Piroxicam (Dosage)

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used in the treatment of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis to relieve pain and inflammation. Piroxicam is primarily metabolized by CYP2C9.

Piroxicam is primarily metabolized by CYP2C9. People with reduced CYP2C9 activity have a higher exposure to piroxicam and a higher risk of side effects.

MECHANISM OF ACTION

Piroxicam is an inhibitor of cyclooxygenase enzymes that acts by reducing the synthesis of prostaglandins, substances that mediate pain, inflammation and fever. Piroxicam also inhibits the migration of leukocytes to the inflammatory focus and inhibits platelet aggregation.

CONTRAINDICATIONS

Treatment with piroxicam is contraindicated in patients with hypersensitivity to piroxicam or to any of the components of the medicine, if they have had reactions to acetylsalicylic acid or another NSAID, a history of asthma, urticaria or other allergic-type reactions after taking acetylsalicylic acid or another NSAID, and after coronary artery bypass graft (CABG) surgery. In patients with gastric ulcers, a history of gastrointestinal bleeding or perforation, patients with inflammatory bowel disease, patients with severe heart or liver failure, and in patients who are taking anticoagulants. Piroxicam should also be avoided in pregnant women from the third trimester onwards and during lactation.

SIDE EFFECTS

The most frequent side effects are mild headache, dizziness, drowsiness, nausea, abdominal pain, dyspepsia, diarrhea, vomiting, alterations in blood cell count, loss of appetite, increased blood sugar levels, and swelling of the ankles.

Like all NSAIDs, piroxicam increases the risk of serious cardiovascular problems (myocardial infarction and stroke), as well as severe gastrointestinal disorders such as bleeding, ulceration and perforation.

INTERACTIONS

Piroxicam may interact with corticosteroids, anticoagulants, antiplatelet agents, lithium, selective serotonin reuptake inhibitor antidepressants (SSRIs), immunosuppressants (cyclosporine and tacrolimus), sulfonylureas, methotrexate at doses equal to or greater than 15mg/week (at low doses if there is combined treatment, blood values ​​and kidney function should be closely monitored).

BRAND NAMES

• Feldene®