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Piroxicam Side Effects

Medically reviewed by Drugs.com. Last updated on Apr 26, 2023.

Applies to piroxicam: oral capsule.

Warning

Oral route (Capsule)

NSAIDs cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Piroxicam is contraindicated in the setting of coronary artery bypass graft surgery. NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.

Serious side effects of Piroxicam

Along with its needed effects, piroxicam may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking piroxicam:

More common

Less common

Rare

Get emergency help immediately if any of the following symptoms of overdose occur while taking piroxicam:

Symptoms of overdose

Other side effects of Piroxicam

Some side effects of piroxicam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Less common

Rare

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

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]

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]

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

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]

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]

Dermatologic

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]

Observational studies suggest that piroxicam 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]

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

Rare (0.01% to 0.1%): Anaphylaxis, angioedema

Frequency not reported: Serum sickness[Ref]

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]

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. Product Information. Feldene (piroxicam). Pfizer U.S. Pharmaceuticals. 2001;PROD.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

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