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Piroxicam (Feldene)
- Generic name: Piroxicam
- Trade names: Feldene, Roxam
- Pharmacologic category: Nonsteroidal Anti-inflammatory Drug, Oxicams
- FDA approved: April 6, 1982
- Manufacturer: Pfizer
- Pregnancy risk factor: C
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Medical uses
Piroxicam (Feldene) is a cyclooxygenase inhibiting, nonsteroidal anti-inflammatory drug (NSAID). Piroxicam is used for
rheumatoid arthritis, osteoarthritis, and dysmenorrhoea. |
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Pharmacological characteristics
- Onset of action: 1 hour
- Metabolism: Hepatic
- Elimination half-life: 45-50 hours
- Excretion: Primarily urine and feces (small amounts)
as unchanged drug (5%) and metabolites
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Benefits
- A primary advantage of the Oxicam family of drugs is their long half-life which permits once-day dosing.
- Less cardiovascular side effects.
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Disadvantages
- High risk of gastrointestinal side effects. Appears
to have the highest incidence of serious gastrointestinal side
effects.
- High risk of skin reactions. Evidence from observational
studies suggests that piroxicam may be associated with a higher
risk of serious skin reactions (including Stevens-Johnson syndrome
and toxic epidermal necrolysis) than other non-oxicam NSAIDs.
Patients seem to be at highest risk of these reactions early
in the course of therapy: most cases occur within the first
month.
- Cardiovascular side effects. Piroxicam may cause cardiovascular
problems, including heart attack, stroke, and new onset or worsening
of preexisting hypertension.
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Unlabeled uses
- Ankylosing spondylitis
- Menstrual cramps
- Pain
- Juvenile rheumatoid arthritis
- Postoperative pain
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Mode of action
Inhibits prostaglandin synthesis, acts on the hypothalamus heat-regulating
center to reduce fever, blocks prostaglandin synthetase action
which prevents formation of the platelet-aggregating substance
thromboxane A2; decreases pain receptor sensitivity. Other proposed
mechanisms of salicylate anti-inflammatory action are
lysosomal stabilization, kinin and leukotriene production, alteration
of chemotactic factors, and inhibition of neutrophil activation.
This latter mechanism may be the most significant pharmacologic
action to reduce inflammation. |
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References
Last modified: July, 2011 |
Interesting facts
- Evidence from epidemiological studies suggests that piroxicam
poses a significantly greater risk of serious gastrointestinal toxicity
than other NSAIDs, including gastrointestinal haemorrhage, ulceration,
and perforation.
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