Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These
factors may affect how you should use Dom Piroxicam.
HEALTH CANADA ADVISORY
June 8, 2021
Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.
Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., ibuprofen, Ketoprofen, ketorolac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take
Dom Piroxicam. If you experience symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; wheezing; swelling of the face, tongue, or throat), get immediate medical attention.
Aseptic meningitis: Dom Piroxicam can rarely cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). If you have an autoimmune condition (e.g., systemic Lupus
erythematosus, mixed connective tissue disease), you are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking Dom Piroxicam can get immediate
medical attention.
Bladder problems: Dom Piroxicam may cause bladder pain, painful or difficult urination, or increased frequency of urination. If these symptoms occur without an explanation (e.g., infection), stop taking Dom Piroxicam and contact your doctor.
Blood clotting: Dom Piroxicam may reduce the ability of the blood to clot. If you are taking anticoagulants (e.g., Warfarin, Heparin) or have Hemophilia or other blood disorders (e.g., low platelets), discuss with your doctor how Dom Piroxicam
may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Dom Piroxicam, and whether any special monitoring is needed. If you have a bleeding disorder, do not take Dom Piroxicam.
Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. If you notice any signs of Anemia (e.g., unusual tiredness, difficulty breathing) or unusual bleeding or bruising, contact your doctor.
Drowsiness/reduced alertness: Piroxicam may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid these and other hazardous tasks until you have determined how Dom Piroxicam affects you.
Fluid and electrolyte balance: NSAIDs such as piroxicam can cause fluid retention and edema (swelling). This can lead to high blood pressure or worsening of heart failure. If you have heart failure or high blood pressure, discuss with your doctor
how Dom Piroxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Dom Piroxicam, and whether any special monitoring is needed. If you have severe, uncontrolled heart failure, you should not take
Dom Piroxicam.
Piroxicam may also cause high blood potassium levels. If you are a senior; have Diabetes or kidney failure; or are taking beta-blockers (e.g., Metoprolol, Atenolol), angiotensin converting enzyme (ACE) inhibitors (e.g., Ramipril, Enalapril), or some diuretics
(e.g., triamterene, Amiloride), you are more at risk of high blood potassium. If you have high blood potassium levels, you should not take Dom Piroxicam.
Heart attack and stroke: Dom Piroxicam may be associated with an increased risk of heart attack or stroke. The risk is higher with larger total daily doses and longer treatment periods. If you have a history of heart disease (e.g., heart attack,
stroke, heart failure) or have risk factors for heart disease (e.g., high blood pressure, High Cholesterol, diabetes, smoking, Kidney Disease) discuss with your doctor how Dom Piroxicam may affect your medical condition, how your medical condition may affect
the dosing and effectiveness of Dom Piroxicam, and whether any special monitoring is needed.
Kidney function: Long-term use of piroxicam may lead to a higher risk of reduced kidney function. If you have kidney disease, liver disease, or heart failure; take diuretics (water pills); or are a senior: you have an increased risk for kidney problems
while taking Dom Piroxicam. .If you are taking medications such as diuretics (e.g., Hydrochlorothiazide, triamterene, Indapamide), ACE inhibitors (e.g., enalapril, ramipril), angiotensin receptor blockers (e.g., Valsartan, Candesartan), or Cyclosporine,
you are also at an increased risk.
If you have these conditions or are taking these medications, discuss with your doctor how Dom Piroxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Dom Piroxicam,
and whether any special monitoring is needed. If you have severe kidney problems, you should not take Dom Piroxicam.
Liver function: Liver disease or reduced liver function may cause Dom Piroxicam to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Dom Piroxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Dom Piroxicam, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Dom Piroxicam.
Rarely, Dom Piroxicam causes liver problems. If you experience unexplained tiredness, loss of appetite, itchy skin or yellowing of the skin or eyes while taking Dom Piroxicam, contact your doctor immediately. If you have liver disease or severely reduced liver function, you should not take Dom Piroxicam.
Skin reactions: This medication can cause skin reactions, some of which may be severe. If you experience a skin rash, especially where the skin is blistering or peeling, stop taking Dom Piroxicam and contact your doctor.
Dom Piroxicam may make your skin more sensitive to sunlight (including sunlamps) and may cause Sunburn, skin blisters, and skin redness, itching or discolouration. If you have a reaction from the sun while taking Dom Piroxicam, contact your doctor.
Ulcers or bleeding in the stomach or intestines: Piroxicam can cause stomach ulcers, perforation (holes), and bleeding from the stomach. These complications can occur at any time without warning, and are sometimes severe enough to require immediate
medical attention. The risk of ulcers and bleeding increase if you are taking higher doses of piroxicam for longer periods of time.
Other factors that increase the risk of these complications include drinking excessive amounts of alcohol, increased age, smoking, poor health, H pylori infection, and taking certain medications (e.g., warfarin, ASA, Clopidogrel, Prednisone, Citalopram,
Fluoxetine, Paroxetine, Sertraline).
If you currently have ulcers in the stomach or intestines that are bleeding, or have an inflammatory bowel disease (e.g., Crohn's disease, ulcerative colitis), you should not take Dom Piroxicam. If you have a history of these conditions, discuss with your
doctor how Dom Piroxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Dom Piroxicam, and whether any special monitoring is needed.
Stop taking the medication and get immediate medical attention if you experience symptoms or signs of stomach ulcers or bleeding in the stomach (black, tarry stools, blood in stools, stomach pain, vomiting blood or coffee-grind material). These reactions
can occur at any time during treatment without warning.
Pregnancy: Dom Piroxicam should not be used during pregnancy, especially during the third trimester. If you become pregnant while taking Dom Piroxicam, contact your doctor immediately.
Dom Piroxicam may reduce fertility. If you are trying to get pregnant or are having difficulty getting pregnant, you should not use Dom Piroxicam.
Breast-feeding: Piroxicam passes into breast milk. If you are a breast-feeding mother and are taking Dom Piroxicam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of Dom Piroxicam have not been established for children less than 16 years of age.
Seniors: If you are a senior, you may have a higher risk of experiencing side effects from Dom Piroxicam. You should use the lowest effective dose under close medical supervision.