Piroxicam

Piroxicam is a prescription medication used to relieve pain, tenderness, swelling, and stiffness of osteoarthritis and rheumatoid arthritis. Piroxicam belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by blocking substances called prostaglandins that cause pain and inflammation.

This medication comes in capsule form. It is taken once or twice daily, with or after food to minimize stomach upset.

Common side effects include stomach pain, constipation, and diarrhea. Piroxicam may cause drowsiness. Do not drive or operate heavy machinery until you know how it affects you.

Piroxicam is a prescription medication used:

• For relief of the signs and symptoms of osteoarthritis.
• For relief of the signs and symptoms of rheumatoid arthritis.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Piroxicam may be found in some form under the following brand names:

• Feldene

Common side effects include:

• indigestion
• heartburn
• stomach pain
• diarrhea
• constipation
• gas
• headache
• dizziness
• nervousness
• drowsiness

This is not a complete list of piroxicam side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• aspirin
• methotrexate (Rheumatrex, Trexall)
• angiotensin-converting enzyme (ACE) blockers such as
  • benazepril (Lotensin, Lotensin HCT)
  • captopril (Capoten, Capozide)
  • enalapril (Vasotec, Vaseretic)
  • fosinopril (Monopril, Monopril HCT)
  • lisinopril (Prinivil, Prinzide, Zestril, Zestoretic)
  • moexipril (Univasc, Uniretic)
  • quinapril (Accupril, Accuretic, Quinaretic)
  • ramipril (Altace)
  • trandolapril (Mavik, Tarka)
• diuretics such as
  • acetazolamide (Diamox)
  • amiloride (Midamor)
  • bumetanide (Bumex)
  • chlorothiazide (Diuril)
  • chlorthalidone (Thalitone)
  • ethacrynic acid (Edecrin)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide, HCTZ)
  • metolazone (Zaroxolyn)
  • torsemide (Demadex)
  • triamterene (Dyrenium, Dyazide, Maxzide)
• warfarin (Coumadin, Jantoven)
• lithium (Lithobid)
• highly protein bound drugs such as phenytoin (Dilantin, Phenytek)

This is not a complete list of piroxicam drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with piroxicam including the following:

• Cardiovascular thrombotic events. Piroxicam can increase your risk of cardiovascular and heart diseases such as strokes and myocardial infarctions, which can lead to death. Tell your doctor if you have a history of heart disease.
• Gastrointestinal effects. Piroxicam can cause digestive tract problems such as ulcers, bleeding, inflammation, and perforations (small holes). Tell your doctor if you have a history of digestive problems, or if you smoke or frequently drink alcohol. Alert your doctor if you take anticoagulants (blood-thinners) or corticosteroids such as prednisone.
• Renal effects. Kidney damage can result from the use of piroxicam. Tell your doctor if you have a history of kidney disease or take ACE inhibitors (such as lisinopril and enalapril) or diuretics (water pills).
• Hypersensitivity reaction. An allergic reaction to piroxicam can occur. Symptoms of a hypersensitivity reaction include:
  • hives
  • rash
  • difficulty breathing or swallowing
  • itching
  • swelling
• Adverse skin reactions. Piroxicam can lead to dangerous skin reactions. Symptoms of a skin reaction include:
  • rash
  • red, itchy, or scaly skin
  • blisters
  • fever
• Pregnancy. Piroxicam should not be taken in late pregnancy.

Piroxicam can cause drowsiness. Do not drive or operate heavy machinery until you know how piroxicam affects you.

Do not take piroxicam if you:

• are allergic to piroxicam or to any of its ingredients
• have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like reactions to NSAIDs have been reported in such patients.
• being treated for peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of piroxicam, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking piroxicam, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to piroxicam or to any of its ingredients
• about all of the medicines you take. NSAIDs such as piroxicam and some other medicines can interact with each other and cause serious side effects. Keep a list of your medicines to show to your healthcare provider and pharmacist.
• if you are pregnant. NSAID medicines should not be used by pregnant women late in their pregnancy.
• if you are breastfeeding. Talk to your doctor.
• have or have ever had asthma, especially if you also have frequent stuffy or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs
• have liver or kidney disease
• if you are having surgery, including dental surgery

Talk to your doctor about the risks and benefits of taking piroxicam if you are 65 years of age or older.

• Older adults should usually take lower doses of piroxicam for short periods of time because higher doses taken regularly may not be more effective and are more likely to cause serious side effects.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Piroxicam falls into category C. There are no well-controlled studies that have been done in pregnant women. Piroxicam capsules are not recommended for use in pregnant women since safety has not been established in humans. Piroxicam should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

In late pregnancy, as with other NSAIDs, piroxicam should be avoided.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Piroxicam has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from piroxicam, a choice should be made whether to stop nursing or to stop use of this medication. Piroxicam is not recommended for use in nursing mothers.

Take piroxicam exactly as prescribed.

Piroxicam comes in capsule form. It is taken once or twice daily, with or after food to minimize stomach upset.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of piroxicam at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your liver function
• your age

The recommended dose of piroxicam (Feldene) for the relief of rheumatoid arthritis and osteoarthritis is 20 mg given orally once per day.

• If needed, the daily dose may be divided.

If you take too much piroxicam, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store piroxicam at 20° to 25°C (68° to 77°F).
• Keep this and all medicines out of the reach of children.