Ctrl

K

Piroxicam

Class
Nonsteroidal anti-inflammatory drugs
Subclass
Oxicams
Substance name
Piroxicam
Brand names
Feldene®
Common formulations
Capsule
Dosage and administration
Adults patients
Symptomatic relief
Osteoarthritis
•
20 mg PO daily
Rheumatoid arthritis
•
20 mg PO daily
Treatment
Treatment of osteoarthritis
•
20 mg PO daily
Indications for use
Labeled indications
Adults
•
Symptomatic relief of osteoarthritis
•
Symptomatic relief of rheumatoid arthritis
•
Treatment of osteoarthritis
•
Treatment of rheumatoid arthritis
Safety risks
Contraindications
A recent history of CABG surgery
Aspirin-sensitive asthma or the aspirin triad
Chronic use of piroxicam and a history of or active Gastrointestinal disease
Salicylate hypersensitivity or NSAID hypersensitivity
Warnings and precautions
Abnormal LFTs
•
Use caution with hepatic disease.
Fluid retention
•
Use caution with renal disease, or renal impairment.
Hematologic disorder
•
Use caution with a history of immunosuppression or other risk factors for developing hematological disease (e.g., coagulopathy or hemophilia or thrombocytopenia).
Thromboembolism
•
Use caution with known heart disease.
Specific populations
Renal impairment
eGFR 20-50 mL/min/1.73 m²
•
Avoid use as much as possible. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
eGFR 10-20 mL/min/1.73 m²
•
Avoid use as much as possible. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
eGFR < 10 mL/min/1.73 m²
•
Avoid use as much as possible. Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
Renal replacement therapy
Continuous renal replacement
•
Avoid use as much as possible. Dose as in eGFR 10-20 mL/min/1.73 m². Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
Intermittent hemodialysis
•
Avoid use as much as possible. Dose as in eGFR < 10 mL/min/1.73 m². Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
Peritoneal dialysis
•
Avoid use as much as possible. Dose as in eGFR < 10 mL/min/1.73 m². Monitor serum creatinine. Monitor for reduction in intrarenal autocoid synthesis.
Hepatic impairment
Any severity
•
Reduce dose.
Substantial chronic alcohol consumption
•
Use with caution.
Pregnancy and breastfeeding
Pregnancy
< 20 weeks of gestation • Australia Category: C
•
Use only if benefits outweigh potential risks.
20-30 weeks of gestation • Australia Category: C
•
Use only if benefits outweigh potential risks. Monitor for oligohydramnios. If oligohydramnios occurs, discontinue NSAID and treat it properly.
> 30 weeks of gestation • Australia Category: C
•
Avoid use.
Breastfeeding
Consider alternative agents that may be safer.
Low excretion in breastmilk (5-25%).
Undetectable levels in breastfed infants.
No overt adverse effects reported in breastfed infants.
Adverse reactions
Very common > 10%
•
↑ LFTs
Common 1-10%
•
AKI, abdominal pain, constipation, diarrhea, dizziness, flatulence, generalized pruritus, headache, heartburn, loss of appetite, nausea, skin rash, tinnitus, vomiting
Rare < 0.1%
•
Agranulocytosis, aplastic anemia, hemolytic anemia
Unknown frequency
•
Acute liver failure, acute intermittent porphyria, acute pancreatitis, alopecia, anaphylaxis, asthma, bronchospasm, cerebrovascular accident, colitis, congestive heart failure, DRESS syndrome, ↓ WBC count, ↓ blood neutrophil count, ↓ fertility, ↓ platelet count, ↓ serum sodium, edema, erythema multiforme, erythroderma, esophagitis, fixed drug eruption, fluid retention, gastrointestinal bleeding, gastrointestinal perforation, gastrointestinal ulceration, glomerulonephritis, gouty arthritis, hepatic necrosis, hepatitis, hypertension, inflammatory bowel disease, ↑ serum potassium, jaundice, myocardial infarction, osteoarthritis, pancytopenia, pemphigus vulgaris, photosensitivity of skin, ↑bleeding time, renal failure, bleeding, blurred vision, systemic lupus erythematosus, Stevens-Johnson syndrome, toxic epidermal necrolysis, tubulointerstitial nephritis
Interactions
Drug(s)
Check Interactions
Reset

What did you think about this content?

Create free account

Sign up for free to access the full drug resource