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More frequently reported side effects include: heartburn, nausea, and prolonged bleeding time. See below for a comprehensive list of adverse effects.
Applies to piroxicam: oral capsule
Oral route (Capsule)
NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Piroxicam is contraindicated in the setting of coronary artery bypass graft surgery. NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.
Along with its needed effects, piroxicam 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 while taking piroxicam:
Get emergency help immediately if any of the following symptoms of overdose occur while taking piroxicam:
Symptoms of overdose
Some side effects of piroxicam 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:
Applies to piroxicam: compounding powder, oral capsule
The most commonly reported adverse effects are abdominal pain/discomfort, flatulence, nausea, epigastric distress, constipation, diarrhea, dizziness, and headache.
Common (1% to 10%): Anorexia, indigestion, abdominal pain/discomfort, constipation, diarrhea, dyspepsia, flatulence, gross bleeding/perforation, heartburn, nausea, gastric and duodenal ulcers, vomiting, epigastric distress
Uncommon (0.1% to 1%): Dry mouth, esophagitis, gastritis, glossitis, hematemesis, melena, rectal bleeding, stomatitis
Rare (0.01% to 0.1%): Colic, eructation, pancreatitis
Frequency not reported: Peptic ulceration, gastrointestinal hemorrhage
Evidence from observational studies have shown administration of doses greater than 20 mg orally per day increases the risk for gastrointestinal (GI) side effects. This drug may be associated with a high risk of GI toxicity relative to other nonsteroidal anti-inflammatory drugs (NSAIDs). About 1 in 5 patients who develop serious upper GI adverse events due to NSAID therapy are symptomatic. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occur in approximately 1% of patients whom are treated for 3 to 6 months and in 2% to 4% of patients treated for 1 year.
Common (1% to 10%): Abnormal renal function
Uncommon (0.1% to 1%): Renal papillary necrosis, glomerulonephritis, interstitial nephritis, nephrotic syndrome, renal failure
Renal toxicity while using piroxicam has occurred in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of NSAIDs may cause a dose dependent reduction in prostaglandin formation and secondarily, renal blood flow, which may precipitate overt renal decompensation.
Common (1% to 10%): Elevated liver enzymes
Uncommon (0.1% to 1%): Hepatitis, jaundice
Rare (0.01% to 0.1%): Liver failure
Significant elevations of the liver enzymes AST and ALT (about 3 or more times the upper limit of normal) have occurred in approximately 1% of patients in clinical trials with nonsteroidal anti-inflammatory drugs (NSAIDs). Borderline elevations have occurred in up to 15% of patients taking NSAIDs, including this drug.
Common (1% to 10%): Edema
Uncommon (0.1% to 1%): Congestive heart failure, hypertension, tachycardia, syncope
Rare (0.01% to 0.1%): Arrhythmia, exacerbation of angina, hypotension, myocardial infarction, palpitations, vasculitis, chest pain
Frequency not reported: Arterial thrombotic events
Clinical trials of several COX-2 selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) of up to 3 years duration have shown an increased risk of serious and sometimes fatal cardiovascular thrombotic events, myocardial infarction, and stroke.
Observational studies suggest that piroxicam may be associated with a higher risk of severe cutaneous adverse reactions than other non-oxicam NSAIDs. There is an increased risk early in the course of therapy, with the majority of cases occurring within the first month.
Common (1% to 10%): Pruritus, rash
Uncommon (0.1% to 1%): Alopecia, bruising, desquamation, erythema, photosensitivity,
Rare (0.01% to 0.1%): Toxic epidermal necrosis, erythema multiforme, exfoliative dermatitis, onycholysis, Stevens - Johnson syndrome, urticaria, vesiculobullous reaction, ecchymosis, petechial rash
Frequency not reported: Non-thrombocytopenic purpura (Henoch-Schonlein)
Common (1% to 10%): Anemia, prolonged bleeding time
Uncommon (0.1% to 1%): Eosinophilia, leukopenia, purpura, thrombocytopenia
Rare (0.01% to 0.1%): Agranulocytosis, hemolytic anemia, aplastic anemia, lymphadenopathy, pancytopenia
Frequency not reported: Decreased hemoglobin and hematocrit
A combination of dermatological/allergic signs and symptoms suggestive of serum sickness have occasionally occurred while using this drug. These include arthralgias, pruritus, fever, fatigue and rash (e.g., vesiculobullous reactions and exfoliative dermatitis).
Rare (0.01% to 0.1%): Anaphylaxis, angioedema
Frequency not reported: Serum sickness
Common (1% to 10%): Elevated BUN, elevated serum creatinine, anorexia
Uncommon (0.1% to 1%): Weight changes, hyperkalemia, fluid retention
Rare (0.01% to 0.1%): Appetite changes, hyperglycemia, hypoglycemia
Common (1% to 10%): Dizziness, headache, sedation
Uncommon (0.1% to 1%): Asthenia, drowsiness, malaise, paresthesia, somnolence, tremors, vertigo, amnesia
Rare (0.01% to 0.1%): Akathisia, convulsions, coma, meningitis
Postmarketing experience: Aseptic meningitis
Uncommon (0.1% to 1%): Asthma, dyspnea, epistaxis
Rare (0.01% to 0.1%): Respiratory depression, pneumonia
Frequency not reported: Bronchospasm
Common (1% to 10%): Tinnitus, deafness
Uncommon (0.1% to 1%): Fever
Rare (0.01% to 0.1%): Death, hearing impairment, thirst
Rare (0.01% to 0.1%): Female fertility decreased
Uncommon (0.1% to 1%): Infections, sepsis
Rare (0.01% to 0.1%): Positive ANA, flu-like syndrome
Uncommon (0.1% to 1%): Cystitis, dysuria, hematuria, oliguria, polyuria, proteinuria, urinary frequency, menorrhagia
Rare (0.01% to 0.1%): Sweating
Uncommon (0.1% to 1%): Blurred vision
Rare (0.01% to 0.1%): Conjunctivitis, swollen eyes
Uncommon (0.1% to 1%): Anxiety, confusion, depression, dream abnormalities, personality changes
Rare (0.01% to 0.1%): Hallucinations, mood alterations, nervousness
Frequency not reported: Insomnia
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