Piroxicam

Brand Name

View Brand Information

FDA approval date: January 26, 1994

Classification: Nonsteroidal Anti-inflammatory Drug

Form: Capsule

What is Piroxicam?

Living with chronic pain or joint stiffness can make everyday activities like walking, bending, or even sleeping difficult. Whether it’s from arthritis, trauma, or long-term inflammation, persistent pain can take a toll on both physical and emotional well-being. Piroxicam is a medication designed to help ease this burden by reducing pain, swelling, and stiffness, allowing people to regain comfort and mobility in their daily lives.

Piroxicam belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). It’s been available for several decades and remains a widely used option for managing chronic inflammatory conditions such as osteoarthritis and rheumatoid arthritis. By addressing both pain and inflammation, Piroxicam plays a central role in improving quality of life for individuals living with long-term joint or muscle discomfort.

What does Piroxicam do?

Piroxicam is primarily prescribed to reduce pain, inflammation, and swelling in conditions that affect the joints, muscles, or connective tissues. It is commonly used to treat:

Osteoarthritis (OA): the wear-and-tear form of arthritis that causes joint pain and stiffness.

Rheumatoid arthritis (RA): an autoimmune condition that leads to joint inflammation and deformity.

Ankylosing spondylitis: a chronic inflammatory disease affecting the spine.

Acute musculoskeletal pain: such as sprains, strains, or tendonitis.

For most patients, regular use of Piroxicam leads to less pain, reduced swelling, and improved movement. It doesn’t cure the underlying condition, but it helps manage symptoms, making daily tasks more comfortable.

Clinical studies have shown that Piroxicam is as effective as other NSAIDs like ibuprofen or naproxen in relieving pain and stiffness. Its long half-life means it can be taken once daily, which can be more convenient for patients managing chronic conditions (NIH, 2024).

How does Piroxicam work?

Piroxicam works by blocking the activity of certain enzymes in the body known as cyclooxygenase (COX-1 and COX-2). These enzymes play a key role in producing prostaglandins, which are natural chemicals responsible for pain, inflammation, and fever.

By inhibiting prostaglandin production, Piroxicam helps to:

Reduce inflammation in affected joints or tissues.

Decrease pain and stiffness.

Lower fever if present.

In simpler terms, Piroxicam calms the body’s overactive inflammatory response, easing discomfort and improving joint function.

Clinically, this mechanism is important because chronic inflammation can lead to ongoing tissue damage and worsening pain over time. By controlling inflammation early, Piroxicam not only relieves symptoms but may also help slow progression of joint damage in conditions like arthritis.

Piroxicam side effects

Like other NSAIDs, Piroxicam can cause side effects, but most people tolerate it well when taken as prescribed and monitored by a healthcare professional.

Common side effects may include:

Upset stomach, nausea, or heartburn

Diarrhea or constipation

Dizziness or headache

Mild swelling (especially in the ankles or feet)

Serious side effects (less common):

Stomach or intestinal bleeding, ulcers, or severe abdominal pain

Chest pain, shortness of breath, or sudden weakness (possible heart or circulation issues)

Yellowing of the skin or eyes (liver problems)

Severe rash or skin reaction

Kidney problems (decreased urine output, swelling, or fatigue)

Who should avoid Piroxicam:

People with a history of stomach ulcers, gastrointestinal bleeding, or inflammatory bowel disease

Those with heart disease, high blood pressure, or kidney disease

Individuals allergic to NSAIDs or aspirin

Patients should seek immediate medical attention if they experience symptoms of allergic reaction (such as swelling of the face or difficulty breathing) or black or bloody stools, which could indicate internal bleeding.

Because Piroxicam can increase the risk of heart attack or stroke when used long-term, doctors often recommend the lowest effective dose for the shortest duration possible. Regular checkups help monitor for any side effects and keep treatment safe.

Piroxicam dosage

Piroxicam is typically taken orally (capsule/tablet) once daily for chronic pain. Gel or topical forms may be available regionally for localized pain. Doctors adjust dosage; take with food/milk to reduce stomach upset.

During treatment, healthcare providers may monitor:

Kidney and liver function tests

Blood pressure

Signs of stomach irritation or bleeding

Older adults, especially those taking other medications or with heart or kidney disease, may need closer monitoring. Piroxicam should not be used in combination with other NSAIDs unless specifically directed by a doctor, as this increases the risk of side effects.

Does Piroxicam have a generic version?

Yes. Piroxicam is available as a generic drug, making it an affordable option for long-term therapy. The generic form is FDA-approved and contains the same active ingredient, strength, and effectiveness as the brand-name versions.

Feldene is a common brand name for Piroxicam, which is widely available generically in the US and internationally at a lower cost. Generic Piroxicam is equally effective under medical supervision, and healthcare providers can help patients choose the most cost-effective option.

Conclusion

Piroxicam is a long-established, effective medication for managing pain and inflammation associated with arthritis and other musculoskeletal conditions. By reducing swelling and improving joint flexibility, it helps people stay active and maintain a better quality of life.

Piroxicam is a potent anti-inflammatory that requires careful use, especially for those with digestive, heart, or kidney issues. Regular medical check-ups ensure its safe, long-term benefits.

Chronic pain treatment is individual. When correctly used and monitored, Piroxicam can reliably help patients move with less pain and more confidence..

References

Mayo Clinic. (2024). Piroxicam (oral route) drug information. Retrieved from https://www.mayoclinic.org

MedlinePlus. (2024). Piroxicam: Uses, side effects, and precautions. National Library of Medicine. Retrieved from https://medlineplus.gov

U.S. Food and Drug Administration (FDA). (2024). Approved Drug Products: Piroxicam. Retrieved from https://www.accessdata.fda.gov

National Institutes of Health (NIH). (2024). Nonsteroidal anti-inflammatory drugs and pain management overview. Retrieved from https://www.nih.gov

Approved To Treat

Top Global Experts

There are no experts for this drug

Save this treatment for later

Not sure about your diagnosis?

Check Your Symptoms

Related Clinical Trials

There is no clinical trials being done for this treatment

Related Latest Advances

There is no latest advances for this treatment

Brand Information

Piroxicam (piroxicam)

WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS

Cardiovascular Thrombotic Events

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use
Piroxicam capsules are contraindicated in the setting of coronary artery bypass graft (CABG) surgery

Gastrointestinal Bleeding, Ulceration, and Perforation

NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events

1INDICATIONS AND USAGE

Piroxicam capsules are indicated:

For relief of the signs and symptoms of osteoarthritis.
For relief of the signs and symptoms of rheumatoid arthritis.

2DOSAGE AND ADMINISTRATION

Carefully consider the potential benefits and risks of piroxicam capsules and other treatment options before deciding to use piroxicam capsules. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals

After observing the response to initial therapy with piroxicam capsules, the dose and frequency should be adjusted to suit an individual patient’s needs.

For the relief of rheumatoid arthritis and osteoarthritis, the dosage is 20 mg given orally once per day. If desired, the daily dose may be divided. Because of the long half-life of piroxicam capsules, steady-state blood levels are not reached for 7 to 12 days. Therefore, although the therapeutic effects of piroxicam capsules are evident early in treatment, there is a progressive increase in response over several weeks and the effect of therapy should not be assessed for two weeks.

3DOSAGE FORMS AND STRENGTHS

Piroxicam Capsules, USP are available containing 10 mg or 20 mg of piroxicam, USP.

The 10 mg capsule is a hard gelatin capsule with a swedish orange opaque cap and ivory opaque body containing white to off-white powder. The capsule is imprinted with
The 20 mg capsule is a hard gelatin capsule with a swedish orange opaque cap and swedish orange opaque body containing white to off-white powder. The capsule is imprinted with

4CONTRAINDICATIONS

Piroxicam capsules are contraindicated in the following patients:

Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to piroxicam or any components of the drug product
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients
In the setting of CABG surgery

5ADVERSE REACTIONS

The following adverse reactions are discussed in greater detail in other sections of the labeling:

Cardiovascular Thrombotic Events
GI Bleeding, Ulceration and Perforation
Hepatotoxicity
Hypertension
Heart Failure and Edema
Renal Toxicity and Hyperkalemia
Anaphylactic Reactions
Serious Skin Reactions
Hematologic Toxicity

5.1Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

In patients taking piroxicam capsules or other NSAIDs, the most frequently reported adverse experiences occurring in approximately 1% to 10% of patients are:

Cardiovascular System:Edema

Digestive System:Anorexia, abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting

Nervous System:Dizziness, headache, vertigo

Skin and Appendages:Pruritus, rash

Special Senses:Tinnitus

Additional adverse experiences reported occasionally include:

Cardiovascular System:Palpitations

Digestive System:Stomatitis

Nervous System:Drowsiness

Special Senses:Blurred vision

5.2Postmarketing Experience

The following adverse reactions have been identified during post approval use of piroxicam capsules. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Body As a Whole:Fever, infection, sepsis, anaphylactic reactions, appetite changes, death, flu-like syndrome, pain (colic), serum sickness

Cardiovascular System:Congestive heart failure, hypertension, tachycardia, syncope, arrhythmia, exacerbation of angina, hypotension, myocardial infarction, vasculitis

Digestive System:Dyspepsia, elevated liver enzymes, gross bleeding/perforation, heartburn, ulcers (gastric/duodenal), dry mouth, esophagitis, gastritis, glossitis, hematemesis, hepatitis, jaundice, melena, rectal bleeding, eructation, liver failure, pancreatitis

Hemic and Lymphatic System:Anemia, increased bleeding time, ecchymosis, eosinophilia, epistaxis, leukopenia, purpura, petechial rash, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia, lymphadenopathy, pancytopenia

Hypersensitivity: Positive ANA

Metabolic and Nutritional:Weight changes, Fluid retention, hyperglycemia, hypoglycemia

Nervous System:Anxiety, asthenia, confusion, depression, dream abnormalities, insomnia, malaise, nervousness, paresthesia, somnolence, tremors, akathisia, convulsions, coma, hallucinations, meningitis, mood alterations

Respiratory System:Asthma, dyspnea, respiratory depression, pneumonia

Skin and Appendages:Alopecia, bruising, desquamation, erythema, photosensitivity, sweat, angioedema, toxic epidermal necrosis, erythema multiforme, exfoliative dermatitis, onycholysis, Stevens Johnson Syndrome, urticaria, vesiculobullous reaction

Special Senses:Conjunctivitis, hearing impairment, swollen eyes

Urogenital System:Abnormal renal function, cystitis, dysuria, hematuria, hyperkalemia, interstitial nephritis, nephrotic syndrome, oliguria/polyuria, proteinuria, renal failure, glomerulonephritis

Reproductive System and Breast Disorders:Female fertility decreased

6DRUG INTERACTIONS

See Table 1 for clinically significant drug interactions with piroxicam.

Table 1: Clinically Significant Drug Interactions with Piroxicam

7OVERDOSAGE

Symptoms following acute NSAID overdoses have been typically limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding has occurred. Hypertension, acute renal failure, respiratory depression, and coma have occurred, but were rare

Manage patients with symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Consider emesis and/or activated charcoal (60 grams to 100 grams in adults, 1 gram to 2 grams per kg of body weight in pediatric patients) and/or osmotic cathartic in symptomatic patients seen within four hours of ingestion or in patients with a large overdosage (5 to 10 times the recommended dosage).

The long plasma half-life of piroxicam should be considered when treating an overdose with piroxicam. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.

For additional information about overdosage treatment contact a poison control center (1-800-222-1222).

8DESCRIPTION

Piroxicam Capsules, USP is a nonsteroidal anti-inflammatory drug, available as Ivory opaque/Swedish orange opaque 10 mg capsules and Swedish orange opaque/Swedish orange opaque 20 mg capsules for oral administration. The chemical name is 4-hydroxyl-2-methyl-

Piroxicam occurs as a white crystalline solid, sparingly soluble in water, dilute acid, and most organic solvents. It is slightly soluble in alcohol and in aqueous solutions. It exhibits a weakly acidic 4-hydroxy proton (pKa 5.1) and a weakly basic pyridyl nitrogen (pKa 1.8).

The inactive ingredients in piroxicam capsules include: Hard gelatin capsules (which may contain FD&C Blue 1, FD&C Red 40, D&C Yellow 10, titanium dioxide and gelatin inactive ingredients), corn starch, lactose, magnesium stearate and sodium lauryl sulfate.

9CLINICAL STUDIES

In controlled clinical trials, the effectiveness of piroxicam capsules has been established for both acute exacerbations and long term management of rheumatoid arthritis and osteoarthritis.

The therapeutic effects of piroxicam capsules are evident early in the treatment of both diseases with a progressive increase in response over several (8-12) weeks. Efficacy is seen in terms of pain relief and, when present, subsidence of inflammation.

Doses of 20 mg/day piroxicam capsules display a therapeutic effect comparable to therapeutic doses of aspirin, with a lower incidence of minor gastrointestinal effects and tinnitus.

Piroxicam capsules have been administered concomitantly with fixed doses of gold and corticosteroids. The existence of a “steroid sparing” effect has not been adequately studied to date.

10HOW SUPPLIED/STORAGE AND HANDLING

Piroxicam Capsules, USP

The 10 mg capsules are hard gelatin capsules with a swedish orange opaque cap and ivory opaque body containing white to off-white powder.

NDC: 72162-1290-1: 100 Capsules in a BOTTLE, PLASTIC

Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F). [see USP Controlled Room Temperature].

Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure.

Repackaged/Relabeled by:

Bryant Ranch Prepack, Inc.

Burbank, CA 91504

11PATIENT COUNSELING INFORMATION

Advise the patient to read the FDA-approved patient labeling (

Cardiovascular Thrombotic Events Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their health care provider immediately [see .

Gastrointestinal Bleeding, Ulceration, and Perforation Advise patients to report symptoms of ulcerations and bleeding, including epigastric pain, dyspepsia, melena, and hematemesis to their healthcare provider. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, inform patients of the increased risk for and the signs and symptoms of GI bleeding [see .

HepatotoxicityInform patients of the warning signs and symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, pruritus, diarrhea, jaundice, right upper quadrant tenderness, and “flu-like” symptoms). If these occur, instruct patients to stop piroxicam capsules and seek immediate medical therapy [see .

Heart Failure and EdemaAdvise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur [see .

Anaphylactic ReactionsInform patients of the signs of an anaphylactic reaction (e.g., difficulty breathing, swelling of the face or throat). Instruct patients to seek immediate emergency help if these occur [see .

Serious Skin ReactionsAdvise patients to stop piroxicam capsules immediately if they develop any type of rash and to contact their healthcare provider as soon as possible [see .

Female FertilityAdvise females of reproductive potential who desire pregnancy that NSAIDs, including piroxicam capsules, may be associated with a reversible delay in ovulation [see .

Fetal ToxicityInform pregnant women to avoid use of piroxicam capsules and other NSAIDs starting at 30 weeks gestation because of the risk of the premature closing of the fetal ductus arteriosus [see .

Avoid Concomitant Use of NSAIDsInform patients that the concomitant use of piroxicam capsules with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy [see Alert patients that NSAIDs may be present in “over the counter” medications for treatment of colds, fever, or insomnia.

Use of NSAIDs and Low-Dose AspirinInform patients not to use low-dose aspirin concomitantly with piroxicam capsules until they talk to their healthcare provider [see .

Manufactured by:

Rev: November 2019

12Medication Guide for Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Manufactured by:

Rev: November 2019