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Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID).
Piroxicam is used to treat pain or inflammation caused by osteoarthritis or rheumatoid arthritis.
Piroxicam may also be used for purposes not listed in this medication guide.
Piroxicam can increase your risk of fatal heart attack or stroke. Do not use piroxicam just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Piroxicam may also cause stomach or intestinal bleeding, which can be fatal.
You should not use piroxicam if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.
Piroxicam can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).
Piroxicam may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using piroxicam, especially in older adults.
Tell your doctor if you have ever had:
heart disease, high blood pressure, or if you smoke;
a heart attack, stroke, or blood clot;
a stomach ulcer or stomach bleeding (especially while using an NSAID);
asthma; or
liver or kidney disease.
Taking piroxicam during the last 3 months of pregnancy may harm the unborn baby. Tell your doctor if you are pregnant.
Ovulation (release of an egg from your ovary) could be delayed while you are taking piroxicam. This effect is usually not permanent. You should not take piroxicam while you are trying to get pregnant.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Piroxicam is not approved for use by anyone younger than 18 years old.
Follow all directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition.
It may take up to 2 weeks before your symptoms improve. Keep using the medicine as directed and tell your doctor if your symptoms do not improve.
If you use piroxicam long-term, you may need frequent medical tests.
Store at room temperature away from moisture and heat.
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include nausea, vomiting, stomach pain, black or bloody stools, or coughing up blood.
Avoid drinking alcohol. It may increase your risk of stomach bleeding.
Avoid taking aspirin while you are taking piroxicam.
Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to piroxicam (such as aspirin, ibuprofen, ketoprofen, or naproxen).
Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).
Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.
Stop using piroxicam and call your doctor at once if you have:
severe headache, blurred vision, pounding in your neck or ears;
heart problems--swelling, rapid weight gain, feeling short of breath;
liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or
low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.
Common side effects may include:
abnormal liver function tests;
urination problems;
upset stomach, heartburn, loss of appetite, stomach pain, nausea, vomiting;
gas, diarrhea, constipation;
dizziness, headache;
itching, rash; or
ringing in your ears.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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.
Ask your doctor before using piroxicam if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.
Tell your doctor about all your other medicines, especially:
lithium;
methotrexate;
a blood thinner or other medication used to prevent blood clots;
heart or blood pressure medication, including a diuretic or "water pill"; or
steroid medicine (such as prednisone).
This list is not complete. Other drugs may affect piroxicam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Piroxicam (www.drugs.com/mtm/piroxicam.html).
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:
More common
Less common
Rare
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:
More common
Less common
Rare
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
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Piroxicam (www.drugs.com/mtm/piroxicam.html).
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