Sulfasalazine
Contraindicated
Textbook
Exacerbation of inflammatory bowel disease (IBD).
Avoid combining sulfasalazine with traditional NSAIDs.
Source: G&G 14e · p1112
Drug reference
Tenoxicam
NSAID · Anti-inflammatory
NSAIDAnti-inflammatory
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 12 →
- SulfasalazineContraindicatedTextbookG&G 14e · p1112
- AminoglycosideSevereTextbookKDT 7e · p746
- AminoglycosidesSevereTextbookKDT 7e
- AnticoagulantsSevereTextbookKDT 7e
Mechanism
Tenoxicam, like other nonselective COX inhibitors (traditional NSAIDs), primarily acts by inhibiting cyclooxygenase (COX) enzymes, which are responsible for prostaglandin (PG) generation from arachidonic acid. It inhibits both COX-1 and COX-2 isoforms. The inhibition of COX-2 mediated enhanced PG synthesis at the site of inflammation is considered the most important mechanism of its anti-inflammatory action.
Indications
Arthritissimilar to piroxicam
Dosing
- Adult
- 20 mg OD
- Geriatric
- Start at a low dosage and increase only if therapeutic efficacy is insufficient, due to elevated plasma concentrations in elderly patients.
Pharmacokinetics
Half-life
long t1/2
Metabolism
primarily oxidative metabolism
Side effects
Common
Gastric mucosal damageBleeding: inhibition of platelet functionLimitation of renal blood flow (leading to Na+ and water retention)
Serious
- Asthma and anaphylactoid reactions in susceptible individuals
- Delay/prolongation of labour
Drug interactions
Aminoglycoside
Severe
Textbook
Increased risk of nephrotoxicity.
Avoid concurrent use.
Source: KDT 7e · p746
Aminoglycosides
Severe
Textbook
Increased aminoglycoside levels and potential toxicity.
Monitor aminoglycoside levels and renal function; adjust dosage as needed.
Source: KDT 7e
Anticoagulants
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider alternative analgesics or gastroprotective agents.
Source: KDT 7e
Ciprofloxacin
Severe
Textbook
Enhanced CNS toxicity, seizures reported.
Source: KDT 7e
Citalopram
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Clopidogrel
Severe
Textbook
Increased bleeding risk.
Exercise extra caution and monitor for signs of bleeding.
Source: G&G 14e
Corticosteroids
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents.
Source: KDT 7e
Cyclosporine
Severe
Textbook
Increased nephrotoxicity.
Avoid concomitant use or monitor renal function closely.
Source: KDT 7e
Dapoxetine
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Enalaprilat
Severe
Textbook
Reduced effectiveness of ACE inhibitors. Marked hyperkalemia, potentially leading to cardiac arrhythmia.
Use with caution, especially in the elderly and in patients with hypertension, diabetes mellitus, or ischemic heart disease.
Source: G&G 14e · p836
Escitalopram + Clonazepam
Severe
Textbook
Increased risk of gastrointestinal bleed.
Monitor for bleeding; consider gastroprotective agents or alternative analgesics.
Source: KDT 7e
Related guidelines
Other NSAID drugs
Ask House about Tenoxicam
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Sources: KD Tripathi 7e, Katzung, BNF·Verified: 2026-05-10 · House clinical team