Piroxicam

Piroxicam is an active ingredient for the treatment of pain and inflammation. It belongs to the prominent group of NSAIDs - non-steroidal anti-inflammatory drugs, which also includes ibuprofen and aspirin. Piroxicam belongs to the oxicam group. Piroxicam has analgesic, antipyretic and anti-inflammatory effects and is used for mild to moderate pain conditions, such as menstrual pain or toothache. Piroxicam inhibits cyclooxygenase 1 (COX-1) and has no narcotic effect. It is available as a white crystalline powder and is insoluble in water.

Piroxicam works by inhibiting the enzyme cyclooxygenase, or COX for short. This is often referred to as a COX inhibitor. By binding the active ingredient to the binding site, the actual substrate, namely arachidonic acid, cannot bind to the receptor. The inhibition of cyclooxygenase leads to a decrease in prostaglandin synthesis. Prostaglandins, in turn, are involved in inflammatory reactions. There are several cyclooxygenase enzymes (COX1&2).

Piroxicam is metabolized in the liver. The half-life, i.e. the time the body needs to excrete half of the active substance, is 50 hours.

Always take Piroxicam exactly as described in the package leaflet or as advised by your doctor.

Adults:

The usual recommended dose is 20 mg daily.

The maximum daily dose is also 20 mg.

Adolescents (aged 15 years and over):

The usual recommended dose is 20 mg daily .

The maximum daily dose is also 20 mg.

The following side effects may occur:

Very common:

• Gastrointestinal complaints
• heartburn
• abdominal pain
• Nausea
• vomiting
• flatulence
• diarrhea
• Constipation

Common:

• Anemia
• Eosinophilia
• leukopenia
• Thrombocytopenia
• Decrease in blood pigment and cellular components
• Gastrointestinal bleeding
• Loss of appetite
• Increased appetite
• weight gain
• high blood sugar
• headaches
• (spinning) dizziness
• tiredness
• drowsiness
• drowsiness
• fever
• ringing in the ears
• belching
• feeling of fullness
• indigestion
• Gastrointestinal ulcers
• Inflammation of the oral mucosa
• gastritis
• inflammation of the small/colon intestine
• Bile stasis
• hepatitis
• Skin rash
• itching
• sweating
• swelling
• elevated blood urea
• increased liver function values
• increased alkaline phosphatase

Occasionally:

• disorders of blood formation
• allergic reactions
• Decreased blood sugar
• blood sugar fluctuations
• insomnia
• changes in dreams
• depression
• mood swings
• Irritability
• nervousness
• hallucinations
• States of agitation and confusion
• tingling
• visual disturbances
• Swelling and irritation of the eyes
• Hearing disorders
• Hearing loss
• palpitations
• palpitations
• High blood pressure
• Blood in the stool
• vomiting blood
• jaundice
• Hypersensitivity of the skin to light
• Elevated kidney values
• kidney failure
• kidney inflammation
• pain when urinating
• frequent urge to urinate
• Blood in the urine
• weight fluctuations
• malaise
• flu-like symptoms

Rarely:

• Worsening of an existing collagenosis
• Inflammatory tissue damage
• seizures
• shock
• Acute cardiac insufficiency
• inflammation of the blood vessels
• hair loss
• nail detachment
• Nail growth disorder

Very rare:

• Intensification of an infection-related inflammation
• Increased and prolonged bleeding
• heart attack
• Oral and mucosal bleeding
• pancreatitis
• oesophagitis
• Lower abdominal complaints
• liver failure
• Membrane-like constrictions in the small and large intestine
• Stevens-Johnson syndrome
• Toxic epidermal necrolysis

Frequency unknown:

• Special form of anaemia
• Disorders of the water balance
• aseptic meningitis
• Spasms of the airways
• shortness of breath
• nosebleeds
• fatal inflammation of the liver
• angioedema
• DRESS syndrome
• vesiculo-bullous reactions
• erythema multiforme
• fixed drug exanthema
• blistering
• urticaria
• inflammation of the renal corpuscles
• Reduced fertility in women
• occurrence of abnormal antibodies in the blood
• weight loss

Interactions may occur if the following medicines are taken at the same time:

• other non-steroidal anti-inflammatory drugs
• acetylsalicylic acid
• glucocorticoids
• Anticoagulants (blood thinners)
• Antithrombotics
• Platelet aggregation inhibitors
• SSRIs (drugs for the treatment of depression)
• Antihypertensives including ACE inhibitors, angiotensin II antagonists, beta blockers and diuretics (drugs for the treatment of high blood pressure)
• Potassium-sparing diuretics (diuretic medication)
• Cardiac glycosides (medication for the treatment of cardiac insufficiency)
• Oral antidiabetics (medication for the treatment of type 2 diabetes mellitus)
• phenytoin
• lithium
• probenecid
• Sulfinpyrazone
• Methotrexate
• cyclophosphamide
• Vinca alkaloids
• Ciclosporin
• tacrolimus
• cimetidine
• Colestyramine
• Drugs with high protein binding
• Alcohol

Piroxicam must NOT be taken in the following cases:

• if you are allergic to piroxicam or other oxicams
• allergy to other medicines from the NSAID group
• in the case of gastrointestinal ulcers
• for bleeding or perforations in the gastrointestinal tract
• in diseases of the gastrointestinal tract in which bleeding may occur
• for disorders of blood formation
• with an increased tendency to bleed
• for bleeding in general
• in cases of severe heart, kidney or. hepatic insufficiency
• for the treatment of pain after bypass surgery

Patients under 15 years of age and over 80 years of age should NOT use piroxicam.

Piroxicam should NOT be taken during pregnancy as it can cause heart and kidney problems in the unborn child. From the 20th week of pregnancy, the unborn baby's ductus ateriosus botalli can become blocked, which in turn can lead to kidney damage.

Piroxicam should NOT be taken while breastfeeding, as it passes into breast milk and is a cause for concern due to its long half-life.

Ibuprofen (1st and 2nd trimester of pregnancy and breastfeeding) and paracetamol (throughout pregnancy and breastfeeding) can be taken as an alternative during both pregnancy and breastfeeding.