Precautions and Warnings With Piroxicam
There are many piroxicam warnings and precautions to be aware of. Before you begin treatment, let your doctor know if you have high blood pressure, bleeding problems, asthma, or any allergies to medications -- including aspirin. Other safety concerns include potential drug interactions; serious side effects, like congestive heart failure, gastrointestinal bleeding, and a serious rash; and the risk of a heart attack or stroke.
Piroxicam: What Should I Tell My Healthcare Provider?You should talk with your healthcare provider prior to taking piroxicam (Feldene®) if you have:
- Heart disease, including congestive heart failure
- High blood pressure (hypertension)
- Liver disease or liver failure
- Kidney disease or kidney failure
- Bleeding problems (or if you are taking medicine that decreases the blood's ability to clot)
- Stomach ulcers, stomach bleeding, or a history of either condition
- Any allergies to medicines, including aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs).
Let your healthcare provider know if you:
- Are pregnant or thinking about becoming pregnant
- Are breastfeeding
- Drink alcohol frequently
- Are having or have recently had heart surgery.
Also, tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
Specific Precautions and Warnings With PiroxicamSome warnings and precautions to be aware of prior to taking piroxicam include the following:
- Piroxicam can interact with certain medications (see Drug Interactions With Piroxicam).
To decrease the chances of these problems occurring, you should take the smallest effective dose for the shortest period of time. Also, call 911 or an ambulance if you notice things such as:
- Chest pain
- Shortness of breath
- Slurring of speech.
- All NSAIDs, including piroxicam, may worsen high blood pressure or cause it. Piroxicam should be used with caution in people with known high blood pressure (hypertension).
- All NSAIDs may cause congestive heart failure or swelling. Make sure to contact your healthcare provider if you notice unexplained weight gain or swelling. Also, piroxicam should be used with caution in people with heart failure.
- All NSAIDs, including piroxicam, have been reported to cause problems in the stomach and intestines, including bleeding (known as gastrointestinal bleeding), stomach ulcers, or holes in the stomach or intestines. These problems can lead to serious complications or even loss of life. Extreme caution should be used if piroxicam is prescribed to people with a history of ulcers or gastrointestinal bleeding.
To decrease the chances of these problems occurring, you should take the smallest effective dose for the shortest period of time. Make sure to contact your healthcare provider immediately if you experience any signs or symptoms of stomach ulcers or bleeding, including:
- Stomach pain
- Black, tarry stools
- Vomiting blood.
- People taking NSAIDs can experience kidney damage. It is more common in the elderly and people with kidney disease, heart failure, or liver problems. It is also more common in those taking diuretics or ACE inhibitors.
- People taking piroxicam can experience liver damage. Contact your healthcare provider immediately if you notice things such as:
- Itchy or yellowing skin
- Abdominal pain (stomach pain)
- Flu-like symptoms.
- NSAIDs, including piroxicam, have been reported to cause allergic reactions. Seek emergency medical attention immediately if you notice things such as difficulty breathing and swelling of the face and throat.
- In rare cases, people taking piroxicam can develop a serious rash. If you notice an unexplained rash or blisters, fever, or itchy skin, stop taking the the drug and call your healthcare provider.
- If you are an alcoholic or drink alcohol frequently, discuss this with your healthcare provider prior to starting piroxicam. Alcohol can affect the way the liver works, indirectly affecting piroxicam.
- NSAIDs have been known to cause an increase in liver enzymes. Therefore, it is recommended that you have a blood test that looks at your liver function before starting piroxicam and 12 weeks after treatment has started.
- Piroxicam has been known to cause anemia. If you are taking this medication for an extended amount of time and show signs of anemia, talk with your healthcare provider.
- You should not take piroxicam with any other NSAID, as this may increase your risk of any of the problems discussed previously. Many NSAIDs are available with or without a prescription; make sure to read labels carefully. A partial list of NSAIDs includes:
You can ask your doctor or pharmacist for a complete list of these medications.
- Piroxicam is a pregnancy Category C medicine, meaning that it could potentially cause harm to your unborn child. If you are pregnant, you should take this medication only if the benefit outweighs the possible risk to your unborn child. Piroxicam is not recommended for women in the third trimester of pregnancy because it can cause injury and even death to the developing fetus. If you become pregnant while taking the drug, contact your healthcare provider immediately (see Feldene and Pregnancy for more information).
- If you are nursing, you should not to take piroxicam. Ask your healthcare provider whether to stop nursing or stop taking piroxicam.