The Basics
What is Piroxicam?
Used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis and rheumatoid arthritis.
Brand names for Piroxicam
Feldene
How Piroxicam is classified
Analgesic Agents, Nonsteroidal Antiinflammatory Agents
Piroxicam During Pregnancy
Piroxicam pregnancy category
Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Piroxicam while pregnant
Use of NSAIDs, including FELDENE, during the third trimester of pregnancy increases the risk of premature closure of the fetal ductus arteriosus. Avoid use of NSAIDs, including FELDENE, in pregnant women starting at 30 weeks of gestation (third trimester). There are no adequate and well-controlled studies of FELDENE in pregnant women. Data from observational studies regarding potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive. In the general U.S. population, all clinically recognized pregnancies, regardless of drug exposure, have a background rate of 2–4% for major malformations, and 15– 20% for pregnancy loss. In animal reproduction studies in rats and rabbits, there was no evidence of teratogenicity at exposures up to 5 and 10 times the MRHD, respectively. In rat studies with piroxicam, fetotoxicity (postimplantation loss) was observed at exposures 2 times the MRHD, and delayed parturition and an increased incidence of stillbirth were noted at doses equivalent to the MRHD of piroxicam. Based on animal data, prostaglandins have been shown to have an important role in endometrial vascular permeability, blastocyst implantation, and decidualization. In animal studies, administration of prostaglandin synthesis inhibitors such as piroxicam, resulted in increased pre- and post-implantation loss.
Taking Piroxicam While Breastfeeding
What are recommendations for lactation if you're taking Piroxicam?
Low amounts of piroxicam in milk and failure to detect piroxicam or its metabolites in the urine of 2 older infants indicates that it would not be expected to cause adverse effects in older breastfed infants. Because there is no published experience with piroxicam during breastfeeding in the newborn period, shorter-acting agents may be preferred while nursing a newborn or preterm infant.
Maternal / infant drug levels
Low amounts of piroxicam in milk and failure to detect piroxicam or its metabolites in the urine of 2 older infants indicates that it would not be expected to cause adverse effects in older breastfed infants. Because there is no published experience with piroxicam during breastfeeding in the newborn period, shorter-acting agents may be preferred while nursing a newborn or preterm infant.
Possible effects of Piroxicam on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Piroxicam
Acetaminophen, Flurbiprofen, Ibuprofen, Indomethacin, Naproxen.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Ostensen M. Piroxicam in human breast milk. Eur J Clin Pharmacol. 1983;25:829-30. PMID: 6662182
2. Ostensen M, Matheson I, Laufen H. Piroxicam in breast milk after long-term treatment. Eur J Clin Pharmacol. 1988;35:567-9. PMID: 3234465
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.