Piroxicam and Hyperkalemic Acidosis

Excerpt

To the editor: Several nonsteroidal antiinflammatory drugs have been associated with reversible azotemia and hyperkalemia (1). Piroxicam is a new, chemically unique, nonsteroidal antiinflammatory drug in the oxicam family (2). We have observed reversible, hyperkalemic, hyperchloremic acidosis associated with piroxicam therapy in a patient with rheumatoid arthritis.

A 55-year-old man with a 25-year history of rheumatoid arthritis complicated by hypocomplementemic glomerulonephritis was hospitalized for bilateral total replacement of the hip. Therapy consisted of piroxicam, 20 mg/day, for 6 months, and chronic hypertension was controlled with propranolol, 40 to 60 mg/day. His previous arthritis treatment had included