Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic, and fever-reducing properties. The drug is a derivative of oxicam and thus falls into the enolic acid group of NSAIDs. Piroxicam works by blocking the effect of cyclooxygenase (COX) enzymes. COX enzymes are associated with the production of prostaglandins at the injury site, which cause both pain and inflammation. Blocking COX enzymes decreases prostaglandin production, thereby lowering pain and inflammation. The drug has both analgesic and antipyretic properties. Piroxicam is used to treat both osteoarthritis and rheumatoid arthritis and may have activity against dysmenorrhea, headaches, muscle pain, gout, and ankylosing spondylitis.
For more information, including a MSDS sheet, please see PNA’sPiroxicam page.
Osteoarthritis: Piroxicam is used to treat pain, stiffness, and tenderness in patients suffering from osteoarthritis, a type of arthritis caused by a breakdown of lining in the joint. Joints that are typically affected include those in the knee, ankle, foot, elbow, wrist, and hand.
Rheumatoid Arthritis: Piroxicam is also used to manage symptoms of rheumatoid arthritis, a chronic, autoimmune inflammatory disorder that typically affects the small joints in the hands and feet.
Other Uses: As an NSAID, piroxicam can be used to treat ankylosing spondylitis (a chronic inflammatory arthritis that primarily affects the spine), pain caused by menstruation or childbirth, and gout (arthritis that first presents in the big toe).2
Side Effects and Drug Interactions
Common side effects in patients taking piroxicam include3:
Abdominal pain or gas
Constipation, diarrhea, or indigestion
Upset stomach or stomach pain
Nausea or vomiting
Skin itch or rash
Patients who suffer from severity of these common side effects should contact their pharmacist or physician right away. Patients who experience an allergic reaction (hives, trouble breathing, swelling of the face, lips, tongue, or throat) or black, bloody, or tarry stools, bloody cough, swelling or rapid weight gain, problems urinating, jaundice, fever, sore throat, severe rash, bruising, numbness, tingling, muscle weakness, neck stiffness, or seizures should contact their physician right away.
Patients who are allergic to piroxicam should not take this drug. Patients taking aspirin, methotrexate, ACE-inhibitors, diuretics, lithium, warfarin, or highly protein-bound drugs should inform their physician before starting this medication. Patients who have or who have had cardiovascular thrombotic events, hypertension, congestive heart failure and edema, or gastrointestinal or renal conditions should also inform their physician before taking this drug. This drug is not indicated for patients late in pregnancy.
Latest News and Research
Piroxicam has the potential to treat a number of widespread conditions. Due to the drug’s anti-inflammatory properties and its long half-life, piroxicam may be suitable for delivery as a suppository. Such a delivery method would be particularly helpful in patients who have difficulties taking the drug orally, such as those who have gastrointestinal disorders or patients just out of surgery.4
Piroxicam has long been studied for use as an eye drop, specifically for treating conjunctivitis. Studies have shown that when used with an antibiotic, piroxicam eye drops helped to relieve discomfort and pain in patients, and accelerate their overall recovery.5 More recently, the drug is being studied for ophthalmic delivery as ocular inserts.6 Initial results show that when delivered this way, piroxicam has a longer, more sustained release and may be a more effective treatment.
Another area piroxicam may used in is for the treatment of nonmelanoma skin cancer.7 In a recent study, piroxicam showed efficacy against nonmelanoma skin cancer along different mechanisms with minimal side effects.