piroxicam
Piroxicam (Feldene) is a nonsteroidal anti-inflammatory drug (NSAID) that works well to relieve symptoms of arthritis, such as joint pain, swelling, and stiffness. It's a capsule that's taken by mouth, typically once daily. Possible side effects include diarrhea, nausea, vomiting, and rash.
What is Piroxicam (Feldene)?
What is Piroxicam (Feldene) used for?
Pain from osteoarthritis
Pain from rheumatoid arthritis
How Piroxicam (Feldene) works
Piroxicam (Feldene) is a nonsteroidal anti-inflammatory drug (NSAID). It works by blocking proteins in your body (called cyclooxygenase or COX) that cause inflammation, pain, and swelling.
Drug Facts
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What are the side effects of Piroxicam (Feldene)?
Common Side Effects
- Nausea and vomiting
- Constipation
- Passing gas
- Stomach pain
- Diarrhea
- Headache
- Dizziness
- Swelling or fluid buildup
- Rash
- Ringing in the ears
Other Side Effects
- Pounding heart
- Mouth sores
- Blurred vision
- Drowsiness
Serious Side Effects
- Stomach bleeding: feeling faint, vomiting blood, bloody or dark stools, severe stomach pain or discomfort
- Heart attack: chest pain or tightness, pain that radiates up to your shoulder, arm, neck, or jaw
- Stroke: chest pain, trouble breathing, weakness in one part of your body or face, slurred speech
- Heart failure: difficulty breathing, swelling, fast heartbeat
- Liver problems: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
- Kidney problems: tiredness, dry and itchy skin, low appetite, urinating less than usual, foamy or bloody urine, muscle cramps
- Allergic reactions: hives, rash, blisters, swelling of the lips or tongue, difficulty breathing
- Serious skin reactions: skin reddening, blisters, rash
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine 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:
More common
bloody or black, tarry stools
burning upper abdominal or stomach pain
cloudy urine
decrease in urine output or decrease in urine-concentrating ability
headache
indigestion
itching skin or rash
loss of appetite
nausea or vomiting
pale skin
severe abdominal or stomach pain, cramping, or burning
severe and continuing nausea
swelling
swelling of the face, fingers, feet, or lower legs
troubled breathing with exertion
unusual bleeding or bruising
unusual tiredness or weakness
vomiting of blood or material that looks like coffee grounds
weight changes
Less common
Bleeding gums
blood in the urine
bloody nose
blurred vision
burning feeling in the chest or stomach
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
clay-colored stools
confusion
cough or hoarseness
dark urine
difficult or labored breathing
difficult, burning, or painful urination
difficulty with swallowing
dilated neck veins
dizziness
extreme fatigue
fainting
fever or chills
flushing or redness of the skin
frequent urge to urinate
increased sensitivity of the skin to sunlight
increased thirst
increased volume of pale, dilute urine
large, flat, blue, or purplish patches in the skin
lightheadedness
lower back or side pain
nervousness
noisy breathing
numbness or tingling in the hands, feet, or lips
pain or burning in the throat
peeling of the skin
pinpoint red or purple spots on the skin
pounding in the ears
rapid, shallow breathing
redness or other discoloration of the skin
redness, swelling, or soreness of the tongue
severe sunburn
slow, fast, pounding, or irregular heartbeat or pulse
sores, ulcers, or white spots on the lips or tongue or inside the mouth
stomach upset
swelling or inflammation of the mouth
swollen glands
tenderness in the stomach area
tightness in the chest
unpleasant breath odor
unusually warm skin
weakness or heaviness of the legs
yellow eyes or skin
Rare
back or leg pains
burning, dry, or itching eyes
cold sweats
coma
cracks in the skin
discharge or excessive tearing
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
flushed, dry skin
fruit-like breath odor
general body swelling
general feeling of discomfort or illness
high fever
increased hunger
increased urination
inflammation of the joints
irregular, fast or slow, or shallow breathing
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
light-colored stools
loss of heat from the body
muscle aches and pains
nightmares
no blood pressure
no breathing
no pulse
pain or discomfort in the arms, jaw, back, or neck
pains in the stomach, side, or abdomen, possibly radiating to the back
pale or blue lips, fingernails, or skin
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
seeing, hearing, or feeling things that are not there
seizures
severe headache
shakiness
shivering
sleepiness
slurred speech
sores, welting, or blisters
stiff neck or back
stomach pain, continuing
suddenly sweating
swollen, painful, or tender lymph glands in the neck, armpit, or groin
trouble sleeping
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Agitation
hostility
irritability
muscle twitching
pain or discomfort in the chest, upper stomach, or throat
rapid weight gain
stupor
swelling of the ankles or hands
unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
Some side effects 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
Acid or sour stomach
belching
continuing ringing or buzzing or other unexplained noise in the ears
excess air or gas in the stomach or intestines
hearing loss
passing gas
stomach discomfort or upset
Less common
Feeling of constant movement of self or surroundings
hair loss or thinning of the hair
lack or loss of strength
sensation of spinning
shakiness in the legs, arms, hands, or feet
trembling or shaking of the hands or feet
Rare
Change in hearing
changes in appetite
inability to sit still
mood alterations
need to keep moving
restlessness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Piroxicam (Feldene)
Pros
Can be taken once daily
Taken by mouth
Available as a lower-cost generic
Cons
Not available as a liquid
Can take 2 to 3 months to get the full effects
Can cause serious complications, including stomach bleeding and kidney problems, if taken for a long period of time.
Pharmacist tips for Piroxicam (Feldene)
You can take piroxicam (Feldene) with or without food. But it's best to take it with food or milk to prevent getting an upset stomach as a side effect of the medication.
Don't drink alcohol while taking piroxicam (Feldene) because it can raise your risk for stomach bleeds and stomach ulcers.
Don't take piroxicam (Feldene) with other NSAIDs, such as ibuprofen (Motrin, Advil). Doing so puts you at higher risk for stomach bleeds. NSAIDs are commonly found in over-the-counter pain and cold medications. Talk with your healthcare provider or pharmacist if you're not sure whether you're already taking an NSAID.
Piroxicam (Feldene) can interact with a lot of other common medications, such as blood pressure medications and blood thinners (including aspirin). Make sure to tell your provider about all of the medications you're taking or planning to take before starting piroxicam (Feldene). They can make sure your medications are safe for you to take together.
If you are allergic to aspirin, there is a chance you might be allergic to piroxicam (Feldene) as well. Tell your provider about all your allergies.
Though rare, piroxicam (Feldene) can cause vision problems. Let your provider know right away if you experience blurry vision or eye pain.
Store piroxicam (Feldene) up and away from children and pets so they're less likely to reach and accidentally take the medication. If you think your child accidentally took the medication, call a Poison Control Center right away at 1-800-222-1222.
Frequently asked questions about Piroxicam (Feldene)
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What are the risks and warnings for Piroxicam (Feldene)?
Piroxicam (Feldene) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heart attack and stroke
Risk factors: History of heart problems, including heart attack | Taking high doses of piroxicam (Feldene) | Taking piroxicam (Feldene) for a long time | History of heart bypass surgery
Piroxicam (Feldene) can raise your risk of having blood clots, heart attacks, or strokes. This can happen as early as within the first weeks of starting this medication. People with heart problems, those taking high doses of piroxicam (Feldene), and those taking piroxicam (Feldene) for a long time have a higher risk of this happening. That’s why it’s important to take the lowest possible dose for the shortest possible time. If you have heart problems, talk to your healthcare provider before starting this medication. Don't take piroxicam (Feldene) if you've had or will be having heart bypass surgery. Call 911 or seek immediate medical help if you experience chest pain, trouble breathing, weakness on one side of your body, or trouble speaking or walking.
Stomach bleeding and ulcers
Risk factors: History of stomach bleeding or ulcers | Older adults | Taking aspirin (Aspir-Low), other NSAIDs, corticosteroids, blood thinners, or SSRIs | Drinking alcohol | Smoking | Having poor health | Bleeding problems | Liver problems | Taking piroxicam (Feldene) for a long time | Taking high doses of piroxicam (Feldene)
Piroxicam (Feldene) can cause stomach bleeding and ulcers, which can be dangerous. There are many conditions and medications that raise your risk of this problem, so speak with your provider before starting this medication. Stomach bleeding and ulcers can occur without warning or symptoms, so it's best to take the lowest possible dose for the shortest possible time to minimize your risk. If you notice blood in your vomit, stool that looks like black coffee grounds, or if you have pain in your stomach that doesn't go away, stop taking piroxicam (Feldene) and talk to your healthcare provider right away.
High blood pressure and heart failure
Risk factors: Heart problems
Piroxicam (Feldene) can cause your body to hold onto extra fluid, which can raise your blood pressure or put you at risk for heart failure. Tell your provider if you have a history of heart problems or are taking blood pressure medications before starting piroxicam (Feldene) to make sure it's safe for you. Your provider will check for heart problems before they prescribe this medication to you. If you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while taking piroxicam (Feldene), contact your provider.
Kidney damage and high potassium levels
Risk factors: Kidney or liver problems | Heart failure | Taking certain high blood pressure medications, such as water pills, ACE inhibitors, or ARBs | Older adults | Loss of body fluid through conditions such as severe vomiting, bleeding, or diarrhea | Using piroxicam (Feldene) for a long time
Piroxicam (Feldene) can damage your kidneys by slowing down blood flow to the kidneys. The risk is higher if you're taking certain blood pressure medications (like ACE inhibitors, ARBs, or water pills), or have certain conditions (like kidney or liver problems and heart failure). Kidney damage is usually reversible once you stop taking piroxicam (Feldene). This medication isn't recommended if you have very severe kidney problems, so discuss the risks and benefits of taking it with your provider. Let your provider know if you notice a change in how often you urinate after starting piroxicam (Feldene) as this can be a sign of kidney damage.
In addition, kidney damage from piroxicam (Feldene) can also lead to high potassium levels. Sometimes, this medication can cause high potassium levels even in people with normal kidneys. If you experience signs of high potassium levels, such as nausea, muscle weakness, or tingling sensations in your muscles, tell your healthcare provider right away because it might be dangerous.
Liver damage
Risk factors: History of liver damage | Taking other medications that can cause liver damage | Taking high doses of piroxicam (Feldene) | Taking piroxicam (Feldene) for a long time
Very rarely, piroxicam (Feldene) can cause life-threatening liver damage. This can happen as early as within the first month of starting this medication. Your risk is higher if you take piroxicam (Feldene) with other medications that can also cause liver damage, such as acetaminophen (Tylenol). Liver damage can happen with or without symptoms, so if you take this medication for a long time, you might need to get lab work done regularly to check your liver. Stop piroxicam (Feldene) and talk to your healthcare provider right away if you experience symptoms, such as fever, chills, fatigue, nausea, vomiting, yellowing of the skin or whites of the eyes, clay-colored stool, and dark urine.
Severe allergic reactions
Risk factors: Aspirin allergy | NSAID allergy
Severe allergic reactions to piroxicam (Feldene) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis. Let your provider know if you have an allergy to aspirin or other NSAIDs before starting piroxicam (Feldene). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using piroxicam (Feldene), call for medical help as soon as possible.
Although rare, piroxicam (Feldene) can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using piroxicam (Feldene) and get medical attention right away.
Not for use in pregnant or breastfeeding females
If you're pregnant or breastfeeding, talk to your provider first about the risk and benefits of piroxicam (Feldene) before using this medication. Piroxicam (Feldene) can cause harm to your unborn baby or complications during delivery if taken during the second half of pregnancy.
Piroxicam (Feldene) dosage forms
Typical dosing for Piroxicam (Feldene)
The typical dose is 20 mg by mouth once per day. If needed, your provider might divide the daily dose into smaller doses to be taken throughout the day.
Interactions between Piroxicam (Feldene) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abciximab
- Aceclofenac
- Acemetacin
- Acenocoumarol
- Amiloride
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Amtolmetin Guacil
- Anagrelide
- Apixaban
- Ardeparin
- Argatroban
- Aspirin
- Balsalazide
- Bemiparin
- Bendroflumethiazide
- Benzthiazide
- Betamethasone
- Betrixaban
- Bismuth Subsalicylate
- Bivalirudin
- Bromfenac
- Budesonide
- Bufexamac
- Bumetanide
- Cangrelor
- Celecoxib
- Ceritinib
- Certoparin
- Chlorothiazide
- Chlorthalidone
- Choline Magnesium Trisalicylate
- Choline Salicylate
- Cilostazol
- Citalopram
- Clomipramine
- Clonixin
- Clopamide
- Clopidogrel
- Cortisone
- Cyclopenthiazide
- Cyclosporine
- Dabigatran Etexilate
- Dalteparin
- Danaparoid
- Deflazacort
- Desipramine
- Desirudin
- Desmopressin
- Desvenlafaxine
- Dexamethasone
- Dexibuprofen
- Dexketoprofen
- Diazoxide
- Dibenzepin
- Diclofenac
- Dicumarol
- Diflunisal
- Digoxin
- Dipyridamole
- Dipyrone
- Dothiepin
- Doxepin
- Droxicam
- Duloxetine
- Edoxaban
- Enoxaparin
- Eplerenone
- Epoprostenol
- Eptifibatide
- Escitalopram
- Ethacrynic Acid
- Etodolac
- Etofenamate
- Etoricoxib
- Felbinac
- Fenoprofen
- Fepradinol
- Feprazone
- Feverfew
- Floctafenine
- Flufenamic Acid
- Fluocortolone
- Fluoxetine
- Flurbiprofen
- Fluvoxamine
- Fondaparinux
- Furosemide
- Ginkgo
- Gossypol
- Heparin
- Hydrochlorothiazide
- Hydrocortisone
- Hydroflumethiazide
- Ibuprofen
- Iloprost
- Imipramine
- Indapamide
- Indomethacin
- Inotersen
- Ketoprofen
- Lepirudin
- Levomilnacipran
- Lithium
- Lofepramine
- Lornoxicam
- Loxoprofen
- Lumiracoxib
- Magnesium Salicylate
- Meadowsweet
- Meclofenamate
- Mefenamic Acid
- Melitracen
- Meloxicam
- Mesalamine
- Methotrexate
- Methyclothiazide
- Methylprednisolone
- Metolazone
- Milnacipran
- Morniflumate
- Nabumetone
- Nadroparin
- Naproxen
- Nefazodone
- Nepafenac
- Niflumic Acid
- Nimesulide
- Nimesulide Beta Cyclodextrin
- Nortriptyline
- Olsalazine
- Opipramol
- Oxaprozin
- Oxyphenbutazone
- Paramethasone
- Parecoxib
- Parnaparin
- Paroxetine
- Pemetrexed
- Pentosan Polysulfate Sodium
- Pentoxifylline
- Phenindione
- Phenprocoumon
- Phenylbutazone
- Phenyl Salicylate
- Piketoprofen
- Polythiazide
- Prasugrel
- Prednisolone
- Prednisone
- Proglumetacin
- Propyphenazone
- Proquazone
- Protein C
- Protriptyline
- Reboxetine
- Reviparin
- Rivaroxaban
- Rofecoxib
- Salicylamide
- Salicylic Acid
- Salsalate
- Sertraline
- Sibutramine
- Sodium Salicylate
- Spironolactone
- Sulfasalazine
- Sulindac
- Tacrolimus
- Tenofovir Disoproxil Fumarate
- Tenoxicam
- Tianeptine
- Tiaprofenic Acid
- Ticagrelor
- Ticlopidine
- Tinzaparin
- Tirofiban
- Tolfenamic Acid
- Tolmetin
- Torsemide
- Trazodone
- Treprostinil
- Triamterene
- Trichlormethiazide
- Trimipramine
- Trolamine Salicylate
- Valdecoxib
- Venlafaxine
- Vilazodone
- Vorapaxar
- Vortioxetine
- Warfarin
- Xipamide
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Alacepril
- Anisindione
- Atenolol
- Azilsartan
- Azilsartan Medoxomil
- Benazepril
- Betaxolol
- Bisoprolol
- Candesartan Cilexetil
- Captopril
- Carteolol
- Carvedilol
- Celiprolol
- Enalapril
- Enalaprilat
- Eprosartan
- Esmolol
- Fosinopril
- Irbesartan
- Labetalol
- Levobunolol
- Lisinopril
- Losartan
- Metipranolol
- Metoprolol
- Moexipril
- Nadolol
- Nebivolol
- Olmesartan Medoxomil
- Oxprenolol
- Penbutolol
- Perindopril Erbumine
- Pindolol
- Practolol
- Propranolol
- Quinapril
- Ramipril
- Sotalol
- Spirapril
- Telmisartan
- Timolol
- Trandolapril
- Valsartan
How much does Piroxicam (Feldene) cost?
Piroxicam (Feldene) contraindications
Allergy to other NSAIDs
History of asthma, hives, or other allergic reactions after taking aspirin or another NSAID
Use of piroxicam (Feldene) after coronary artery bypass graft surgery (CABG)
What are alternatives to Piroxicam (Feldene)?
Pain from osteoarthritis
Pain from rheumatoid arthritis
Pain from osteoarthritis (capsules, tablets, and oral suspension)
Pain from rheumatoid arthritis and juvenile rheumatoid arthritis (JRA) (tablets and oral suspension)
Moderate-to-severe pain (Anjeso injection)
What is the latest news about Piroxicam (Feldene)?
Piroxicam (Feldene) images
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References
Best studies we foundAmerican Heart Association. (2020). What are anticoagulants and antiplatelet agents?
American Kidney Fund. (2023). High potassium (hyperkalemia): Causes, prevention and treatment.
Arthritis Foundation. (n.d.). Juvenile idiopathic arthritis (JIA).
Baudax Bio, Inc. (2022). ANJESO- meloxicam injection [package insert]. DailyMed.
Drugs and Lactation Database (LactMed). (2021). Piroxicam. National Institute of Child Health and Human Development.
Emerald Therapeutics, LLC. (2022). MELOXICAM suspension [package insert]. DailyMed.
Greenstone LLC. (2023). PIROXICAM capsule [package insert]. DailyMed.
Hosie, J., et al. (1997). Efficacy and tolerability of meloxicam versus piroxicam in patients with osteoarthritis of the hip or knee. Clinical Drug Investigation.
Lupin Pharmaceuticals, Inc. (2022). MELOXICAM capsule [package insert]. DailyMed.
Montford, J. R., et al. (2017). How dangerous is hyperkalemia? Journal of the American Society of Nephrology: JASN.
National Heart, Lung, and Blood Institute. (2022). What is coronary artery bypass grafting?
Sousa, A. G. P., et al. (2016). Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management. World Journal of Diabetes.
U.S. Food and Drug Administration. (2020). Nonsteroidal anti-inflammatory drugs (NSAIDs): Drug safety communication - Avoid use of NSAIDs in pregnancy at 20 weeks or later.
Zydus Pharmaceuticals USA Inc. (2022). MELOXICAM tablet [package insert]. DailyMed.
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