Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Piroxicam is a
nonsteroidal
anti-inflammatory drug (NSAID) that is effective in treating fever, pain, and
inflammation in the body. As a group, NSAIDs are non-narcotic relievers of mild
to moderate pain of many causes, including injury, menstrual cramps, arthritis,
and other musculoskeletal conditions. Other members of this class include
ibuprofen (Motrin), naproxen (Aleve), indomethacin (Indocin), nabumetone
(Relafen) and several others. They work by reducing the levels of
prostaglandins, chemicals that are responsible for pain, fever, and
inflammation. Piroxicam blocks the enzyme that makes prostaglandins (cyclooxygenase),
resulting in lower concentrations of prostaglandins. As a consequence,
inflammation, pain and fever are reduced. The FDA approved piroxicam in 1982.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Capsules: 10 and 20 mg
STORAGE: Piroxicam should be stored at room temperature in a sealed
container that excludes moisture.
DOSING: The recommended dose is 20 mg once daily or 10 mg twice daily.
Piroxicam should be taken with food.
DRUG INTERACTIONS: Piroxicam may increase the blood levels of lithium
(Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys.
Increased levels of lithium may lead to lithium toxicity.
Piroxicam may reduce the blood pressure lowering effects of blood pressure
medications. This may occur because prostaglandins play a role in the regulation
(reduction) of blood pressure.
Combining NSAIDs such as piroxicam with angiotensin receptor blockers (for
example, valsartan [Diovan], losartan [Cozaar], irbesartan [Avapro]) or
angiotensin converting enzyme ACE) inhibitors (for example, enalapril [Vasotec],
captopril [Capoten]) in patients who are elderly, volume-depleted (including
those on diuretic therapy), or with poor kidney function may result in reduced
kidney function, including kidney failure. These effects usually are reversible.
When piroxicam is used in combination with methotrexate (Rheumatrex, Trexall)
or aminoglycoside antibiotics (for example, gentamicin) the blood levels of
methotrexate or aminoglycoside may increase, presumably because the elimination
of methotrexate or aminoglycosides from the body is reduced. This may lead to
more methotrexate- or aminoglycoside- related side effects.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Reactive arthritis is a chronic, systemic rheumatic disease characterized by three conditions, including conjunctivitis, joint inflammation, and genital, urinary or gastrointestinal system inflammation. Inflammation leads to pain, swelling, warmth, redness, and stiffness of the affected joints. Non-joint areas may experience irritation and pain. Treatment for reactive arthritis depends on which area of the body is affected. Joint inflammation is treated with antiinflammatory medications.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
What are nonsteroidal anti-inflammatory drugs (NSAIDs)?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed medications for the inflammation of arthritis and other body tissues, such as in
tendinitis and bursitis. The are also used for minor aches and pain.
Examples of NSAIDs include:
aspirin,
indomethacin (Indocin),
ibuprofen (Motrin),
naproxen (Naprosyn),
piroxicam (Feldene),
nabumetone (Relafen), and
Celecoxib (Celebrex).
NSAIDs are available by prescription or without a prescription (over-the-counter). They are also ingredients in many over the counter medications used for
colds and minor aches and
pain. They are administered orally as capsules, tablets, liquids, or by
injection ketorolac
(Toradol). Although not included in this review, NSAIDs are also used as eye drops for eye inflammation (f...
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