piroxicam, Feldene

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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. 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.

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

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.

Individuals taking oral blood thinners or anticoagulants, for example, warfarin, (Coumadin), should avoid piroxicam because piroxicam also thins the blood, and excessive blood thinning may lead to bleeding.




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