What is piroxicam?
Piroxicam (brand name: Feldene®) is a nonsteroidal anti-inflammatory (NSAID) and an anti-tumor medication used in dogs primarily to treat bladder transitional cell carcinoma, as well as other cancers, such as squamous cell carcinoma, mammary adenocarcinoma, inflammatory mammary carcinoma, and transmissible venereal tumors. It can also be used to treat degenerative joint disease, but safer alternative NSAIDs are available.
In rabbits, it has been used as an anti-inflammatory pain medication but safer alternative NSAIDs are available.
Its use in dogs and small mammals is “off label” or “extra label”. Many drugs are commonly prescribed for off-label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as they may be significantly different from those on the label.
How is piroxicam given?
- Give piroxicam by mouth as a capsule.
- Give with food to reduce the chance of stomach upset.
- If your pet acts sick or vomits, contact your veterinarian.
This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow. When used for treatment of cancer, additional testing may be warranted to see if the drug is having the desired effects.
What if I miss giving my pet the medication?
If you miss a dose, give it when you remember. However, if it is close to the time for the next dose, skip the dose you missed, give it at the next scheduled time, and return to the regular dosing schedule. Never give your pet two doses at once or give extra doses.
Are there any potential side effects?
SERIOUS ADVERSE REACTIONS associated with this drug may occur without warning and could, and in rare cases, lead to death. Piroxicam can cause:
- significant gastrointestinal ulceration and bleeding
- kidney damage
- central nervous system effects such as dizziness, ringing in the ears
- itchiness and rash
- limb swelling
- elevated liver enzymes
If any of the following signs develop, stop giving piroxicam and contact your veterinarian immediately:
- persistent vomiting or diarrhea or soft stool
- vomiting with blood or a dark, coffee-ground-like substance
- dark tarry stools or bloody stools
- itching
- changes in drinking and/or urination habits
- swollen feet or limbs
- unsteady gait or difficulty rising
- pale gums
- lethargy
- poor appetite
This moderate-acting medication should stop working in a few days, although effects can be longer in pets with liver or kidney disease.
Are there any risk factors for this medication?
Piroxicam SHOULD NOT BE USED IN PATIENTS that:
- are allergic to it or other NSAIDs
- are taking other NSAIDs or corticosteroids
Piroxicam SHOULD BE USED WITH EXTREME CAUTION in pets that:
- have current or a history of gastrointestinal ulcers
- have bleeding disorders
Piroxicam SHOULD BE USED WITH CAUTION in pets:
- with impaired heart function
- who are pregnant or nursing
- who are considered senior
PIROXICAM USE IN CATS HAS NOT BEEN EVALUATED and SHOULD BE USED WITH EXTREME CAUTION or not at all, as cats are particularly vulnerable to kidney affects due to NSAIDs.
Are there any drug interactions I should be aware of?
- Avoid giving your dog other NSAIDs or corticosteroids (e.g., prednisone, dexamethasone) while they are taking piroxicam.
- Certain medications may interact with piroxicam and so it is important to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your dog is taking before starting any new treatment. Medications of concern include:
- cyclosporine (Atopica®)
- furosemide (Lasix®)
- selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine [Reconcile®, Prozac®])
- tricyclic antidepressants (e.g., amitriptyline [Elavil®], clomipramine [Clomicalm®])
Is any monitoring needed with this medication?
- Your veterinarian should perform baseline bloodwork and urinalysis before your pet starts piroxicam.
- If your dog is taking piroxicam for extended periods (as in the treatment of osteoarthritis or cancer), your veterinarian will do periodic blood tests to check liver and kidney function. It is very important to attend these follow-up appointments.
- Your veterinarian may recommend recheck examinations to ensure the medication is working adequately to manage pain.
- At home, monitor for any side effects such as those noted above. If any side effects occur, discontinue the medication, and contact your veterinarian.
How do I store piroxicam?
- Piroxicam should be stored at room temperature (below 86°F or 30°C) in a tightly sealed container.
- Protect from light.
- Keep the container out of reach of children and pets.
- Store compounded forms of this medication according to the label.
What should I do in case of emergency?
If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.
