Piroxicam Side Effect

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Facts giving rise to injury 






Feldene, also known as Piroxicam is an oxicam NSAID derivative that carries the highest risk of SJS and TEN of all NSAIDs marketed in the United States. Epidemiologic studies have implicated the oxicams has having increased risks of SJS and TEN during the first 8 weeks of therapy. Isoxicam, an oxicam NSAID was withdrawn from the French market after only 13 reports of SJS and TEN. Feldene was first approved in the U.S. in the early 1768's and is not used widely in this country for the treatment of arthritis or pain

Piroxicam (Feldene)

Can cause an adverse side effect in some people called Stevens-Johnson Syndrome.  These may be skin related and can range from mild rash or to a more serious, potentially fatal skin reaction such as Stevens-Johnson Syndrome. Any skin reaction to a drug, medication, medicine, prescription or over-the-counter should be seen urgently by a medical professional for diagnosis and possible withdrawal of casual drug, medicine, mediction or prescription.

The development of a Piroxicam reaction or side effect may occur half a hour to eight hours or more after taking the causative drug, medicine, medication or prescription.

The reaction may develop within two weeks of initiation of the drug, medicine, medications or prescription.  It may occur anywhere on the body but the most common places are the hands and feet and genitals.  Also the eyes and mouth may also be affected. The skin lesions are usually round, red, and may be slightly swollen and are accompanied by blistering. 

Signs and symptoms of Stevens-Johnson Syndrome include: fever, sore throat, and fatigue.  Ulcers may appear in the mouth, the nose and near all mucous membranes in the body.  Conjunctivities may occur along with a rash.

To overcome a Stevens-Johnson Syndrome reaction stop taking the drug, medicine, medication, or prescription immediately.



JAMA. 1984 Sep 21;252(11):1433-7
An expanded profile of cutaneous reactions to nonsteroidal anti-inflammatory drugs. Reports to a specialty-based system for spontaneous reporting of adverse reactions to drugs.


Stevens-lohnson Syndrome and Toxic Epidermal Necrolysis: Assessment of Medication Risks with Emphasis on Recently Marketed Drugs. The EuroSCAR-Study

Concerning NSAIDs there were variable levels of risks. As already suspected, oxicam derivatives were associated with a high risk and acetic acid derivatives with a lower risk for SCAR (Mockenhaupt et al., 2003), whereas for propionic acid derivatives including ibuprofen we did not find a significant risk. "

SCAR, 1995-pp.1603-1604 "Among NSAIDs, only oxicam derivatives were significantly associated with the diseases (multivariate relative risk, 22).

Stevens-johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe cutaneous adverse reactions (SCAR) related to a variety of medications. They have a significant public health impact because of high mortality and morbidity. A multinational case-control study conducted in Europe between 1997 and 2001 evaluated the risk of medications to induce SCAR...



Roujeau, JC , 1990-pg. 1047 "In France, the risk linked to isoxicam was about 10 times higher than the risk linked to piroxicam,4O despite identical indications, closely related chemical structures, and the comparable long half-lives of these two oxicams.116 "

The use of antibacterial sulfonamides, anticonvulsant agents, oxicam NSAIDs, allopurinol, chlormezanone, and corticosteroids is associated with large increases in the risk of Stevens–Johnson syndrome or toxic epidermal necrolysis...


Toxic epidermal necrolysis (Lyell syndrome)

Toxic epidermal necrolysis is perhaps the most formidable disease encountered by dermatologists. Uncommon but not rare, toxic epidermal necrolysis occurs in 60 to 70 persons per year in France. It remains as puzzling a disorder as it was 34 years ago, when described by LyeU. Whether or not toxic epidermal necrolysis is the most severe form of erythema multiforme is still the subject of discussion...


Harrison's pg. 346, "Drugs that most commonly cause SIS or TEN are anti-infectious sulfonamides, nevirapine, allopurinol, lamotrigine, aromatic anticonvulsants, and oxicam NSAIDs. "

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