Piroxicam

trade name: Feldene; drug class: nonsteroidal antiinflammatory; action: inhibits prostaglandin synthesis by interfering with cy-clooxygenase needed for biosynthesis; possesses analgesic, antiinflammatory, antipyretic properties; uses: osteoarthritis, rheumatoid arthritis.

Brand names: Feldene®

Chemical formula:

Español:
• Piroxicam, Cápsula oral

Piroxicam Oral capsule

What is this medicine?

PIROXICAM (peer OX i kam) is a non-steroidal anti-inflammatory drug (NSAID). It is used to reduce swelling and to treat pain. It may be used to treat osteoarthritis and rheumatoid arthritis.
 
This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• asthma, especially aspirin sensitive asthma
• coronary artery bypass graft (CABG) surgery within the past 2 weeks
• drink more than 3 alcohol containing drinks a day
• heart disease or circulation problems like heart failure or leg edema (fluid retention)
• high blood pressure
• kidney disease
• liver disease
• stomach bleeding or ulcers
• an unusual or allergic reaction to piroxicam, aspirin, other NSAIDs, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Take this medicine by mouth with food and with a full glass of water. Follow the directions on the prescription label. Take your medicine at regular intervals. Do not take your medicine more often than directed. Long-term, continuous use may increase the risk of heart attack or stroke.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction and need a smaller dose.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What may interact with this medicine?

Do not take this medicine with any of the following medications:
• cidofovir
• ketorolac
• methotrexate
• pemetrexed

This medicine may also interact with the following medications:
• alcohol
• aspirin and aspirin-like medicines
• diuretics
• lithium
• medicines for high blood pressure
• medicines that treat or prevent blood clots such as warfarin and other blood thinners
• NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen
• steroid medicines like prednisone or cortisone

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Tell your doctor or health care professional if your pain does not go away, if it gets worse, or if you have new or a different type of pain. It can take up to 2 weeks before the medicine works. Do not take with other pain killers without advice from your doctor. If you get flu like symptoms (fever, chills, muscle aches, and pains), call your doctor or health care professional. Do not treat yourself.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Do not smoke cigarettes or drink alcohol. These increase irritation to your stomach and can make it more susceptible to damage from the medicine.

The medicine can cause you to bleed more easily. Try to avoid damage to your teeth and gums when you brush or floss your teeth.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
• changes in vision
• chest pain
• difficulty breathing or wheezing
• nausea or vomiting
• redness, blistering, peeling or loosening of the skin, including inside the mouth
• slurred speech or weakness on one side of the body
• unexplained weight gain or swelling
• unusual bleeding or bruising
• unusually weak or tired
• yellowing of eyes or skin

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
• diarrhea
• dizziness
• headache
• heartburn

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store below 30 degrees C (86 degrees F). Keep container tightly closed. Protect from light. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

A non-steroidal anti-inflammatory drug (NSAID) used to treat musculoskeletal injuries. Side-effects are similar to those of aspirin.

A nonsteroidal anti-inflammatory agent with antineoplastic activity; used in the treatment of transitional cell carcinoma in dogs.

Piroxicam
Systematic (IUPAC) name
(8E)-8-[hydroxy-(pyridin-2-ylamino)methylidene]- 9-methyl-10,10-dioxo-10λ6-thia-9-azabicyclo[4.4.0] deca-1,3,5-trien-7-one
Identifiers
CAS number	36322-90-4
ATC code	M01AC01 M02AA07, S01BC06
PubChem	5280452
DrugBank	APRD01187
ChemSpider	10442653
Chemical data
Formula	C15H13N3O4S
Mol. mass	331.348 g/mol
Pharmacokinetic data
Bioavailability	?
Metabolism	4 to 10% renal
Half life	30 to 86 hours
Excretion	4 to 10% renal
Therapeutic considerations
Pregnancy cat.	C, D if used in the third trimester or near delivery
Legal status	POM
Routes	PO
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Piroxicam is a non-steroidal anti-inflammatory drug used to relieve the symptoms of rheumatoid and osteoarthritis, primary dysmenorrhoea, postoperative pain; and act as an analgesic, especially where there is an inflammatory component. It is manufactured by Pfizer under the tradename Feldene, and is available in the  United Kingdom,  Australia,  Italy and  United States. It is also manufactured by Bosnalijek under the tradename Roxam, and is available in Eastern Europe, Africa, and the Middle East.

It is also used in veterinary medicine to treat certain neoplasias expressing cyclooxygenase (COX) receptors, such as bladder, colon, and prostate cancers.

Other brand names for Piroxicam include "Brexidol", "Brexin", "Erazon", "Exipan", "Felden", "Feldoral", "Hotemin", "Pirox von ct", "Proponol", "Reumador", "Tracam", "Veral", "Mobilis" and "Vurdon", "Roxam".

Mechanism of action

Main article: Non-steroidal anti-inflammatory drug

Piroxicam is an NSAID and, as such, is a non-selective COX inhibitor possessing both analgesic and antipyretic properties. It undergoes enterohepatic circulation.

Adverse effects

Main article: Non-steroidal anti-inflammatory drug

Piroxicam use can result in gastrointestinal toxicity, tinnitus, dizziness, headache, rash, and pruritus. The most severe adverse reactions are peptic ulceration and gastrointestinal bleeding. Approximately 30% of all patients receiving daily doses of 20 mg of piroxicam experience side effects.^[1]

Piroxicam may cause skin to become more sensitive to sunlight.^[2] Avoidance of sunlight and use of sunscreen is recommended.^{[citation needed]}

Footnotes

1. ^ New Zealand Medicines and Medical Devices Safety Authority. "Candyl Medicines datasheet". http://www.medsafe.govt.nz. Retrieved 2006-09-10. 
2. ^ Mammen L, Schmidt CP (August 1995). "Photosensitivity reactions: a case report involving NSAIDs". Am Fam Physician 52 (2): 575–9. PMID 7625330. 

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v • d • e Non-steroidal anti-inflammatory drug (NSAID) products (primarily M01A and M02A, also N02BA) Salicylates Aspirin (acetylsalicylic acid) · Aloxiprin · Benorylate · Diflunisal · Ethenzamide · Magnesium salicylate · Methyl salicylate · Salsalate · Salicin · Salicylamide · Sodium salicylate Arylalkanoic acids Diclofenac · Aceclofenac · Acemetacin · Alclofenac · Bromfenac · Etodolac · Indometacin · Indometacin farnesil · Nabumetone · Oxametacin · Proglumetacin · Sulindac · Tolmetin 2-Arylpropionic acids (profens) Ibuprofen · Alminoprofen · Benoxaprofen · Carprofen · Dexibuprofen · Dexketoprofen · Fenbufen · Fenoprofen · Flunoxaprofen · Flurbiprofen · Ibuproxam · Indoprofen† · Ketoprofen · Ketorolac · Loxoprofen · Miroprofen · Naproxen · Oxaprozin · Pirprofen · Suprofen · Tarenflurbil · Tiaprofenic acid N-Arylanthranilic acids (fenamic acids) Mefenamic acid · Flufenamic acid · Meclofenamic acid · Tolfenamic acid Pyrazolidine derivatives Phenylbutazone · Ampyrone · Azapropazone · Clofezone · Kebuzone · Metamizole† · Mofebutazone · Oxyphenbutazone · Phenazone · Sulfinpyrazone Oxicams Piroxicam · Droxicam · Lornoxicam · Meloxicam · Tenoxicam · Ampiroxicam COX-2 inhibitors Celecoxib · Deracoxib‡ · Etoricoxib · Firocoxib‡ · Lumiracoxib† · Parecoxib · Rofecoxib† · Valdecoxib† Sulfonanilides Nimesulide Topically used products Bendazac · Diclofenac · Etofenamate · Felbinac · Flurbiprofen · Ibuprofen · Indometacin · Ketoprofen · Naproxen · Piroxicam · Suprofen COX-inhibiting nitric oxide donators Naproxcinod Others Fluproquazone Items listed in bold indicate initially developed compounds of specific groups. †Withdrawn drugs. ‡Veterinary use medications.

v • d • e Topical products for joint and muscular pain (M02) Anti-inflammatory preparations, non-steroids Butylpyrazolidines Phenylbutazone • Mofebutazone • Clofezone • Oxyphenbutazone Acetic acid derivatives Tolmetin • Diclofenac • Fentiazac Other Benzydamine • Etofenamate • Piroxicam • Felbinac • Bufexamac • Ketoprofen • Bendazac • Naproxen • Ibuprofen • Feprazone • Niflumic acid • Meclofenamic acid • Flurbiprofen • Suxibuzone • Indometacin • Nifenazone Capsaicin derivatives Zucapsaicin Other Tolazoline • Dimethyl sulfoxide

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