The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!
Piroxicam - a descriptive characteristic
Piroxicam(Piroxicam) belongs to the group of non-steroidal anti-inflammatory drugs, and is used to treat many diseases with pain syndrome.Composition and release forms
It is produced in several dosage forms:1. 10 mg capsules with a blue cap, a white body.
2. Capsules of 20 mg, with a green lid, and a white body - in a package of 20 and 60 pieces, the contents of the capsules are yellowish powder. Excipients for capsules are potato starch, cellulose, talc, silicon dioxide. The capsule consists of gelatin, yellow iron oxide, titanium dioxide, dye and water. The package contains 20 capsules.
3. Gel, cream, ointment for external use in tubes of 30, 50 and 100 g.
4. A solution of 0.02 g in 1 ml and 0.04 g in 2 ml, available in ampoules.
5. Rectal suppositories at a dose of 0.02 g.
Medicines-synonyms for Piroxicam
- Vero-Piroxicam;
- Piroxicam-Altpharm;
- Pirokam;
- Piroxicam-Acri;
- Piroxicam Stada;
- Calmopyrol;
- Piroxicam-Werte;
- Piroxifer;
- Piroxicam Yenafarm;
- Revmador;
- Piroxicam-ratiopharm;
- Remoxicam;
- Hotemin;
- Sanik;
- Velden;
- Feldoral SEDIKO;
- Finalgel.
pharmachologic effect
As mentioned, Piroxicam is a non-steroidal anti-inflammatory drug (NSAID). It has three main actions:1. Analgesic.
2. Antipyretic.
3. Anti-inflammatory.
The mechanism of action of NSAIDs is very complex. The antipyretic effect is accompanied by increased heat transfer due to vasodilation. This is due to a calming effect on the excitability of the centers of the diencephalon, the structure of which is changed under the influence of a pathological process.
The anti-inflammatory effect of these drugs is due to the effect on the factors of regulation of homeostasis. It is achieved due to the normalization of capillary permeability and microcirculation.
Piroxicam, as a rule, inhibits the synthesis of prostaglandins - biogenic substances that play a special role in the development of inflammation and pain syndromes. Suppression of the exudative and proliferative phases of inflammation leads to attenuation of the inflammatory process and associated pain.
This pharmacological agent also inhibits the activity of cyclooxygenase, inhibits the aggregation of neutrophils and platelets, and suppresses phagocytosis. There is a decrease in the concentration of prostanoids in the gastric mucosa, urine, synovial fluid.
The effect of Piroxicam in the direction of reducing thermoregulation helps to weaken the pain syndrome of moderate intensity, thereby increasing the level of pain sensitivity.
The analgesic effect occurs mainly after half an hour after taking the drug, and lasts for a day. In this regard, the agent is used for rheumatoid arthritis, algodismenorrhea, inflammatory and degenerative diseases of the musculoskeletal system.
Piroxicam is able to relieve pain of moderate intensity, reduce inflammation, stop pain at rest in articular pathologies, help reduce stiffness in the morning, the intensity of pain during movement, and helps to increase the volume and range of motion in the joints.
The anti-inflammatory effect begins to manifest itself when the capsules are taken within a week. With a single dose, the effect lasts for 24 hours. Does not accumulate in the body.
The use of the drug externally in the form of gels, ointments and cream provides a local decongestant, anti-inflammatory and analgesic effect on tissues, relieving pain in muscles, joints, tissues, both at rest and during movement, reducing edema and increasing the range of motion.
The advantage of external use of dosage forms of the drug is the manifestation of a therapeutic effect with a minimum level of the active substance in the blood plasma.
Pharmacokinetics
Piroxicam is well absorbed when taken orally from the gastrointestinal tract. The maximum concentration in blood plasma is achieved in an average of three to five hours; it is directly proportional to the dosage of the drug. Food can slow down the absorption of the product. The bioavailability of the drug is 99%. This drug perfectly penetrates the placental barrier, can enter the child's body with breast milk, and penetrates into the synovial fluid. It is metabolized in the liver by hydrolysis and conjugation. It is excreted, as a rule, by the kidneys, and in small amounts through the intestines.The half-life is 50 hours. In patients with liver disease, it can increase significantly. In this regard, the drug is prescribed mainly once a day.
With local therapy, the agent penetrates well through the skin barrier, and reaches an effective concentration for treatment in less than 20 minutes. At this time, the concentration of the active substance in the circulatory system is very low, which helps to avoid side effects in local therapy.
Indications for use
Piroxicam is used in the treatment of edematous, accompanied by pain, joint diseases of inflammatory and degenerative genesis, as well as for spinal injuries, soft tissues, and some systemic diseases. It is prescribed for pain syndrome:
- in the spine, muscles, tissues, tendons with injuries, sprains, bruises, fractures;
- myalgia, inflammation of soft tissues;
- neuralgia of various origins;
- sports injuries;
- after operations.
Articular pathologies and rheumatic diseases:
- osteoarthritis, rheumatoid arthritis (including juvenile);
- psoriatic arthropathy, gout;
- ankylosing spondylitis;
- polymyositis, polymyalgia rheumatica;
- brachial syndrome;
- extra-articular rheumatism;
- humeroscapular periarthritis;
- systemic lupus erythematosus;
- epicondylitis;
- deforming osteoarthritis;
- tendinitis, tendosynovitis.
Instructions for use
Dosage regimen and methods of administration: tablets, injections, ointment, gel, suppositories
Method of application: inside, in capsules or rectallyInside, adults and children over 15 years of age are prescribed the drug in a dose of 10 to 40 mg, mainly once a day after meals. The 40 mg dose is the maximum.
Rectally administered in a dose of 20-40 mg in the form of suppositories.
The drug is used for acute and chronic diseases of the musculoskeletal system in the acute stage, 40 mg per day in the first five days, with a gradual decrease in the next seven days from 20 mg to 10 mg per day.
In the postoperative period: 20 mg per day, with severe pain, you can double the dose.
With rheumatoid arthritis, ankylosing spondylitis, as a rule, the initial dose is 20 mg, the maintenance dose is 10 mg per day. It is possible to increase the dose to 30 mg with intense pain syndrome.
Help: gastric lavage with activated charcoal intake, hospitalization.
Drug interactions
Simultaneous reception of Piroxicam with the following drugs leads to an increase in the concentration of the latter in the blood plasma:- oral anticoagulants;
- cyclophosphamides;
- oral hypoglycemic drugs;
- nalidixic acid;
- triiodothyronine.
Piroxicam weakens the action of diuretics and hypertensive drugs.
The simultaneous use of lithium preparations with Piroxicam increases the concentration of the former in the blood plasma.
Side effects
Side effects develop with prolonged use of Piroxicam, as well as when taken in large doses. The most common side effects are those of the digestive system. Nausea, sometimes vomiting, epigastric pain, diarrhea is often observed. If gastric bleeding occurs, the drug is canceled.The following symptoms may occur:
- skin manifestations in the form of urticaria;
- visual impairment;
- manifestations of vasculitis;
- bronchospasm.
From the hematopoietic system anemia is observed - mainly leukopenia and a decrease in platelet aggregation.
On the part of the cardiovascular system fluctuations in blood pressure, palpitations, shortness of breath are noted.
For external use often itching, redness of the skin, symptoms of local dermatitis appear.
When using rectal suppositories irritation of the rectal mucosa, bleeding, bloody stools may occur.
It must be remembered that the incidence of side effects directly depends on the level of the daily dose of the drug.
Contraindications for use
An absolute contraindication is drug intolerance. Also, Piroxicam is contraindicated in the following conditions:
- children under 15 years of age;
- bronchial asthma caused by non-steroidal anti-inflammatory drugs;
- recurrent polyposis;
- hypersensitivity to the drug and its components;
- proctitis, bleeding of the rectal mucosa (for suppositories);
- hepatic and renal failure;
- peptic ulcer of any localization in the acute stage;
- stomach and intestinal bleeding;
- hemorrhagic diathesis;
- coronary artery bypass grafting;
- decompensated heart failure;
- anticoagulant treatment;
- pregnancy, lactation.
Piroxicam should be taken with caution in diseases and situations such as:
- bronchial asthma;
- porphyria;
- postoperative period;
- taking prednisolone, warfarin, acetylsalicylic acid, selective inhibitors of citalopram, paroxetine and others;
- long-term use of other NSAIDs.
Piroxicam during pregnancy
In the third trimester of pregnancy, Piroxicam should not be taken. In the first and second trimesters, it is necessary to correlate the benefits of the drug and the risk to the fetus, and only then decide on the use of Piroxicam. There is a risk of delayed and pathological childbirth. Therefore, it is not recommended to take the drug on your own, it should be prescribed only by a specialist with a thorough examination of the pregnant woman.This pharmacological agent is excreted in breast milk and, therefore, is contraindicated in breastfeeding. External use of the drug is not recommended for pregnant and lactating women, since there is no reliable data on the benefits or harms of its use.
IVF reception
In vitro fertilization, or in vitro fertilization, is more effective in treating infertility than other methods. Indications for its use are obstruction of the fallopian tubes, endometriosis, male factor of infertility, ovarian disease and other factors. IVF is recommended for couples who have already used other ineffective fertility treatments. The IVF protocol includes stimulation of the ovaries, in which several follicles with eggs mature. Then the specialist performs a puncture of the ovary with the extraction of the egg. Eggs fertilized with the husband's sperm under special conditions are transferred into the woman's uterine cavity. Further, the development of the embryo continues.
Recently, research has been carried out proving the positive effect of Piroxicam with the IVF method. It was found that the drug can reduce the contractile activity of the uterus, to some extent increasing the likelihood of pregnancy. The authors of these works recommend taking 1 tablet of Piroxicam 3 times a day, the day before transfer, and taking 1 tablet in the morning, directly on the day of transfer of embryos into the uterus.
Admission for embryo transfer
Scientists have found that taking one dose (20 mg) of Piroxicam on the day of transfer improves blood flow, soothes the uterus, and relieves cervical spasm.It is recommended to take one tablet of the product 2 hours before the transfer. The ability to improve the rheological properties of blood, including uterine blood flow, is an indication for its use in IVF. But in this case, it is important to remember that the drug is prescribed only by a doctor.
The choice of NSAIDs for various diseases
Practical medicine has a large arsenal of effective non-steroidal anti-inflammatory drugs.Such drugs are prescribed for various inflammatory diseases. According to medicine, the use of NSAIDs per inhabitant per year averages up to 40 grams. Every day in the world these drugs are used by about 30 million patients.
In numerous studies, the drugs Piroxicam, Meloxicam and Oxaglucamine exhibit the greatest anti-inflammatory activity in diseases of the musculoskeletal system.
During the period of taking the drug, you should avoid smoking and drinking alcohol.
During the period of taking the drug, you should not perform work requiring increased attention.
Piroxicam price
The cost of a Piroxicam package containing 20 capsules in a dose of 10 mg is affordable and ranges from 19 to 42 rubles.Piroxicam - reviews
Alena, 24:"After sports training, the shoulder muscles were strongly stretched. After taking Piroxicam, I felt an instant improvement, the swelling went away, the pain also significantly decreased. I liked the drug!"Vadim, 35 years old:"I suffer from lupus erythematosus. Periodically the doctor prescribes a course of Piroxicam. Rheumatic pains were especially painful. The remedy helps very well - the taste for life has returned!"
Asya, 40 years old:“After the stress, psoriasis began - and, as a result, psoriatic arthropathy.
As you can see, the reviews about the drug are positive, which proves its effectiveness.
Storage conditions and shelf life
The drug is stored in a dark place, out of the reach of children, at a temperature of 15 o to 25 o C.Dispensed from the pharmacy with a doctor's prescription.
Shelf life is 3 years.
One Piroxicam capsule(including in the preparation Piroxicam Acri) contains 10 or 20 mg of the active substance of the same name. Additional components: wheat starch, MCC, talc, glycine, colloidal silicon dioxide, magnesium stearate. Components of the capsule: gelatin, indigo carmine, iron oxide, titanium dioxide, sunset yellow.
In one gram gel Piroxicam contains 0.5 g of the active substance of the same name. Additional components: ethanol 95%, carbomer, methyl parahydroxybenzoate, trolamine, propylene glycol, water.
Piroxicam tablet contains 20 mg of active ingredient.
Release form
- Twenty tablets in a contour package, one package in a cardboard box.
- Hard capsules, cylindrical, white odorless powder inside. Five such capsules in a contour package; two or four packages in a cardboard box. Seven of these capsules in a contour package; two or four packages in a cardboard box. Ten such capsules in a contour package; one or two packages in a cardboard box. Ten such capsules in a blister; ten, twenty, three, one or two blisters in a cardboard box.
- Transparent yellow gel with a characteristic odor; possible presence of air bubbles. 10, 15, 20, 25, 30 or 50 grams of gel in a tinted glass jar, one jar in a cardboard box. 30 or 50 grams of gel in an aluminum tube, one tube in a cardboard box.
pharmachologic effect
Non-steroidal anti-inflammatory agent.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics
Non-steroidal anti-inflammatory agent from the group oxicam ... Possesses anti-inflammatory, analgesic and antipyretic action ... Inhibits enzyme cyclooxygenase , which leads to a slowdown in biosynthesis from molecules arachidonic acid ... With systemic use, it suppresses pain. Inhibits platelet aggregation.
When used externally, it weakens or reduces the severity of inflammation and pain in the joint area during movement and at rest, relieves morning stiffness and swelling of the joints, helps to increase the amplitude and range of motion in the joints. The analgesic effect is recorded half an hour after oral administration. The anti-inflammatory effect is observed after 5-7 days. After a single dose of the drug, the effect lasts for a day.
Pharmacokinetics
Well absorbed from the intestines. The maximum concentration in the blood is reached after 4 hours. Plasma protein binding reaches 99%. It crosses the placenta and is excreted during lactation. It is metabolized in the liver through hydrolysis and conjugation reactions.
It is excreted unchanged and in the form of derivatives, mainly by the kidneys and in small quantities with feces. The half-life is about two days.
In patients with liver damage, this period may increase.
Indications for the use of Piroxicam
Indications for the use of Piroxicam in the form of capsules (tablets) and gel:
- articular syndrome ( , );
- back pain myalgia, neuralgia , traumatic inflammation.
Indications for capsules and tablets only:
- for females from 12 years old;
- acute lesions of the upper respiratory tract of an infectious and inflammatory nature.
Contraindications
Use is contraindicated for:
- gastrointestinal diseases that can cause bleeding ( Crohn's disease , gastrointestinal tract cancer, ulcerative, diverticulitis );
- ulcers of the gastrointestinal tract, perforations or bleeding, including a history; inflammatory diseases of the digestive system; active peptic ulcer ;
- joint use with other agents from the group non-steroidal anti-inflammatory ;
- simultaneous use with anticoagulants ;
- history of previous severe, especially cutaneous, such as Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis;
- to auxiliary components;
- heavy renal, cardiac or liver failure;
- pregnancy and lactation;
- children under 14 years old.
Side effects
- External reactions digestive system: loss of appetite, nausea, stomatitis , pain in the epigastric region, flatulence , or, erosive and ulcerative changes in the organs of the digestive tract with possible complications in the form of bleeding and perforations, jaundice , a temporary increase in content hepatic transaminases, liver necrosis with a possible fatal outcome. These side effects usually develop with prolonged use of the drug at a dose of more than 30 mg per day.
- External reactions hematopoietic system: anemia, leukopenia, thrombocytopenia, eosinophilia.
- External reactions metabolism: hypo or hyperglycemia, hyperkalemia, weight changes, transient increase in concentration creatinine and residual nitrogen, uremia on the background hyperkalemia.
- External reactions nervous system: nervousness, mood changes, hallucinations , weakness, eye puffiness, sensory disturbances, visual disturbances and symptoms of eye irritation.
- External reactions genitourinary system: , interstitial acute nephritis.
- Allergic reactions: redness, itching, rash, swelling of the face and hands, pemphigus vulgaris , Stevens-Johnson syndrome, bronchospasm, Lyell's syndrome, vasculitis, serum sickness.
- Dermatological reactions: onycholysis, photosensitivity,.
- Local reactions: tenesmus , rectal irritation.
- Other reactions: nose bleed.
- External reactions: erythema or at the site of application.
Instructions for use of Piroxicam (Way and dosage)
Instructions for use on gel (ointment)
Piroxicam tablets, instructions for use
Instructions for tablets (and capsules) of all manufacturers of Piroxicam recommend the same treatment regimens, including instructions for use Piroxicama Acri ... The drug is taken orally with meals. The recommended daily dose should not be exceeded, because this increases the risk of developing unwanted side effects.
With lesions of the musculoskeletal system or joint diseases ( osteoarthritis , rheumatoid arthritis, spondylitis ) it is recommended to take 10–20 mg per day once or twice. In case of urgent need, it is allowed to temporarily increase the dose taken to 30 mg per day, once or in several doses, or decrease to 10 mg per day.
At acute lesions of the musculoskeletal system in the first few days, take 40 mg per day once or divided into several doses, then - 20 mg per day for a half month.
With acute gout use 40 mg per day for three to five days.
At dysmenorrhea therapy should be started with the first symptoms detected at an initial dose of 40 mg per day, one or more times for two days. Then - 20 mg per day once for one to three days.
At pain of a post-traumatic nature the initial dose includes 20 mg of the drug once a day. If necessary, you can increase the dose taken in the first few days to 40 mg.
The maximum daily permitted dose for adults is no more than 40 mg.
Overdose
Symptoms: drowsiness, blurred vision, loss of consciousness is possible when using large doses.
Symptomatic treatment is carried out. Piroxicam cannot be evacuated from the body using hemodialysis .
Interaction
When used together, Piroxicam may reduce the effect of antihypertensive drugs and diuretics .
When used together with drugs potassium and potassium-sparing diuretics development is possible hyperkalemia.
When used together with others non-steroidal anti-inflammatory or glucocorticosteroid drugs the risk of bleeding from the digestive tract increases.
When used together with lithium salts the content rises lithium in blood.
When used together with anticoagulants (tablets) changes in blood coagulation are possible; c - decrease in concentration piroxicama in blood.
When taking Piroxicam 24 hours before or after use, its concentration in the blood increases and toxicity increases.
When used together with phenobarbital - a decrease in the concentration of Piroxicam in the blood is possible; with phenytoin - possible increase in concentration phenytoin in blood; with NSrobenecid, cimetidine, sulfinpyrazone - an increase in the concentration of Piroxicam in the blood is possible.
Terms of sale
On prescription.
Storage conditions
Keep out of the reach of children. Store at temperatures up to 25 degrees in a dark, dry place.
Shelf life
Three years.
special instructions
Looking through the prism of safety, the drug is not a means of choice, if it is possible to use other antirheumatic or non-steroidal anti-inflammatory drugs.
Side effects can be reduced by using the lowest effective dose for the shortest period of time needed to monitor clinical results.
Gross formula
C 15 H 13 N 3 O 4 SPharmacological group of substance Piroxicam
Nosological classification (ICD-10)
CAS code
36322-90-4Characteristics of the substance Piroxicam
Crystalline powder, white or white with a slightly yellowish sheen. Let's dissolve in chloroform (1: 100), in heated ethanol and methanol (1: 1000), it is difficult to dissolve in water.
Pharmacology
pharmachologic effect- anti-inflammatory, antipyretic, antiaggregatory, analgesic.Inhibits the activity of cyclooxygenase (COX-1 and COX-2), reduces the synthesis of PG, incl. PGE 1, PGE 2, PGE 2alpha and thromboxanes. Suppresses phagocytosis, platelet aggregation.
After oral administration, it is well absorbed from the gastrointestinal tract, C max is reached after 3-5 hours. Equilibrium concentration in the blood is established within 7-12 days. Plasma protein binding is 97-99%. It is metabolized in the liver (oxidized and conjugated), the main metabolites - 5-hydroxypyroxicam, N-methyl-benzosulfonamide, etc. - are pharmacologically inactive. T 1/2 about 50 hours, may increase with liver disease. It is excreted by the kidneys and the gastrointestinal tract (in the urine there is a 2 times greater amount than in the feces), mainly in the form of glucuronides (5% is excreted unchanged). Passes through the placenta and enters breast milk. Does not cumulate.
Helps to relieve pain, symptoms of inflammation with any method of application. With articular syndrome, it weakens or relieves inflammation and pain in the joints at rest and during movement, reduces morning stiffness and swelling of the joints.
Subacute and chronic toxicity studies performed on rats, mice, dogs and monkeys have shown that the most frequent manifestation of toxicity in animals with prolonged administration of piroxicam, like other NSAIDs, is renal papillary necrosis and gastrointestinal tract damage. No effect on fertility and teratogenic effects in animals was found.
Increases the likelihood of pathological delivery and delayed delivery in animals, like other drugs that inhibit the synthesis and release of PG. The toxic effect on the gastrointestinal tract is especially pronounced in women in the third trimester of pregnancy, compared with the effect in the first and second trimesters and in non-pregnant women.
Use of the substance Piroxicam
Inflammatory and degenerative diseases of the joints and spine, accompanied by pain, incl. rheumatoid arthritis, rheumatism, ankylosing spondyloarthritis (ankylosing spondylitis), osteoarthritis, juvenile chronic arthritis, tendonitis, tendovaginitis, brachioles syndrome, periarthritis of the shoulder scapula, acute gout; pain syndrome of various origins: neuralgia, myalgia, primary dysmenorrhea, postoperative and post-traumatic pain, incl. with sports injuries (bruise, dislocation, sprain), pain and swelling in joints, tendons and muscles caused by overstrain, etc.; acute infectious and inflammatory diseases of the upper respiratory tract.
Contraindications
Hypersensitivity, incl. to other NSAIDs, erosive and ulcerative lesions of the gastrointestinal tract (in the stage of exacerbation), "aspirin" asthma, severe liver and / or kidney dysfunction, hemorrhagic diathesis, changes in the blood picture of unknown origin (including history), inflammatory changes or bleeding in the rectum and anus, incl. proctitis (when using suppositories); pregnancy, breastfeeding, children and adolescence (injection solution - up to 18 years; gel, ointment, suppositories - up to 14 years).
Restrictions on use
History of erosive and ulcerative lesions of the gastrointestinal tract, bronchial asthma, allergic diseases, heart failure and other diseases accompanied by edema, arterial hypertension.
Application during pregnancy and lactation
Contraindicated in pregnancy.
During treatment, breastfeeding should be discontinued.
Side effects of the substance Piroxicam
From the nervous system and sensory organs: dizziness, headache, irritability, drowsiness or insomnia, weakness, depression, hallucinations, tinnitus, blurred vision, eye irritation.
On the part of the cardiovascular system and blood (hematopoiesis, hemostasis): increase or decrease in blood pressure, palpitations, anemia, thrombopenia, leukopenia, eosinophilia, decrease in hemoglobin and hematocrit, hemorrhages.
From the digestive tract: dry mouth, stomatitis, gastrointestinal irritation, nausea, belching, anorexia, diarrhea or constipation, flatulence, bleeding gums, pain in the epigastric region, erosive and ulcerative lesions of the gastrointestinal tract and the occurrence of bleeding, liver dysfunction (increased activity of hepatic transaminases).
From the genitourinary system: renal failure, acute interstitial nephritis.
Others: allergic reactions (itching, redness of the skin; edema, including of the face, hands; Stevens-Johnson syndrome, Lyell's syndrome, very rarely - anaphylactic reactions, bronchospasm, photosensitivity, rash), edema (mainly of the lower extremities in patients with impaired function heart), sweating, increased urea, hyperkalemia, hypo- or hyperglycemia, increased or decreased body weight.
Local reactions: irritation of the rectal mucosa, tenesmus, pain and an unpleasant feeling of heaviness in the anal region (suppositories); when applied to the skin - irritation, incl. itching, redness, rash, burning (with prolonged use).
Interaction
Displaces other drugs from the connection with blood proteins. Reduces the effectiveness of antihypertensive drugs. Against the background of other NSAIDs and corticosteroids, the risk of ulcerogenic action increases. Increases the risk of hyperkalemia when combined with potassium-sparing diuretics and other potassium-containing drugs. Increases the concentration of phenytoin and lithium in the blood. Anticoagulants increase the risk of bleeding. Acetylsalicylic acid reduces the concentration of piroxicam in the blood to 80% of the original.
Overdose
Symptoms: drowsiness, blurred vision, at very high doses - loss of consciousness, coma.
Treatment: gastric lavage, taking activated charcoal, antacids (to reduce absorption), symptomatic therapy.
Route of administration
Inside, i / m, rectally, externally.
Precautions for the substance Piroxicam
Before use, incl. local, patients with bronchial asthma, allergic rhinitis, with polyps of the nasal mucosa, chronic obstructive respiratory diseases should consult a doctor. During the period of treatment, it is necessary to monitor the cellular composition of the blood, the function of the kidneys and liver.
During the period of treatment, alcoholic beverages should not be consumed.
Avoid getting the gel or ointment on the mucous membranes, in the eyes, on open wounds, etc.
Interaction with other active ingredients
Trade names
| Name | The value of the Vyshkovsky Index ® |
Piroxicam is a drug that belongs to the group of NSAIDs (non-steroidal anti-inflammatory drugs). The drugs in this group are widely used in traditional medicine, are popular among patients and, as a rule, are dispensed without a prescription from a doctor.
NSAIDs, which include Piroxicam, are broad-spectrum agents used for a wide variety of pathologies, which are accompanied by painful symptoms, inflammatory processes and fever.
In this article, we will consider why doctors prescribe Piroxicam, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Piroxicam can be read in the comments.
Piroxicam is available in the form of capsules and tablets for oral administration, as well as in the form of a gel for external use.
- One capsule of Piroxicam (including the preparation Piroxicam Acri) contains 10 or 20 mg of the active substance of the same name. Additional components: wheat starch, MCC, talc, glycine, colloidal silicon dioxide, magnesium stearate.
- Components of the capsule: gelatin, indigo carmine, iron oxide, titanium dioxide, sunset yellow.
Pharmacological action: non-steroidal anti-inflammatory drug.
Indications for use
Piroxicam is prescribed by a doctor for spinal injuries, diseases of soft tissues and joints. If we consider the indications for the use of this substance in more detail, we can highlight:
- extra-articular rheumatism;
- ankylosing spondylitis;
- rheumatoid arthritis and osteoarthritis;
- injuries of tendons, muscles and spine, fractures, sprains, bruises;
- postoperative syndromes;
- neuralgia;
- gout and psoriatic arthropathy;
- tendinitis;
- deforming osteoarthritis.
It is important to note that Piroxicam effectively relieves pain and reduces the intensity of the inflammatory process at the time of application, but does not affect the progression of the disease.
pharmachologic effect
The active ingredient of Piroxicam capsules is a representative of non-steroidal anti-inflammatory drugs of the oxicam group. It inhibits (suppresses) the activity of the enzyme cyclooxygenase (COX), which catalyzes the conversion of arachidonic acid to prostaglandins (inflammatory mediators).
Piroxicam is known as an antipyretic, analgesic, anti-inflammatory and antiaggregatory (reduces the likelihood of thrombus formation) agent. When taken orally, it is rapidly absorbed, reaching a maximum effect after 2-3 hours after administration.
The remedy significantly reduces pain in the case of systemic use. The analgesic effect of the drug is felt within half an hour after administration.
Instructions for use
According to the instructions for use, Piroxicam capsules are taken orally after meals. They are not chewed and washed down with a sufficient amount of water.
- For oral administration, the dose is 10-30 mg 1 time / day. Rectally - 20-40 mg 1-2 times / day. In acute gout, the initial dose is 40 mg 1 time / day for the first 2 days, then 40 mg 1 time / day or 20 mg 2 times / day for 4-6 days.
In acute conditions or exacerbation of a chronic process, it can be administered intramuscularly at a dose of 20-40 mg 1 time / day. After stopping the acute process, they switch to maintenance therapy with oral forms.
Topically applied 3-4 times / day.
Contraindications
The use of Piroxicam should be excluded in conditions such as:
- the patient's age is less than 15 years old;
- hemophilia;
- duodenal ulcer, stomach;
- bleeding from the gastrointestinal tract;
- hemorrhagic diathesis;
- bronchial asthma, which is caused by other NSAIDs;
- recurring polyposis;
- proctitis, intestinal bleeding (for the drug, in the form of rectal suppositories);
- hepatic, renal, cardiac insufficiency;
- Crohn's disease;
- period of bearing the child;
- breast-feeding;
- intolerance to the active or one of the auxiliary components of the drug.
Limitations in the use of Piroxicam - previously transferred erosive and ulcerative lesions of the gastrointestinal tract; bronchial asthma, allergic diseases, heart failure and other diseases accompanied by edema, arterial hypertension.
Side effects
Side effects develop with prolonged use of Piroxicam, as well as when taken in large doses.
- Digestive organs: nausea, vomiting, belching, dry mouth, stomatitis, epigastric pain, loss of appetite, diarrhea or constipation, flatulence, erosive and ulcerative lesions (before perforation) and / or bleeding (in exceptional cases before anemia) of the gastrointestinal tract , increased activity of liver enzymes, liver failure, increased plasma nitrogen concentration;
- Nervous system: insomnia, dizziness, headache, drowsiness, lethargy, depression, irritability, paresthesia, hallucinations, mood changes;
- Cardiovascular system: increase or decrease in blood pressure, rarely - shortness of breath, palpitations;
- Urinary system: renal failure, interstitial nephritis, nephrotic syndrome, nephrosis, proteinuria, erythrocyturia, hyperkalemia, papillary necrosis, glomerulonephritis, increased plasma concentrations of creatinine and urea;
- Hematopoietic organs and hemostasis system: aplastic, hemolytic and other types of anemia, thrombocytopenia, eosinophilia, leukopenia, hemorrhagic vasculitis (Shenlein-Henoch disease), decreased hematocrit;
- Allergic reactions: skin rash, dermatitis with desquamation of the stratum corneum, itching, erythema multiforme, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), anaphylactic shock, bronchospasm, photosensitivity, vibasculitis, angioedema;
Others: swelling of the feet and legs, increased sweating, hypoglycemia, increased urea concentration.
Analogues of Piroxicam
Structural analogues for the active substance:
- Vero Piroxicam;
- Calmopyrol;
- Pirokam;
- Piroxicam Stada;
- Piroxicam Acri;
- Piroxicam Verte;
- Piroxicam ratiopharm;
- Piroxifer;
- Revmador;
- Remoxicam;
- Sanik;
- Feldoral;
- Velden;
- Finalgel;
- Hotemin.
Attention: the use of analogs must be agreed with the attending physician.
Price
The average price of Piroxicam in pharmacies (Moscow) is 80 rubles.
Conditions of dispensing from pharmacies
Active substance
Release form, composition and packaging
Capsules hard gelatinous, size No. 3, with a white body and a blue lid; the contents of the capsule are white to creamy-white powder, the formation of a cylindrical shape is possible, easily disintegrating when touched.
Excipients: microcrystalline cellulose, wheat starch, glycine, colloidal silicon dioxide, talc, magnesium stearate.
Shell composition: gelatin, titanium dioxide, iron oxide yellow, sunset yellow.
10 pieces. - blisters (2) - cardboard packs.
pharmachologic effect
Non-steroidal anti-inflammatory drug from the oxicam group. It has anti-inflammatory, analgesic and antipyretic effects.
The mechanism of action is associated with inhibition of prostaglandin synthesis due to inhibition of cyclooxygenase activity.
Relieves pain syndrome. Reduces or relieves inflammation and pain in joints at rest and during movement, reduces morning stiffness and swelling of the joints, increases range of motion.
The analgesic effect occurs within 30 minutes after taking the drug inside. The anti-inflammatory effect appears by the end of the first week of treatment. After a single dose, the action lasts for 24 hours.
Pharmacokinetics
Suction
After oral administration, piroxicam is well absorbed from the gastrointestinal tract. C max in is achieved within 3-5 hours.
Distribution
Plasma protein binding is 98%. V d - 0.12-0.14 l / kg.
Metabolism
It is metabolized in the liver by hydrolysis and conjugation.
Withdrawal
It is excreted from the body mainly in the urine (2/3 of the dose taken) and in small quantities in the feces. T 1/2 is about 36-45 hours.
Indications
- joint diseases: chronic polyarthritis, ankylosing spondylitis, Reiter's syndrome, psoriatic arthritis, arthrosis (coxarthrosis, gonarthrosis, spondyloarthrosis and polyarthrosis);
- Diseases of soft tissues: periarthritis, bursitis, tendinitis;
- cervicobrachial syndrome, lumbago, sciatica;
- pain after surgical, orthopedic, gynecological, dental interventions;
- post-traumatic conditions (pain syndrome during sprains, dislocations, fractures);
-gout;
- dysmenorrhea, adnexitis, cystitis.
Contraindications
—Indications in the history of bronchial asthma, urticaria, acute rhinitis associated with taking other NSAIDs;
- peptic ulcer of the stomach and duodenum in the acute phase;
- disturbances in the picture of peripheral blood of unknown origin (including in the anamnesis);
- Severe liver and kidney dysfunctions;
-pregnancy;
- lactation period;
- children and adolescents up to 15 years old;
- Increased sensitivity to piroxicam.
Dosage
The drug is prescribed in a daily dose of 20 mg. Take 1 time / day or divide into 2 doses.
With severe clinical symptoms, the daily dose can be briefly increased to 40 mg.
The capsules are taken orally with meals.
Side effects
From the digestive system: often - heartburn, nausea, vomiting, diarrhea, erosive and ulcerative lesions of the gastrointestinal tract with possible bleeding and perforations (the frequency of these disorders increases with an increase in the daily dose of the drug).
From the side of the central nervous system: dizziness, drowsiness, disorientation.
Allergic reactions: itching, urticaria.
Dermatological reactions: photosensitivity.
From the hematopoietic system: rarely - anemia, granulocytopenia.
From the urinary system: rarely - renal dysfunction.
Overdose
Symptoms: nausea, vomiting (bloody at high doses), melena, less-like phenomena, tinnitus, clonic and tonic convulsions, coma, hemorrhagic diathesis, agranulocytosis, aplastic anemia, petechial or bullous rash, urticaria, measles or typhoid-like rash; in predisposed patients - toxic-allergic shock.
Treatment: carried out according to generally accepted principles of clinical toxicology.
Drug interactions
With the simultaneous use of Piroxicam with oral, sulfonamides, nalidixic acid, oral hypoglycemic drugs, triiodothyronine, cyclophosphamide, their concentration in blood plasma may increase.
With simultaneous use with other NSAIDs, GCS increases the risk of allergic reactions and side effects from the gastrointestinal tract.
With the simultaneous use of Piroxicam, it can weaken the effect of diuretics and antihypertensive drugs.
With the simultaneous use of lithium preparations with Piroxicam, an increase in the lithium content in the blood plasma is possible.
special instructions
WITH special care the drug should be prescribed to patients with gastrointestinal diseases (ulcerative colitis, Crohn's disease) in history, arterial hypertension, chronic heart failure, infectious diseases, as well as elderly patients.
WITH caution and only under the supervision of a physician, the drug is prescribed to patients with bronchial asthma, allergic rhinitis, nasal polyposis, chronic obstructive respiratory diseases.
During the period of taking the drug, you should avoid the simultaneous intake of alcohol.
Influence on the ability to drive vehicles and control mechanisms
During the period of taking the drug, you should not perform work that requires increased attention and speed of psychomotor reactions.
Pregnancy and lactation
Piroxicam is contraindicated for use during pregnancy and lactation.