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Piroxicam

    DEA Class;  Rx

    Common Brand Names; Feldene

     NSAIDs

    NSAID of the enolic acid class; given once daily; similar anti-inflammatory activity to indomethacin; used for OA and RA; causes an increased risk of serious gastrointestinal adverse effects; may cause an increased risk of serious cardiovascular events; use lowest effective dose for the shortest possible duration.

    For the treatment of osteoarthritis and rheumatoid arthritis.

    Absolute: ASA allergy

    Relative: bleeding disorders, duodenal/gastric/peptic ulcer, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of the ductus arteriosus)

    Common

    Edema

    Anorexia

    Abdominal pain

    Constipation

    Diarrhea

    Flatulence

    Nausea

    Vomiting

    Dizziness

    Headache

    Vertigo

    Pruritus

    Rash

    Tinnitus

    Uncommon

    Palpitations

    Stomatitis

    Drowsiness

    Blurred vision

    May increase risk of asthma (bronchial), cardiac disease, CHF, hepatic impairment, HTN, renal impairment

    Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

    May cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine when used long term and can be fatal; administer lowest effective dose for short periods; use caution

    Factors that increase risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants; or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status

    Not for administration to patients that have experienced aspirin anaphylactoid reactions

    Pregnancy

    Use of NSAID can cause premature closure of fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment

    Because of these risks, limit dose and duration of use between about 20 and 30 weeks of gestation, and avoid use at about 30 weeks of gestation and later in pregnancy

    Lactation

    Limited data from 2 published reports that included a total of 6 breastfeeding women and 2 infants showed piroxicam is excreted in human milk at approximately 1% to 3% of the maternal concentration

    No accumulation of piroxicam occurred in milk relative to that in maternal plasma during treatment; the developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition

    Adults

    20 mg/day PO.

    Elderly

    20 mg/day PO.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    capsule

    • 10mg
    • 20mg