Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: piroxicam

BRAND NAME: Feldene

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. NSAIDs, including piroxicam, block the enzyme in the body that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. Prostaglandins are responsible for causing many types of pain, fever and inflammation. As a consequence of taking NSAIDs, inflammation, pain and fever are reduced. The FDA approved piroxicam in 1982.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: capsules: 10, 20 mg

STORAGE: Store at room temperature in a sealed container that excludes moisture.

PRESCRIBED FOR: Piroxicam is used for the treatment of inflammation and pain caused by rheumatoid arthritis and osteoarthritis.

DOSING: The recommended dose is 20 mg once daily or 10 mg twice daily. Piroxicam should be taken with food.

DRUG INTERACTIONS: Piroxicam generally is used with caution in patients taking blood thinning medications to prevent the clotting of blood (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding. The increased risk is due to the fact that NSAIDs prevent the clotting of blood though by a different mechanism than anticoagulants. (They inhibit blood platelets which are important for the clotting of blood.) Piroxicam can increase blood levels of several drugs. Patients taking lithium can develop toxic blood lithium levels, and patients taking cyclosporine (Sandimmune) can develop kidney toxicity. Piroxicam may increase the toxic effects of methotrexate and may reduce the effectiveness of angiotensin converting enzyme (ACE) inhibitors .

PREGNANCY: Safety during pregnancy has not been established. Use in late pregnancy may cause premature closing of the ductus arteriosus in the fetus.

NURSING MOTHERS: Piroxicam is excreted into human breast milk. Use by nursing mothers is not recommended.

SIDE EFFECTS: Most patients benefit from piroxicam and other NSAIDs with few side effects. However, serious side effects can occur and generally tend to occur more frequently at higher doses. Therefore, it is advisable to use the lowest effective dose to minimize side effects. The most common side effects of piroxicam involve the gastrointestinal system. It can cause ulcerations, abdominal pain, cramping, nausea, gastritis, and even serious gastrointestinal bleeding and liver toxicity. Sometimes, stomach ulceration and bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of internal bleeding. Rash, kidney impairment, ringing in the ears, and lightheadedness also can occur.

From the Doctors at MedicineNet.com

Rheumatoid Arthritis - Learn more about rheumatoid arthritis, an autoimmune disease that causes chronic joint inflammation, which has symptoms that include stiffness, fever, muscle and joint aches, loss of appetite, and fatigue. Treatment of rheumatoid arthritis incorporates the use of first-line drugs (aspirin and corticosteroids for pain and inflammation) and second-line drugs (methotrexate and hydroxychloroquine to prevent joint destruction and promote remission). Source:MedicineNet Reactive Arthritis - Learn about reactive arthritis, 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. Source:MedicineNet Nonsteroidal Anti-inflammatory Drugs and Ulcers - Source:MedicineNet Read 27 more piroxicam related articles ... So Much to Do, So Little Sleep Head Injuries All Too Common in Summer Play Health Tip: The Word on Wisdom Teeth Health Tip: Make Exercise a Daily Habit New Source of Heart Stem Cells Found Health Highlights: June 23, 2008 Poorer Patients Have Poorer Survival After Cancer Diagnosis One Gene May Be Key to Myeloma Crocodile Babies Cry Out for Hatching Immune Molecule Key to Preventing Organ Rejection