Tenoxicam belongs to the class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to relieve the inflammation, swelling, stiffness, and pain associated with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis (a type of arthritis involving the spine), tendonitis (inflammation of a tendon), bursitis (inflammation of a bursa, a fluid-filled sac located around joints and near the bones), and periarthritis of the shoulders or hips (inflammation of tissues surrounding these joints).

Tenoxicam works by interfering with the production of compounds in the body that cause pain and inflammation. Tenoxicam may begin to work early in the treatment but for certain types of arthritis up to 2 weeks may pass before you notice the full benefits of this medication.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult dose of tenoxicam is 20 mg taken once daily. Some people may require lower doses to control pain and inflammation. Higher doses are not recommended as they do not provide any additional benefit.

This medication should be taken at the same time each day and immediately after a meal or after food to avoid stomach upset.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to tenoxicam or any ingredients of the medication
• are a senior who will been given anesthesia or have surgery
• are at risk of increased bleeding
• are at risk of kidney failure
• have an active inflammatory disease involving the stomach or intestine (e.g., ulcerative colitis)
• have an active stomach or intestinal ulcer
• have had an acute asthmatic attack, hives, rhinitis (inflammation of the inner lining of the nasal passage), or other allergic reactions caused by ASA (acetylsalicylic acid) or other nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., diclofenac, ibuprofen, indomethacin, naproxen)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain or discomfort (mild or moderate)
• constipation
• diarrhea
• dizziness
• headache (mild or moderate)
• heartburn
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• hearing problems (e.g., ringing in your ears)
• palpitations or fast heartbeat
• severe abdominal pain or discomfort
• skin rash or itchiness
• swelling of hands, arms, feet, or lower legs

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a severe allergic reaction:
  • hives
  • shortness of breath or difficulty breathing
  • swelling of the eyes, mouth, lips, or throat
• signs of bleeding, e.g.:
  • blood in urine
  • bloody or black tarry stools
  • nose bleeds

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking 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 this medication.

Heart disease: Like other NSAID medications, tenoxicam may cause fluid retention and swelling. This increases the amount of work your heart must do, causing increased blood pressure and heart failure. People with a history of heart conditions should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

History of stomach ulcer or stomach bleeding: Tenoxicam may cause stomach problems. If you notice signs of bleeding from the stomach, such as bloody or black tarry stools or vomiting a coffee-ground like substance, stop taking this medication and get medical attention right away.

People with a history of stomach ulcers or stomach bleed should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Like other NSAID medications, tenoxicam increases the risk of decreased kidney function. People with reduced kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: People with reduced liver function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Potassium levels: There is a risk of high blood potassium levels with NSAID treatment. People most at risk include seniors; those having conditions such as diabetes or kidney failure; and those taking beta-adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, or some diuretics (water pills). While on tenoxicam, your doctor will periodically monitor your blood potassium levels.

Vision: Blurred or decreased vision have been reported by some people taking tenoxicam. If you experience any changes in vision, speak to your doctor immediately. If you are receiving tenoxicam for an extended period, your doctor may periodically request that ophthalmic exams be done.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking tenoxicam, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using this medication have not been established for children and adolescents less than 16 years of age.

Seniors: Seniors are more likely to experience the harmful effects of this medication. Lower doses may be required.

There may be an interaction between tenoxicam and any of the following:

• acetylsalicylic acid (ASA)
• alpha-1 blockers (e.g., doxazosin, tamsulosin, terazosin)
• calcium channel blockers (e.g., nifedipine, verapamil)
• certain diabetes medications (e.g., sulfonylureas, such as glyburide and gliclazide)
• cholestyramine
• cyclosporine
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
• evening primrose
• ginkgo biloba
• lithium
• ketorolac
• methotrexate
• other high blood pressure medications (e.g., irbesartan, losartan)
• other NSAIDs (e.g., celecoxib, diclofenac, ibuprofen, indomethacin)
• phenytoin
• selective serotonin reuptake inhibitors (e.g., citalopram, fluoxetine, sertraline)
• sulfonamide-containing medications (e.g., sulfamethoxazole)
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.