Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain or inflammation caused by osteoarthritis or rheumatoid arthritis.

Piroxicam may also be used for purposes not listed in this medication guide.

Piroxicam can increase your risk of fatal heart attack or stroke. Do not use piroxicam just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Piroxicam may also cause stomach or intestinal bleeding, which can be fatal.

Follow all directions on your prescription label and read all medication guides. Your doctor may occasionally change your dose. Use the lowest dose that is effective in treating your condition.

It may take up to 2 weeks before your symptoms improve. Keep using the medicine as directed and tell your doctor if your symptoms do not improve.

If you use piroxicam long-term, you may need frequent medical tests.

Store at room temperature away from moisture and heat.

Usual Adult Dose for Rheumatoid Arthritis:

Recommended dose: 20 mg orally once a day

Comments:
-The lowest effective dose for the shortest duration possible should be used based on individual patient treatment goals.
-Due to the long half-life, there is a progressive response to treatment over several weeks; the effect of therapy should not be assessed for 2 weeks.

Use: For the relief of signs and symptoms of rheumatoid arthritis.

Usual Adult Dose for Osteoarthritis:

Recommended dose: 20 mg orally once a day

Comments:
-The lowest effective dose for the shortest duration possible should be used based on individual patient treatment goals.
-Due to the long half-life, there is a progressive response to treatment over several weeks; the effect of therapy should not be assessed for 2 weeks.

Use: For the relief of signs and symptoms of osteoarthritis.

You should not use piroxicam if you are allergic to it, or if you have ever had an asthma attack or severe allergic reaction after taking aspirin or an NSAID.

Piroxicam can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG).

Piroxicam may also cause stomach or intestinal bleeding, which can be fatal. These conditions can occur without warning while you are using piroxicam, especially in older adults.

Tell your doctor if you have ever had:

• heart disease, high blood pressure, or if you smoke;

• a heart attack, stroke, or blood clot;

• a stomach ulcer or stomach bleeding (especially while using an NSAID);

• liver or kidney disease;

• asthma; or

• if you take aspirin to prevent heart attack or stroke.

If you are pregnant, you should not take piroxicam unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy.

Ovulation (release of an egg from your ovary) could be delayed while you are taking piroxicam. This effect is usually not permanent. You should not take piroxicam while you are trying to get pregnant.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Piroxicam is not approved for use by anyone younger than 18 years old.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include nausea, vomiting, stomach pain, black or bloody stools, or coughing up blood.

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.

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

Avoid drinking alcohol. It may increase your risk of stomach bleeding.

Avoid taking aspirin while you are taking piroxicam.

Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to piroxicam (such as aspirin, ibuprofen, ketoprofen, or naproxen).

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Get emergency medical help if you have signs of a heart attack or stroke: chest pain spreading to your jaw or shoulder, sudden numbness or weakness on one side of the body, slurred speech, leg swelling, feeling short of breath.

Stop using piroxicam and seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Piroxicam may cause serious side effects. Stop using piroxicam and call your doctor at once if you have:

• severe headache, blurred vision, pounding in your neck or ears;

• heart problems--swelling, rapid weight gain, feeling short of breath;

• liver problems--loss of appetite, stomach pain (upper right side), tiredness, itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• signs of stomach bleeding--bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• kidney problems--little or no urination, swelling in your feet or ankles, feeling tired or short of breath; or

• low red blood cells (anemia)--pale skin, unusual tiredness, feeling light-headed or short of breath, cold hands and feet.

Common side effects of piroxicam may include:

• abnormal liver function tests;

• urination problems;

• upset stomach, heartburn, loss of appetite, stomach pain, nausea, vomiting;

• gas, diarrhea, constipation;

• dizziness, headache;

• itching, rash; or

• ringing in your ears.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ask your doctor before using piroxicam if you take an antidepressant. Taking certain antidepressants with an NSAID may cause you to bruise or bleed easily.

Tell your doctor about all your other medicines, especially:

• digoxin;

• lithium;

• methotrexate;

• a blood thinner or other medication used to prevent blood clots;

• heart or blood pressure medication, including a diuretic or "water pill"; or

• steroid medicine (such as prednisone).

This list is not complete. Other drugs may affect piroxicam, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

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.