Feldene (piroxicam) is a potent nonsteroidal anti-inflammatory drug (NSAID) specifically formulated for the management of osteoarthritis and rheumatoid arthritis. It belongs to the oxicam class of NSAIDs and works by inhibiting cyclooxygenase (COX) enzymes, thereby reducing the production of prostaglandins that mediate pain, inflammation, and fever. Its long half-life allows for once-daily dosing, promoting patient adherence and consistent therapeutic levels. Clinically, it is valued for its efficacy in improving joint function and reducing stiffness, making it a cornerstone in chronic anti-inflammatory therapy.

Features

• Active ingredient: Piroxicam 10 mg or 20 mg capsules
• Pharmacologic class: Nonsteroidal anti-inflammatory drug (NSAID), oxicam derivative
• Mechanism: Selective inhibition of cyclooxygenase-2 (COX-2), with some effect on COX-1
• Administration: Oral
• Dosage form: Gelatin capsules
• Half-life: Approximately 50 hours, permitting once-daily dosing
• Onset of action: analgesic effects may begin within 30 minutes; anti-inflammatory effects typically observed after several days of therapy

Benefits

• Provides significant reduction in joint pain and swelling associated with chronic arthritis conditions
• Enhances mobility and functional capacity by decreasing morning stiffness and improving range of motion
• Convenient once-daily dosing supports treatment adherence and steady-state plasma concentrations
• Demonstrates strong anti-inflammatory, analgesic, and antipyretic properties through prostaglandin synthesis inhibition
• Effective as both monotherapy and as part of a comprehensive arthritis management plan
• Suitable for long-term use under appropriate medical supervision and monitoring

Common use

Feldene is primarily indicated for the symptomatic treatment of osteoarthritis and rheumatoid arthritis. It is used to alleviate pain, reduce inflammation, decrease joint swelling, and improve physical function in affected patients. It may also be prescribed off-label for other painful inflammatory conditions, such as acute gout or ankylosing spondylitis, though such use should be carefully evaluated by a healthcare provider based on individual patient factors and risk profiles.

Dosage and direction

The recommended initial dosage for osteoarthritis and rheumatoid arthritis is 20 mg once daily. This may be administered as a single dose or divided (e.g., 10 mg twice daily), though the once-daily regimen is preferred for maintenance due to the drug’s long half-life. The dose should be taken with food or milk to minimize gastrointestinal upset. For some patients, especially the elderly or those with renal impairment, a lower maintenance dose of 10 mg daily may be sufficient. Dosage should be individualized based on therapeutic response and tolerability, and the lowest effective dose should be used for the shortest duration possible.

Precautions

Patients should be advised to avoid alcohol and tobacco use while on Feldene, as these may increase the risk of gastrointestinal bleeding. Regular monitoring of renal function, liver enzymes, and complete blood count is recommended during prolonged therapy. Use with caution in patients with a history of peptic ulcer disease, cardiovascular risk factors, hypertension, fluid retention, or heart failure. Feldene may mask the signs of infection, such as fever and inflammation. Patients should report any unusual bruising, bleeding, abdominal pain, or visual disturbances promptly.

Contraindications

Feldene is contraindicated in patients with known hypersensitivity to piroxicam, aspirin, or other NSAIDs. It should not be used in individuals who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Contraindications also include the perioperative period of coronary artery bypass graft (CABG) surgery, active peptic ulcer disease, recent gastrointestinal bleeding or perforation, and severe hepatic impairment or active liver disease. It is not recommended during the third trimester of pregnancy.

Possible side effect

Common side effects may include dyspepsia, nausea, abdominal pain, diarrhea, constipation, flatulence, dizziness, headache, and peripheral edema. Less frequently, rash, pruritus, tinnitus, and increased blood pressure may occur. Serious adverse effects can include gastrointestinal ulceration, bleeding, or perforation; renal impairment or failure; hepatotoxicity; severe skin reactions; and cardiovascular thrombotic events such as myocardial infarction or stroke. Patients should seek immediate medical attention for symptoms such as black/tarry stools, vomiting blood, chest pain, shortness of breath, weakness on one side of the body, or slurred speech.

Drug interaction

Feldene may interact with anticoagulants like warfarin, increasing the risk of bleeding. Concurrent use with other NSAIDs or corticosteroids may elevate the risk of GI adverse events. It may reduce the effectiveness of antihypertensive agents, such as ACE inhibitors or diuretics, and can increase lithium or methotrexate levels. Aspirin use may diminish piroxicam’s efficacy and increase GI toxicity. Caution is advised with SSRIs, SNRIs, and antiplatelet agents due to additive bleeding risks. Always inform your healthcare provider of all medications, including over-the-counter drugs and supplements.

Missed dose

If a dose is missed, it should be taken as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the usual dosing schedule. Do not double the dose to catch up. Maintaining a consistent daily routine is important to sustain anti-inflammatory and analgesic effects.

Overdose

Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, coma, or acute renal failure. Respiratory depression, hypertension, or seizures are possible in severe cases. There is no specific antidote; management is supportive and includes gastric lavage or activated charcoal if presented early, along with symptomatic treatment. Hemodialysis is not effective due to high protein binding. In case of suspected overdose, seek emergency medical attention or contact a poison control center immediately.

Storage

Store at room temperature (15–30°C or 59–86°F) in a dry place, protected from light and moisture. Keep the container tightly closed and out of reach of children and pets. Do not use after the expiration date printed on the packaging. Dispose of unused medication properly according to local guidelines; do not flush down the toilet or pour into drainage unless instructed to do so.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting, changing, or stopping any medication. Individual patient needs and responses may vary. The prescribing physician should be aware of the latest clinical guidelines and safety information regarding NSAID therapy.

Reviews

Clinical studies and patient reports indicate that Feldene is effective in reducing pain and improving function in arthritis patients, with many appreciating the convenience of once-daily dosing. However, some users report gastrointestinal discomfort, and long-term use requires careful monitoring for adverse effects. Overall, it remains a widely used option in rheumatology and pain management when prescribed appropriately for suitable candidates.