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MUSCULO-SKELETAL SYSTEM › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS › ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS › Oxicams
piroxicam
M01AC01
Forms & Strengths
- Capsule: 10 mg
- Capsule: 20 mg
Adult Dosing
- Osteoarthritis / Rheumatoid Arthritis: 20 mg orally once daily
- Maximum daily dose: 20 mg
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Management of acute or long-term use in osteoarthritis
- Management of acute or long-term use in rheumatoid arthritis
Mechanism of Action
- Nonsteroidal anti-inflammatory drug (NSAID) that inhibits synthesis of prostaglandins
- Inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes
- Exhibits anti-inflammatory, analgesic, and antipyretic properties
Contraindications
- Known hypersensitivity to piroxicam or other NSAIDs
- History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs
- In the setting of coronary artery bypass graft (CABG) surgery
- Active peptic ulcer disease or gastrointestinal bleeding
- Severe hepatic impairment
- Severe renal impairment
Adverse Reactions
- Gastrointestinal ulceration, bleeding, perforation, dyspepsia, nausea, abdominal pain
- Cardiovascular thrombotic events, myocardial infarction, stroke, hypertension, edema
- Renal impairment, acute renal failure, hyperkalemia
- Skin reactions including Stevens-Johnson syndrome, toxic epidermal necrolysis, rash, pruritus
- Hematologic effects including anemia, thrombocytopenia, neutropenia
Drug Interactions
- Anticoagulants (e.g., warfarin): Increased risk of severe gastrointestinal bleeding
- Antiplatelet agents (e.g., aspirin): Increased risk of GI ulceration and bleeding
- ACE inhibitors and ARBs: Diminished antihypertensive effect and increased risk of renal impairment
- Diuretics: Reduced diuretic efficacy and increased nephrotoxicity risk
- Lithium: Increased plasma lithium concentrations and risk of toxicity
- Methotrexate: Increased methotrexate toxicity due to reduced clearance
Curated Content: Needs Vetting Before Put to Clinical Use