Oxicam Derivatives

OXICAM  DERIVATIVES

Piroxicam

It is a long acting potent NSAID with anti-inflammatory potency similar to indomethacin and good analgesic antipyretic action. It is a reversible inhibitor of COX; lowers PG concentration in synovial fluid and inhibits platelet aggregation—prolonging bleeding time. In addition, it decreases the production of IgM rheumatoid factor and leucocyte chemotaxis. Thus, it can inhibit inflammation in diverse ways.

Pharmacokinetics

It is rapidly and completely absorbed: 99% plasma protein bound; largely metabolized in liver by hydroxylation and glucuronide conjugation; excreted in urine and bile; enterohepatic cycling occurs. Plasma t½ is long— nearly 2 days. Steady state concentrations are achieved in a week. Single daily administration is sufficient.

Adverse Effects

The g.i. side effects are more than ibuprofen, but it is better tolerated and less ulcerogenic than indomethacin or phenylbutazone; causes less faecal blood loss than aspirin. Rashes and pruritus are seen in < 1% patients. Edema and reversible azotaemia have been observed.

Uses

Piroxicam is suitable for use as short-term analgesic as well as longterm anti-inflammatory drug—rheumatoid and osteoarthritis, ankylosing spondylitis, acute gout, musculoskeletal injuries, dentistry, episiotomy, dysmenorrhoea, etc.

Dose: 20 mg BD for two days followed by 20 mg OD: DOLONEX, PIROX 10, 20 mg cap, 20 mg dispersible tab, 20 mg/ml inj in 1 and 2 ml amps; PIRICAM 10, 20 mg cap.

Tenoxicam A congener of piroxicam with similar properties and uses.

TOBITIL 20 mg tab; dose 20 mg OD.