Xycam is piroxicam 20 mg, taken once daily for arthritis. It comes as a capsule and as a dispersible effervescent tablet. It is a long-acting anti-inflammatory that regulators have restricted to long-term arthritis treatment, because it carries higher stomach and skin risks than ordinary NSAIDs.
What is Xycam?
The South African Medicine Price Registry lists two presentations, both Schedule 3:
| Product | Form | Strength |
|---|---|---|
| Xycam | Capsule | Piroxicam 20 mg |
| Xycam Dispers | Effervescent tablet | Piroxicam 20 mg |
Both contain the same amount of the same medicine. The dispersible tablet dissolves in water before drinking, which suits people who struggle to swallow capsules, and the resulting solution is absorbed slightly faster. It does not reduce the stomach risk in any meaningful way — that risk comes from the drug circulating in the body, not from the capsule sitting against the stomach wall, and this is a common and important misunderstanding about dispersible NSAIDs.
Piroxicam is an NSAID that blocks the cyclo-oxygenase enzymes producing prostaglandins — the chemicals behind pain, swelling and fever.
Its defining feature is duration. Piroxicam has a half-life of around 50 hours, several times longer than ibuprofen or diclofenac, so a single daily dose maintains its effect around the clock.
That long duration is also the source of its risk. The drug and its effects persist, and piroxicam carries a higher risk of serious gastrointestinal bleeding and of severe skin reactions than most other NSAIDs. Medicines regulators including the EMA have accordingly restricted it: not for first-line use, not for acute pain, and prescribed only by a doctor familiar with the risks, generally after safer NSAIDs have been considered.
What is Xycam commonly used for?
- Osteoarthritis — long-term symptomatic relief of pain and stiffness.
- Rheumatoid arthritis.
- Ankylosing spondylitis.
- Chronic inflammatory musculoskeletal pain, under medical supervision.
It is specifically not intended for: headache, period pain, dental pain, sprains, strains, or any short-lived problem. Ibuprofen, diclofenac or naproxen do the same job for those with lower risk, and paracetamol lower still.
In inflammatory arthritis, an NSAID is not the treatment. Rheumatoid and psoriatic arthritis are driven by an immune process that damages joints permanently if left uncontrolled, and what prevents that damage is disease-modifying treatment — methotrexate, sulfasalazine or a biologic. Piroxicam makes you comfortable while those do the real work.
In ankylosing spondylitis, regular NSAID use is a genuine part of treatment alongside exercise and physiotherapy — and exercise is not optional there, it is central.
Review matters. Because piroxicam is once daily and effective, it is easy to keep taking indefinitely — and indefinite use is exactly where the risks accumulate. Expect a doctor to reassess it periodically rather than repeating it automatically.
How Xycam fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Long-acting NSAIDs | Piroxicam (Xycam) | Once daily; higher GI and skin risk; restricted use |
| Standard NSAIDs | Ibuprofen, diclofenac, naproxen | First-line; shorter-acting |
| COX-2 selective | Celecoxib, etoricoxib | Gentler on the stomach; cardiovascular caution |
| Topical NSAIDs | Piroxicam or diclofenac gel | Localised pain; far lower systemic risk |
| Simple analgesics | Paracetamol (Donapan) | Gentlest; no anti-inflammatory effect |
| Corticosteroids | Prednisone | Powerful; flares and bridging |
| Disease-modifying drugs | Methotrexate, biologics | Prevent joint damage in inflammatory arthritis |
For a single accessible joint, a topical NSAID achieves much of the benefit with a fraction of the risk. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Xycam
Ask whether you should be on stomach protection. Because of the bleeding risk, piroxicam is commonly prescribed alongside a proton pump inhibitor such as omeprazole — particularly in anyone over 65 or with any stomach history.
Tell your doctor or pharmacist if you:
- Have or have had a stomach ulcer, gastritis or gastrointestinal bleeding — piroxicam is contraindicated after GI bleeding on an NSAID.
- Have inflammatory bowel disease.
- Have had a serious skin reaction to any medicine, or a rash on another NSAID — a contraindication.
- Have asthma, particularly NSAID-sensitive asthma.
- Have heart disease, heart failure, high blood pressure or a history of stroke.
- Have kidney or liver disease.
- Take blood thinners, aspirin, another NSAID, steroids, SSRIs, lithium, methotrexate, diuretics or ACE inhibitors.
- Are pregnant, particularly from 20 weeks, or breastfeeding.
- Are over 65 — GI and kidney risks rise substantially, and lower-risk alternatives should be considered first.
Practical points:
- Take it with or after food, with a full glass of water.
- Dissolve the dispersible tablet fully in water and drink it, then rinse the glass and drink that too.
- Take it once daily at the same time.
- Do not combine it with another NSAID, and check cold and flu remedies for a hidden one.
- Stay well hydrated — dehydration plus an NSAID is hard on the kidneys.
Possible cautions and when to ask a pharmacist or doctor
Common effects are indigestion, heartburn, nausea, abdominal pain, headache, dizziness and swollen ankles.
Stop taking it and get medical attention for any rash. Piroxicam carries a higher risk than other NSAIDs of severe skin reactions — Stevens-Johnson syndrome and toxic epidermal necrolysis — and these begin as an ordinary rash. Warning signs are any new or spreading rash, blistering or peeling skin, sores in the mouth, eyes or genitals, or a rash with fever or facial swelling.
Most rashes turn out to be minor; because the dangerous ones look the same at the start, stopping and being seen is always the safe response.
Get emergency help for:
- Vomiting blood, or material like coffee grounds.
- Black, tarry stools, or severe stomach pain.
- Chest pain, breathlessness, or signs of a stroke — sudden weakness, facial droop, slurred speech or a severe unusual headache.
- Sudden worsening of asthma or wheezing.
- Swelling of the face, lips or tongue, or difficulty breathing.
Contact your doctor if:
- You develop swollen ankles, reduced urine output or unexplained tiredness.
- Indigestion persists, which may mean you need stomach protection or a different medicine.
- Joint symptoms are worsening, or joints are becoming stiffer or more swollen — that suggests disease activity needing more than a painkiller.
- You have been taking it long-term without review.
- You have yellowing of the skin or eyes.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What are Xycam tablets used for? Long-term treatment of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis. It contains piroxicam 20 mg.
What is the difference between Xycam and Xycam Dispers? Only the form. The dispersible tablet dissolves in water, which suits people who cannot swallow capsules. Both contain 20 mg of piroxicam.
Is the dispersible version gentler on the stomach? No. The stomach risk comes from the drug circulating in the body, not from the capsule touching the stomach lining.
Why once a day? Piroxicam has a half-life of around 50 hours, far longer than most anti-inflammatories.
Can I use it for a headache or a sprain? No. It is restricted to long-term arthritis treatment. A shorter-acting NSAID or paracetamol is more appropriate for short-lived pain.
Why might I need omeprazole with it? Piroxicam carries a raised risk of stomach bleeding, so stomach protection is commonly prescribed alongside it.
What if I develop a rash? Stop taking it and seek medical attention the same day — piroxicam carries a higher risk of serious skin reactions.
Does it treat the arthritis itself? No. In rheumatoid and psoriatic arthritis, disease-modifying treatment is what prevents joint damage.