Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation in conditions like osteoarthritis and rheumatoid arthritis. Brand name commonly Feldene. It works by inhibiting prostaglandin synthesis (COX-1 and COX-2).
Key points
- Uses: relief of pain and inflammation in OA/RA; sometimes for other musculoskeletal conditions. Not a cure.
- How long it lasts: has a relatively long half-life, so dosing is typically once daily.
Dosing (general guidance; your doctor will tailor this)
- Adults with OA/RA: usually 20 mg once daily (some patients may start at 10 mg if tolerated or if dose reduction is needed). Do not exceed 20 mg per day.
- Elderly or those with GI or kidney risk: may start at 10 mg once daily.
- If you miss a dose: take it as soon as you remember, unless it’s near the time of the next dose. Do not double up.
- Take with food or milk to reduce stomach upset.
- Use the lowest effective dose for the shortest period possible.
Common side effects
- Gastrointestinal upset: indigestion, nausea, heartburn
- More serious GI issues: ulcers, GI bleeding (more likely in older adults or with long-term use)
- Headache, dizziness
- Fluid retention, swelling
- Rash or itching (allergic reactions rare but possible)
Serious risks (important)
- GI ulcers/bleeding
- Kidney function effects (reduced kidney function, particularly with dehydration or other kidney issues)
- Liver effects (rare)
- Heart-related risks (including fluid retention and high blood pressure)
- Allergic reactions (including asthma symptoms, hives, swelling)
- Skin reactions (rare but can be severe)
Contraindications and precautions
- Active or history of gastrointestinal ulcers or bleeding
- Severe kidney or liver disease
- Certain heart conditions with fluid retention or heart failure
- Pregnancy: NSAIDs are generally avoided in pregnancy, especially in the third trimester
- Nursing: may pass into breast milk; consult a clinician
- Allergy to piroxicam or other NSAIDs
Drug interactions to know (not exhaustive)
- Other NSAIDs (increase risk of GI bleed and kidney problems)
- Anticoagulants (e.g., warfarin) and antiplatelet drugs
- Corticosteroids
- Lithium, methotrexate
- ACE inhibitors, ARBs, diuretics, cyclosporine (can affect kidney function)
- Probenecid or sulfinpyrazone (affect levels?)
What to do if you have concerns
- If you have a history of ulcers, kidney or liver disease, heart failure, or are pregnant/nursing, talk to your clinician before taking piroxicam.
- Seek medical attention for signs of serious reactions (severe stomach pain, black/tarry stools, vomiting blood, severe allergic reaction, chest swelling, shortness of breath).
Availability
- Piroxicam is prescription-only in many places. Generic versions are common; brand names include Feldene.
If you tell me your condition (e.g., OA vs RA), age, and any other meds or health issues, I can tailor the information (typical dosing range, who might need a lower dose, and important interactions).