Indications |
Oral Rheumatic disorders Adult: Initially, 20 mg daily as a single dose. Maintenance: 10-30 mg in single or divided doses. Oral Acute gout Adult: 40 mg daily for 5-7 days. Oral Acute musculoskeletal disorders Adult: Initially, 40 mg daily given for 2 days. Maintenance: 20 mg daily for 1-2 wk. Oral Postoperative pain Adult: Initially, 40 mg daily given for 2 days. Maintenance: 20 mg daily for 1-2 wk. Oral Juvenile idiopathic arthritis Child: ≥6 yr: <15 kg: 5 mg, 16-25 kg: 10 mg, 26-45 kg: 15 mg, ≥46 kg: 20 mg. Doses to be taken once daily. Topical/Cutaneous Local pain relief Adult: Apply a 0.5% gel 3-4 times daily over the affected area. Treatment should be reviewed after 4 wk. |
Contraindications |
Hypersensitivity, active peptic ulceration, porphyria, pregnancy (3rd trimester) and lactation. |
Warnings / Precautions |
Elderly, childn <12 yr. Patients with infections, asthma, allergic disorders, haemorrhagic disorders or hypertension. Impaired renal, hepatic or cardiac function. Monitor for signs of liver, kidney, blood or eye disorders. |
Adverse Reactions |
GI disturbances, peptic ulcer, GI bleeding, headache, dizziness, blurred vision, tinnitus, skin rashes and pruritus. Haematological changes and photosensitivity. Potentially Fatal: Thrombocytopaenia and acute nephropathy. Toxic epidermal necrolysis and Stevens-Johnson syndrome. |
Overdose Reactions |
Symptoms are usually mild and include nausea and vomiting, headache, drowsiness, blurred vision and dizziness. |
Drug Interactions |
Increased risk of hyperkalaemia when used with ACE inhibitors and potassium-sparing diuretics. Convulsions may occur when used with quinolones. Effects of phenytoin and sulfonylureas may be enhanced. Antihypertensive effects of ACE inhibitors, β-blockers and diuretics may be reduced. Increased risk of GI bleeding and ulceration when used with corticosteroids, SSRIs or antiplatelet agents. Increased risk of haematotoxicity when used with zidovudine. ACE inhibitors, ciclosporin, tacrolimus or diuretics may increase nephrotoxicity. Potentially Fatal: May potentiate anticoagulants. Increased levels of lithium, methotrexate and cardiac glycosides. See Below for More piroxicam Drug Interactions |
Lab Interactions |
May interfere with thyroid function tests. |
Mechanism of Actions |
Piroxicam is a NSAID, belonging to the oxicam group. It inhibits prostaglandin synthesis, reduces fever by acting on the heat-regulating center of the hypothalamus, inhibits platelet-aggregating substance thromboxane A2 and reduces pain receptor sensitivity. It also exerts anti-inflammatory effect by lysosomal stabilisation, kinin and leukotriene production, alteration of chemotactic factors and neutrophil activation inhibition. Absorption: Well absorbed from the GIT (oral); peak plasma concentrations 3-5 hr after an oral dose. Distribution: Detected in breast milk. Protein-binding: 99% Metabolism: Hepatic via hydroxylation and conjugation; undergoes enterohepatic recycling. Excretion: Mainly in urine (as metabolites and unchanged drug), faeces; elimination half-life: 50 hr. |
Administration |
Should be taken with food. |
Storage Conditions |
Oral: Store at <30°C. Topical/Cutaneous: Store at <30°C. |
ATC Classification |
M01AC01 - piroxicam ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, oxicams. M02AA07 - piroxicam ; Belongs to the class of non-steroidal antiinflammatory preparations for topical use. Used in the treatment of joint and muscular pains. S01BC06 - piroxicam ; Belongs to the class of non-steroidal antiinflammatory agents. Used in the treatment of inflammation of the eye. |
Storage |
Oral: Store at <30°C. Topical/Cutaneous: Store at <30°C. |
Available As |
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Piroxicam
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Piroxicam is used in following diseases
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