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Overview: Xifyrm is a nonsteroidal anti-inflammatory drug (NSAID) that is given intravenously (IV) to treat moderate to severe pain. Constipation is the most commonly reported side effect. Xifyrm will only be used at the lowest effective dose and for the shortest amount of time to minimize side effects. Tell your health care provider right away if you feel that your pain is not well controlled. 

Uses

What is Xifyrm used for?

Xifyrm is commonly used to treat moderate to severe pain.

Xifyrm may also be used for other conditions as determined by your health care provider.

How does Xifyrm work (mechanism of action)?

Xifyrm works by blocking certain substances in the body that cause pain, inflammation, and fever.

How is Xifyrm supplied (dosage forms)?

Xifyrm is available as an intravenous injection that is given by a health care provider.

How should I store Xifyrm?

Xifyrm is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Xifyrm?

Constipation is the most commonly reported side effect of Xifyrm. Tell your health care provider if you get constipation that bothers you.

There may be other side effects of Xifyrm that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Xifyrm?

While less common, the most serious side effects of Xifyrm are described below, along with what to do if they happen.

Heart Attack and Stroke. Xifyrm can increase your risk of a heart attack or stroke that can lead to death. This risk is higher in people who already have heart disease and with higher doses and longer use of Xifyrm. Do not take Xifyrm if you have had a recent heart attack without talking to your health care provider. This could increase your risk of having another heart attack. Get emergency help if you have any of the following symptoms of a heart attack or stroke.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness
  • Sudden weakness on one side of your body
  • Sudden and severe headache
  • Slurred speech or trouble understanding speech

Stomach Bleeding. Xifyrm can increase your risk of bleeding, ulcers, and tears (perforation) in your gut. This can sometimes lead to death. The risk is higher if you have a history of stomach ulcers, or bleeding problems, use higher doses of Xifyrm or use it for longer than directed, have poor health, are age 60 or older, have liver disease, smoke, drink alcohol, or take certain other medicines. Stop using Xifyrm and get emergency help right away if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using Xifyrm. This can sometimes lead to liver failure or even death. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Increased Blood Pressure (Hypertension). Xifyrm may increase your blood pressure or make it worse if you have a history of high blood pressure. Call your healthcare provider if your blood pressure increases while using this medicine.

If you measure your blood pressure and the top number (systolic) is 180 mm Hg or higher or the bottom number (diastolic) is 120 mm Hg or higher, get medical attention right away. An increase in blood pressure may not be noticeable but look out for any of the following symptoms of severely high blood pressure.

  • Sudden, severe headache
  • Chest pain
  • Dizziness or confusion
  • Trouble breathing
  • Nausea/vomiting
  • Blurry or other changes to the vision
  • Anxiety
  • Buzzing in the ears
  • Nosebleed
  • Feeling of skipped heartbeats

Heart Failure. Xifyrm may increase your risk of heart failure. Tell your health care provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs (edema)
  • Unusually fast weight gain
  • Unusual tiredness

Kidney Damage. Kidney damage can happen when using Xifyrm. Stop using Xifyrm and call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs (edema)
  • Weakness or unusual tiredness
  • Difficulty catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

High Potassium Levels (Hyperkalemia). Xifyrm can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your health care provider may check your potassium levels, especially if you take certain other medicines. Tell your health care provider right away if you have any of the following symptoms of a high potassium level. 

  • Muscle weakness or unusual tiredness
  • Slow heartbeat or feeling of skipped heartbeats 
  • Nausea or vomiting
  • Trouble breathing
  • Abnormal heart rhythm

Severe Skin Reactions. Xifyrm can cause severe skin reactions called exfoliative dermatitisStevens-Johnson Syndrome (SJS), and Toxic Epidermal Necrolysis (TEN) that can lead to death if not treated. If you get a rash, stop Xifyrm and call your health care provider right away. Get emergency help right away if you have any of the following symptoms of a severe skin reaction.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Fever

Severe Allergic Reactions. Xifyrm may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored urine
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Anemia. Xifyrm may cause anemia, which is when you have low levels of red blood cells. Tell your health care provider if you have any of the following symptoms of anemia.

  • Unusual weakness or tiredness
  • Cold hands and feet
  • Fast or abnormal heartbeat
  • Pale or yellowish skin 
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Shortness of breath

Bleeding. Xifyrm can increase your risk of bleeding, especially if you have a bleeding disorder or take other medicines that increase your risk for bleeding. Tell your health care provider right away if you notice any signs of bleeding, including easy bruising or bleeding.

Warnings & Precautions

Who should not use Xifyrm?

Allergies to Ingredients. People who are allergic to any of the following should not use Xifyrm.

  • Meloxicam
  • Xifyrm
  • Aspirin or any other medicine known as a nonsteroidal anti-inflammatory drug (NSAID)
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Xifyrm.

Heart Surgery. Do not take Xifyrm right before or after a heart surgery called coronary artery bypass graft (CABG). Using Xifyrm during this time can increase your risk for a heart attack or stroke.

What should I know about Xifyrm before using it?

People aged 65 years or older can be at greater risk for some side effects of Xifyrm. Talk to your health care provider about your risks if you are in this age group.

Your health care provider may need to check lab work before and while you are using Xifyrm. 

Using Xifyrm may make it more difficult for you to get pregnant. Talk to your health care provider if you have any concerns.

What should I tell my healthcare provider before using Xifyrm?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Xifyrm is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Heart problems such as heart failure or a recent heart attack
  • Bleeding problems
  • Kidney or liver problems
  • Fluid retention (edema)
  • Stomach ulcers, bleeding, or other stomach problems like heartburn
  • High blood pressure
  • Asthma
  • Stroke

Other Medicines and Supplements. Xifyrm may interact with other medicines and supplements. Before using Xifyrm, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Do not use Xifyrm at 20 weeks or later in pregnancy without talking to your health care provider. Taking Xifyrm during this time may cause harm to an unborn baby and complications during delivery. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should use Xifyrm while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if Xifyrm passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Xifyrm while breastfeeding.

Interactions

Does Xifyrm interact with foods or drinks?

There are no known interactions between Xifyrm and foods or drinks.

Drinking alcohol while using Xifyrm increases your risk of stomach ulcers and bleeding. It is best to limit the amount of alcohol you drink.

Does Xifyrm interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Xifyrm.

  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • A selective serotonin reuptake inhibitor (SSRI) or a serotonin norepinephrine reuptake inhibitor (SNRI), which is a medicine commonly used for anxiety and depression
  • Aspirin, which is in many prescription and OTC products including those for pain, swelling, and fever
  • An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • Lithium, which is a medicine for certain mental health conditions
  • Methotrexate (Trexall and others), which is a medicine commonly used for rheumatoid arthritis or certain types of cancer
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others), which is a medicine to suppress your immune system
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
  • A salicylate, such as diflunisal or salsalate, which is a medicine used for osteoarthritis or rheumatoid arthritis
  • Pemetrexed (Alimta, Pemfexy), which is a medicine to treat certain cancers
  • A corticosteroid, which is a medicine for certain inflammatory conditions
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure 
  • Cholestyramine (Prevalite), which is a medicine for high cholesterol

Some other medicines may alter the blood levels of Xifyrm. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Xifyrm. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Xifyrm?

If you or someone else has used too much Xifyrm, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Xifyrm?

Xifyrm is usually given by a health care provider in a hospital. Your health care provider will make sure you are receiving Xifyrm as scheduled.