Piroxicam

DEA Class;  Rx

Common Brand Names; Feldene

 NSAIDs

Absolute: ASA allergy

Relative: bleeding disorders, duodenal/gastric/peptic ulcer, stomatitis, SLE, ulcerative colitis, upper GI disease, late pregnancy (may cause premature closure of the ductus arteriosus)

Common

Edema

Anorexia

Abdominal pain

Constipation

Diarrhea

Flatulence

Nausea

Vomiting

Dizziness

Headache

Vertigo

Pruritus

Rash

Tinnitus

Uncommon

Palpitations

Stomatitis

Drowsiness

Blurred vision

May increase risk of asthma (bronchial), cardiac disease, CHF, hepatic impairment, HTN, renal impairment

Long-term administration of NSAIDs may result in renal papillary necrosis and other renal injury; patients at greatest risk include the elderly, or those with impaired renal function, hypovolemia, heart failure, liver dysfunction, salt depletion, and individuals taking diuretics, ACE inhibitors, or ARBs

May cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the stomach, small intestine, or large intestine when used long term and can be fatal; administer lowest effective dose for short periods; use caution

Factors that increase risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, antiplatelet drugs (such as aspirin), anticoagulants; or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status

Not for administration to patients that have experienced aspirin anaphylactoid reactions

Pregnancy

Use of NSAID can cause premature closure of fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment

Because of these risks, limit dose and duration of use between about 20 and 30 weeks of gestation, and avoid use at about 30 weeks of gestation and later in pregnancy

Lactation

Limited data from 2 published reports that included a total of 6 breastfeeding women and 2 infants showed piroxicam is excreted in human milk at approximately 1% to 3% of the maternal concentration

No accumulation of piroxicam occurred in milk relative to that in maternal plasma during treatment; the developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed infant from therapy or from underlying maternal condition

capsule

• 10mg
• 20mg