PIROXICAM

Its anti-inflammatory potency is similar to indomethacin and analgesic action is greater than aspirin. It has useful antipyretic property.

Indications

Rheumatoid arthritis, osteoarthritis, ankylosing Spondylitis. Acute musculo-skeletal disorders. Acute gout.

Dosage

-Rheumatoid arthritis, osteoarthritis, ankylosing, Spondylitis: 20 mg daily as single dose. Maint. 10-30 mg. -Acute Musculo-skeletal disorders: 40 mg in a single or divided doses for 7-14 days. -Acute gout : 40 mg as a single dose. Maint : 40 mg in single or divided doses for 4-6 days.

Contra-Indications

Hypersensitivity, Pregnancy, children patients who develop asthma or allergy with other inflammatory drugs, lactation.

Special Precautions

-Gastrointestinal Effects: Piroxicam can cause serious gastrointestinal (GI) adverse events, including bleeding, ulceration, and perforation. Use with caution in patients with a history of GI disease. -Cardiovascular Effects: Increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke. Use the lowest effective dose for the shortest duration possible. -Renal Effects: Monitor renal function in patients with renal impairment or in those taking diuretics or ACE inhibitors. -Hepatic Effects: Monitor liver function tests in patients with hepatic impairment. -Pregnancy and Lactation: Not recommended during the third trimester of pregnancy. Caution should be exercised when administered to nursing women.

Side Effects

Common side effects include: -Gastrointestinal disturbances (e.g., nausea, vomiting, dyspepsia, diarrhea, constipation) -Headache -Dizziness -Rash Serious side effects include: -Gastrointestinal bleeding, ulceration, and perforation -Cardiovascular events (e.g., myocardial infarction, stroke) -Hypertension -Hepatic dysfunction -Renal impairment

Drug Interactions

-Anticoagulants and Antiplatelet Agents: Increased risk of bleeding. -Other NSAIDs: Increased risk of adverse GI and renal effects. -ACE Inhibitors and Angiotensin II Receptor Antagonists: Reduced antihypertensive effect and increased risk of renal impairment. -Diuretics: Increased risk of nephrotoxicity. -Lithium: Increased serum lithium levels. -Methotrexate: Increased risk of toxicity.