Piroxicam Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 24, 2024.

Applies to piroxicam: oral capsule.

Precautions

It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

This medicine may raise your risk of having a heart attack or stroke. This is more likely in people who already have heart disease. People who use this medicine for a long time might also have a higher risk. Check with your doctor right away if you are having chest pain or discomfort, nausea or vomiting, pain or discomfort in the arms, jaw, back, or neck, trouble breathing, slurred speech, or weakness.

This medicine may cause bleeding in your stomach or intestines. These problems can happen without warning signs. This is more likely if you have had a stomach ulcer in the past, if you smoke or drink alcohol regularly, are over 60 years of age, are in poor health, or using certain other medicines (eg, steroid medicine, blood thinner).

Check with your doctor right away if you have any symptoms of liver problems including dark-colored urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, or yellow skin or eyes.

Some possible warning signs of serious side effects that can occur during treatment with this medicine may include black, tarry stools, decreased urination, severe stomach pain, skin rash, swelling of the face, fingers, feet, or lower legs, unusual bleeding or bruising, unusual weight gain, vomiting of blood or material that looks like coffee grounds, or yellow skin or eyes. Also, signs of serious heart problems could occur such as chest pain or tightness, fast or irregular heartbeat, unusual flushing or warmth of the skin, weakness, or slurring of speech. Check with your doctor immediately if you notice any of these warning signs.

Check with your doctor right away if you have bloody urine, a decrease in frequency or amount of urine, an increase in blood pressure, increased thirst, loss of appetite, lower back or side pain, nausea, swelling of the face, fingers, or lower legs, trouble breathing, unusual tiredness or weakness, vomiting, or weight gain. These could be symptoms of a serious kidney problem.

Hyperkalemia (high potassium in the blood) may occur while you are using this medicine. Check with your doctor right away if you have stomach pain, confusion, difficulty with breathing, irregular heartbeat, nausea or vomiting, nervousness, numbness or tingling in the hands, feet, or lips, or weakness or heaviness of the legs.

This medicine may also cause serious allergic reaction called anaphylaxis, which can be life-threatening and requires medical attention. Although this is rare, it may occur more often in patients who are allergic to aspirin or to any of the nonsteroidal anti-inflammatory drugs (NSAIDs). Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Serious skin reactions, including exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and drug reaction with eosinophilia and systemic symptoms (DRESS) can occur with this medicine. Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, fever, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

Using this medicine during the later part of a pregnancy can harm your unborn baby. If you think you have become pregnant while using the medicine, tell your doctor right away.

This medicine may cause a delay in ovulation for women and may affect their ability to have children. If you plan to have children, talk with your doctor before using this medicine.

Check with your doctor immediately if blurred vision, difficulty in reading, or any other change in vision occurs during or after your treatment. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).

Before having any kind of surgery or medical tests, tell your doctor that you are using this medicine. It may be necessary for you to stop treatment for a while, or to change to a different nonsteroidal anti-inflammatory drug before your procedure.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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:

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

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

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:

For healthcare professionals

Applies to piroxicam: compounding powder, oral capsule.

General adverse events

The most common adverse reactions were nausea, constipation, flatulence, abdominal pain, diarrhea, headache, dizziness, edema, and rash.^[Ref]

Cardiovascular

• Uncommon (0.1% to 1%): Palpitations
• Frequency not reported: Flushing, cardiac failure, arterial thrombotic events
• Postmarketing reports: Congestive heart failure, hypertension, tachycardia, syncope, arrhythmia, exacerbation of angina, hypotension, myocardial infarction, vasculitis

Dermatologic

• Common (1% to 10%): Pruritus, rash
• Very rare (less than 0.01%): Severe cutaneous adverse reactions (SCARs)
• Frequency not reported: Drug reaction with eosinophilia and systemic symptoms (DRESS), photoallergic reactions, Henoch-Schonlein purpura, sweating
• Postmarketing reports: Alopecia, bruising, desquamation, erythema, photosensitivity, sweat, angioedema, toxic epidermal necrolysis, erythema multiforme, exfoliative dermatitis, onycholysis, Stevens-Johnson syndrome, urticaria, vesiculobullous reaction, ecchymosis, purpura, petechial rash, fixed drug eruption

SCARs included Stevens-Johnson syndrome and toxic epidermal necrolysis.

Gastrointestinal

• Common (1% to 10%): Abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting, abdominal discomfort, epigastric distress, peptic ulcer, stomatitis, indigestion
• Frequency not reported: Serious gastrointestinal (GI) adverse events
• Postmarketing reports: Colic, dyspepsia, gross GI bleeding, GI perforation, GI ulceration, heartburn, gastric ulcers, duodenal ulcers, dry mouth, esophagitis, gastritis, glossitis, hematemesis, melena, rectal bleeding, eructation, pancreatitis, fatal GI events

Nonsteroidal anti-inflammatory drugs (NSAIDs), including this drug, have caused serious GI adverse events (including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine); such events were sometimes fatal. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occurred in about 1% of patients treated for 3 to 6 months, and in about 2% to 4% of patients treated for 1 year.

Most postmarketing reports of fatal GI events occurred in older adult or debilitated patients.

Genitourinary

• Frequency not reported: Urinary frequency, menorrhagia
• Postmarketing reports: Cystitis, dysuria, hematuria, oliguria, polyuria, proteinuria, decreased female fertility

Hematologic

• Common (1% to 10%): Anemia, eosinophilia, leukopenia, thrombocytopenia, decreased hemoglobin, decreased hematocrit
• Frequency not reported: Decreased platelet count, decreased WBC count, thrombocytopenic purpura, nonthrombocytopenic purpura
• Postmarketing reports: Anemia, increased bleeding time, eosinophilia, leukopenia, thrombocytopenia, agranulocytosis, hemolytic anemia, aplastic anemia, lymphadenopathy, pancytopenia

Decreased hemoglobin and hematocrit, not associated with obvious GI bleeding, have occurred.

Hepatic

• Very common (10% or more): Elevated ALT or AST (up to 15%)
• Common (1% to 10%): Increased serum transaminase levels
• Frequency not reported: Severe hepatic injury, changes in various liver function parameters, fatal hepatitis
• Postmarketing reports: Elevated liver enzymes, hepatitis, jaundice, liver failure

Elevated ALT or AST (less than 3 times the upper limit of normal [3 x ULN]) has been reported in up to 15% of patients treated with NSAIDs, including this drug. Elevated ALT or AST (at least 3 x ULN) has been reported in about 1% of NSAID-treated patients. Rare, sometimes fatal, cases of severe hepatic injury (including fulminant hepatitis, liver necrosis, and hepatic failure) have been reported.

Hypersensitivity

• Postmarketing reports: Anaphylactic reactions, serum sickness

Immunologic

• Postmarketing reports: Positive antinuclear antibodies

Metabolic

• Common (1% to 10%): Anorexia, hyperglycemia
• Uncommon (0.1% to 1%): Hypoglycemia
• Frequency not reported: Increased appetite
• Postmarketing reports: Appetite changes, fluid retention, hyperglycemia, hypoglycemia, hyperkalemia

Nervous system

• Common (1% to 10%): Dizziness, headache, somnolence, vertigo, tinnitus
• Frequency not reported: Drowsiness, sedation, amnesia
• Postmarketing reports: Paresthesia, somnolence, tremors, akathisia, convulsions, coma, meningitis, aseptic meningitis

Ocular

• Uncommon (0.1% to 1%): Blurred vision
• Frequency not reported: Eye irritation
• Postmarketing reports: Conjunctivitis, swollen eyes

Other

• Common (1% to 10%): Edema, increased weight
• Frequency not reported: Deafness, elevated LDH, elevated alkaline phosphatase, decreased serum proteins, chest pain, thirst, chills, oligohydramnios, ductus arteriosus premature closure, prolonged labor, prolonged pregnancy
• Postmarketing reports: Fever, infection, sepsis, death, influenza-like syndrome, pain, weight changes, asthenia, malaise, hearing impairment, increased weight, decreased weight

Edema (mainly ankle edema) has been reported.

Psychiatric

• Frequency not reported: Personality change
• Postmarketing reports: Anxiety, confusion, depression, dream abnormalities, insomnia, nervousness, hallucinations, mood alterations

Renal

• Rare (0.01% to 0.1%): Renal failure, nephrotic syndrome, interstitial nephritis, renal papillary necrosis
• Frequency not reported: Elevated BUN, elevated serum creatinine, neonatal renal impairment
• Postmarketing reports: Abnormal renal function, interstitial nephritis, nephrotic syndrome, renal failure, glomerulonephritis

Respiratory

• Frequency not reported: Breathlessness, bronchospasm
• Postmarketing reports: Epistaxis, asthma, dyspnea, respiratory depression, pneumonia

See also:

Further information

Piroxicam side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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