Piroxicam

Anti-rheumatic, Systemic · Oxicam

Indications

ORAL: Rheumatoid arthritis, osteoarthrosis, ankylosing spondylitis, acute musculo-skeletal disorders, acute gout, juvenile chronic arthritis (JCA). INJECTION: Initial treatment of acute conditions and acute exacerbations of chronic conditions. Pain following orthopaedic, dental and major surgery.

Dosage

ORAL: Adults: 20 mg daily as a single dose. Musculo-skeletal disorders: Adults: Initially 40 mg daily for 2 days then 20 mg daily for 7-14 days. Gout: Adults: Initially 40 mg as a single dose then 40 mg daily in single or divided doses for next 4-6 days. INJECTION: Same as oral dose by deep IM Inj into upper quadrant of buttocks. Maintenance, use oral preps. Children: Not recommended. SUPPOSITORY: Adults: 1 suppository daily, in severe cases 2 suppositories daily. Children: Not recommended.

Administration

IM: It should be made using aseptic technique into a relatively large muscle. The preferred site is the upper outer quadrant of the buttock (i.e. gluteus maximus). Aspiration is necessary to help avoid inadvertent injection into a blood vessel.

Adverse Effects

Gl disturbances, skin reactions, oedema, CNS effects, malaise, tinnitus, headache, vertigo, blood dyscrasias, renal or hepatic impairment, visual disturbances, hypertension, dizziness, anorexia, wt gain, hyperglycaemia, somnolence, raised serum transaminase, pancreatitis, skin reaction. Reports of peptic ulceration, perforation and GI bleeding.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Positive evidence of risk: Use only when no safer alternative exists for a serious problem. Lactation: Caution advised or effect undetermined. Contraindications: Active peptic ulcer, history of recurrent ulceration or GI cancer. Severe allergy to any drug. Severe heart failure. Precautions: Impaired renal or hepatic function. Monitor on long term therapy. Heart failure; elderly. Phenylketonuria. History of asthma, haemorrhagic disorder, hypertension. Poor CYP2C9 metabolisers. Use lowest effective dose for shortest duration. Monitor for serious skin reactions and discontinue if occur. Risk factors for serious GI events.

Interactions

Anticoagulants, other NSAIDs, hypoglycaemics, lithium, antiplatelets, SSRIs, other plasma protein bound drugs, methotrexate, penicillamine, digoxin, diuretics, corticosteroids, antihypertensives, quinolones, cyclosporin, tacrolimus, mifepristone, pentoxifylline.

Advice to Patient

Take immediately after meals. Swallow dispersible tablet with any fluid or disperse it in atleast 50 mL of water and then swallow. Do not crush, break, chew or open capsules, swallow whole. Do not lie down for 15-30 minutes after taking medication. Discontinue medication and inform prescriber immediately if there is constant stomach pain, cramps, indigestion or blood in stool. Contact prescriber if there is unusual cough, difficulty in breathing, swelling of extremities, unusual weight gain, chest pain, palpitations, fast heartbeat, unusual fatigue, changes in urinary pattern, unusual bruising or bleeding, blood in urine/mouth/stool/vomitus, skin rash, itching, blisters, fever, changes in hearing, ringing in ears, difficulty in speaking. Avoid alcohol during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Do not…

Pharmacokinetics

Absorption: Well absorbed from the GI tract. More rapidly absorbed after IM use. Metabolism: Hepatic. Half-life elimination: 50 hrs. Time to peak, plasma: Oral: 3-5 hrs. Excretion: Urine (mainly). Faeces (small amounts).

Brands with this active ingredient

Compiled by Healify Pharmacy from published drug references. How we compile it →

Always consult a pharmacist or doctor.