Piroxicam

By Rania Gollakner, BS, DVM

Medications

What is piroxicam?

Piroxicam (brand name: Feldene®) is a nonsteroidal anti-inflammatory (NSAID) and an anti-tumor medication used 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 to treat fractures associated limb swelling.

Its use in dogs, cats, and small mammals to treat cancer 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 their directions may be significantly different from those on the label.

How is piroxicam given?

Piroxicam is given by mouth in the form of a capsule, preferably with food to reduce the chance of stomach upset. This medication will take effect quickly, in about 1 to 2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose, give it when you remember, but if it is close to the time for the next dose, skip the dose you missed and 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?

Piroxicam can cause significant gastrointestinal ulceration and bleeding, as well as kidney damage. Other possible side effects include central nervous system effects such as dizziness, ringing in the ears, itchiness and rash, and limb swelling. Your veterinarian may notice elevated liver enzymes with bloodwork.

In cats, gastrointestinal effects, decreasing red blood cell counts, and kidney damage are all possible.

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. It should be used with extreme caution in pets that have current or a history of gastrointestinal ulcers or bleeding disorders. It should be used with caution in pets with impaired heart function, or in pregnant or nursing pets.

In aging pets, piroxicam should be used with caution, as advancing age is associated with an increased likelihood of adverse effects.

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?

The following medications should be used with caution when given with piroxicam: aminoglycosides, anticoagulants, aspirin, bisphosphonates, cisplatin, corticosteroids, cyclosporine, digoxin, diuretics, highly protein bound drugs (such as other anti-inflammatory agents, sulfonamides, or anticoagulants), methotrexate, SNRIs and SSRIs, tacrolimus, and tricyclic antidepressants.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

Your pet should be monitored for signs of gastrointestinal effects such as vomiting, diarrhea, bloody vomit or stools, and poor appetite. Your veterinarian may monitor your pet to be sure that the medication is working. When using this medication long-term, blood tests evaluating liver enzymes and kidney function should be monitored occasionally.

How do I store piroxicam?

Piroxicam should be stored at room temperature (below 30°C or 86°F) in a tight container and protected from light.

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.

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