Indication:
Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is
effective in treating fever, pain, and inflammation in the body.
Piroxicam is used for the treatment of inflammation and pain caused
by rheumatoid arthritis or osteoarthritis.
Drug Interactions:
Piroxicam may increase the blood levels of lithium (Eskalith,
Lithobid) by reducing the excretion of lithium by the kidneys.
Increased levels of lithium may lead to lithium toxicity.
Piroxicam may reduce the blood pressure lowering effects of blood
pressure medications. This may occur because prostaglandins play a
role in the regulation (reduction) of blood pressure.
Combining NSAIDs such as piroxicam with angiotensin receptor
blockers (for example, valsartan [Diovan], losartan [Cozaar],
irbesartan [Avapro]) or angiotensin converting enzyme ACE)
inhibitors (for example, enalapril [Vasotec], captopril [Capoten])
in patients who are elderly, volume-depleted (including those on
diuretic therapy), or with poor kidney function may result in
reduced kidney function, including kidney failure. These effects
usually are reversible.
When piroxicam is used in combination with methotrexate
(Rheumatrex, Trexall) or aminoglycoside antibiotics (for example,
gentamicin) the blood levels of methotrexate or aminoglycoside may
increase, presumably because the elimination of methotrexate or
aminoglycosides from the body is reduced. This may lead to more
methotrexate- or aminoglycoside- related side effects.
Individuals taking oral blood thinners or anticoagulants, for
example, warfarin, (Coumadin), should avoid piroxicam because
piroxicam also thins the blood, and excessive blood thinning may
lead to bleeding.
Alcohol consumption may increase the risk of developing stomach
ulcers when taking piroxicam or other NSAIDs.
Pregnancy:
Safety during pregnancy has not been established. Use in late
pregnancy may cause premature closing of the ductus arteriosus in
the fetus.
Nursing mothers:
Piroxicam is excreted into human breast milk. Use by nursing
mothers is not recommended.
Side effects:
The most common side effects of piroxicam are rash, headaches,
dizziness, drowsiness, abdominal pain, nausea, constipation, fluid
retention, ringing in the ears, and photosensitivity. NSAIDs reduce
the ability of blood to clot and therefore increase bleeding after
an injury. Piroxicam also may cause stomach and intestinal bleeding
and ulcers. Sometimes, stomach ulceration and intestinal bleeding
can occur without any abdominal pain. Black tarry stools, weakness,
and dizziness upon standing may be the only signs of the bleeding.
People who are allergic to other NSAIDs should not use piroxicam.
NSAIDs reduce the flow of blood to the kidneys and impair function
of the kidneys. The impairment is most likely to occur in patients
with preexisting impairment of kidney function or congestive heart
failure, and use of NSAIDs in these patients should be done
cautiously. Individuals with asthma are more likely to experience
allergic reactions to prioxicam and other NSAIDs. Fluid retention,
blood clots, heart attacks, hypertension, and heart failure have
also been associated with the use of NSAIDs.
Dosage:
The recommended dose is 20 mg once daily or 10 mg twice daily.
Piroxicam should be taken with food.
Storage:
Piroxicam should be stored at room temperature in a sealed
container that excludes moisture.
