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Feldene
Feldene (generic name: piroxicam) is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation caused by conditions such as osteoarthritis and rheumatoid arthritis. It works by reducing the production of certain chemicals in the body that cause inflammation and pain. Feldene is often prescribed for long-term management of arthritis symptoms, including joint pain, swelling, and stiffness.
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Frequently Asked Questions
How long does it take for Feldene to start working?
Feldene may take 1 to 2 weeks to reach its full effect in treating arthritis symptoms, although some patients may notice pain relief within a few days.
Can I take Feldene with other pain medications?
You can take Feldene with acetaminophen (Tylenol), but you should avoid taking it with other NSAIDs (such as ibuprofen or naproxen) to minimize the risk of side effects, especially gastrointestinal bleeding.
What should I do if I miss a dose of Feldene?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.
Can Feldene be used long-term?
Feldene can be used long-term to manage chronic conditions like arthritis, but regular monitoring is required to minimize the risk of serious side effects such as gastrointestinal bleeding and cardiovascular events. Your doctor may recommend the lowest effective dose for the shortest duration necessary.
Is Feldene safe for patients with heart disease?
Patients with heart disease should use Feldene with caution due to the increased risk of cardiovascular events such as heart attack and stroke, especially with long-term use. Consult your healthcare provider to assess the risks and benefits.
Comprehensive Drug Guide
How Does Feldene Work?
Feldene works by inhibiting the cyclooxygenase (COX) enzymes, specifically COX-1 and COX-2, which are responsible for the production of prostaglandins. Prostaglandins are chemicals in the body that promote inflammation, pain, and fever. By blocking these enzymes, Feldene reduces inflammation and alleviates pain, making it effective for treating arthritis and other inflammatory conditions.
Common Dosages
The typical dosage for Feldene is:
- 10 mg once daily for milder cases.
- 20 mg once daily for more severe cases. In some cases, the 20 mg dose can be divided into 10 mg twice daily to minimize gastrointestinal side effects.
Typical Dosing
- For osteoarthritis and rheumatoid arthritis: The usual recommended dose is 20 mg once daily, or 10 mg twice daily.
- Feldene should be taken with food or milk to minimize gastrointestinal discomfort.
- The lowest effective dose should be used for the shortest duration possible to reduce the risk of side effects.
Typical Dosing
FDA Approved Indications
- Osteoarthritis: To relieve pain, inflammation, and stiffness associated with the breakdown of joint cartilage.
- Rheumatoid arthritis: To reduce pain, swelling, and joint stiffness caused by the immune system attacking joint tissues.
Who Shouldn't Take Feldene?
- Known hypersensitivity to piroxicam or other NSAIDs.
- Active peptic ulcers, gastric bleeding, or a history of gastrointestinal bleeding.
- Severe kidney or liver disease.
- History of asthma, hives, or allergic reactions to aspirin or other NSAIDs.
- Coronary artery bypass graft (CABG) surgery, as NSAIDs are contraindicated for perioperative pain in this context.
Advice From The Pharmacist
- Take Feldene with food or milk to minimize the risk of stomach upset, irritation, or ulcers.
- Avoid drinking alcohol while taking Feldene, as it may increase the risk of gastrointestinal bleeding.
- Stay hydrated and report any signs of kidney problems, such as changes in urination or swelling in the hands or feet.
- Avoid prolonged use, as long-term use of NSAIDs increases the risk of cardiovascular and gastrointestinal side effects.
- If you are taking other medications, especially blood thinners (e.g., warfarin) or corticosteroids, consult your doctor to manage potential interactions.
Side Effects of Feldene
Common Side Effects
- Stomach upset
- Nausea
- Dizziness
- Headache
- Heartburn
Uncommon/Severe Side Effects
- Gastrointestinal bleeding or ulcers (symptoms include bloody or black stools, vomiting blood, severe stomach pain).
- Cardiovascular events such as heart attack or stroke, particularly with long-term use.
- Liver problems (yellowing of the skin or eyes, dark urine, fatigue).
- Kidney problems (reduced urination, swelling in the feet or hands).
Risks and Warnings of Feldene
- Gastrointestinal Risk: Feldene increases the risk of serious gastrointestinal bleeding, ulcers, and perforation of the stomach or intestines. These risks are higher in elderly patients and in those with a history of GI issues.
- Cardiovascular Risk: Long-term use of Feldene may increase the risk of heart attack, stroke, and other cardiovascular events. Patients with pre-existing heart disease or risk factors for cardiovascular disease should use Feldene with caution.
- Kidney Risk: Feldene may affect kidney function, particularly in patients with existing kidney problems or those taking diuretics or ACE inhibitors.
- Liver Toxicity: In rare cases, Feldene can cause liver damage, leading to jaundice and abnormal liver function tests.
Interactions with Feldene
Common Drug Interactions
- Blood thinners (e.g., warfarin): Feldene can increase the risk of bleeding, especially when taken with anticoagulants.
- Other NSAIDs or aspirin: Combining Feldene with other NSAIDs can increase the risk of gastrointestinal side effects.
- ACE inhibitors and diuretics: Feldene may reduce the effectiveness of blood pressure medications and increase the risk of kidney problems.
- Corticosteroids: The risk of gastrointestinal bleeding is higher when Feldene is taken with corticosteroids like prednisone.
Alternatives to Feldene
- Ibuprofen (Advil, Motrin): A commonly used NSAID with a shorter duration of action, often taken for similar inflammatory conditions.
- Naproxen (Aleve): Another NSAID used for pain and inflammation, offering longer-lasting effects compared to ibuprofen.
- Celecoxib (Celebrex): A COX-2 selective inhibitor that may have fewer gastrointestinal side effects than non-selective NSAIDs like Feldene.
- Acetaminophen (Tylenol): An alternative for pain relief without anti-inflammatory effects, often used in patients who cannot tolerate NSAIDs.
