Medications and Drugs
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.
Reference: FDA Prescribing Information
Last Editorial Review: 12/21/2006
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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