GENERIC NAME: piroxicam

BRAND NAME: Feldene

DRUG CLASS AND MECHANISM: Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) 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. Since the response to different NSAIDs varies from patient to patient, it is not unusual for a doctor to try different NSAIDs for any given condition.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: capsules: 10mg, 20mg

STORAGE: Store at room temperature, sealed container, avoid moisture.

PRESCRIBED FOR: Piroxicam is used for the treatment of inflammation and pain that results from rheumatoid arthritis and osteoarthritis .

DOSING: Should be taken with food.

DRUG INTERACTIONS: Piroxicam should be avoided by patients with a history of asthma exacerbation, hives , or other allergic reactions to aspirin or other NSAIDs. Rare but severe allergic reactions have been reported in such individuals. It also should be avoided by patients with peptic ulcer disease or kidney disease, since this medication can aggravate both conditions. Piroxicam is generally used with caution in patients taking blood thinning medications (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding. Patients taking lithium can develop toxic blood lithium levels. Patients taking cyclosporine (Sandimmune) can develop kidney toxicity. Use in children has not been adequately studied. Piroxicam is not habit forming. NSAIDs should be discontinued prior to elective surgery because of a mild interference with clotting that is characteristic of this group of medicines. Piroxicam is best discontinued at least five days in advance of the procedure.

Persons who have more than 3 alcoholic beverages per day are at increased risk of developing stomach ulcers when taking piroxicam or other NSAIDs.

Piroxicam has the convenience of once-daily dosing, because of sustained blood levels after each dose. Since it stays in the body longer, it should be used with caution in those who are elderly or have poor kidney function.

PREGNANCY: Piroxicam is generally avoided during pregnancy.

NURSING MOTHERS: Piroxicam is generally avoided in nursing mothers.

SIDE EFFECTS: Most patients benefit from piroxicam and other NSAIDs with few side effects. However, serious side effects can occur, and generally tend to be dose related. 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 can also occur.

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