Feldene

Feldene (piroxicam) is a nonsteroidal anti-inflammatory drug (NSAID) specifically formulated to provide long-lasting relief from pain, inflammation, and stiffness associated with chronic inflammatory conditions. As a potent oxicam derivative, it offers a prolonged half-life, allowing for once-daily dosing that supports consistent therapeutic levels and improved patient compliance. Its mechanism of action involves the inhibition of cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis and mitigating the underlying inflammatory processes. Clinically, it is indicated for the management of osteoarthritis and rheumatoid arthritis, providing both symptomatic relief and functional improvement. This product card provides a comprehensive overview of Feldene for healthcare professionals seeking detailed prescribing information.

Features

• Active ingredient: piroxicam 10 mg or 20 mg capsules
• Pharmacologic class: nonsteroidal anti-inflammatory drug (NSAID), oxicam derivative
• Administration: oral
• Half-life: approximately 50 hours
• Dosing regimen: once daily
• Available formulations: capsules, dispersible tablets, and gel for topical use (in some markets)

Benefits

• Provides sustained 24-hour relief from pain and inflammation with a single daily dose
• Reduces joint swelling and morning stiffness, improving mobility in arthritic conditions
• Demonstrates high bioavailability and predictable pharmacokinetics
• Supports long-term management of chronic inflammatory disorders with consistent dosing
• Available in multiple formulations to accommodate patient-specific needs and preferences
• Well-established efficacy profile supported by extensive clinical use and research

Common use

Feldene is primarily prescribed for the symptomatic treatment of osteoarthritis and rheumatoid arthritis. It is also used off-label for other painful inflammatory conditions such as acute gout, ankylosing spondylitis, and soft tissue injuries. Its long half-life makes it particularly suitable for chronic conditions requiring continuous anti-inflammatory and analgesic effects. Clinical use should always be guided by a thorough assessment of the patient’s medical history, risk factors, and treatment goals.

Dosage and direction

The recommended initial dose for most adults is 20 mg once daily, which may be taken with food or milk to minimize gastrointestinal discomfort. For long-term maintenance, the dose may be reduced to 10 mg daily depending on individual response and tolerability. The maximum daily dose should not exceed 20 mg. Feldene should be taken at the same time each day to maintain steady plasma concentrations. For topical gel formulations, apply a thin layer to the affected area up to four times daily, following specific regional guidelines. Dosage adjustments are necessary in elderly patients and those with renal or hepatic impairment.

Precautions

Patients should be advised to use the lowest effective dose for the shortest duration possible to reduce the risk of adverse events. Regular monitoring of renal function, blood pressure, and hemoglobin levels is recommended during prolonged therapy. Caution is advised in patients with a history of gastrointestinal ulcers, bleeding disorders, cardiovascular disease, or fluid retention. Feldene may mask signs of infection such as fever and inflammation. Avoid concomitant use of other NSAIDs, including over-the-counter products like aspirin or ibuprofen.

Contraindications

Feldene is contraindicated in patients with known hypersensitivity to piroxicam, other NSAIDs, or any component of the formulation. It must not be used in individuals who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Additional contraindications include active peptic ulcer disease, recent gastrointestinal bleeding or perforation, severe heart failure, third trimester of pregnancy, and severe hepatic impairment. Use is also prohibited in patients undergoing coronary artery bypass graft (CABG) surgery.

Possible side effect

Common adverse reactions include dyspepsia, nausea, abdominal pain, diarrhea, and dizziness. Serious side effects may include gastrointestinal bleeding, ulceration, or perforation; cardiovascular thrombotic events; renal toxicity; hepatotoxicity; and severe skin reactions such as exfoliative dermatitis or Stevens-Johnson syndrome. Other potential effects include hypertension, edema, tinnitus, and hematological abnormalities like anemia or leukopenia. Patients should be instructed to seek immediate medical attention for signs of bleeding, shortness of breath, slurred speech, or swelling.

Drug interaction

Feldene may interact with anticoagulants (e.g., warfarin), antiplatelet agents, and selective serotonin reuptake inhibitors (SSRIs), increasing the risk of bleeding. Concurrent use with other NSAIDs or corticosteroids elevates the risk of gastrointestinal toxicity. It may reduce the effectiveness of antihypertensive agents and diuretics. Piroxicam can increase lithium and methotrexate levels, necessitating close monitoring. Use with caution alongside cyclosporine, pemetrexed, or aminoglycosides due to potential nephrotoxicity.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly 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 make up for a missed one. Consistent daily dosing is important to maintain therapeutic effects, so patients should be encouraged to adhere to the prescribed regimen.

Overdose

Symptoms of overdose may include drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, coma, or acute renal failure. Respiratory depression and cardiovascular collapse are possible in severe cases. There is no specific antidote; management involves supportive care and symptomatic treatment. Gastric lavage or activated charcoal may be considered if ingestion was recent. Hemodialysis is not effective due to high protein binding. Contact a poison control center immediately for guidance.

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 beyond the expiration date printed on the packaging. Dispose of unused medication properly according to local regulations; do not flush down the toilet or pour into drains.

Disclaimer

This information is intended for healthcare professionals and should not replace clinical judgment or direct consultation with a qualified medical practitioner. Prescribing decisions must be based on individual patient assessment, official prescribing information, and current clinical guidelines. The manufacturer and author disclaim any liability for adverse effects resulting from the use or misuse of this information.

Reviews

Feldene has been widely studied and used since its introduction, with numerous clinical trials and meta-analyses supporting its efficacy and safety profile in managing inflammatory arthritis. Many rheumatologists note its utility in patients who require once-daily dosing for improved adherence. Some critiques highlight gastrointestinal and cardiovascular risks consistent with the NSAID class, emphasizing the need for careful patient selection and monitoring. Overall, it remains a valued option within the NSAID arsenal for appropriate patient populations.