequent applications use of large quantities or over large areas of skin use on compromised or diseased skin or open wounds and use of occlusive dressings or heating pads over application areas.

References
1	Product Information. Solaraze (diclofenac topical). Doak Dermatologics Division, Fairfield, NJ.