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In patients taking FELDENE (piroxicam) or other NSAIDs, the most frequently reported adverse experiences occurring in approximately 1-10% of patients are:
Cardiovascular System: Edema.
Hemic and Lymphatic System: Anemia, increased bleeding time.
Nervous System: Dizziness, headache.
Special Senses: Tinnitus.
Urogenital System: Abnormal renal function.
Additional adverse experiences reported occasionally include:
Metabolic and Nutritional: Weight changes.
Special Senses: Blurred vision.
Other adverse reactions which occur rarely are:
Hypersensitivity: Positive ANA.
Respiratory: Respiratory depression, pneumonia.
Special Senses: Conjunctivitis, hearing impairment, swollen eyes.
Read the Feldene (piroxicam) Side Effects Center for a complete guide to possible side effects
Highly Protein Bound Drugs: FELDENE (piroxicam) is highly protein bound and, therefore, might be expected to displace other protein bound drugs. Physicians should closely monitor patients for a change in dosage requirements when administering FELDENE (piroxicam) to patients on other highly protein bound drugs.
Aspirin: When FELDENE (piroxicam) is administered with aspirin, its protein binding is reduced, although the clearance of free FELDENE is not altered. Plasma levels of piroxicam are depressed to approximately 80% of their normal values when FELDENE (piroxicam) is administered (20 mg/day) in conjunction with aspirin (3900 mg/day). The clinical significance of this interaction is not known; however, as with other NSAIDs, concomitant administration of piroxicam and aspirin is not generally recommended because of the potential for increased adverse effects.
Methotrexate: NSAIDs have been reported to competitively inhibit methotrexate accumulation in rabbit kidney slices. This may indicate that they could enhance the toxicity of methotrexate. Caution should be used when NSAIDs are administered concomitantly with methotrexate.
ACE-Inhibitors: Reports suggest that NSAIDs may diminish the antihypertensive effect of ACE-inhibitors. This interaction should be given consideration in patients taking NSAIDs concomitantly with ACE-inhibitors.
Diuretics: Clinical studies, as well as postmarketing observations, have shown that FELDENE (piroxicam) can reduce the natriuretic effect of furosemide and thiazides in some patients. This response has been attributed to inhibition of renal prostaglandin synthesis. During concomitant therapy with NSAIDs, the patient should be observed closely for signs of renal failure (see WARNINGS: Renal Effects), as well as to assure diuretic efficacy.
Lithium: NSAIDs have produced an elevation of plasma lithium levels and a reduction in renal lithium clearance. The mean minimum lithium concentration increased 15% and the renal clearance was decreased by approximately 20%. These effects have been attributed to inhibition of renal prostaglandin synthesis by the NSAID. Thus, when NSAIDs and lithium are administered concurrently, subjects should be observed carefully for signs of lithium toxicity.
Warfarin: The effects of warfarin and NSAIDs on GI bleeding are synergistic, such that users of both drugs together have a risk of serious GI bleeding higher than users of either drug alone.
Read the Feldene Drug Interactions Center for a complete guide to possible interactions
Last reviewed on RxList: 9/14/2010
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