What to Know About Feldene (Piroxicam)

Feldene (piroxicam) is a prescription-only nonsteroidal anti-inflammatory drug (NSAID) most commonly used to treat the pain, swelling, stiffness, and tenderness caused by osteoarthritis and rheumatoid arthritis. Piroxicam works by stopping the body’s formation of a substance that causes pain, fever, and inflammation.

The drug comes in pill form in both 10 and 20 milligram (mg) doses and is taken orally. It is available in the generic form as piroxicam and in the brand name form as Feldene.

Uses

Piroxicam is approved to treat osteoarthritis and rheumatoid arthritis. Sometimes piroxicam is prescribed off label to treat gouty arthritis and ankylosing spondylitis. It has also been proven effective at treating migraines without aura.

You may also be prescribed piroxicam or Feldene post-surgery or childbirth or to help you manage the pain caused by menstrual cramps.

Before Taking

When prescribing Piroxicam your healthcare provider will evaluate your disease state and levels of pain. Talk to your healthcare provider about all medications, supplements, and vitamins that you currently take.

While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

If you have osteoarthritis or rheumatoid arthritis your healthcare provider may start you on a low dose and work your way up to the maximum dose needed to achieve relief. Feldene has a long half-life and can take up to seven to 12 days before the benefits of the drug are felt.

You may need to be reassessed by your healthcare provider after beginning the medication to ensure that it is working.

Precautions and Contraindications

While piroxicam can help relieve the pain associated with osteoarthritis and rheumatoid arthritis there are certain instances when taking the drug may pose more risks for you.

If you have a history of asthma, hives, or other allergic reactions to aspirin or other NSAIDs, it is not recommended you take piroxicam or Feldene. Anyone over the age of 75 may also find that piroxicam is not the right fit for them.

Taking piroxicam, and other prescription NSAIDs can increase your risk of having a heart attack or stroke. This risk may be higher if you take NSAIDs for long periods of time. Do not take piroxicam if you have recently had a heart attack unless your healthcare provider has approved its use.

If you are scheduled for a coronary artery bypass graft, you should not take piroxicam right before or right after surgery.

For females who are experiencing difficulties in conceiving, use of piroxicam is not recommended as NSAIDs, including Feldene, can cause a reversible delay in ovulation. 

Other NSAIDs

There are many other NSAIDs, both prescription and over the counter that may be helpful for your condition. It is important to talk to your healthcare provider about the right choice for you. Other NSAIDs that treat pain, inflammation, swelling, and tenderness, especially when caused by arthritis, are:

• Advil (ibuprofen)
• Aleve (naproxen sodium)
• Etodolac
• Zorvolex (diclofenac)

Dosage

The maximum dosage for piroxicam according to the manufacturer is 20 mg a day. This can be taken in once-daily pills of 20 mg each or divided into two doses of 10 mg each.

When prescribed piroxicam or any other medication, it is important to follow the directions on your prescription label carefully. If you have any questions, ask your healthcare provider or pharmacist to explain anything you do not understand.

How to Take and Store

Take piroxicam as directed. If you miss a dose of piroxicam, take the next dose as soon as you remember. However, if it is almost time to take your next dose skip the missed dose and return to your regular schedule. Do not take a double dose.

You may also want to take the drug with food to reduce the incidence of adverse gastrointestinal effects.

Piroxicam should be stored in a cool, dry location at room temperature away from excess heat and moisture—do not store in the bathroom. Keep this medication and all other medications away from children.

Side Effects

As with all drugs, piroxicam can cause side effects. It is important to tell your healthcare provider about any common side effects that do not go away or become more severe.

Common

Common side effects include:

• Diarrhea
• Constipation
• Gas
• Headache
• Dizziness
• Ringing in the ear

Severe 

If you experience any of the following severe side effects, discontinue use and contact your healthcare provider immediately:

• Vision problems
• Unusual weight gain
• Yellowing of eyes or skin
• More tired or weaker than usual
• Vomiting of blood
• Blood in stools
• Skin rash or blisters with fever
• Swelling of the arms, legs, hands, and feet

Warnings and Interactions

If you are on piroxicam long term, your healthcare provider will most likely monitor your use of the medication in order to make sure that you are not experiencing any adverse effects to your liver, kidneys, or gastrointestinal system.

It is important to keep all appointments and talk to your healthcare provider about any concerns. They will most likely order tests to check your body’s response to piroxicam and make adjustments to your dosage as needed in order to prescribe the right amount of medication to treat you with the least amount of side effects.

Taking piroxicam with other NSAIDs, prescription and over the counter, is contraindicated and could cause serious side effects such as intestinal bleeding and gastrointestinal toxicity.

Before taking any other medications for pain, fever, swelling, or cold/flu symptoms, talk to your healthcare provider or pharmacist as they may contain similar ingredients to piroxicam that can cause adverse effects or increased side effects.

When taking piroxicam, avoid drinking alcohol as this increases your risk of stomach bleeding.

Before taking piroxicam, let your healthcare provider know if you take antidepressants as these may cause you to bleed or bruise easily.

If you have a history of gastrointestinal bleeding or peptic ulcer disease, your risk for developing a GI bleed increases by 10% with the use of piroxicam and other NSAIDs.