Piroxicam

Piroxicam Brand Name– Feldene

What is Piroxicam

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) of the enolic acid chemical class.

Piroxicam is structurally related to meloxicam, another NSAID. Piroxicam has a long half-life and may be administered as a single daily dose, which can be an advantage over other NSAIDs.

Other NSAIDs that can be given as a single daily dose include oxaprozin (propionic acid derivative) and nabumetone (acetic acid derivative).

The anti-inflammatory potential of piroxicam has been equated with that of indomethacin, and its analgesic activity has been shown to be greater than that of aspirin.

All NSAIDs including piroxicam cause an increased risk of serious gastrointestinal adverse effects including bleeding, ulceration, and perforation of the stomach or intestines and may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke.

The lowest effective piroxicam dose for the shortest possible duration is recommended, as the risk for adverse effects may increase with duration of use.

Piroxicam is indicated in the treatment of osteoarthritis and rheumatoid arthritis.

It was approved by the FDA in April 1982.

A topical ophthalmic version of piroxicam is under investigation to reduce post-cataract surgery ocular inflammation.

Indications

• headache
• osteoarthritis
• rheumatoid arthritis

For the treatment of osteoarthritis and rheumatoid arthritis

Side Effects

1. abdominal pain
2. agranulocytosis
3. akathisia
4. alopecia
5. anaphylactoid reactions
6. anemia
7. angina
8. angioedema
9. anorexia
10. anxiety
11. aplastic anemia
12. appetite stimulation
13. arrhythmia exacerbation
14. aseptic meningitis
15. asthenia
16. blurred vision
17. bullous rash
18. colic
19. coma
20. confusion
21. conjunctivitis
22. constipation
23. cystitis
24. depression
25. diaphoresis
26. diarrhea
27. dizziness
28. drowsiness
29. dysphagia
30. dyspnea
31. dysuria
32. ecchymosis
33. edema
34. elevated hepatic enzymes
35. eosinophilia
36. epistaxis
37. eructation
38. erythema
39. erythema multiforme
40. esophageal stricture
41. esophageal ulceration
42. esophagitis
43. exfoliative dermatitis
44. fever
45. flatulence
46. fluid retention
47. gastritis
48. GI bleeding
49. GI perforation
50. glomerulonephritis
51. glossitis
52. hallucinations
53. headache
54. hearing loss
55. heart failure
56. hematemesis
57. hematuria
58. hemolytic anemia
59. hepatic failure
60. hepatitis
61. hyperglycemia
62. hyperkalemia
63. hypertension
64. hypoglycemia
65. hyponatremia
66. hypotension
67. infection
68. infertility
69. insomnia
70. interstitial nephritis
71. jaundice
72. leukopenia
73. lymphadenopathy
74. malaise
75. melena
76. myocardial infarction
77. nausea
78. nephrotic syndrome
79. odynophagia
80. oliguria
81. onycholysis
82. palpitations
83. pancytopenia
84. paresthesias
85. peptic ulcer
86. petechiae
87. photophobia
88. photosensitivity
89. platelet dysfunction
90. polyuria
91. proteinuria
92. pruritus
93. purpura
94. pyrosis (heartburn)
95. rash
96. renal failure (unspecified)
97. renal papillary necrosis
98. respiratory depression
99. seizures
100. serum sickness
101. sinus tachycardia
102. Stevens-Johnson syndrome
103. stomatitis
104. stroke
105. syncope
106. thrombocytopenia
107. thromboembolism
108. tinnitus
109. toxic epidermal necrolysis
110. tremor
111. urticaria
112. vasculitis
113. vertigo
114. visual impairment
115. vomiting
116. weight gain
117. weight loss
118. xerostomia

Monitoring Parameters

• CBC
• LFTs
• serum creatinine/BUN
• stool guaiac

Contraindications

• acute bronchospasm
• acute myocardial infarction
• alcoholism
• anemia
• angina
• anticoagulant therapy
• asthma
• bone marrow suppression
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• cardiomyopathy
• cerebrovascular disease
• chemotherapy
• children
• coagulopathy
• coronary artery bypass graft surgery (CABG)
• coronary artery disease
• corticosteroid therapy
• dehydration
• dental disease
• dental work
• diabetes mellitus
• edema
• geriatric
• GI bleeding
• GI disease
• GI perforation
• heart failure
• hematological disease
• hemophilia
• hepatic disease
• hypertension
• hypovolemia
• immunosuppression
• infertility
• intramuscular injections
• jaundice
• labor
• lactase deficiency
• myocardial infarction
• nasal polyps
• neutropenia
• NSAID hypersensitivity
• obstetric delivery
• peptic ulcer disease
• peripheral vascular disease
• poor metabolizers
• pregnancy
• renal disease
• renal failure
• renal impairment
• reproductive risk
• rheumatoid arthritis
• salicylate hypersensitivity
• stroke
• surgery
• systemic lupus erythematosus (SLE)
• tachycardia
• thrombocytopenia
• thromboembolism
• tobacco smoking
• ulcerative colitis
• urticaria

Interactions

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