Piroxicam topical
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Gel formulation of piroxicam.
Drugs List
Therapeutic Indications
Uses
Osteoarthritis of superficial joints
Relief of pain and inflammation due to trauma
Symptomatic relief of pain of the muscles,tendons and joints
Dosage
Adults
1g of gel (corresponding to 3cm) should be applied to the affected area 3 to 4 times a day.
The gel should be rubbed in to leave no residual product on the skin.
Contraindications
Children under 18 years
Nasal polyps, angioedema, and bronchospastic reactivity to NSAIDs
Precautions and Warnings
Breastfeeding
Dermatitis
Dermatosis
Pregnancy
Renal impairment
NSAIDs may provoke or exacerbate asthma
Some formulations contain propylene glycol
Some presentations may contain benzyl alcohol
Advise patient to wash hands after use
Avoid contact with eyes
Avoid contact with mucous membranes
Avoid occlusive dressings
Do not apply to broken or denuded skin
Monitor skin changes
Review therapy after 4 weeks
Discontinue if local irritation occurs
Discontinue treatment if rash occurs
Advise patient that photosensitivity possible
Advise patient to minimise exposure of treated areas to sunlight/sunlamps
If the patient has developed Stevens-Johnson syndrome or toxic epidermal necrolysis with the use of piroxicam, piroxicam must not be re-started in this patient at any time.
Pregnancy and Lactation
Pregnancy
Use topical piroxicam with caution in pregnancy.
The manufacturer states that due to the potential for reproductive toxicity with systemic piroxicam, use of topical piroxicam is not recommended.
In animals, systemic administration of prostaglandin inhibitors has been shown to adversely affect pregnancy including pre and post implantation loss therefore, as a precaution, use is not recommended.
Lactation
Use topical piroxicam with caution in breastfeeding.
The manufacturer states that safety of topical piroxicam in breastfeeding has not been established and use is not recommended.
Piroxicam is poorly absorbed from intact skin. Schaefer (2015) suggests that local application of NSAIDs should not prevent breastfeeding.
Side Effects
Abdominal pain
Bronchospasm
Contact dermatitis
Dermatitis
Drug rash with eosinophilia and systemic symptoms (DRESS)
Dyspepsia
Dyspnoea
Eczema
Erythema
Gastritis
Hypersensitivity reactions
Irritation (localised)
Nausea
Photosensitivity
Pruritus
Stevens-Johnson syndrome
Toxic epidermal necrolysis
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: February 2019
Reference Sources
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Summary of Product Characteristics: Feldene Gel. Pfizer Ltd. Revised March 2021.
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