Piroxicam-Induced Renal Failure and Hyperkalemia

Excerpt

To the editor: We report a case of piroxicam-induced acute renal failure and hyperkalemia. Although these complications have accompanied the use of other nonsteroidal antiinflammatory agents (1-4), they have not to our knowledge been reported with piroxicam.

An 82-year-old white woman had a long history of hypertension, cerebrovascular disease, stable angina pectoris, and rheumatoid arthritis. She was taking prednisone, folic acid, timolol, triamterene-hydrochlorothiazide, and digoxin, and developed bilateral lumbar pain. The patient was treated with oral cotrimoxazole and piroxicam. Six days later, effort-induced dyspnea and frequent presyncopal episodes necessitated hospital admission.

The patient's heart rate ranged from 20 to 80/min,