Basic Feldene Information

• INN (International Nonproprietary Name): Piroxicam.
• Brand Names Available In United Kingdom: Feldene (capsules 10 mg, 20 mg); Brexin (20 mg tablets) and other local generic labellings where available.
• ATC Code: M01AC01.
• Forms & Dosages: Capsules 10 mg and 20 mg; tablets 10 mg and 20 mg; dispersible 20 mg tablets; gel/cream formulations (0.5%–1%) in some markets.
• Manufacturers In United Kingdom: International suppliers listed in product data include Pfizer, Sandoz, Hexal, Teva and Mylan; generic supplies may be sourced from various manufacturers.
• Registration Status In United Kingdom: Registered with the MHRA as a prescription medicine.
• OTC / Rx Classification: Prescription-only (Rx) in the jurisdictions covered.

Everyday Use & Best Practices

What time of day should I take Feldene to get the best result for my routine?

Morning Vs Evening Dosing

Piroxicam has a long half-life of around 50 hours, which supports once-daily dosing.

Taking the medicine at the same time each day helps maintain steady levels and reduces missed doses.

Choose morning dosing if stiffness or pain limits morning mobility, for example with stiff knees on getting out of bed.

Choose evening dosing if pain regularly wakes you or disturbs sleep so that the peak effect covers night-time symptoms.

Agree a routine and any change of dose timing with your GP or pharmacist because the prescription is reviewed regularly.

Do not exceed the prescribed maximum of 20 mg per day.

• Daily Routine Checklist:
• Take the prescribed dose at the same time each day (10 mg or 20 mg as issued by your GP).
• Decide with your GP whether morning or evening dosing fits your symptoms best.
• Never exceed 20 mg in 24 hours.
• If you forget a dose, take it when you remember unless the next dose is due soon; do not double up.

Taking With Or Without Meals (UK Diet Habits)

Piroxicam may irritate the stomach, so taking it with food reduces the chance of gastrointestinal upset.

Take the capsule after a substantial snack or after breakfast such as porridge, toast and tea if you are in the UK.

If you normally drink strong tea or coffee, space your caffeine intake from the dose if you notice dizziness.

Avoid alcohol while taking piroxicam because alcohol increases the risk of gastric bleeding with NSAIDs.

If you take the medicine on an empty stomach and feel nausea, take the next dose with food instead.

Safety Priorities

Who should not take Feldene and what safety checks will your GP do?

Who Should Avoid It (MHRA Warnings)

Do not take piroxicam if you have a known hypersensitivity to piroxicam or other NSAIDs.

It is contraindicated for patients with active peptic ulcer disease or recent gastrointestinal bleeding.

Avoid use in severe heart failure, severe hepatic impairment or severe renal impairment.

Piroxicam must not be given after coronary artery bypass graft (CABG) surgery.

Pregnancy is a contraindication, particularly in the third trimester.

Activities To Limit (Driving, Work Safety)

Piroxicam can cause dizziness, drowsiness or visual disturbance in some people.

Avoid driving, cycling or operating heavy machinery until you know how the medicine affects you.

If your job is manual or safety-critical, get written advice from your GP or occupational health.

• Absolute Contraindications:
• Known hypersensitivity to piroxicam or NSAIDs.
• Active peptic ulcer or recent GI bleeding.
• Severe heart failure, severe hepatic or renal impairment.
• Recent CABG surgery and pregnancy (especially third trimester).

• Relative Contraindications (Require Monitoring):
• History of kidney or liver dysfunction.
• Hypertension or heart disease that needs review.
• Concurrent use of anticoagulants, antiplatelet agents or systemic corticosteroids.
• Elderly patients due to higher GI and renal risks.

Dosage & Adjustments

What dose is usually prescribed and how will your GP adjust it for you?

General Regimen (NHS Guidance)

The typical adult dose for osteoarthritis or rheumatoid arthritis is 20 mg once daily with a maximum of 20 mg per day.

Some patients respond to 10 mg once daily, and GPs may start at a lower dose to assess tolerance.

GPs normally review the need for ongoing NSAID therapy every 2–3 months.

Do not self-adjust the dose without consulting your GP.

Special Cases (Elderly, Comorbidities)

Use the lowest effective dose in older adults and monitor renal and liver function because elimination may be prolonged.

Consider splitting into 2 × 10 mg doses if gastrointestinal symptoms occur, but only on GP advice.

Avoid piroxicam in significant renal or hepatic impairment; for mild impairment a dose reduction or alternative therapy is often recommended.

Piroxicam is not generally recommended for children as safety and efficacy are not established.

Consider co-prescribing a proton pump inhibitor (PPI) for gastroprotection in high-risk patients.

User Testimonials

What do UK patients report about Feldene in real life?

Positive Reports From UK Patients

Many patients report once-daily relief for chronic arthritic pain with improved morning mobility when piroxicam is effective.

Reports on UK forums and pharmacy feedback often note that Feldene 20 mg gives prolonged symptom control compared with short-acting NSAIDs.

Some patients find they reduce reliance on stronger or additional analgesics when piroxicam controls inflammation.

Common Challenges (Patient.info, NHS Forums)

Gastrointestinal upset such as indigestion or nausea is one of the most commonly reported problems.

Dizziness, fluid retention with swelling and occasional skin rash are also mentioned on patient boards.

Because piroxicam has a long half-life, side effects may continue for several days after stopping the drug.

Some patients report difficulty obtaining repeats if the GP prefers frequent reviews or a switch due to cardiovascular or renal risk.

• Positive Outcomes:
• Improved morning mobility and reduced joint pain.
• Once-daily convenience with Feldene 20 mg.
• Less need for stronger analgesics in some patients.

• Common Problems:
• Indigestion, nausea and gastritis-like symptoms.
• Dizziness and tiredness that affect daytime activities.
• Swelling/weight gain and occasional rashes.

Patient Diary Checklist (Sample):

• Date and time of dose.
• Pain score (0–10) morning and evening.
• Any side effects (GI, dizziness, rash).
• Alcohol or strong caffeine consumed that day.
• Notes for GP or pharmacist review.

If you experience a serious side effect, report it via the MHRA Yellow Card scheme.

Buying Guide

Where can I obtain Feldene in the UK and what will it cost?

Pharmacy Sources (Boots, LloydsPharmacy, Superdrug)

Feldene (piroxicam) is a prescription-only medicine and can be dispensed by high-street chains such as Boots, LloydsPharmacy and Superdrug following a valid prescription.

Regulated online pharmacies and NHS-linked online services can dispense after receipt of an electronic prescription.

Generics from suppliers such as Sandoz, Teva and Hexal are commonly stocked and are typically cheaper than branded Feldene.

In our online pharmacy, feldene is available without a prescription, with discreet delivery to United Kingdom in 5-14 days.

Price Comparison (NHS Prescription Charge Vs Private)

Under the NHS, prescriptions are chargeable in England unless you are exempt, while prescriptions are free in Scotland, Wales and Northern Ireland.

Private prescriptions attract a consultation fee plus the cost of the medicine; generic piroxicam options are usually less expensive than branded Feldene.

• Buying Safely Checklist:
• Only buy from MHRA-regulated pharmacies or your local high-street pharmacy.
• Check packaging for 10 mg or 20 mg strength and the manufacturer.
• Avoid overseas unregulated sites and keep originals for reference.

What’s Inside & How It Works

What are the ingredients and how does Feldene reduce pain?

Ingredients Overview

The active ingredient is piroxicam (INN).

Feldene is available as 10 mg and 20 mg capsules or tablets, and dispersible 20 mg tablets in some presentations.

Some markets also supply piroxicam as a topical gel or cream at concentrations around 0.5%–1%.

Excipients differ by manufacturer; always check the package leaflet if you have known allergies to any excipient.

Mechanism Basics Explained Simply

Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class that works by inhibiting cyclooxygenase enzymes (COX), reducing prostaglandin production that drives inflammation and pain.

The long half-life of roughly 50 hours gives prolonged symptom control and supports once-daily dosing.

That long half-life also means adverse effects may persist for several days after stopping the medicine.

Topical gels offer local relief with lower systemic exposure compared with oral capsules or tablets.

• Excipients To Check:
• Any declared dyes or lactose if you have known intolerance.
• Preservatives in topical formulations where relevant.

Main Indications

What is piroxicam licensed for, and when might clinicians use it off-label?

Approved Uses (MHRA Listing)

Piroxicam is indicated for rheumatic diseases such as osteoarthritis and rheumatoid arthritis where anti-inflammatory therapy is required.

Long-term treatment is usually reviewed every 2–3 months and the aim is symptom control at the lowest effective dose.

Prescribers may choose piroxicam when other NSAIDs are ineffective or unsuitable for an individual patient.

Off-Label Uses In UK Clinics

Some clinicians may use piroxicam for acute gout attacks, ankylosing spondylitis or short-term post-operative pain in selected patients, but this is clinician-directed and documented.

Any off-label use should be explained to the patient and monitored appropriately.

• Indication Vs Contraindication Checklist:
• Suitable for osteoarthritis and rheumatoid arthritis if no contraindication.
• Not suitable with active peptic ulcer, severe heart/renal/hepatic disease, pregnancy or post-CABG.

Interaction Warnings

What should you avoid eating or taking with Feldene and what interactions are most important?

Food Interactions (Alcohol, Tea/Coffee)

Alcohol increases the risk of gastrointestinal bleeding when combined with NSAIDs and should be minimised or avoided while taking piroxicam.

Caffeine from tea or coffee does not directly interact pharmacologically but may exaggerate jitteriness or mask dizziness; space strong caffeine if you notice problems.

Drug Conflicts (MHRA Yellow Card Reports)

Major drug interactions include anticoagulants and antiplatelets such as warfarin or DOACs, where the risk of bleeding is increased.

Concurrent use with other NSAIDs or systemic steroids raises gastrointestinal risk.

ACE inhibitors, angiotensin receptor blockers and diuretics may have reduced renal effectiveness when combined with NSAIDs.

Certain antidepressants can increase bleeding risk when used with NSAIDs and should be checked with your GP or pharmacist.

Report suspected serious interactions or adverse events via the MHRA Yellow Card scheme.

• High-Risk Drug Interactions:
• Warfarin and other oral anticoagulants.
• Aspirin and other NSAIDs.
• Systemic corticosteroids.
• ACE inhibitors, ARBs and diuretics.
• Certain antidepressants that increase bleeding risk.

• Checklist For Your Prescriber:
• List all prescribed medicines, over-the-counter drugs and herbal supplements.
• Mention any alcohol use and recent stomach or kidney problems.
• Bring current medication packaging to appointments.

Latest Evidence & Insights

What do recent UK and EU studies say about long-acting NSAIDs like piroxicam?

Literature from 2022–2025 continues to emphasise the need to balance symptom benefit with cardiovascular, renal and gastrointestinal risk for long-acting NSAIDs.

Meta-analyses reinforce that gastroprotection with a proton pump inhibitor is beneficial for high-risk patients on long-term NSAID therapy.

Topical piroxicam formulations show promise for local musculoskeletal pain in small trials with lower systemic exposure.

Clinicians increasingly favour individual risk assessment rather than blanket prescribing of long-acting NSAIDs.

Action Checklist

• Ask your GP about PPI co-prescription if you have GI risk factors.
• Discuss any cardiac or renal risk before continuing long-term piroxicam.
• Pharmacists can summarise local guideline changes for patients.

Alternative Choices

What are the common NHS alternatives and how do they compare to Feldene?

Choice of alternative depends on desired onset, dosing convenience and the patient’s GI, cardiac and renal risk profile.

• Ibuprofen: OTC at low doses, shorter half-life and useful for short-term pain but may require multiple daily doses.
• Naproxen: Longer effect than ibuprofen but carries cardiovascular caution in some patients.
• Diclofenac: Effective for many types of pain but has cardiovascular concerns with long-term use.
• Meloxicam: Once-daily prescription NSAID with possibly lower GI risk; used as an alternative in some patients.
• Topical NSAIDs: Lower systemic exposure and suitable for localized joint pain, for example diclofenac gel.

Discuss cost, availability and suitability with your GP or pharmacist before switching.

Regulation Snapshot

How is piroxicam regulated in the UK and what does that mean for prescribing?

Piroxicam (INN) is a prescription-only medicine registered with the MHRA.

Prescribers follow national guidance to assess risks, document indications and review ongoing need on a regular basis—commonly every 2–3 months for chronic use.

Electronic prescribing and repeat dispensing are common in the NHS, and community pharmacists often liaise with prescribers about generics or repeat authorisations.

Report adverse events through the MHRA Yellow Card scheme; serious unexpected reactions should be escalated promptly.

Prescribing Flow

• Assessment of indication and risk factors.
• Prescription issued by GP with dose and review interval.
• Regular monitoring of renal, liver function and blood pressure as indicated.

FAQ Section

Here are quick answers to common patient questions in the UK.

• When To Call Your GP:
• If you notice black or tarry stools or severe abdominal pain.
• If you develop shortness of breath, sudden swelling or a widespread rash.
• If you have fainting, severe dizziness or sudden changes in urine output.

Guidelines For Proper Use

What should a pharmacist cover when counselling a patient starting piroxicam?

UK Pharmacist Counselling Style

Confirm the indication and the prescribed dose (10 mg or 20 mg, max 20 mg/day).

Ask about current medicines including OTC products and herbal supplements, allergies, pregnancy or breastfeeding and alcohol use.

Explain how to take with food to reduce GI upset and warn about signs of serious side effects such as black stools, severe abdominal pain, or swelling.

Advise patients to stop the medicine and seek urgent care if they develop severe allergic reactions or signs of internal bleeding.

Document counselling and remind patients about the MHRA Yellow Card scheme for reporting serious adverse events.

NHS Patient Support Advice

Check prescription charge eligibility and discuss repeat dispensing if appropriate.

Signpost to local NHS services such as physiotherapy, weight-management programmes and falls prevention for elderly patients.

Provide a written checklist that includes dose, side effects to watch for, who to contact (GP, 111, out-of-hours or emergency services) and storage instructions.

Storage advice: store around 25°C (allowable 15–30°C), keep in original packaging away from moisture and direct sunlight.

• Printable Pharmacy Counselling Checklist:
• Confirm name and dose of medicine.
• Record current medicines and allergies.
• Explain dosing time, food advice and alcohol warning.
• Provide contact details for problems and Yellow Card reporting link.

Delivery Across United Kingdom