HealthyCanada.com

Piroxicam is used to relieve the pain tenderness inflammation and stiffness caused by gout arthritis (osteoarthritis rheumatoid arthritis) and other inflammatory conditions (e.g. ankylosing spondylitis). It can also be used to relieve other pain including pain due to headaches (e.g. migraines) muscle/joint/tendon strains or sprains menstrual cramps dental work or surgery/procedures.

Is there any reason not to take this drug?

You should not take this drug if you have had itchiness hives or other allergic reactions to piroxicam or naproxen aspirin (ASA) or other similar drugs (e.g. diclofenac ibuprofen). Tell your doctor if you have or have ever had:

• angina (chest pain) or previous heart attack
• asthma
• congestive heart failure
• high blood pressure
• problems with your kidney or liver
• problems with stomach ulcers bleeding of the stomach or heartburn
• problems with severe dehydration
• problems with bleeding (e.g. easy bruising nose bleeds)
• problems with drinking a lot of alcohol
• swelling of the ankles or legs

What about possible side effects?

The most common side effects are:

• nausea gas heartburn stomach pain
• swelling of the ankles or feet (this may make signs and symptoms of blood pressure or heart failure worse)
• constipation
• dizziness lightheadedness

Some of these side effects are related to the dose and may go away with time.

Other less common and/or sometimes severe side effects include:

• stomach ulcer with or without bleeding (contact your doctor immediately if you see blood in your vomit bloody diarrhea or black tarry stools)
• skin rash itching increased sensitivity to the sun
• problems with hearing or ringing in the ears
• problems with the kidney
• rare cases of hepatitis (inflammation of the liver) and jaundice (yellowing of skin and eyes) have been reported - call your doctor immediately if you experience unexplained nausea vomiting stomach pain fatigue loss of appetite dark urine and/or yellowing of the skin and/or eyes
• blurred vision
• may interfere with how well your blood can form clots - call your doctor if you notice bleeding or significant increases in bruising
• increase risk for heart attack or stroke

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

• other pain medications that include ASA and other anti-inflammatories (e.g. ibuprofen voltaren diclofenac) - this can increase your chances of having side effects especially ulcers and/or bleeding
• if you are taking medications to treat high blood pressure this medication may interfere with how well your blood pressure medication can work and your blood pressure may increase - your doctor will likely check your blood pressure periodically while you are taking this medication
• water pills (e.g. hydrochlorothiazide furosemide) - this medication may cause swelling of the ankles and feet and may interfere with how well the water pills can work
• if you are taking medications for congestive heart failure this medication may make your symptoms of congestive heart failure worse and interfere with how well your medications can work - call your doctor immediately if you notice that your symptoms of heart failure are getting worse
• lithium (may cause an increase in the amount of lithium in your blood)
• warfarin clopidogrel (can increase your chances of bleeding)
• methotrexate (may increase the amount of methotrexate in your blood)
• glyburide gliclizide glimepiride tolbutamide (may increase your chances of having low blood sugar)
• potassium supplements triameterine amiloride spironolactone (may increase the amount of potassium in your blood).
• cyclosporine (may see increase amount of cyclosporine in your blood and increase the chances of having problems with the kidney)

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other Information

Surgery: If you are having surgery including dental surgery inform your doctor well in advance if you are taking piroxicam as excessive bleeding during and after surgery may occur. Your doctor may advise you to discontinue the medication a few days prior to surgery.

Children: This drug is sometimes used in children. A lower dose is necessary.

Seniors: More sensitive to the side effects. Lower doses may be required

Pregnant women: Should be avoided in the last three months of pregnancy as it may prolong labour and could have an adverse effect on the baby's heart. Talk to your doctor.

Women who are nursing: Passes into breast milk. Can be taken but talk to your doctor first.

People who drive or operate machinery: Should not do so until they know the impact this drug has on them personally. This drug can sometimes cause dizziness and lightheadedness

Alcohol: Should only be consumed in small amounts as it may increase your chances of having problems with your stomach.

Overdose: If you experience any unusual reactions or if you seriously exceed the recommended dosage call 911.

Stopping the drug: If you have been taking this drug regularly talk to your doctor before you stop. If you take it occasionally for short-term pain relief you can safely stop when it is no longer required. Your symptoms may return when you stop the medication

If you miss a dose: take the next dose when you remember. If it is within two or three hours of your next scheduled dose take it now but skip the next dose. Never double dose.

Storage conditions: Closed container; cool dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: Since this medication may cause an upset stomach take piroxicam with food or milk.