Feldene

Basic Feldene information

• INN (international nonproprietary name): Piroxicam
• Brand names available in the United Kingdom: Feldene (capsules 10 mg, 20 mg) and generic piroxicam products.
• ATC code: M01AC01
• Forms and dosages: capsules/tablets 10 mg and 20 mg; dispersible 20 mg tablets; topical gel.
• Manufacturers in the United Kingdom: Pfizer (Feldene) and generic manufacturers such as Sandoz, Teva and Mylan.
• Registration status in the United Kingdom: Registered with the MHRA as a prescription medicine.
• OTC / Rx classification: Prescription-only medicine (POM)
• Standard dosages per condition: Osteoarthritis and rheumatoid arthritis — typically 20 mg once daily (maximum 20 mg/day); some patients start at 10 mg once daily or split 2 × 10 mg to reduce gastrointestinal disturbance.
• Dosage adjustments: Not generally recommended for children; elderly should use the lowest effective dose with monitoring; avoid or use caution in renal or hepatic impairment.
• Typical treatment duration: Chronic treatment reviewed every 2–3 months; short-term, lowest effective dose recommended.
• Missed dose and overdose: Take missed dose when remembered unless near next dose; do not double up. Overdose requires immediate medical attention; management is supportive.
• Storage and transport: Store at 25°C with permitted excursions 15–30°C; keep in original packaging away from moisture and direct sunlight; do not freeze gels/creams.
• Absolute contraindications: Known hypersensitivity to piroxicam or other NSAIDs; active peptic ulcer or GI bleeding; severe heart failure; severe hepatic or renal impairment; post‑CABG patients; pregnancy (especially third trimester).
• Relative contraindications: History of mild‑moderate kidney or liver dysfunction; hypertension or heart failure; prior peptic ulcer disease; elderly patients; concurrent anticoagulant, antiplatelet or corticosteroid therapy.
• Common side effects: Gastrointestinal upset (nausea, dyspepsia), headache, dizziness, rash, oedema and raised blood pressure.
• Other key data: Half‑life ~50 hours (once‑daily dosing; risk of accumulation); sometimes co‑prescribed with gastroprotective agents; occasional off‑label uses under physician direction.

Legal status and availability in the UK

Feldene (piroxicam) is a prescription-only medicine (POM) in the UK.

In our online pharmacy, Feldene is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Product forms and strengths

Feldene and generic piroxicam are supplied as capsules and tablets of 10 mg and 20 mg strengths, plus dispersible 20 mg tablets. Topical gel is also available but is less common in the UK. The MHRA-approved patient information leaflet and SmPC give full details of each product.

Indications and typical dosing regimens

Standard adult doses and condition-specific guidance

Piroxicam is indicated for pain and inflammation in rheumatic diseases, especially osteoarthritis and rheumatoid arthritis.

The standard adult dose is 20 mg once daily with a maximum of 20 mg per day for most patients.

Some patients respond adequately to 10 mg once daily, and splitting into 2 × 10 mg doses is sometimes used to reduce gastrointestinal effects.

Treatment is typically reviewed every 2–3 months and prescribers are advised to use the lowest effective dose for the shortest possible time consistent with the condition.

Before treatment, the prescriber confirms the indication and intended duration, assesses gastrointestinal, cardiac and renal risks, and may recommend gastroprotection such as a proton pump inhibitor for high‑risk patients.

Paediatric use is generally not recommended and elderly patients should be monitored closely for adverse effects.

Because the half‑life is around 50 hours, accumulation is possible and prolonged courses should not continue without review.

Contraindications and clinical cautions

Absolute contraindications

Absolute contraindications include known hypersensitivity to piroxicam or other NSAIDs, active peptic ulceration or gastrointestinal bleeding, severe heart failure, and severe hepatic or renal impairment.

Use after coronary artery bypass graft surgery is contraindicated and piroxicam should not be used in pregnancy, particularly during the third trimester.

Relative contraindications that require close monitoring include a history of mild‑to‑moderate kidney or liver dysfunction, uncontrolled hypertension, prior peptic ulcer disease and elderly status.

Concurrent use of anticoagulants, antiplatelet agents or systemic corticosteroids increases risk and needs prescriber review.

Side effects: common and serious

Monitoring and early warning signs

Common mild to moderate adverse effects include gastrointestinal upset such as nausea, dyspepsia and abdominal pain, along with constipation or diarrhoea.

Other frequent symptoms are headache, dizziness, skin rash, oedema and raised blood pressure.

Serious risks include gastrointestinal bleeding and perforation, renal impairment, hypersensitivity reactions and rare severe skin reactions.

A basic monitoring schedule for longer treatment should include baseline and periodic blood pressure checks and renal and liver function tests when treatment extends beyond 4–8 weeks or the patient is at risk.

Stop the medicine and seek urgent care for black or tarry stools, sudden severe abdominal pain, jaundice, sudden breathlessness or any severe skin reaction.

Interactions and co‑prescribing guidance

Major drug interactions

Piroxicam increases bleeding risk when combined with anticoagulants such as warfarin and adds to gastrointestinal bleeding risk if used with SSRIs or corticosteroids.

Concomitant use with ACE inhibitors, angiotensin receptor blockers or diuretics can blunt antihypertensive effects and raise the risk of renal impairment.

Other important interactions include lithium and methotrexate, where piroxicam may reduce clearance and increase toxicity.

Do not take over‑the‑counter NSAIDs or aspirin without clinician approval.

Because piroxicam has a long half‑life, interactions may persist after stopping the drug and monitoring is advised where drug levels are clinically relevant.

Missing doses, overdose and emergency advice

What patients should do

If a dose is missed, the patient should take it as soon as they remember unless it is almost time for the next dose; doubling up is not recommended.

In the event of suspected overdose, immediate medical attention is required and symptoms can include severe nausea, vomiting, gastrointestinal bleeding, drowsiness or coma.

Emergency management is supportive and symptomatic; patients should bring the packaging and prescription details to A&E.

In an emergency call 999 or attend A&E; NHS 111 can advise if symptoms are worrying but not immediately life-threatening. Tell the prescriber, particularly when cumulative effects are possible due to the long half‑life.

Storage and shelf life

Storage requirements

Store at 25°C with permitted excursions between 15°C and 30°C and keep products in their original packaging away from moisture and direct sunlight.

Do not freeze topical gels or creams and avoid exposing tubes to excessive heat during transport.

Check expiry dates and blister integrity, and keep medicines away from children.

For topical preparations, follow the manufacturer’s guidance on discarding after opening.

Legal classification

Piroxicam (Feldene) is prescription‑only in the UK and is registered with the MHRA as a prescription medicine.

The active ingredient is classified under ATC code M01AC01 in the oxicam derivatives subgroup of NSAIDs.

Counselling points

Tell your prescriber or pharmacist about any NSAID allergy and about other medicines, especially anticoagulants, SSRIs and diuretics.

Take once daily with food; report black stools, severe abdominal pain, breathlessness or marked swelling; avoid ibuprofen or naproxen unless instructed.

Tell your GP if you have stomach ulcers, kidney disease, heart failure or take blood thinners.

Alternatives, switching and comparative considerations

When to choose other NSAIDs or topical options

Alternatives include ibuprofen, diclofenac, meloxicam and naproxen, each with a different half‑life, gastrointestinal and cardiovascular risk profile.

Topical NSAIDs or paracetamol may be preferred for localised osteoarthritis to reduce systemic risk.

Meloxicam can be an alternative once‑daily option with potentially lower gastrointestinal risk compared with piroxicam for some patients.

Piroxicam is best reserved for patients who specifically benefit from long duration and once‑daily dosing and who accept the need for enhanced monitoring.

When switching, review the indication, stop piroxicam allowing an appropriate washout period guided by the long half‑life, and monitor for flare or withdrawal effects and adverse reactions during the transition.

Delivery across the United Kingdom