Piroxicam is a non-steroidal anti-inflammatory drug with best anti-arthritic activity. It inhibits the activity of prostaglandin synthetase enzyme which is responsible for the biosynthesis of prostaglandins, the known mediators of inflammation. The drug also inhibits collagen induced platelet aggregation.
DOSAGE AND ADMINISTRATION: Rheumatoid arthritis, ankylosing spondylitis: 20mg daily as a single dose.
Acute musculoskeletal disorders: 40mg daily in a single or divided doses for first 2 days and 20mg daily for the remaining 7 to 14 days.
Primary dysmenorrhea: 40mg daily for first 2 days and 20mg daily for 2-3 days thereafter.
Post-operative and post-traumatic pain: The recommended starting dose is 20mg, given as a single daily dose. In cases where a more rapid onset of action is desired, therapy should be initiated with 40mg daily for the first two days, given in single or divided doses. For the remainder of the treatment period, the dose should be reduced to 20mg daily.
Upper respiratory Tract Inflammation: The usual adult dosage is 10-20mg orally once daily. In cases where a more rapid onset of action is desired, therapy should be initiated with 40mg once daily for the first two days, followed by 10-20mg daily for the three to five days.
OVERDAOSAGE AND TREATMENT: In the event of overdosage with Piroxicam, supportive therapy is indicated. Studies indicate the administration of activated charcoal may result in reduced absorption of Piroxicam thus reducing the total amount of active drug available.
ABSORPTION AND EXCRETION: Piroxicam is well absorbed from the gastro-intestinal tract. It is metabolized in the liver by hydroxylation and conjugation with glucuronic acid and excreted predominantly in the urine with smaller amounts in the faeces. Less than 5% of the dose is excreted unchanged.
CONTRA-INDICATIONS: Active peptic ulceration. Piroxicam should be used with caution in patients with impaired renal function, cardiovascular disorders and known to be hypersensitive to aspirin.
WARNING: Safety during pregnancy and lactation has not been established. Dosage recommendation and indications for children under12 years of age have not been established.
SIDE EFFECTS: Gastro intestinal disturbances are the most common adverse effect. Peptic ulceration and gastro-intestinal bleeding have been rarely reported. Other reported side effects are: headache, dizziness, blurred vision, tinnitus, skin rashes, pruritis and oedema.
STORAGE: Piroxicam should be stored in a cool dry place at a temperature below 30oC. Keep medicine out of the reach of children.