Feldene: Effective Relief from Osteoarthritis and Rheumatoid Arthritis
Feldene (piroxicam) is a nonsteroidal anti-inflammatory drug (NSAID) indicated for the management of signs and symptoms of osteoarthritis and rheumatoid arthritis. As a potent, long-acting agent from the oxicam class, it provides sustained anti-inflammatory, analgesic, and antipyretic effects through the inhibition of prostaglandin synthesis. Its once-daily dosing regimen supports patient adherence and offers consistent 24-hour therapeutic coverage, making it a cornerstone in chronic inflammatory arthritic conditions. This product card provides a comprehensive overview for healthcare professionals to ensure informed prescribing and patient counseling.
Features
- Active Ingredient: Piroxicam 10 mg or 20 mg per capsule
- Drug Class: Nonsteroidal anti-inflammatory drug (NSAID), oxicam derivative
- Pharmacokinetics: Long half-life (~50 hours); reaches steady state in 7–12 days
- Administration: Oral capsule formulation
- Mechanism of Action: Cyclooxygenase (COX-1 and COX-2) inhibition, reducing prostaglandin production
Benefits
- Provides continuous 24-hour relief from pain and inflammation with a single daily dose
- Reduces joint stiffness and improves physical function in arthritic conditions
- Demonstrates high bioavailability and predictable pharmacokinetics
- Effective in managing chronic symptoms, supporting long-term treatment plans
- Minimizes dosing frequency, enhancing patient compliance and quality of life
- Suitable for a broad range of adult patients under appropriate medical supervision
Common use
Feldene is primarily prescribed for the relief of signs and symptoms of osteoarthritis and rheumatoid arthritis in adults. It is used to manage pain, reduce inflammation, decrease joint swelling, and improve mobility. It is not indicated for initial therapy or for conditions requiring rapid onset of action due to its prolonged half-life and time to reach steady state. Use should be limited to the lowest effective dose for the shortest duration consistent with individual treatment goals.
Dosage and direction
For osteoarthritis and rheumatoid arthritis, the recommended initial dose is 20 mg once daily. Depending on response, the dose may be decreased to 10 mg once daily. Feldene should be taken with food or milk to minimize gastrointestinal upset. Because of its long half-life, steady-state plasma levels are achieved after approximately 7–12 days of daily dosing. Dosage adjustments may be necessary in elderly patients or those with renal impairment. Do not crush or chew capsules.
Precautions
Patients should be advised to use the lowest effective dose for the shortest possible duration. Monitor renal function, especially in the elderly, those with pre-existing renal impairment, heart failure, or liver dysfunction. Use with caution in patients with a history of gastrointestinal bleeding or ulceration. Blood pressure should be monitored during treatment. Avoid use in late pregnancy due to risk of premature closure of the ductus arteriosus. Patients should report any signs of bleeding, visual changes, or skin reactions.
Contraindications
Feldene is contraindicated in patients with known hypersensitivity to piroxicam or any components of the formulation. It should not be used in patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. Contraindicated in the setting of coronary artery bypass graft (CABG) surgery. Do not use in patients with active gastrointestinal bleeding or peptic ulcer disease. Avoid in severe hepatic impairment or advanced renal disease.
Possible side effect
Common adverse reactions include nausea, dyspepsia, abdominal pain, diarrhea, and dizziness. Serious side effects may include gastrointestinal bleeding, ulceration, or perforation; cardiovascular thrombotic events; renal injury; hepatotoxicity; and severe skin reactions. Other potential effects include edema, hypertension, tinnitus, and pruritus. Patients should seek immediate medical attention for symptoms such as black stools, vomiting blood, chest pain, shortness of breath, weakness on one side, or slurred speech.
Drug interaction
Feldene may increase the risk of bleeding when used with anticoagulants like warfarin. Concurrent use with other NSAIDs or corticosteroids may increase the risk of GI toxicity. It may reduce the antihypertensive effect of ACE inhibitors, angiotensin II receptor blockers, or diuretics. Piroxicam can increase lithium or methotrexate levels. Use with caution alongside SSRIs or SNRIs due to additive bleeding risk. Aspirin may decrease piroxicam concentrations.
Missed dose
If a dose is missed, it should be taken as soon as remembered, unless it is almost 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.
Overdose
Symptoms of overdose may include lethargy, drowsiness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, coma, or acute renal failure. There is no specific antidote. Management is supportive and includes gastric lavage or activated charcoal (if presented early), and symptomatic treatment. Hemodialysis is not effective due to high protein binding. Monitor and support vital functions.
Storage
Store at room temperature (20–25°C or 68–77°F), in a dry place, protected from light and moisture. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.
Disclaimer
This information is intended for healthcare professionals and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions regarding a medical condition. Do not disregard professional medical advice or delay in seeking it because of something you have read in this document.
Reviews
Clinical studies and post-marketing surveillance have demonstrated Feldene’s efficacy in reducing pain and improving function in patients with osteoarthritis and rheumatoid arthritis. Many patients report significant improvement in daily activities and quality of life with once-daily dosing. However, healthcare providers emphasize the importance of monitoring for gastrointestinal and cardiovascular risks, especially in long-term users. Overall, it remains a valuable option in NSAID therapy when used appropriately in indicated populations.