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Feldene Side Effects

Generic Name: piroxicam

Note: This page contains information about the side effects of piroxicam. Some of the dosage forms included on this document may not apply to the brand name Feldene.

In Summary

More frequent side effects include: heartburn, nausea, and prolonged bleeding time. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to piroxicam: oral capsule, oral tablet

In addition to its needed effects, some unwanted effects may be caused by piroxicam (the active ingredient contained in Feldene). In the event that any of these side effects do occur, they may require medical attention.

Severity: Major

You should check with your doctor immediately if any of these side effects occur when taking piroxicam:

More common:
  • Bloating
  • bloody or black, tarry stools
  • burning upper abdominal or stomach pain
  • cloudy urine
  • constipation
  • decrease in urine output or decrease in urine-concentrating ability
  • headache
  • heartburn
  • indigestion
  • itching skin or rash
  • loss of appetite
  • nausea or vomiting
  • pale skin
  • severe abdominal or stomach pain, cramping, or burning
  • severe and continuing nausea
  • swelling
  • swelling of the face, fingers, feet, or lower legs
  • troubled breathing with exertion
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • weight changes
Less common:
  • Bleeding gums
  • blood in the urine
  • bloody nose
  • blurred vision
  • burning feeling in the chest or stomach
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • chest pain
  • clay-colored stools
  • confusion
  • cough or hoarseness
  • dark urine
  • difficult or labored breathing
  • difficult, burning, or painful urination
  • difficulty with swallowing
  • dilated neck veins
  • dizziness
  • extreme fatigue
  • fainting
  • fever or chills
  • flushing or redness of the skin
  • frequent urge to urinate
  • increased sensitivity of the skin to sunlight
  • increased thirst
  • increased volume of pale, dilute urine
  • large, flat, blue, or purplish patches in the skin
  • lightheadedness
  • lower back or side pain
  • nervousness
  • noisy breathing
  • numbness or tingling in the hands, feet, or lips
  • pain or burning in the throat
  • peeling of the skin
  • pinpoint red or purple spots on the skin
  • pounding in the ears
  • rapid, shallow breathing
  • redness or other discoloration of the skin
  • redness, swelling, or soreness of the tongue
  • severe sunburn
  • slow, fast, pounding, or irregular heartbeat or pulse
  • sore throat
  • sores, ulcers, or white spots on the lips or tongue or inside the mouth
  • stomach upset
  • swelling or inflammation of the mouth
  • swollen glands
  • tenderness in the stomach area
  • tightness in the chest
  • unpleasant breath odor
  • unusually warm skin
  • weakness or heaviness of the legs
  • yellow eyes or skin
Rare:
  • Anxiety
  • back or leg pains
  • burning, dry, or itching eyes
  • cold sweats
  • coma
  • cracks in the skin
  • diarrhea
  • discharge or excessive tearing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • general body swelling
  • general feeling of discomfort or illness
  • high fever
  • increased hunger
  • increased urination
  • inflammation of the joints
  • irregular, fast or slow, or shallow breathing
  • joint pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of heat from the body
  • muscle aches and pains
  • nightmares
  • no blood pressure
  • no breathing
  • no pulse
  • pain or discomfort in the arms, jaw, back, or neck
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale or blue lips, fingernails, or skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness, pain, or swelling of the eye, eyelid, or inner lining of the eyelid
  • runny nose
  • scaly skin
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe headache
  • shakiness
  • shivering
  • sleepiness
  • slurred speech
  • sneezing
  • sores, welting, or blisters
  • stiff neck or back
  • stomach pain, continuing
  • suddenly sweating
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • trouble sleeping

If any of the following symptoms of overdose occur while taking piroxicam, get emergency help immediately:

Symptoms of overdose:
  • Agitation
  • depression
  • hives
  • hostility
  • irritability
  • muscle twitching
  • pain or discomfort in the chest, upper stomach, or throat
  • rapid weight gain
  • stupor
  • swelling of the ankles or hands
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Severity: Minor

Some of the side effects that can occur with piroxicam may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common:
  • Acid or sour stomach
  • belching
  • continuing ringing or buzzing or other unexplained noise in the ears
  • excess air or gas in the stomach or intestines
  • hearing loss
  • passing gas
  • stomach discomfort or upset
Less common:
  • Feeling of constant movement of self or surroundings
  • hair loss or thinning of the hair
  • lack or loss of strength
  • sensation of spinning
  • shakiness in the legs, arms, hands, or feet
  • trembling or shaking of the hands or feet
Rare:
  • Change in hearing
  • changes in appetite
  • inability to sit still
  • mood alterations
  • need to keep moving
  • restlessness

For Healthcare Professionals

Applies to piroxicam: compounding powder, oral capsule

General

The most commonly reported adverse effects are abdominal pain/discomfort, flatulence, nausea, epigastric distress, constipation, diarrhea, dizziness, and headache.[Ref]

Gastrointestinal

Common (1% to 10%): Anorexia, indigestion, abdominal pain/discomfort, constipation, diarrhea, dyspepsia, flatulence, gross bleeding/perforation, heartburn, nausea, gastric and duodenal ulcers, vomiting, epigastric distress
Uncommon (0.1% to 1%): Dry mouth, esophagitis, gastritis, glossitis, hematemesis, melena, rectal bleeding, stomatitis
Rare (0.01% to 0.1%): Colic, eructation, pancreatitis
Frequency not reported: Peptic ulceration, gastrointestinal hemorrhage[Ref]

Evidence from observational studies have shown administration of doses greater than 20 mg orally per day increases the risk for gastrointestinal (GI) side effects. This drug may be associated with a high risk of GI toxicity relative to other nonsteroidal anti-inflammatory drugs (NSAIDs). About 1 in 5 patients who develop serious upper GI adverse events due to NSAID therapy are symptomatic. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occur in approximately 1% of patients whom are treated for 3 to 6 months and in 2% to 4% of patients treated for 1 year.[Ref]

Renal

Common (1% to 10%): Abnormal renal function
Uncommon (0.1% to 1%): Renal papillary necrosis, glomerulonephritis, interstitial nephritis, nephrotic syndrome, renal failure[Ref]

Renal toxicity while using piroxicam has occurred in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of NSAIDs may cause a dose dependent reduction in prostaglandin formation and secondarily, renal blood flow, which may precipitate overt renal decompensation.[Ref]

Hepatic

Common (1% to 10%): Elevated liver enzymes
Uncommon (0.1% to 1%): Hepatitis, jaundice
Rare (0.01% to 0.1%): Liver failure[Ref]

Significant elevations of the liver enzymes AST and ALT (about 3 or more times the upper limit of normal) have occurred in approximately 1% of patients in clinical trials with nonsteroidal anti-inflammatory drugs (NSAIDs). Borderline elevations have occurred in up to 15% of patients taking NSAIDs, including this drug.[Ref]

Cardiovascular

Common (1% to 10%): Edema
Uncommon (0.1% to 1%): Congestive heart failure, hypertension, tachycardia, syncope
Rare (0.01% to 0.1%): Arrhythmia, exacerbation of angina, hypotension, myocardial infarction, palpitations, vasculitis, chest pain
Frequency not reported: Arterial thrombotic events[Ref]

Clinical trials of several COX-2 selective and nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) of up to 3 years duration have shown an increased risk of serious and sometimes fatal cardiovascular thrombotic events, myocardial infarction, and stroke.[Ref]

Dermatologic

Observational studies suggest that piroxicam (the active ingredient contained in Feldene) may be associated with a higher risk of severe cutaneous adverse reactions than other non-oxicam NSAIDs. There is an increased risk early in the course of therapy, with the majority of cases occurring within the first month.[Ref]

Common (1% to 10%): Pruritus, rash
Uncommon (0.1% to 1%): Alopecia, bruising, desquamation, erythema, photosensitivity,
Rare (0.01% to 0.1%): Toxic epidermal necrosis, erythema multiforme, exfoliative dermatitis, onycholysis, Stevens - Johnson syndrome, urticaria, vesiculobullous reaction, ecchymosis, petechial rash
Frequency not reported: Non-thrombocytopenic purpura (Henoch-Schonlein)[Ref]

Hematologic

Common (1% to 10%): Anemia, prolonged bleeding time
Uncommon (0.1% to 1%): Eosinophilia, leukopenia, purpura, thrombocytopenia
Rare (0.01% to 0.1%): Agranulocytosis, hemolytic anemia, aplastic anemia, lymphadenopathy, pancytopenia
Frequency not reported: Decreased hemoglobin and hematocrit[Ref]

Hypersensitivity

A combination of dermatological/allergic signs and symptoms suggestive of serum sickness have occasionally occurred while using this drug. These include arthralgias, pruritus, fever, fatigue and rash (e.g., vesiculobullous reactions and exfoliative dermatitis).[Ref]

Rare (0.01% to 0.1%): Anaphylaxis, angioedema
Frequency not reported: Serum sickness[Ref]

Metabolic

Common (1% to 10%): Elevated BUN, elevated serum creatinine, anorexia
Uncommon (0.1% to 1%): Weight changes, hyperkalemia, fluid retention
Rare (0.01% to 0.1%): Appetite changes, hyperglycemia, hypoglycemia[Ref]

Nervous system

Common (1% to 10%): Dizziness, headache, sedation
Uncommon (0.1% to 1%): Asthenia, drowsiness, malaise, paresthesia, somnolence, tremors, vertigo, amnesia
Rare (0.01% to 0.1%): Akathisia, convulsions, coma, meningitis
Postmarketing experience: Aseptic meningitis[Ref]

Respiratory

Uncommon (0.1% to 1%): Asthma, dyspnea, epistaxis
Rare (0.01% to 0.1%): Respiratory depression, pneumonia
Frequency not reported: Bronchospasm[Ref]

Other

Common (1% to 10%): Tinnitus, deafness
Uncommon (0.1% to 1%): Fever
Rare (0.01% to 0.1%): Death, hearing impairment, thirst[Ref]

Endocrine

Rare (0.01% to 0.1%): Female fertility decreased[Ref]

Immunologic

Uncommon (0.1% to 1%): Infections, sepsis
Rare (0.01% to 0.1%): Positive ANA, flu-like syndrome[Ref]

Genitourinary

Uncommon (0.1% to 1%): Cystitis, dysuria, hematuria, oliguria, polyuria, proteinuria, urinary frequency, menorrhagia[Ref]

Local

Rare (0.01% to 0.1%): Sweating[Ref]

Ocular

Uncommon (0.1% to 1%): Blurred vision
Rare (0.01% to 0.1%): Conjunctivitis, swollen eyes[Ref]

Psychiatric

Uncommon (0.1% to 1%): Anxiety, confusion, depression, dream abnormalities, personality changes
Rare (0.01% to 0.1%): Hallucinations, mood alterations, nervousness
Frequency not reported: Insomnia[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.

Not all side effects for Feldene may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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