Piroxicam (Oral Route)

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ARTICLE SECTIONS

US Brand Names

Feldene

Canadian Brand Names

Alti-Piroxicam

Description

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and help relieve symptoms of arthritis (osteoarthritis and rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain. This medicine does not cure arthritis and will help you only as long as you continue to take it .

This medicine is available only with your doctor's prescription .

This product is available in the following dosage forms:

Capsule
Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of piroxicam in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of piroxicam in the elderly. However, elderly patients may be more sensitive to the effects of piroxicam than younger adults, and are more likely to have age-related kidney problems, which may require adjustment of dosage in patients receiving piroxicam .

Pregnancy

	Pregnancy Category	Explanation
All Trimesters	C	Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Drug Interactions

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Ketorolac

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

Anemia or
Asthma or
Bleeding problems or
Blood clots or
Edema (fluid retention or body swelling) or
Heart attack, history of or
Heart disease (e.g., congestive heart failure) or
High blood pressure or
Kidney disease or
Liver disease (e.g., hepatitis) or
Stomach or intestinal ulcers or bleeding or
Stroke, history of—Use with caution. This medicine may make these conditions worse .

Aspirin sensitivity, history of—This medicine should NOT be used in patients with this condition .

Heart surgery (e.g., coronary artery bypass graft [CABG] surgery)—This medicine should NOT be used to relieve pain right before or after the surgery .

Proper Use

For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your doctor. Taking too much of this medicine may increase the chance of unwanted effects, especially in elderly patients .

When used for severe or continuing arthritis, this medicine must be taken regularly as ordered by your doctor in order for it to help you. This medicine usually begins to work within one week, but in severe cases up to two weeks or even longer may pass before you begin to feel better. Also, several weeks may pass before you feel the full effects of this medicine.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (capsules):
- For osteoarthritis and rheumatoid arthritis:
  - Adults—20 milligrams (mg) once a day or 10 mg twice a day.
  - Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood and urine tests may be needed to check for unwanted effects .

This medicine may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk .

This medicine may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, if you are over 60 years old, if you are in poor health, or if you are using certain other medicines (a steroid or a blood thinner) .

Serious skin reactions can occur during treatment with this medicine. Check with your doctor right away if you have any of the following symptoms while taking this medicine: blistering, peeling, loosening of skin, chills, cough, diarrhea, fever, itching, joint or muscle pain, red skin lesions, sore throat, sores, ulcers, white spots in mouth or on lips, or unusual tiredness or weakness .

Possible warning signs of some serious side effects that can occur during treatment with this medicine may include swelling of the face, fingers, feet, and/or lower legs; severe stomach pain, black, tarry stools, and/or vomiting of blood or material that looks like coffee grounds; unusual weight gain; yellow skin or eyes; decreased urination; unusual bleeding or bruising; and/or skin rash. Also, signs of serious heart problems could occur such as chest pain, tightness in chest, fast or irregular heartbeat, unusual flushing or warmth of skin, weakness, or slurring of speech. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs .

This medicine may also cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur more often in patients who are allergic to aspirin or to any of the nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing, or fainting. Other signs may include changes in color of the skin of the face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; and puffiness or swellings of the eyelids or around the eyes. If these effects occur, get emergency help at once .

Using this medicine while you are pregnant can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away .

Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor) .

Before having any kind of surgery or medical tests, tell your doctor that you are taking this medicine. It may be necessary for you to stop treatment for a while, or to change to a different nonsteroidal anti-inflammatory drug before your procedure .

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Bloating
Bloody or black, tarry stools
Burning upper abdominal pain
Cloudy urine
Constipation
Decrease in urine output or decrease in urine-concentrating ability
Headache
Heartburn
Indigestion
Itching skin
Loss of appetite
Nausea or vomiting
Pale skin
Severe abdominal pain, cramping, or burning
Severe and continuing nausea
Skin rash
Swelling
Troubled breathing with exertion
Unusual bleeding or bruising
Unusual tiredness or weakness
Vomiting of blood or material that looks like coffee grounds
Weight loss

Less common

Bleeding gums
Blood in urine
Bloody nose
Blurred vision
Burning feeling in chest or stomach
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
Chest pain
Clay-colored stools
Confusion
Cough or hoarseness
Dark urine
Difficult or labored breathing
Difficult, burning, or painful urination
Difficulty swallowing
Dilated neck veins
Dizziness
Extreme fatigue
Fainting
Fever or chills
Flushing, redness of skin
Frequent urge to urinate
Increased sensitivity of skin to sunlight
Increased thirst
Increased volume of pale, dilute urine
Large, flat, blue or purplish patches in the skin
Lightheadedness
Lower back or side pain
Nervousness
Noisy breathing
Numbness or tingling in hands, feet, or lips
Pain or burning in throat
Peeling of skin
Pinpoint red or purple spots on skin
Pounding in the ears
Rapid, shallow breathing
Redness or other discoloration of skin
Redness, swelling, or soreness of tongue
Severe sunburn
Shortness of breath
Slow, fast, pounding, or irregular heartbeat or pulse
Sore throat
Sores, ulcers, or white spots on lips or tongue or inside the mouth
Stomach upset
Swelling of face, fingers, feet, or lower legs
Swelling or inflammation of the mouth
Swollen glands
Tenderness in stomach area
Tightness in chest
Unpleasant breath odor
Unusually warm skin
Weakness or heaviness of legs
Weight gain
Wheezing
Yellow eyes or skin

Rare

Anxiety
Back or leg pains
Burning, dry, or itching eyes
Cold sweats
Coma
Cracks in the skin
Diarrhea
Discharge, excessive tearing
Dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
Dry mouth
Flushed, dry skin
Fruit-like breath odor
General body swelling
General feeling of discomfort or illness
High fever
Increased hunger
Increased urination
Inflammation of joints
Irregular, fast or slow, or shallow breathing
Joint pain
Large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
Light-colored stools
Loss of heat from the body
Muscle aches and pains
Nightmares
No blood pressure
No breathing
No pulse
Pain or discomfort in arms, jaw, back or neck
Pains in stomach, side, or abdomen, possibly radiating to the back
Pale or blue lips, fingernails, or skin
Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
Red irritated eyes
Red skin lesions, often with a purple center
Redness, pain, swelling of eye, eyelid, or inner lining of eyelid
Runny nose
Scaly skin
Seeing, hearing, or feeling things that are not there
Seizures
Severe headache
Shakiness
Shivering
Sleepiness
Slurred speech
Sneezing
Sores, welting, or blisters
Stiff neck and/or back
Stomach pain, continuing
Suddenly sweating
Swollen, painful, or tender lymph glands in neck, armpit, or groin
Trouble sleeping

Symptoms of overdose

Agitation
Depression
Hives
Hostility
Irritability
Muscle twitching
Pain or discomfort in chest, upper stomach, or throat
Rapid weight gain
Stupor
Swelling of ankles or hands
Unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common