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- What is piroxicam, and how does it work (mechanism of action)?
- What brand names are available for piroxicam?
- Is piroxicam available as a generic drug?
- Do I need a prescription for piroxicam?
- What are the side effects of piroxicam?
- What is the dosage for piroxicam?
- Which drugs or supplements interact with piroxicam?
- Is piroxicam safe to take if I'm pregnant or breastfeeding?
- What else should I know about piroxicam?
What is piroxicam, and how does it work (mechanism of action)?
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.
What are the side effects of piroxicam?
The most common side effects of piroxicam are:
- abdominal pain,
- fluid retention,
- ringing in the ears, and
NSAIDs reduce the ability of blood to clot and therefore increase bleeding after an injury.
Piroxicam also may cause stomach and intestinal bleeding and ulcers. Sometimes, stomach ulceration and intestinal bleeding can occur without any abdominal pain. Black tarry stools, weakness, and dizziness upon standing may be the only signs of the bleeding. People who are allergic to other NSAIDs should not use piroxicam.
NSAIDs reduce the flow of blood to the kidneys and impair function of the kidneys. The impairment is most likely to occur in patients with preexisting impairment of kidney function or congestive heart failure, and use of NSAIDs in these patients should be done cautiously.
Individuals with asthma are more likely to experience allergic reactions to prioxicam and other NSAIDs. Fluid retention, blood clots, heart attacks, hypertension, and heart failure have also been associated with the use of NSAIDs.
Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment
What is the dosage for piroxicam?
The recommended dose is 20 mg once daily or 10 mg twice daily. Piroxicam should be taken with food.
Which drugs or supplements interact with piroxicam?
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.
Alcohol consumption may increase the risk of developing stomach ulcers when taking piroxicam or other NSAIDs.
Is piroxicam safe to take if I'm pregnant or breastfeeding?
Piroxicam is excreted into human breast milk. Use by nursing mothers is not recommended.
What else should I know about piroxicam?
What preparations of piroxicam are available?
Capsules: 10 and 20 mg
How should I keep piroxicam stored?
Piroxicam should be stored at room temperature in a sealed container that excludes moisture.
Reference: FDA Prescribing Information
Quick GuideRheumatoid Arthritis (RA) Symptoms & Treatment
Piroxicam (Feldene) is a NSAID prescribed for the treatment of rheumatoid arthritis and osteoarthritis. Side effects, drug interactions, warnings and precautions, and pregnancy safety information should be reviewed prior to taking this medication.
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Rheumatoid Arthritis (RA)
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- Rheumatoid Arthritis FAQs
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Medications & Supplements
- Nonsteroidal Antiinflammatory Drugs (NSAIDs)
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- Drugs: What You Should Know About Your Drugs
- celecoxib, Celebrex
- indomethacin, Indocin, Indocin-SR (Discontinued Brand in U.S.)
- Drug Interactions
- etodolac, Lodine (Discontinued)
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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.
Top piroxicam Related ArticlesComplete List
Aspirin vs NSAIDs
Aspirin and nonsteroidal anti-inflammatory drugs, or NSAIDs, are both drugs used to treat pain, redness, swelling, and inflammation from a variety of medical conditions like menstrual cramps, arthritis, minor strains and sprains, and headaches. Aspirin also treats fever. Aspirin also is an NSAID, but it works in the body differently than other NSAIDs.
Some of the common side effects of aspirin and NSAIDS are nausea, vomiting, diarrhea, constipation, loss of appetite, peptic ulcers, and tinnitus. NSAIDs also can cause dizziness, headache, and drowsiness. Important and serious side effects of both drugs are kidney or liver failure, GI bleeding, and prolonged bleeding after surgery.
Aspirin and nonsteroidal anti-inflammatory drugs have other important side effects and drug interactions that should be reviewed prior to taking either drug.
REFERENCE: FDA. Medication Guide for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
celecoxibCelecoxib (Celebrex - Discontinued Brand) is a NSAID (nonsteroidal antiinflammatory drug) that is used to treat pain, arthritis pain, menstrual cramps, and colonic polyps. Celebrex is also used relief of pain, fever, swelling, and tenderness caused by osteoarthritis, juvenile arthritis, rheumatoid arthritis, and ankylosing spondylitis. There are important drug interactions to review when taking Celebrex. Side effects should also be reviewed.
Chronic PainChronic 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.
diflunisalDiflunisal (Dolobid) is a NSAID drug used to treat mild to moderate the fever, pain, and inflammation, osteoarthritis and rheumatoid arthritis. Side effects, drug interactions, warnings and precautions, and patient information should be reviewed prior to taking any medication.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
etodolacEtodolac (Lodine ([Discontinued]) is a NSAID prescribed to treat pain and inflammation associated with osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, tendinitis, bursitis, and menstrual cramps. Side effects, drug interactions, and pregnancy safety information should be reviewed prior to taking this medication.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce mild to moderate pain, inflammation, and fever. Ibuprofen works by blocking an enzyme that makes prostaglandin (a hormone-like substance that participates in a variety of body functions), which results in lower levels of prostaglandins in the body. Lower levels of prostaglandins reduce pain, inflammation, and fever.
Ibuprofen is prescribed to treat diseases and conditions that cause mild to moderate pain, fever, and inflammation. For example:
- Pain from strains and sprains
- Pain from cuts, scrapes, and puncture wounds
- Muscle aches and pains
- Tooth pain
- Common cold
- Mild headache
- Some arthritis conditions
- Joint pain
- To reduce fever
Common side effects of ibuprofen include:
- Belly pain
- Tinnitus (ringing in the ears)
- Mild rash
More serious side effects and adverse effects include:
- Increased bleeding after injury
- Stomach ulcers
- Impaired kidney function
- Severe allergic reaction (anaphylaxis)
- Blood clots
- Heart attack
- Heart failure
- High blood pressure
The maximum dose prescribed under a doctor's care is 3.2 g daily. Otherwise, the over-the-counter (OTC) maximum daily dose is 1.2 g daily. Dosage depends upon the age, weight, and any current medical conditions of the patient. Several drugs interact with ibuprofen so check with your doctor, pharmacist, or other health care professional with questions in regard to this drug. Doctors don't know if it is safe to take ibuprofen if your are pregnant, therefore it is not recommended if you are pregnant. According to the American Academy of Pediatrics, ibuprofen is safe to take while breastfeeding.
REFERENCE: FDA Prescribing Information.
indomethacinindomethacin; Indocin, Indocin-SR (Discontinued Brand in U.S.) is a nonsteroidal anti-inflammatory (NSAID) drug prescribed for the treatment of inflammation caused by gouty arthritis, osteoarthritis, soft tissue injuries such as bursitis and tendinitis, rheumatoid arthritis, and ankylolsing spondylitis. Side effects, drug interactions, pregnancy safety, and dosage information should be reviewed prior to taking this medication.
naproxenNaproxen (Anaprox, Naprelan, Naprosyn, Aleve) is in the class of drugs called nonsteroidal antiinflammatory drugs (NSAIDs). Naproxen is prescribed for the treatment of mild to moderate pain, inflammation, and fever. Side effects, drug interactions, and pregnancy information should be reviewed prior to taking this medication.
Nonsteroidal Anti-inflammatory Drugs and UlcersNonsteroidal 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.
Nonsteroidal Antiinflammatory DrugsNonsteroidal antiinflammatory drugs (NSAIDs) are a class of drugs are used to treat inflammation, mild to moderate pain, and fever. Examples of the most common NSAIDs include: aspirin salsalate (Amigesic), diflunisal (Dolobid), ibuprofen (Motrin), ketoprofen (Orudis), nabumetone (Relafen), piroxicam (Feldene), naproxen (Aleve, Naprosyn,) diclofenac (Voltaren), indomethacin (Indocin), sulindac (Clinoril), tolmetin (Tolectin), etodolac (Lodine), ketorolac (Toradol), oxaprozin (Daypro), celecoxib (Celebrex).
OsteoarthritisOsteoarthritis 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.
Reactive ArthritisReactive 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 anti-inflammatory medications.
Rheumatoid ArthritisRheumatoid arthritis (RA) 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.
RA Friendly ExercisesRegular exercise boosts fitness and helps reverse joint stiffness for people with rheumatoid arthritis (RA). Our experts offer helpful exercises to get you started.
RA SlideshowWhat is rheumatoid arthritis (RA)? Learn about juvenile rheumatoid arthritis. Discover rheumatoid arthritis (RA) symptoms, diagnosis, and treatment.
Take the RA QuizHow is rheumatoid arthritis different from other forms of arthritis, such as osteoarthritis and gout? Take the Rheumatoid Arthritis (RA) Quiz to rest your RA IQ.