mph Bangladesh


Piroxicam

(peer ox' i kam)

PCaution when used during lactation : Caution when used during pregnancy

LCaution when used during lactation : Caution when used during lactation

Molecule Info

 | See TERMINOLOGY & ABBREVIATIONS |
Indication(s) & Dosage

Oral route
Rheumatoid arthritis
Adult: 15 mg daily as a single dose. Patients with increased risk of adverse effects: Initially 7.5 mg.
Elderly: 7.5 mg daily for long-term treatment.

Ankylosing spondylitis
Adult: 15 mg daily as a single dose. Patients with increased risk of adverse effects: Initially 7.5 mg.
Elderly: 7.5 mg daily for long-term treatment.

Acute exacerbations of osteoarthritis
Adult: 7.5 mg daily up to a max of 15 mg as a single dose.
Elderly: 7.5 mg daily.

Juvenile rheumatoid arthritis
Child: â‰¥2 yr: 125 mcg/kg ocne daily. Max dose: 7.5 mg daily.

Rectal route
Ankylosing spondylitis
Adult: 15 mg daily as a single dose. Patient with increased risk of adverse effects: Initially 7.5 mg. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.

Rheumatoid arthritis
Adult: 15 mg daily as a single dose. Patient with increased risk of adverse effects: Initially 7.5 mg. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.

Acute exacerbations of osteoarthritis
Adult: 7.5 mg daily up to a max of 15 mg daily as a single dose. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.

Special Populations: In patients with an increased risk of adverse reactions: Initially, 7.5 mg daily. Dialysis patients: Max daily dose of 7.5 mg.

Administration May be taken with or without food.
Overdosage Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain. Severe symptoms e.g. apnoea, metabolic acidosis, coma, nystagmus, seizures, leukocytosis, renal failure may occur. Management: Supportive and symptomatic. Multiple doses of charcoal may be needed; cholestyramine increases meloxicam clearance. Not dialysable.
Contraindications Hypersensitivity to meloxicam, aspirin or other NSAIDs; severe hepatic impairment; bleeding disorders; renal failure without dialysis. Rectal admin in patients with proctitis, haemorrhoids or rectal bleeding.
Special Precautions History of GI disease, asthma, hypertension, CVD or risk factors, fluid retention or heart failure. Monitor patients with advanced renal disease. May impair ability to drive or operate machinery. Elderly. Pregnancy (avoid in the 3rd trimester) and lactation.
Adverse Drug Reaction(s) Dyspepsia, headache, nausea, diarrhoea, upper respiratory tract infection, abdominal pain, dizziness, oedema, flatulence, influenza-like symptoms, back pain, muscle spasms, musculoskeletal pain, rash, anaemia. GI perforation, ulceration and/or bleeding. In children: Abdominal pain, vomiting, diarrhoea, headache, pyrexia.
Potentially Fatal: Stevens Johnson syndrome, thrombocytopenia, interstitial nephritis and idiosyncratic liver abnormality.
Drug Interactions May reduce effects of antihypertensives. Increased clearance with bile acid sequestrants e.g. colestyramine. Increased risk of renal failure with diuretics; may reduce natriuretic effects of furosemide and thiazides. May increase toxicity of methotrexate.
Potentially Fatal: May increase plasma concentrations and toxicity of lithium. Increased risk of severe GI effects with aspirin, warfarin. Please consult detailed drug interactions before prescribing.
Food Interaction Avoid herbal preparations or food with antiplatelet activity e.g. alfalfa, anise, bilberry, bladderwrack, bromelain, cat's claw, celery, coleus, cordyceps, dong quai, evening primrose, feverfew, fenugreek, garlic, ginger, ginkgo biloba, red clover, horse chestnut, grapeseed, green tea, ginseng, guggul, horse chestnut seed, horseradish, licorice, prickly ash, red clover, reishi, sweet clover, turmeric, white willow.
Pregnancy Category (FDA)

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Category D: In 3rd trimester or near term. There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Storage Oral: Store at 25°C (77°F).
Pharmacology Meloxicam inhibits prostaglandin synthesis by reducing cyclooxygenase enzyme activity. This results in decreased production of prostaglandin precursors.
Absorption: Well absorbed from the GI tract (oral).
Distribution: Protein-binding: 99%.
Metabolism: Extensively hepatic via oxidation pathway.
Excretion: Via urine and faeces (as inactive metabolites); 20 hr (elimination half-life).
ATC Classification M01AC06 - meloxicam; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, oxicams. Used in the treatment of inflammation and rheumatism.

Brand/Product Info


Total Products : 3   
Brand Name Manufacturer/Marketer Composition Dosage Form Pack Size & Price
FLEXICAM Renata Limited Piroxicam 10mg Capsule 100's: 167.00 MRP
FLEXICAM IM Renata Limited Piroxicam 40mg/2ml ampoule (I/M Injection Injection 2ml: 14.72 MRP
RHEUDENE Gaco Pharmaceutical Ltd. Piroxicam 10mg Capsule 100's: 175.00 MRP

Gen. MedInfo

IMPORTANT WARNING: 

People who take nonsteroidal anti-inflammatory medications (NSAIDs) (other than aspirin) such as piroxicam may have a higher risk of having a heart attack or a stroke than people who do not take these medications. These events may happen without warning and may cause death. This risk may be higher for people who take NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke, if you smoke, and if you have or have ever had high cholesterol, high blood pressure, or diabetes. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not take piroxicam right before or right after the surgery.

NSAIDs such as piroxicam may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, or drink large amounts of alcohol while you are taking piroxicam. Tell your doctor if you take any of the following medications: anticoagulants ('blood thinners') such as warfarin; aspirin; other NSAIDs such as ibuprofen and naproxen or oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone. Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines or other bleeding disorders. If you experience any of the following symptoms, stop taking piroxicam and call your doctor: stomach pain, heartburn, vomiting a substance that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Keep all appointments with your doctor and the laboratory. Your doctor will monitor your symptoms carefully and will probably order certain tests to check your body's response to piroxicam. Be sure to tell your doctor how you are feeling so that your doctor can prescribe the right amount of medication to treat your condition with the lowest risk of serious side effects.

Your doctor will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with piroxicam and each time you refill your prescription. Read the information carefully and ask your doctor if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer's website to obtain the Medication Guide.

 

Why is this medication prescribed?

Piroxicam is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis (arthritis caused by a breakdown of the lining of the joints) and rheumatoid arthritis (arthritis caused by swelling of the lining of the joints). Piroxicam is in a class of medications called NSAIDs. It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

How should this medicine be used?

Piroxicam comes as a capsule to take by mouth. It is usually taken once or twice a day. Take piroxicam at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor to explain any part you do not understand. Take piroxicam exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Piroxicam will help control your symptoms but will not cure your condition. It may take 8 to 12 weeks or longer before you feel the full benefit of piroxicam.

Other uses for this medicine 

Piroxicam is also sometimes used to treat gouty arthritis (attacks of severe joint pain and swelling caused by a build-up of certain substances in the joints) and ankylosing spondylitis (arthritis that mainly affects the spine). It is also sometimes used to relieve muscle pain and swelling, menstrual pain, and pain after surgery or childbirth. Talk to your doctor about the risks of using this medication for your condition.

What special precautions should I follow? 

Before taking piroxicam, 

  • tell your doctor if you are allergic to piroxicam, aspirin,or other NSAIDs such as ibuprofen and naproxen or any other medications.
  • tell your doctor what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, and trandolapril; diuretics ('water pills'); lithium; medications for diabetes; methotrexate and phenytoin.
  • tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffy or runny nose or nasal polyps (swelling of the lining of the nose); swelling of the hands, feet, ankles, or lower legs ; or liver, or kidney disease.
  • tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy, you plan to become pregnant, or you are breast-feeding. If you become pregnant while taking piroxicam, call your doctor.

talk to your doctor about the risks and benefits of taking piroxicam if you are 65 years of age or older. Older adults should usually take lower doses of piroxicam for short periods of time because higher doses taken regularly may not be more effective and are more likely to cause serious side effects.

  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking piroxicam.

What special dietary instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose? 

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause? 

Piroxicam may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away: 

  • diarrhea

  • constipation

  • gas

  • headache

  • dizziness

  • ringing in the ears

Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more piroxicam until you speak to your doctor. 

  • vision problems

  • unexplained weight gain

  • fever

  • blisters

  • joint pain

  • rash

  • itching

  • hives

  • swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs

  • difficulty breathing or swallowing

  • hoarseness

  • pale skin

  • fast hearbeat

  • excessive tiredness

  • unusual bleeding or bruising

  • lack of energy

  • upset stomach

  • loss of appetite

  • pain in the upper right part of the stomach

  • flu-like symptoms

  • yellowing of the skin or eyes

  • cloudy, discolored, or bloody urine

  • back pain

  • difficult or painful urination

Piroxicam may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What should I know about storage and disposal of this medication? 

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose 

In case of overdose, consult your doctor. If the victim has collapsed or is not breathing, consult local medical emergency services.

Symptoms of overdose may include: 

  • lack of energy

  • drowsiness

  • upset stomach

  • vomiting

  • stomach pain

  • bloody, black, or tarry stools

  • vomiting a substance that is bloody or looks like coffee grounds

  • difficulty breathing

  • coma (loss of consciousness for a period of time)

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.

Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Ref:  U.S. National Library of Medicine.


This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.

Simple Breath Test Might Diagnose Heart Failure An experimental breath test, designed to quickly identify patients suffering from heart failure simply by analyzing the contents of a...
Osteoporosis drug stops Breast cancer growth   News & Events News & Events     HIGHLIGHTS Osteoporosis drug stops growth of breast cancer...
Generic drug safety info loophole FDA plans to close generic drug safety info loophole The US Food and Drug Administration has announced plans to speed up the dissemination of...
Large trials unpublished   News & Events News & Events   HIGHLIGHTS Almost 1 in 3 of large clinical trials unpublished after...
TB activists boo Indian minister News & Events News & Events   HIGHLIGHTS TB activists at world conference boo Indian minister off...
Key bone marrow protein identified News & Events News & Events   HIGHLIGHTS Key bone marrow protein identified as potential new leukemia...