Two medicines, side by side
Indomethacin vs piroxicam
Indomethacin and piroxicam are both labeled for osteoarthritis and rheumatoid arthritis. Drugs@FDA records approvals of indomethacin since 1965 and of piroxicam since 1982. Pharmacies paid $0.210 per indomethacin ER 75 mg capsule and $0.215 per piroxicam 20 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. How each works, in its label's words: Indomethacin, “The mechanism of action of indomethacin capsules, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).”; Piroxicam, “The mechanism of action of piroxicam, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).”
Check it at the source: the indomethacin FDA label on DailyMed (effective December 19, 2025); the piroxicam FDA label on DailyMed (effective August 19, 2026).
Highlights of the indomethacin record
Indomethacin (Indocin) · label of December 19, 2025
RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS See full prescribing information for complete boxed warning.
Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
Used for
From the label: indicationsIndomethacin capsules are indicated for: • Moderate to severe rheumatoid arthritis including acute flares of chronic disease • Moderate to severe ankylosing spondylitis • Moderate to severe osteoarthritis • Acute painful shoulder (bursitis and/or tendinitis) • Acute gouty arthritis Indomethacin capsules are nonsteroidal anti-inflammatory drug indicated for: • Moderate to severe rheumatoid arthritis including acute […]
On the market
- Earliest approval on file
- June 10, 1965
- Generic labelers
- 31 labelers
- Pharmacy cost
- $0.210 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 9
Highlights of the piroxicam record
Piroxicam (Feldene) · label of August 19, 2026
RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Cardiovascular Thrombotic Events Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use [see Warnings and Precautions ( 5.1 )].
Used for
From the label: indicationsPiroxicam capsules are indicated: For relief of the signs and symptoms of osteoarthritis. For relief of the signs and symptoms of rheumatoid arthritis. Piroxicam capsules are a nonsteroidal anti-inflammatory drug indicated for Relief of the signs and symptoms of osteoarthritis (OA) ( 1 ) Relief of the signs and symptoms of rheumatoid arthritis (RA)
On the market
- Earliest approval on file
- April 6, 1982
- Generic labelers
- 10 labelers
- Pharmacy cost
- $0.215 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Source: FDA drug labels via openFDA (Indomethacin label of December 19, 2025, Piroxicam label of August 19, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do indomethacin and piroxicam differ on the record?
How each works, in its label's words: Indomethacin, “The mechanism of action of indomethacin capsules, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).”; Piroxicam, “The mechanism of action of piroxicam, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2).”
Both are in FDA's class nonsteroidal anti-inflammatory drugs.
Half-life, in each label's words: Indomethacin, “The mean half-life of indomethacin is estimated to be about 4.5 hours.”; Piroxicam, “The plasma half-life (t ½ ) for piroxicam is approximately 50 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: indomethacin since 1985; piroxicam since 1992 (Drugs@FDA).
| Indomethacin | Piroxicam | |
|---|---|---|
| Labeled for | Rheumatoid arthritis, Osteoarthritis | Osteoarthritis, Rheumatoid arthritis |
| Pharmacologic class | Nonsteroidal Anti-inflammatory Drug | Nonsteroidal Anti-inflammatory Drug |
| How it works (label) | Indomethacin has analgesic, anti-inflammatory, and antipyretic properties. The mechanism of action of indomethacin capsules, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and … | Piroxicam has analgesic, anti-inflammatory, and antipyretic properties. The mechanism of action of piroxicam, like that of other NSAIDs, is not completely understood but involves inhibition of cyclooxygenase (COX-1 and COX-2). |
| Half-life (label) | The mean half-life of indomethacin is estimated to be about 4.5 hours. | The plasma half-life (t ½ ) for piroxicam is approximately 50 hours. |
| Earliest approval on file (Drugs@FDA) | June 10, 1965 | April 6, 1982 |
| First generic approved | September 4, 1985 | May 29, 1992 |
| Generic labelers (NDC) | 31 labelers | 10 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.210 per capsule (Indomethacin ER 75 mg capsule) | $0.215 per capsule (Piroxicam 20 mg capsule) |
| 12-month price change | -1% | -0.6% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 9 | 0 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 13,174 | 6,345 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Indomethacin label, drug interactionsConcomitant use of indomethacin with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy [ see Warnings and Precautions ( 5.2 ) ].
Piroxicam label, drug interactionsConcomitant use of piroxicam with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy [see Warnings and Precautions ( 5.2 )].
Source: FDA drug labels via openFDA
What next?
- Alternatives to indomethacin
- every medicine labeled for the same conditions