Piroxicam
Introduction To Piroxicam
Piroxicam is a pain-relieving medicine. It is used in the treatment of moderate to severe pain. It helps to relieve pain and swelling of various conditions related to joints and muscles. It is usually given in cases where oral administration is unsuitable.
Piroxicam is generally administered by a healthcare professional. You should not self-administer this medicine at home. The dose and duration will depend on what you are taking it for and how well it helps your symptoms. You should keep receiving the medicine until the doctor says it is okay to stop using the medicine.
The most common side effects of this medicine include injection site reactions (such as pain, redness, and swelling), vomiting, stomach pain, indigestion, diarrhea, headache, and dizziness. If any of these side effects persist or get worse, you should let your doctor know. Your doctor may be able to suggest ways of preventing or reducing the symptoms.
Before using it, you should let your doctor know if you have a history of stomach ulcers, heart diseases, high blood pressure, and liver or kidney disease. Let your doctor also know about all the other medicines you are taking because they may affect, or be affected by, this medicine.
This medicine is not recommended for pregnant or breastfeeding women. Pregnant and breastfeeding mothers must consult with their doctors before using the medicine. Your doctor may also regularly monitor your kidney function, liver function, and levels of blood components if you are taking this medicine for long-term treatment.
Uses of Piroxicam
- Pain relief
Benefits of Piroxicam
Pain relief
Piroxicam is used for short-term relief of pain, inflammation, and swelling
in conditions that affect joints and muscles. It works by blocking chemical
messengers in the brain that tell us we have pain. It can help relieve pain in
conditions like rheumatoid arthritis and osteoarthritis or even after a dental
(tooth-related) surgery.
Take it as it is prescribed to get the most benefit. Do not take more or for
longer than needed as that can be dangerous. In general, you should take the
lowest dose that works, for the shortest possible time. This will help you to
go about your daily activities more easily and have a better, more active,
quality of life.
Side effects of Piroxicam
Most side effects do not require any medical attention and disappear as your body adjusts to the medicine. Consult your doctor if they persist or if you’re worried about them
Common side effects of Dracam
- Injection site reactions (pain, swelling, redness)
- Vomiting
- Stomach pain
- Nausea
- Headache
- Dizziness
How to use Piroxicam
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Piroxicam works
Piroxicam is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking the release of certain chemical messengers that are responsible for inflammation (pain and swelling).
Quick tips
- Piroxicam helps relieve pain and swelling of various joints and muscles.
- It may cause dizziness and fatigue. Do not drive or do anything requiring concentration until you know how it affects you.
- Avoid consuming alcohol when taking this medicine as it may cause excessive drowsiness.
- Inform your doctor if you are pregnant or planning to conceive or breastfeeding.
Safety Advice
PregnancyCONSULT YOUR DOCTOR
Can I take Piroxicam if I’m pregnant?
Piroxicam is unsafe to use during pregnancy as there is definite evidence of risk to the developing baby. However, the doctor may rarely prescribe it in some life-threatening situations if the benefits are more than the potential risks. Please consult your doctor.
BreastfeedingSAFE IF PRESCRIBED
Can I take Piroxicam if I’m breastfeeding?
Piroxicam is safe to use during breastfeeding. Human studies suggest that the drug does not pass into the breastmilk in a significant amount and is not harmful to the baby.
AlcoholCAUTION
Is drinking alcohol while taking Piroxicam safe?
Caution is advised when consuming alcohol with Piroxicam. Please consult your doctor.
DrivingUNSAFE
Can I drive after taking Piroxicam?
Piroxicam may decrease alertness, affect your vision or make you feel sleepy and dizzy. Do not drive if these symptoms occur.
KidneyCAUTION
Can I take Piroxicam if I have/had kidney diseases?
Piroxicam should be used with caution in patients with severe kidney disease. Dose adjustment of Piroxicam may be needed. Please consult your doctor. No dose adjustment is recommended in patients with mild to moderate kidney disease. Regular monitoring of kidney function test is advised while you are taking this medicine.
LiverCAUTION
Can I take Piroxicam if I have/had liver diseases?
Piroxicam should be used with caution in patients with liver disease. Dose adjustment of Piroxicam may be needed. Please consult your doctor.
Frequently Asked Questions
Q. What is the difference between Piroxicam and diclofenac?
Both Piroxicam and diclofenac are pain killers. However, piroxicam is a non- selective COX (cyclooxygenase - an enzyme responsible for inflammation and pain) inhibitor whereas diclofenac has a bit more selectivity to a COX-2 enzyme. This selectivity of diclofenac is supposed to decrease the side effects as compared to Piroxicam.
Q. What is the difference between Piroxicam and naproxen?
Both Piroxicam and naproxen are pain killers. Both are non-selective COX (cyclooxygenase - an enzyme responsible for inflammation and pain). Research studies have shown both are equally effective. However, gastric side effects are lesser with naproxen as compared to Piroxicam.
Q. What is the difference between Piroxicam and meloxicam?
Both Piroxicam and meloxicam are pain killers. Both are non-selective COX (cyclooxygenase - an enzyme responsible for inflammation and pain). Research studies have shown both are equally effective. However, acute gastric side effects are lesser with meloxicam as compared to Piroxicam.
Q. What is the difference between Piroxicam and ketoprofen?
Both Piroxicam and ketoprofen are pain killers. Both are non-selective COX (cyclooxygenase -an enzyme responsible for inflammation and pain). Research studies have shown ketoprofen topical gel is better and effective as compared to Piroxicam. Ketoprofen gel also showed excellent tolerability.
Q. What is the difference between Piroxicam and tramadol?
Piroxicam is a COX (cyclooxygenase -an enzyme responsible for inflammation and pain) whereas Tramadol is a narcotic-like painkiller. Tramadol is a habit forming medicine.
Q. What is the difference between Piroxicam and nimesulide?
Both Piroxicam and nimesulide are pain killers. However, Piroxicam is a non- selective COX (cyclooxygenase -an enzyme responsible for inflammation and pain) inhibitor whereas nimesulide is selective to the COX-2 enzyme. This selectivity of nimesulide is supposed to decrease the side effects as compared to piroxicam. It should not be used in children below 12 years of age.
Q. Can Piroxicam be used in the treatment of chikungunya?
Usually, the platelet count does not dip in cases of chikungunya and painkillers like piroxicam can lead to the risk of increased bleeding tendency. So refrain from taking Piroxicam or any painkiller in the case of any fever with joint pain. Consult your doctor before starting Piroxicam.
Q. Are Piroxicam and aspirin same?
No. Piroxicam and aspirin are not same. They belong to the same class of drugs known as COX (cyclooxygenase) inhibitors. They both are anti- inflammatory and analgesic.
Q. Can Piroxicam be used along with dexamethasone?
No. Piroxicam should not be used with dexamethasone. They both increase each other's toxicity. There is an increased risk of GI ulceration.
Q. Can Piroxicam be used with methocarbamol?
Yes. Methocarbamol can be used with Piroxicam as no serious side effects are known. Inform your doctor before starting any of the medication.
Q. Can Piroxicam be used along with paracetamol?
Yes. Paracetamol can be used with Piroxicam as no serious side effects are known. Inform your doctor before starting any of the medication.
Q. Is Piroxicam a NSAID?
Yes. Piroxicam is a non-steroidal anti-inflammatory drug (NSAID).
Q. Is Piroxicam a sulfa drug?
Piroxicam is a sulphur containing compound. Piroxicam can cause serious adverse events in sensitive individuals. It can cause severe skin reactions like Steven Johnson Syndrome. Do inform your doctor if you have any kind of allergies.
Q. Is Piroxicam a blood thinner?
No. Piroxicam is not a blood thinner. It is a pain killer. It should be avoided in a patient with a bleeding disorder.
Q. Is Piroxicam a muscle relaxant?
No. Piroxicam is not a muscle relaxant. It is a pain killer which acts on COX (cyclooxygenase -an enzyme responsible for inflammation and pain) enzyme.
Q. Is Piroxicam a narcotic?
No. Piroxicam is not a narcotic. It is a pain killer which acts on COX (cyclooxygenase -an enzyme responsible for inflammation and pain) enzyme to decrease the pain and inflammation.
Q. Can Piroxicam be used in hypertension?
No. Piroxicam is not a medication to control hypertension. It is important to note that Piroxicam decreases the effectiveness of the antihypertensive medication when given together. Inform your doctor if you are taking antihypertensive medications before starting Piroxicam.
Q. Can Piroxicam be used along with Losartan?
No. Piroxicam should not be combined with Losartan. It is important to note that Piroxicam decreases the effectiveness of the antihypertensive medication like losartan when given together leading to failure of antihypertensive therapy. Inform your doctor if you are taking antihypertensive medications before starting Piroxicam.
Q. Can Piroxicam be used with Lisinopril?
No. Piroxicam should be avoided with lisinopril. It is important to note that piroxicam decreases the effectiveness of the antihypertensive medication like lisinopril when given together leading to failure of antihypertensive therapy. Inform your doctor if you are taking antihypertensive medications before starting Piroxicam.
Q. Can Piroxicam be used with calcium channel blocker?
Yes. Piroxicam can be taken with calcium channel blocker. NSAIDs have been observed to reduce the effectiveness of all antihypertensive drugs except calcium channel blockers (ref: White 2007)
Q. Can Piroxicam be used with Tizanidine?
Yes, Piroxicam can be combined with tizanidine. Piroxicam is a pain killer and tizanidine is a skeletal muscle relaxant. It is used in the condition like a backache.
Q. Why is beta cyclodextrin added to Piroxicam?
Yes. Piroxicam can be combined with beta-cyclodextrin. Research has shown that combining Piroxicam with beta-cyclodextrin leads to faster onset of action of piroxicam and reduced gastric side effects.
Q. Are there any alternatives of Piroxicam?
Yes. There are alternatives to Piroxicam. Pain killers are prescribed according to the disease condition. Consult your doctor before starting piroxicam or changing it to other medication.
Q. What are the contraindications for Piroxicam?
Contraindications to piroxicam are an allergy, bleeding tendency, duodenal/gastric/peptic ulcer, stomatitis, Systemic Lupus Erythematosus (SLE), ulcerative colitis, upper GI disease, late pregnancy, cardiac disease, hepatic impairment, renal impairment.
Q. Can Piroxicam be used in the treatment of allergy?
No. Piroxicam is not a drug to treat allergy. It is a pain killer.
Q. How long does Piroxicam work?
Piroxicam is a long acting drug. Once the daily dose is enough for the relief of pain but it depends from person to person as the effectiveness of piroxicam increases when given for few weeks.
Q. Can you get high by using Piroxicam?
No. Piroxicam is not known to cause high. It is a non-narcotic painkiller.
Q. Can Piroxicam be used to treat menstrual cramp?
Piroxicam is not approved for the treatment of menstrual cramps. Research studies have shown that piroxicam is quite effective in significantly decreasing the menstrual cramps.
Q. Can I use Piroxicam for a migraine?
Piroxicam is not approved for the treatment of migraine. Research studies have shown that Piroxicam is effective in significantly decreasing the pain associated with migraine without aura.
Q. Is Piroxicam effective in back pain management?
Yes. It can be given for decreasing the back pain. However, you should consult your doctor for the exact cause of your back pain and then start the treatment. Do not self-medicate yourself with Piroxicam as the cause of back pain can be different for different person.
Q. Is Piroxicam affective in gout management?
Yes. Piroxicam can be given for the treatment of acute gout. Research studies have shown Piroxicam to be highly effective in the treatment of acute gout.
Q. Can you donate blood when on the medication with Piroxicam?
Yes. You can donate blood when on Piroxicam. Do inform your doctor before donating blood.
Q. Can I use Piroxicam if I am a diabetic?
Piroxicam in a diabetic patient can only be taken only by consulting a doctor because these medicines have the propensity to cause renal failure when taken for a long period. Diabetes itself causes renal Piroxicam so taking piroxicam can lead to increased risk of renal failure by many folds.
Q. Can I use Piroxicam if I have a deranged renal function?
No. Piroxicam should not be taken if you have a abnormal renal function because long-term administration of NSAIDs has resulted in renal papillary necrosis and another renal injury.
Q. Can Piroxicam lead to skin reactions?
Yes. Piroxicam is known to cause skin reactions which can be very severe such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. These serious events may occur without warning. You should inform your doctor if you feel you have a mild rash and immediately discontinue the drug.
Q. Can I use Piroxicam if I am pregnant?
No. Piroxicam should not be taken in pregnancy. It causes premature closure of the ductus arteriosus which can lead to fetal heart failure and death of the baby.
Q. Can I use Piroxicam if I have peptic ulcer disease?
No. Piroxicam is contraindicated in cases of active peptic ulcer disease. Piroxicam is known to cause gastric ulceration and bleeding.
Q. Can I use Piroxicam if I have asthma?
Some patients with asthma are hypersensitive to non-steroidal anti- inflammatory (NSAID) drugs like aspirin which can lead to acute attacks of asthma. Consult your doctor before starting this medication.
Q. Can Piroxicam lead to difficulty in conception?
Yes. Piroxicam can sometimes cause reversible infertility. Piroxicam by its mechanism of action may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women. Consult your doctor before starting this medication.
Q. Can Piroxicam be used with diuretics?
No. Piroxicam should not be used with diuretics. Piroxicam reduces the natriuretic effect of furosemide and thiazides diuretics in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis.
Q. Can Piroxicam be used with lithium?
No. Piroxicam should not be used with lithium. Piroxicam leads to an elevation of plasma lithium levels and a reduction in renal lithium clearance. This is because of inhibition of renal prostaglandin synthesis by the NSAID. Consult and inform your doctor before starting this medication.
Q. Can Piroxicam be used with warfarin?
No. Piroxicam should be avoided with warfarin as they both lead to increase in bleeding tendencies. Inform your doctor if you are taking any of the medications. If given together then the therapy should be monitored closely.
Q. What increases the chances of getting a gastric ulcer when I am already taking Piroxicam?
The chances of gastric ulceration increases if you take medicines like corticosteroids and anticoagulants. Long term use, alcohol, smoking and old age are few other factors which can increase the chances of ulceration.
Q. Who should not take a Non-Steroidal Anti-Inflammatory Drug (NSAID)/ Piroxicam?
Patients who had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAID medicine or for pain right before or after heart bypass surgery.
Q. What are the serious side effects of Piroxicam?
GI discomfort and, rarely, serious GI side effects, such as ulcers and bleeding, serious skin side effects such as exfoliative, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis, liver failure, renal damage.
References
Written By:
Dr Advikka Ridhy
MBBS
RMO, Aster MIMS
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