Piroxicam

Piroxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Piroxicam is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

Piroxicam comes as a capsule to take by mouth. It is usually taken once or twice a day. Take piroxicam at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take piroxicam exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Piroxicam will help control your symptoms but will not cure your condition. It may take 8 to 12 weeks or longer before you feel the full benefit of piroxicam.

Piroxicam is also sometimes used to treat gouty arthritis (attacks of severe joint pain and swelling caused by a build-up of certain substances in the joints) and ankylosing spondylitis (arthritis that mainly affects the spine). It is also sometimes used to relieve muscle pain and swelling, menstrual pain, and pain after surgery or childbirth. Talk to your doctor about the risks of using this medication for your condition.

Before taking piroxicam,

• tell your doctor and pharmacist if you are allergic to piroxicam, aspirin, or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in piroxicam capsules. Ask your pharmacist for a list of the inactive ingredients.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi, in Edarbyclor), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); diuretics ('water pills'); lithium (Lithobid); medications for diabetes; methotrexate (Otrexup, Rasuvo, Trexall); and phenytoin (Dilantin, Phenytek). Your doctor may need to change the doses of your medication or monitor you more carefully for side effects.

• tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffy or runny nose or nasal polyps (swelling of the lining of the nose); heart failure; swelling of the hands, feet, ankles, or lower legs; or liver or kidney disease.

• tell your doctor if you are pregnant, plan to become pregnant; or are breast-feeding. Piroxicam may harm the fetus and cause problems with delivery if it is taken around 20 weeks or later during pregnancy. Do not take piroxicam around or after 20 weeks of pregnancy, unless you are told to do so by your doctor. If you become pregnant while taking piroxicam, call your doctor.

• talk to your doctor about the risks and benefits of taking piroxicam if you are 75 years of age or older. Do not take this medication for a longer period of time or at a higher dose than recommended by your doctor.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking piroxicam.

Unless your doctor tells you otherwise, continue your normal diet.

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

• Piroxicam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • diarrhea

  • constipation

  • gas

  • headache

  • dizziness

  • ringing in the ears

• Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more piroxicam until you speak to your doctor.

  • vision problems

  • unexplained weight gain

  • shortness of breath or difficulty breathing

  • swelling in the abdomen, ankles, feet, or legs

  • fever

  • blisters

  • joint pain

  • rash

  • itching

  • hives

  • swelling of the eyes, face, lips, tongue, throat, arms, or hands

  • difficulty breathing or swallowing

  • hoarseness

  • pale skin

  • fast heartbeat

  • excessive tiredness

  • unusual bleeding or bruising

  • lack of energy

  • upset stomach

  • loss of appetite

  • pain in the upper right part of the stomach

  • flu-like symptoms

  • yellowing of the skin or eyes

  • cloudy, discolored, or bloody urine

  • back pain

  • difficult or painful urination

• Piroxicam may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

• If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include the following:

• lack of energy

• drowsiness

• upset stomach

• vomiting

• stomach pain

• bloody, black, or tarry stools

• vomiting a substance that is bloody or looks like coffee grounds

• difficulty breathing

• coma (loss of consciousness for a period of time)

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.