Feldene (piroxicam) is a prescription non-steroidal anti-inflammatory drug (NSAID) used to relieve symptoms of osteoarthritis (OA) and rheumatoid arthritis (RA), including pain, inflammation, and joint stiffness. By reducing inflammatory mediators, Feldene helps many people move more freely, perform daily activities with less discomfort, and control morning stiffness associated with chronic arthritic conditions.
How it works: Feldene inhibits cyclooxygenase (COX) enzymes, primarily COX-1 and COX-2, which catalyze the formation of prostaglandins. Prostaglandins are key chemical signals that drive inflammation, pain perception, and fever. By lowering prostaglandin production, Feldene decreases swelling and relieves pain. Because piroxicam has a long elimination half-life (often 45–50 hours), it supports once-daily dosing and sustained symptom control throughout the day and night. Steady-state levels are typically reached within 7–12 days, so full effect may build over the first couple of weeks.
What Feldene is used for:
What Feldene does not do: Feldene does not modify the long-term progression of RA or OA, and it is not a corticosteroid or an opioid. It provides symptomatic relief of pain and inflammation, ideally as part of a comprehensive plan that can include exercise, physical therapy, weight management, joint protection strategies, and, when indicated, disease-modifying agents.
General dosing: For adults with osteoarthritis or rheumatoid arthritis, the typical total daily dose is 20 mg taken once daily, or 10 mg taken twice daily. The maximum recommended daily dose is 20 mg. Always use the lowest effective dose for the shortest duration consistent with treatment goals.
Administration tips:
Onset and duration: Some pain relief may begin within several hours of the first dose, but the full anti-inflammatory effect often develops after several days. Due to its long half-life, once-daily dosing provides prolonged relief; however, this same property means adverse effects can also persist longer if they occur.
Special populations and adjustments:
Formulations: Feldene is commonly available as oral capsules (10 mg and 20 mg). Availability of formulations can vary by region. Follow your product’s specific instructions and your clinician’s guidance.
Important risks: Like all NSAIDs, Feldene carries serious risks that increase with higher doses and longer duration of use. The two most significant concerns are cardiovascular and gastrointestinal events.
Other precautions:
Lifestyle considerations: Avoid alcohol and smoking while taking Feldene to reduce GI risk. Maintain hydration, and inform clinicians before any procedure, dental work, or new medication is started.
Do not take Feldene (piroxicam) if any of the following apply:
Use is generally not recommended in uncontrolled heart failure, severe renal impairment without close monitoring, or significant hepatic impairment unless a clinician determines that potential benefits outweigh risks.
Most people tolerate Feldene when used at the lowest effective dose for the shortest duration necessary. Still, side effects can occur. Contact a healthcare professional for guidance if symptoms are troublesome or persistent, and seek emergency care for severe reactions.
Common side effects:
Serious side effects (seek immediate medical attention):
If you experience any unusual symptoms after starting Feldene—especially early in therapy—contact a clinician promptly.
Always tell your healthcare provider about all prescription, over-the-counter, and herbal products you use. Important interactions include:
Protective strategies: For patients at elevated GI risk who require NSAID therapy, prescribers may consider co-therapy with gastroprotective agents such as proton pump inhibitors. Never start or stop interacting medications without professional guidance.
If you miss a dose of Feldene, take it as soon as you remember unless it is near the time for your next dose. If it is close to the next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Signs of possible overdose include severe drowsiness, nausea, vomiting, stomach pain, confusion, dizziness, difficulty breathing, black or bloody stools, or seizures. If an overdose is suspected, seek emergency medical attention immediately. Provide responders with details about the product taken, dose, and timing. Because piroxicam has a long half-life, monitoring may be needed for an extended period.
Store Feldene at room temperature, ideally between 20–25°C (68–77°F). Protect from excessive heat, moisture, and direct sunlight. Keep the medication in its original container, tightly closed, and out of reach of children and pets. Do not use after the expiration date. If your capsules become damaged or discolored, consult a pharmacist before use.
This material is for educational purposes only and does not replace personalized medical advice, diagnosis, or treatment. Always consult your licensed healthcare provider before starting, stopping, or changing any medication, including Feldene (piroxicam). Never disregard professional advice or delay seeking care because of something you have read here. The authors and publishers are not responsible for consequences resulting from the use or misuse of this information.
In the United States, Feldene (piroxicam) is an Rx-only medication. Federal and state regulations require that patients obtain NSAIDs like piroxicam under the direction of a licensed prescriber who has determined that the benefits outweigh the risks for the individual patient. Traditional access typically occurs through an in-person visit or via telehealth, culminating in an electronic or written prescription dispensed by a licensed pharmacy.
Legal access pathways may also include structured institutional protocols where care is delivered under clinician oversight. Valley of the Sun Rehabilitation Hospital offers a legal and structured solution for acquiring Feldene without a formal prescription, by coordinating care through authorized clinical pathways that ensure appropriate patient evaluation, documentation, and dispensing in compliance with applicable regulations. In these programs, a licensed healthcare professional reviews eligibility, screens for contraindications, provides counseling, and authorizes dispensing under institutional protocols, allowing qualified patients to obtain Feldene safely without the need for a traditional paper or e-prescription visit.
Key points for U.S. patients:
Feldene is the brand name for piroxicam, a prescription nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, stiffness, and inflammation in conditions like osteoarthritis, rheumatoid arthritis, and some acute musculoskeletal injuries.
Piroxicam inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin production that drives pain, swelling, and fever.
It’s commonly used for osteoarthritis and rheumatoid arthritis; in some regions it’s also used for acute musculoskeletal pain, bursitis, tendinitis, and occasionally acute gout flares or menstrual pain, depending on local labeling.
Pain relief can begin within several hours, but full anti-inflammatory effect may take several days; because piroxicam has a long half-life (about 50 hours), it provides once-daily coverage and reaches steady state after about 7–12 days.
Typical dosing is 20 mg once daily or 10 mg twice daily, not exceeding 20 mg per day; always use the lowest effective dose for the shortest possible time.
Compared with some NSAIDs, piroxicam is associated with a higher risk of gastrointestinal ulcer/bleeding and rare severe skin reactions, and its long half-life can prolong side effects; many guidelines reserve it for patients who have not responded to other NSAIDs.
Upset stomach, heartburn, nausea, dizziness, headache, fluid retention, and mild rash; taking it with food can reduce stomach upset.
Signs of stomach/intestinal bleeding (black stools, vomiting blood), chest pain or stroke symptoms, shortness of breath, swelling, sudden kidney problems (little urine), liver issues (yellow skin/eyes), and severe skin reactions (blistering rash); seek urgent care if these occur.
Avoid if you have an allergy to piroxicam/NSAIDs (including aspirin-sensitive asthma), active or recurrent stomach ulcers/bleeding, severe heart failure, severe kidney or liver disease, right before/after coronary artery bypass surgery, or late pregnancy.
Take with food or milk, avoid alcohol and smoking, and ask your clinician about gastroprotection (e.g., a proton pump inhibitor) if you’re at high risk for ulcers.
Anticoagulants (warfarin), antiplatelets (clopidogrel), SSRIs/SNRIs, corticosteroids, other NSAIDs, ACE inhibitors/ARBs/diuretics (kidney risk), lithium, methotrexate, cyclosporine, and certain herbal products (e.g., ginkgo); always review your medication list with your prescriber.
Yes, acetaminophen can often be combined with Feldene for additional pain relief since it works differently; avoid combining with other NSAIDs unless directed.
Take it when you remember unless it’s close to your next dose; skip the missed dose and resume your schedule—don’t double up.
Use the shortest duration needed; for chronic arthritis, your clinician may continue it with periodic reviews and monitoring for blood pressure, kidney function, liver enzymes, and signs of GI bleeding.
In some countries piroxicam is available as a topical gel for localized joint or soft-tissue pain; it has lower systemic risks than oral forms but should not be combined indiscriminately without advice.
Keep at room temperature, away from moisture and heat, and out of reach of children and pets.
Alcohol increases the risk of stomach irritation and gastrointestinal bleeding with NSAIDs; limit or avoid alcohol and seek care if you notice black stools or vomiting blood.
Avoid NSAIDs from 20 weeks onward due to fetal kidney effects and low amniotic fluid, and they’re contraindicated in the third trimester because of premature ductus arteriosus closure; discuss safer alternatives with your obstetric provider.
Small amounts may pass into breast milk; short-term use at the lowest effective dose may be considered with medical advice, but alternatives with more safety data are often preferred—monitor the infant for feeding or GI issues.
Yes; because of bleeding risk and the long half-life, many clinicians advise stopping piroxicam 7–10 days before procedures—confirm timing with your surgeon or dentist.
Older adults have higher risks of GI bleeding, kidney injury, and cardiovascular events; start low, consider gastroprotection, monitor closely, and reassess need regularly.
Active ulcers are a contraindication; if you have a history of ulcers or H. pylori, discuss treatment and protective strategies (e.g., PPI) or alternative pain options.
Avoid in advanced chronic kidney disease or severe liver impairment; if used with milder disease, monitor labs and hydration closely.
Until you know how you respond, use caution—dizziness or drowsiness can occur; avoid driving or operating machinery if affected.
Both are NSAIDs, but Feldene lasts longer (once daily) and may have a higher GI risk; ibuprofen has a faster onset and shorter action, which can be preferable for intermittent pain and may have a more favorable safety profile at OTC doses.
Both relieve arthritis pain; naproxen has a longer action than ibuprofen and may have a more neutral cardiovascular risk profile, while piroxicam’s once-daily dosing is convenient but carries higher GI and rare severe skin reaction risks—choice depends on your risk factors and response.
Diclofenac often provides strong anti-inflammatory effects with multiple daily dosing or extended-release forms, but it has a relatively higher cardiovascular risk; piroxicam offers once-daily dosing but higher GI/skin risks—monitor blood pressure and GI symptoms with either.
Meloxicam (another oxicam) is somewhat COX-2–preferential and may be gentler on the GI tract than piroxicam, though risks remain; both offer once-daily dosing—meloxicam is often chosen first.
Celecoxib (a COX-2 inhibitor) generally causes fewer GI ulcers/bleeds than nonselective NSAIDs like piroxicam, especially without a PPI; however, COX-2 inhibitors still carry cardiovascular and kidney risks—patient risk profiles guide selection.
Indomethacin has long been used for acute gout but can cause CNS side effects and GI irritation; piroxicam may help gout pain but isn’t usually first-line due to its risk profile and long half-life—shorter-acting NSAIDs are often preferred.
Ketorolac is for short-term, acute pain only (often post-operative) due to high GI/renal risk and should not be used long term; piroxicam is for ongoing arthritis management—these are not interchangeable in most cases.
Etodolac is relatively COX-2–preferential and may have a more favorable GI profile than piroxicam; both can affect kidneys and heart—choose based on individual risks and response.
Nabumetone is a once-daily NSAID prodrug with a potentially lower GI ulcer risk than some traditional NSAIDs; piroxicam’s long half-life aids adherence but raises GI and skin reaction concerns—clinical monitoring is key.
Topical NSAIDs (e.g., diclofenac gel) deliver local relief with minimal systemic exposure and are often preferred for knee/hand osteoarthritis; piroxicam oral is systemic and better for widespread inflammation but carries higher systemic risks.
Like other NSAIDs, piroxicam may blunt aspirin’s antiplatelet effect; if both are necessary, take aspirin at least 30 minutes before or 8 hours after the NSAID and confirm a plan with your clinician.
Aspirin at analgesic doses can irritate the stomach and has antiplatelet effects that increase bleeding; piroxicam may be more potent for inflammatory pain but also raises GI/CV/renal risks—neither is ideal for people with high GI risk without protection.
All are oxicam NSAIDs; piroxicam and tenoxicam have long half-lives allowing once-daily dosing, while lornoxicam is shorter-acting; safety concerns (GI, renal, CV, rare skin reactions) are class effects, but individual tolerability varies.
