II. Indications

  1. See NSAID
  2. FDA approved indications in Adults
    1. Rheumatoid Arthritis
    2. Osteoarthritis

III. Contraindications

  1. See NSAID

IV. Mechanism

  1. See NSAID
  2. NSAID in the Oxicam Class
  3. Piroxicam has a long half life and may be dosed daily
  4. Additional mechanisms beyond inhibition of Prostaglandin synthesis
    1. Inhibits Neutrophil aggregation
    2. Inhibits Lysosome enzyme release

V. Medications

  1. Piroxicam capsules 10 mg, 20 mg

VI. Dosing: Adults

  1. Arthritis (OA, RA): 20 mg orally daily (or divided twice daily)

VII. Adverse Effects

  1. See NSAID

VIII. Safety

  1. See NSAID
  2. Considered safe in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)

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Cost: Medications

piroxicam (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PIROXICAM 10 MG CAPSULE Generic $0.15 each
PIROXICAM 20 MG CAPSULE Generic $0.39 each