FM/CFS/ME RESOURCES - Drug Database - Piroxicam


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Drug Database - Piroxicam Piroxicam 20 mg. capsule

Generic Name: Piroxicam (pir-OX-i-kam)

Brand Names: Brand Name: Feldene®

Classification: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID). It may cause an increased risk of serious and sometimes fatal heart and blood vessel problems (eg, heart attack, stroke). The risk may be greater if you already have heart problems or if you take Piroxicam for a long time. Do not use Piroxicam right before or after bypass heart surgery.

Piroxicam may cause an increased risk of serious and sometimes fatal stomach ulcers and bleeding. Elderly patients may be at greater risk. This may occur without warning signs.

Piroxicam is used for treating rheumatoid arthritis or osteoarthritis along with Fibromyalgia (FM) and CFS/ME. Piroxicam is an NSAID. Exactly how it works is not known. It may block certain substances in the body that are linked to inflammation. NSAIDs treat the symptoms of pain and inflammation. They do not treat the disease that causes those symptoms.

  • How To Use This Medicine
  • Discuss With Your Doctor
  • If You Miss A Dose
  • In Case of Overdose
  • Important Safety Information
  • Side Effects
  • Drug Interactions
  • Divider
    Before Using This Medicine

    Use Piroxicam as directed by your doctor. Check the label on the medicine for exact dosing instructions.

    • Piroxicam comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Piroxicam refilled.

    • Take Piroxicam by mouth. It may be taken with food if it upsets your stomach. This may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor if you have persistent stomach upset.

    • Take Piroxicam with a full glass of water (8 oz/240 mL) as directed by your doctor.

    • If you miss a dose of Piroxicam and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

    Ask your health care provider any questions you may have about how to use Piroxicam.

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    Discuss With Your Doctor

    Some medical conditions may interact with Piroxicam . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

    • if you are pregnant, planning to become pregnant, or are breast-feeding

    • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement

    • if you have allergies to medicines, foods, or other substances

    • if you have a history of kidney or liver disease, diabetes, or stomach or bowel problems (eg, bleeding, perforation, ulcers)

    • if you have a history of swelling or fluid buildup, asthma, growths in the nose (nasal polyps), or mouth inflammation

    • if you have high blood pressure, a blood disorder, bleeding or clotting problems, heart problems (eg, heart failure), or blood vessel disease, or if you are at risk for any of these diseases

    • if you have poor health, dehydration or low fluid volume, or low blood sodium levels, you drink alcohol, or you have a history of alcohol abuse

    Some MEDICINES MAY INTERACT with Piroxicam. Tell your health care provider if you are taking any other medicines, especially any of the following:

    • Anticoagulants:
      • warfarin
      • aspirin
    • corticosteroids (eg, prednisone)
    • heparin
    • selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine)
    • Probenecid because it may increase the risk of Piroxicam's side effects
    • Cyclosporine
    • hydantoins (eg, phenytoin)
    • lithium, methotrexate
    • quinolones (eg, ciprofloxacin)
    • sulfonamides (eg, sulfamethoxazole)
    • sulfonylureas (eg, glipizide)
    • Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril)
    • diuretics (eg, furosemide, hydrochlorothiazide)

    This may not be a complete list of all interactions that may occur. Ask your health care provider if Piroxicam may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

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    If You Miss A Dose

    If you miss a dose of Piroxicam and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

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    In Case of Overdose

    Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (, or emergency room immediately. Symptoms may include:

    • decreased urination
    • loss of consciousness
    • seizures
    • severe dizziness or drowsiness
    • severe nausea or stomach pain
    • slow or troubled breathing; unusual bleeding or bruising
    • vomit that looks like coffee grounds

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    Important Safety Information

    Piroxicam may cause dizziness or drowsiness. These effects may be worse if you take it with alcohol or certain medicines. Use Piroxicam with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

    Serious stomach ulcers or bleeding can occur with the use of Piroxicam. Taking it in high doses or for a long time, smoking, or drinking alcohol increases the risk of these side effects. Taking Piroxicam with food will NOT reduce the risk of these effects. Contact your doctor or emergency room at once if you develop:

    • severe stomach or back pain
    • black, tarry stools
    • vomit that looks like blood or coffee grounds
    • unusual weight gain or swelling

    Do NOT take more than the recommended dose or use for longer than prescribed without checking with your doctor.

    Piroxicam is an NSAID. Before you start taking any new medicine, read the ingredients. If it also has an NSAID (eg, ibuprofen) in it, check with your doctor. If you are not sure, check with your doctor or pharmacist.

    Do not take aspirin while you are using Piroxicam unless your doctor tells you to.

    Lab tests, including kidney function, complete blood cell counts, and blood pressure, may be done to monitor your progress or to check for side effects. Be sure to keep all doctor and lab appointments.

    Use Piroxicam with caution in the ELDERLY; they may be more sensitive to its effects, including stomach bleeding and kidney problems.

    Piroxicam should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.

    PREGNANCY and BREAST-FEEDING: Piroxicam may harm the fetus. Do not use it during the last 3 months of pregnancy. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Piroxicam while you are pregnant. Piroxicam is found in breast milk. Do not breast-feed while you are taking Piroxicam.

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    Side Effects

    Get emergency medical help if you have any of these signs of an allergic reaction:

    • Hives
    • Difficulty breathing
    • Swelling of your face, lips, tongue, or throat

    Seek medical attention right away if any of these SEVERE side effects occur:

    • bloody or black, tarry stools
    • change in the amount of urine produced
    • chest pain
    • confusion
    • dark urine
    • depression
    • fainting
    • fast or irregular heartbeat
    • fever, chills, or persistent sore throat
    • mental or mood changes
    • numbness of an arm or leg
    • one-sided weakness
    • red, swollen, blistered, or peeling skin
    • ringing in the ears
    • seizures
    • severe headache or dizziness
    • severe or persistent stomach pain or nausea
    • severe vomiting; shortness of breath
    • sudden or unexplained weight gain
    • swelling of hands, legs, or feet
    • unusual bruising or bleeding
    • unusual joint or muscle pain
    • unusual tiredness or weakness
    • vision or speech changes
    • vomit that looks like coffee grounds
    • yellowing of the skin or eyes

    Check with your doctor if any of these most COMMON side effects persist or become bothersome:

    • Constipation
    • diarrhea
    • dizziness
    • gas
    • headache
    • heartburn
    • nausea
    • stomach upset

    Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

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    Drug Interactions

    Piroxicam generally is used with caution in patients taking blood thinning medications to prevent the clotting of blood (anticoagulants), such as warfarin (Coumadin), because of an increased risk of bleeding.

    The increased risk is due to the fact that NSAIDs prevent the clotting of blood though by a different mechanism than anticoagulants. (They inhibit blood platelets which are important for the clotting of blood.) Piroxicam can increase blood levels of several drugs.

    Patients taking lithium can develop toxic blood lithium levels, and patients taking cyclosporine (Sandimmune) can develop kidney toxicity. Piroxicam may increase the toxic effects of methotrexate and may reduce the effectiveness of angiotensin converting enzyme (ACE) inhibitors

    There may be other drugs not listed that can affect Piroxicam. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

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