Generic Name: Piroxicam Brand Name(s): .

Uses

What is Piroxicam used for?

Piroxicam is used to reduce pain, swelling, and joint stiffness from arthritis. Reducing these symptoms helps you do more of your normal daily activities. This medication is known as a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking your body’s production of certain natural substances that cause inflammation.

If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain.

How should I take Piroxicam?

Take this medication by mouth as directed by your doctor, usually once daily with a full glass of water (8 ounces/240 milliliters). Do not lie down for at least 10 minutes after taking this drug. To prevent stomach upset, take this medication with food, milk, or an antacid.

The dosage is based on your medical condition and response to treatment. To reduce your risk of stomach bleeding and other side effects, take this medication at the lowest effective dose for the shortest possible time. Do not increase your dose, take it more often, or take it for a longer time than prescribed.

If you are taking this drug “as needed” (not on a regular schedule), remember that pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.

It may take several weeks of taking this drug regularly until you get the full benefit.

Tell your doctor if your condition does not improve or if it worsens.

How do I store Piroxicam?

Piroxicam is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Piroxicam in the bathroom or the freezer. There may be different brands of Piroxicam that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Piroxicam down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Piroxicam?

Before taking piroxicam, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before taking this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), blood disorders (such as anemia, bleeding/clotting problems), growths in the nose (nasal polyps), heart disease (such as previous heart attack), high blood pressure, liver disease, stroke, throat/stomach/intestinal problems (such as bleeding, heartburn, ulcers).

Kidney problems can sometimes occur with the use of NSAID medications, including piroxicam. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications. Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.

This drug may make you dizzy or drowsy. Alcohol or marijuana can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana.

This medicine may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medicine, may increase your risk for stomach bleeding. Limit alcohol and stop smoking. Consult your doctor or pharmacist for more information.

This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially stomach/intestinal bleeding and kidney problems.

Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks (such as miscarriage, trouble getting pregnant). Tell your doctor if you are pregnant or if you plan to become pregnant. During pregnancy, this medication should be used only when clearly needed. It is not recommended for use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and interference with normal labor/delivery.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Piroxicam during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Piroxicam. Piroxicam is pregnancy risk category D (third trimester); C (first and second trimester) according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Piroxicam?

Upset stomach, nausea, dizziness, drowsiness, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.

Tell your doctor right away if you have any serious side effects, including: easy bruising/bleeding, difficult/painful swallowing, hearing changes (such as ringing in the ears), mental/mood changes, signs of kidney problems (such as change in the amount of urine), unexplained stiff neck, vision changes, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).

This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: dark urine, persistent nausea/vomiting/loss of appetite, stomach/abdominal pain, yellowing eyes/skin.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Piroxicam?

Products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, corticosteroids (such as prednisone), lithium, “water pills” (diuretics such as furosemide).

This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/enoxaparin/warfarin, among others.

Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to piroxicam and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually at dosages of 81-325 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.

Piroxicam may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Piroxicam?

Piroxicam may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Piroxicam?

Piroxicam may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Piroxicam.

What is the dose of Piroxicam for an adult?

Usual Adult Dose for Rheumatoid Arthritis

Recommended dose: 20 mg orally once a day

Comments:

-The lowest effective dose for the shortest duration possible should be used based on individual patient treatment goals.

-Due to the long half-life, there is a progressive response to treatment over several weeks; the effect of therapy should not be assessed for 2 weeks.

Use: For the relief of signs and symptoms of rheumatoid arthritis.

Usual Adult Dose for Osteoarthritis

Recommended dose: 20 mg orally once a day

Comments:

-The lowest effective dose for the shortest duration possible should be used based on individual patient treatment goals.

-Due to the long half-life, there is a progressive response to treatment over several weeks; the effect of therapy should not be assessed for 2 weeks.

Use: For the relief of signs and symptoms of osteoarthritis.

Renal Dose Adjustments

Mild to Moderate Renal Dysfunction: No adjustment recommended

Advanced Renal Disease: Not recommended

If treatment is necessary in patients with renal impairment, close monitoring of renal function is advised.

Liver Dose Adjustments

Dose adjustments may be required; however, no specific guidelines have been suggested.

-Patients who have an abnormal liver test or who develop signs or symptoms of liver dysfunction should be evaluated for hepatic dysfunction; if liver disease develops or if systemic manifestations such as eosinophilia or rash occur, this drug should be discontinued.

Dose Adjustments

-This drug should be used at the lowest effective dose in order to achieve therapeutic efficacy and minimize side effects.

-CYP450 2C9 poor metabolizers: This drug should be used with caution in individuals with genetic polymorphisms in the CYP450 2C9 enzyme due to reduced metabolic clearance and consequently the risk for increased systemic exposure.

-Elderly: Consider starting at the low end of the dosing range due to the increased risk for adverse effects.

Other Comments

Administration advice:

-May take orally once a day or in divided doses twice a day

General:

-Prior to initiating treatment, the potential benefits and risks of this drug should be weighed against other treatment options.

-There is an increased risk of heart attack, heart failure, and stroke when taking nonsteroidal anti-inflammatory drugs (NSAIDs); these events may occur at any time during treatment and risk increases with long term use, a history of or risk factors for cardiovascular disease, and higher doses.

-The lowest effective dose for the shortest duration consistent with individual patient treatment goals should be used.

-Due to the increased risk for gastrointestinal (GI) complications, the need for combination therapy with a gastroprotective agent should be considered, especially for elderly patients.

Monitoring:

-Blood pressure should be monitored closely during initiation and throughout course of therapy.

-Monitor for signs/symptoms of gastrointestinal bleeding.

-Monitor renal status, especially in patients with conditions where renal prostaglandins have a supportive role in the maintenance of renal perfusion.

-Monitor blood counts, renal, and hepatic function periodically for patients receiving long-term therapy.

Patient advice:

-Patients should be aware that there are a number of potential drug interactions with this drug and they should speak with a healthcare professional before starting any new medications including over the counter medications.

-Patients should seek medical advice for signs and symptoms of cardiovascular events, gastrointestinal events, adverse skin reactions, allergic reactions, hepatotoxicity, or unexplained weight gain or edema.

-Patients should seek medical attention immediately if shortness of breath, slurred speech, chest pain, or weakness on one side of the body occurs.

-Patients should talk to their health care provider if they are pregnant, planning to become pregnant, or breastfeeding.

What is the dose of Piroxicam for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Piroxicam available?

Piroxicam is available in the following dosage forms and strengths:

  • Oral capsule,
  • Compounding powder.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Piroxicam, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 11, 2018 | Last Modified: April 11, 2018

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