piroxicam, Feldene (cont.)

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Medical and Pharmacy Editor:

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.



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