Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate pain and help relieve symptoms of arthritis (e.g., osteoarthritis and rheumatoid arthritis), such as inflammation, swelling, stiffness, and joint pain. This medicine does not cure arthritis and will help you only as long as you continue to take it.
Piroxicam works by reducing hormones that cause inflammation and pain in the body.
Piroxicam is a non-steroidal anti-inflammatory drug of the oxicam class used to relieve the symptoms of rheumatoid and osteoarthritis, primary dysmenorrhoea, postoperative pain; and act as an analgesic, especially where there is an inflammatory component.
Piroxicam is an NSAID and, as such, is a non-selective COX inhibitor possessing both analgesic and antipyretic properties. It undergoes enterohepatic circulation.
As a group, NSAIDs are non-narcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis, and other musculoskeletal conditions. Other members of this class include ibuprofen, naproxen, indomethacin, nabumetone and several others. They work by reducing the levels of prostaglandins, chemicals that are responsible for pain, fever, and inflammation. Piroxicam blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower concentrations of prostaglandins. As a consequence, inflammation, pain and fever are reduced. The FDA approved piroxicam in 1982.
Piroxicam is a prescription medication that has been licensed to treat several conditions related to pain, inflammation, swelling, and stiffness.
Specific uses for piroxicam include the relief of:
Osteoarthritis symptoms
Rheumatoid arthritis symptoms.
Piroxicam is not a cure for the types of arthritis mentioned, however, nor does it slow down the progression of the disease.
On occasion, your healthcare provider may recommend piroxicam for something other than the conditions discussed in this article. This is called an “off-label” use. Some examples of off-label piroxicam uses include the relief of:
Juvenile arthritis symptoms
Mild to moderate pain, such as lower back pain, neck pain, or leg pain
Fibromyalgia symptoms
Gout symptoms
Chronic fatigue syndrome symptoms
Symptoms of systemic lupus erythematosus (SLE for short or lupus)
Pain or inflammation caused by other conditions.
Piroxicam is used within a variety of protocols to treat TCC, squamous-cell carcinoma (oral and cutaneous), hemangiosarcoma, prostatic carcinoma and some rectal neoplasms. Many protocols combine piroxicam with a chemotherapeutic drug such as cisplatin or mitoxantrone. In one study of dogs with TCC of the bladder, 35.4% had a measurable response to combined chemotherapy and piroxicam, while 75% showed subjective improvement. Mean survival time (MST) for dogs with TCC treated with the combination of piroxicam and mitoxantrone was just under a year. Radiation therapy may be added to piroxicam and mitoxantrone protocols for TCC.
Piroxicam is thought to have a positive effect on survival time for prostatic carcinoma (MST=6.9 months). Treatment of oral squamous-cell carcinoma with cisplatin and piroxicam resulted in a 56% response rate and a MST of almost eight months. There are additional concerns regarding renal toxicity with the drug combination of cisplatin and piroxicam (as high as 86% in one study). The use of piroxicam suppositories for palliative treatment of rectal cancer in dogs is well-accepted for the improvement of quality of life. Piroxicam does not appear to confer additional benefits when combined with doxorubicin to treat lymphoma.
Piroxicam is used in cats as an adjunctive therapy to treat TCC of the bladder and oral squamous-cell carcinoma. The half-life of piroxicam in the cat is 12 to 13 hours, which is shorter than the 37 to 40-hour half-life in dogs.
Piroxicam is well-absorbed orally and the absorption is not affected by the presence of antacids. It should be given with food to decrease the likelihood of GI ulceration. Piroxicam is excreted primarily in the urine and only about 1% of the plasma level is found in milk. Piroxicam may be combined with opioid analgesic drugs to manage pain in cancer patients. NSAIDs provide synergistic pain relief with opioid analgesics allowing for a lower dose which may minimize the sedating 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. Stop taking piroxicam and seek medical attention or call your doctor at once if you have any of these serious side effects:
chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
black, bloody, or tarry stools;
coughing up blood or vomit that looks like coffee grounds;
swelling or rapid weight gain;
urinating less than usual or not at all;
nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
bruising, severe tingling, numbness, pain, muscle weakness; or
fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).
Less serious side effects may include:
upset stomach, mild heartburn or stomach pain, diarrhea, constipation;
bloating, gas;
dizziness, headache, nervousness;
skin itching or rash;
blurred vision; or
ringing in your ears.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
You must not use piroxicam during pregnancy or if you are trying to become pregnant due to possible harm to the unborn baby and interference with normal labor/delivery.
Tell your doctor before using this drug. The manufacturer recommends that due to the potential for serious adverse reactions in nursing infants, a decision should made to discontinue nursing or discontinue piroxicam, taking into account the importance of the drug to the mother. However, Briggs et. al. has assigned piroxicam to risk factor C and states that in studies of nursing women, the concentration in human milk was approximately 1% of the serum levels of the mother and probably do not present a risk to the nursing infant. They state that piroxicam is probably compatible with nursing. However, always talk to your doctor before using this drug during breastfeeding.
You should talk with your healthcare provider prior to taking piroxicam if you have:
Asthma
Heart disease, including congestive heart failure
High blood pressure (hypertension)
Liver disease or liver failure
Kidney disease or kidney failure
Bleeding problems (or if you are taking medicine that decreases the blood's ability to clot)
Diabetes
Stomach ulcers, stomach bleeding, or a history of either condition
Any allergies to medicines, including aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
Let your healthcare provider know if you:
Drink alcohol frequently
Smoke
Are having or have recently had heart surgery.
Also, tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Tell your doctor if you are taking an antidepressant such as citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem, Symbyax), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or venlafaxine (Effexor). Taking any of these drugs with piroxicam may cause you to bruise or bleed easily.
Before taking piroxicam, tell your doctor if you are taking any of the following drugs:
a blood thinner such as warfarin (Coumadin);
lithium (Eskalith, Lithobid);
methotrexate (Rheumatrex, Trexall);
diuretics (water pills) such as furosemide (Lasix);
steroids (prednisone and others);
aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) such as etodolac (Lodine), flurbiprofen (Ansaid), indomethacin (Indocin), ketoprofen (Orudis), ketorolac (Toradol), mefenamic acid (Ponstel), meloxicam (Mobic), nabumetone (Relafen), naproxen (Aleve, Naprosyn), and others; or
an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), ramipril (Altace), and others.
This list is not complete and there may be other drugs that can interact with 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.
Condition: Joint Damage causing Pain and Loss of Function, 9/15/2011 2:06:37 PM
Reviewer: harmonyhollow, 55-64 Female on Treatment for 10 years or more (Patient)
Comment: Have been taking this drug (20 mg/day) for more than 10 years...didn't think it was doing much till I stopped taking it for several days and was nearly unable to walk. Has caused no stomach or bleeding problems even though I take aspirin for break-through pain. It is inexpensive. …
Review by Ghee, October 11, 2007 2:12 PM
piroxicam for Pain: I was introduced to the painkiller for periods cramps in 2005 and it worked [good]. A single pill takes me through a period of 5 days. It gives me relief to go though my job and other duties normally. I wonder whether there are any side effects even though i take one pill per month and at times i dont. I hope am not at any risk as i feel the pill is God sent.
Condition: Joint Damage causing Pain and Loss of Function, 5/14/2011 5:01:08 PM
Reviewer: oldguy, 65-74 Male on Treatment for 10 years or more (Patient)
Comment: Injuries from military service in my late teens early 20s caused early onset of osteoarthritis in my back and knees. I am 67 now and started taking this drug in 1981... It has been great at relieving pain and stiffness in my joints and for me without any side effects or interactions. I've taken it for so long now that I don't realize how good it is until I stop taking it. After 3 or 4 days I notice the increased stiffness and pain. My pain levels have increased over time such that I need additional pain medication now but the piroxicam still is doing its job. I take 20 mg once a day in the morning.
Review by Anonymous, March 28, 2010 3:43 PM, User Rating: 9.0
piroxicam for Osteoarthritis: I have been taking Piroxicam 20mg once daily for several years, mostly for bad knees and as a general anti-inflammatory. I take it in the morning with breakfast. It works very well for me, with no side effects at all. I am very careful to always take it with food and milk, and I have my liver enzymes tested yearly. I chose this NSAID for several reasons: 1)It is a low dosage taken once a day; 2) It appeared to have fewer gastrointestinal issues than others; 3) I cannot take Naproxen; 5) Unlike Lodine or Vioxx, it does not give me any sensation of being mentally "drugged"; 6) ... it is EXTREMELY inexpensive...
Condition: Joint Damage causing Pain and Loss of Function, 4/4/2011 10:35:18 AM
Reviewer: Cheryl Davis, 45-54 Female on Treatment for less than 1 month (Patient)
Comment: WARNING IF YOU ARE BIPOLAR DO NOT TAKE THIS DRUG!I took 1 10mg pill.And in about an hour I had stomach cramps so bad i could hardly stand up.I was crying off and on and could not stop.I have been dealing with it for more than 20 years.And I am very stable. Untill I took just one 10mg pill!!I could not believe what was hapening.Please be careful taking this drug. Did NOTHING for pain!!
Review by Anonymous: User Rating: 6.0, February 10, 2009 7:08 PM
piroxicam for Temporomandibular Joint Disorder: I am using this drug for the first time to ease pain and inflammation due to Temporomandibular joint disorder. Even taken with Nexium (which I have taken for half of a year), it upsets my stomach. The pain is lessened, but not by much. Also, the swelling has continued to get worse. Some drugs work better for some, while some work better for others. I don't discourage anyone from using it. ...
Condition: Joint Damage causing Pain and Loss of Function, 5/13/2010 11:56:41 PM
Reviewer: Tam, 45-54 Female on Treatment for 6 months to less than 1 year (Patient)
Comment: I was on this most of last year and it works better than anything else I hve been on. I used to get really achy after driving back and forth from work (1 hour one way) and at nights i did not sleep well, would wake up stiff and achy, but not on this medication.
Condition: Joint Damage causing Pain and Loss of Function, 3/25/2010 2:10:05 PM
Reviewer: Tone, 55-64 Female on Treatment for 1 to 6 months (Patient)
Comment: Since using this drug, I am no longer stiff in the morning or after sitting for a long periods which would always come after heavy activities. I can walk without pain. Old ankle injury