Generic
Piroxicam
3 brands available in the market
At a glance
Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) used for moderate to severe pain in conditions such as osteoarthritis and rheumatoid arthritis. It helps relieve pain and swelling in joints and muscles.
Description
Piroxicam is an NSAID belonging to the oxicam group. It inhibits prostaglandin synthesis, reduces fever by acting on the hypothalamic heat-regulating center, inhibits platelet-aggregating substance thromboxane A2, and reduces pain receptor sensitivity. It exerts anti-inflammatory effects through lysosomal stabilization, kinin and leukotriene production alteration, chemotactic factor modification, and neutrophil activation inhibition.
Indications
- Osteoarthritis
- Rheumatoid arthritis
- Acute gout
- Acute musculoskeletal conditions
- Post-operative pain
- Juvenile idiopathic arthritis
Therapeutic class
Non-steroidal Anti-inflammatory Drugs
Pharmacological class
Oxicam (NSAID)
Pharmacology
Piroxicam is an NSAID that inhibits COX-1 and COX-2 enzymes to prevent prostaglandin synthesis. It reduces fever by acting on the hypothalamic heat-regulating center, inhibits thromboxane A2 to reduce platelet aggregation, and decreases pain receptor sensitivity. It also exerts anti-inflammatory effects through lysosomal stabilization and reduced kinin and leukotriene production.
Mechanism of action
Reduces pain, inflammation, and fever by inhibiting prostaglandin synthesis.
Dosage
Adult Dose (Oral):
- Rheumatic disorders: Initial 20 mg/day; Maintenance 10-30 mg (single or divided doses)
- Acute gout: 40 mg/day (5-7 days)
- Acute musculoskeletal/Post-op pain: 40 mg/day (2 days); Maintenance 20 mg/day (1-2 weeks)
Pediatric Dose:
- Juvenile idiopathic arthritis (>6 years, 46 kg): 20 mg once daily
Administration
- Take with food (to avoid stomach upset)
- Dissolve in a glass of water before taking (DT form)
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Vomiting
- Stomach pain
- Nausea
- Indigestion
- Diarrhea
- Headache
- Dizziness
Precautions & warnings
- May decrease alertness; do not drive if drowsy or dizzy
- Caution in history of stomach ulcers, GI bleeding
- Caution in heart disease, high blood pressure, liver or kidney disease
- Avoid alcohol
- Avoid concomitant use with anticoagulants, aspirin, other NSAIDs
Contraindications
- Hypersensitivity or asthma-type reactions to piroxicam, aspirin, or other NSAIDs
- History or active GI ulceration, bleeding, and perforation
- Treatment of perioperative pain in CABG surgery
- Concomitant use with aspirin, other NSAIDs, and anticoagulants
Drug interactions
- Antiplatelets, SSRIs: Increased risk of GI bleeding
- Corticosteroids: Increased risk of GI ulceration
- Ciclosporin, tacrolimus: Increased risk of nephrotoxicity
- Cimetidine: Increased absorption
- Lithium: Increased plasma levels
- Antihypertensives: May antagonize effect
- Methotrexate: Reduced excretion (acute toxicity)
- Quinolones: Increased risk of convulsions
- Potentially fatal: Enhances effect of anticoagulants (warfarin); increased risk of serious GI events with aspirin and other NSAIDs
Food interactions
Alcohol consumption with Piroxicam is unsafe.
Use in pregnancy
Use in Pregnancy: Unsafe during pregnancy; definite evidence of risk to the developing baby; doctor may prescribe in life-threatening situations if benefits outweigh risks.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Safe during breastfeeding; human studies show insignificant transfer to breast milk and no harm to the baby.
Pediatric use
Dose established for children >6 years; consult your doctor.
Geriatric use
Caution required in elderly patients; dose adjustment may be needed.
Renal / hepatic impairment
Renal Impairment: Caution in severe kidney disease; dose adjustment may be needed; no dose adjustment in mild-moderate disease; monitor kidney function.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; consult your doctor.
Overdose effects
Overdose: Nausea, vomiting, abdominal pain, dizziness, drowsiness, convulsions, kidney and liver damage; treatment: symptomatic and supportive; activated charcoal; gastric lavage.
Storage conditions
Store in a cool and dry place, away from light; keep out of reach of children.
Chemical structure
Piroxicam