How Does Piroxicam Work?

Piroxicam is a type of drug called a non-steroidal anti-inflammatory drug (NSAID). It works by stopping the production of compounds called prostaglandins in the body, which have a number of effects, including to cause inflammation.

As a result, piroxicam can help to reduce pain and inflammation by stopping the production of prostaglandins. This is why it is usually used to relieve painful inflammatory conditions, such as arthritis.

Brand Names and Doses

Piroxicam is the generic name of the drug, which is the name of the active component that has an effect on your body. You may also know it better by one of its brand names, which are the names given to the medication made by each pharmaceutical company. Brand names of Piroxicam include:

• Mobilis tablets (10mg, 20mg)

• Mobilis capsules (10 mg, 20mg)

• Feldene tablets (20 mg)

• Feldene capsules (10 mg, 20 mg)

• Feldene gel (0.5%)

• Piroxicam capsules (10 mg, 20 mg)

Feldene is also available as a gel (0.5%), which can be applied topically onto the skin. This is particularly useful for relieving pain and inflammation in specific areas of the body, such as sprains or strains.

What type of drug is it?

Piroxicam is a type of drug known as a non-steroidal anti-inflammatory drug (NSAID), which is a group of drugs that all work in a similar way. Other examples of NSAIDs include:

• Aspirin

• Celecoxib

• Diclofenac

• Etoricoxib

• Ibuprofen

• Indomethacin

• Ketoprofen

• Ketorolac

• Mefenamic acid

• Meloxicam

• Naproxen

• Parecoxib

• Sulindac

• Tiaprofenic acid

Piroxicam is a nonselective NSAID, which means that it blocks both COX-1 and COX-2 to stop the production of more types of prostaglandins than some other NSAIDs. This means that it is more likely to cause side effects due to the action of the other prostaglandins that is reduced.

What is Piroxicam used for?

Piroxicam can be used to help relieve symptoms of pain and inflammation caused by a variety of health conditions such as:

• Rheumatoid arthritis

• Osteoarthritis

• Ankylosing spondylitis

• Muscular injury pain (e.g. sprains, strains or other sporting injuries)

The Feledene gel is particularly useful to relieve muscular injury pain because it can be applied directly to the affected area. This helps to direct the action of the drug to where it is needed and reduce the risk of side effects of the medication in other areas of the body.

How does it work?

Piroxicam works by inhibiting COX-1 and COX-2, which are needed to produce the different prostaglandins in your body. You have many different types of prostaglandins in your body, and there are some in almost every tissue of your body. They each have different effects, such as to cause:

• the tissues in your body to become inflamed

• your blood vessels to relax and widen

• the platelets in your blood to come together to form a clot

Piroxicam has a general effect on almost all the prostaglandins because it blocks both COX-1 and COX-2 from producing prostaglandins in your body. This means that it can reduce all of the usual effects prostaglandins. We want it to reduce inflammation because that is why we are using it, but it can also cause hypertension and affect the way the blood forms clots.

Side Effects

There are many different side effects that you may experience if you are taking piroxicam. These do not affect everyone, but it’s important to know what they are so that you can recognize them if you do notice them.

The side effects of piroxicam may include:

• Nausea​

• Heartburn (dyspepsia)

• Diarrhea

• Headache

• Dizziness

• Gastrointestinal ulcers

• Gastrointestinal bleeding

• Hypertension

This is not a complete list of side effects, but just some of the most common. Please see the Piroxicam information leaflet for more detailed information.

Drug Interactions

Piroxicam can interact with many other medications when they are used in together, including:

• ACE Inhibitors

• Aldosterone antagonists

• Alendronate

• Amiloride

• Aspirin

• Beta blockers

• Brimonidine

• Calcineurin inhibitors

• Corticosteroids

• Cyclosporin

• Fluconazole

• Lithium

• Loop diuretics

• Methotrexate

• Phenindione

• Potassium

• Prostaglandin analogues

• Rifampicin

• Sartans

• Tacrolimus

• Thiazide diuretics

• Thiazolidinediones

• Triamterene

• Warfarin

These medications can often be used together, but your doctor should be aware that you are taking both medications so that they can adjust the dose as needed to ensure they are safe and effective.

Cautions

There are some people who may need to avoid using piroxicam, or use it with caution, because they may be at risk of side effects due to the medication.

Peptic ulcers or GI bleeding:

Piroxicam is not usually used for people who have a history of gastrointestinal bleeding or peptic ulcers. This is because it can increase the risk of peptic ulcers or gastrointestinal bleeding. If it is required, a medication to help prevent gastrointestinal problems, such as esomeprazole or pantoprazole, is usually recommended as well.

Skin reaction to Piroxicam in the past:

If you’ve previously taken Piroxicam and it caused you to get a skin rash, you should not take the drug again. Even if the reaction was mild, it is best to avoid taking the drug.

Coagulation disorders:

Piroxicam may increase the risk of bleeding or thrombosis because the antiplatelet effect of the prostaglandins may be reduced.

Cardiovascular disease:

Piroxicam may cause retention of sodium and fluid in the body, which can make hypertension and heart failure worse. It should not be used if you have heart failure, angina, peripheral artery disease or cerebrovascular disease.

Asthma:

Piroxicam may increase the risk of bronchospasm and cause symptoms of asthma to worsen. Some people with asthma can use them without any problems, but it is best to use a low dose and watch for signs of worsening asthma if you are using it for the first time.

Inflammatory Bowel Disease (IBD):

Piroxicam may cause symptoms of inflammatory bowel disease to get worse.

Renal Impairment

Piroxicam can cause renal impairment is some people, particularly when used in combination with some other medications. If you already have some renal impairment, an NSAID may not be the best choice for you.

Pregnancy and Breastfeeding

Piroxicam is not usually recommended for women who are pregnant or trying to conceive. This is because it can interfere with fertility and the development of the fetus.

For women planning to become pregnant, it can prevent or delay ovulation, so that the woman is less likely to conceive. Additionally, using piroxicam during pregnancy, particularly at the time of conception, is linked to a higher risk of miscarriage. It may also cause other problems later on in the pregnancy and should be avoided.

For women who are breastfeeding, piroxicam is considered safe to use.

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