Piroxicam

Piroxicam

Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) belonging to the oxicam class. It prevents the production of endogenous prostaglandins, which mediate pain, kekakuan, tenderness, and pembengkakan.

Piroxicam Tablet Uses

Piroxicam tablets are primarily used to treat the pain, joint swelling, tenderness, and stiffness caused by osteoarthritis and rheumatoid radang sendi. These conditions involve peradangan atau pembengkakan and breakdown of the joints, leading to discomfort and reduced mobility.

Additionally, Piroxicam finds applications in managing:

• Joint pain and swelling in gouty arthritis
• Ankylosing spondylitis
• Muscle pain and swelling
• Nyeri haid
• Post-surgical or post-childbirth pain

How to Use Piroxicam

Piroxicam comes in capsules or tablets and can be taken orally. It is typically taken once or twice a day, depending on the prescribed dosage. You should follow the following guidelines for safe and effective use:

• Dosage Instructions: Follow the directions on your prescription label carefully, and take Piroxicam precisely as your doctor directs. 
• Timing and Duration: Take Piroxicam around the same time(s) daily to maintain consistent levels of the medication in your body. Use Piroxicam for the shortest duration possible, as recommended by your doctor, based on your individual treatment goals.

Side Effects of piroxicam tablet

Like any other medication, Piroxicam can also cause side effects. The side effects of Piroxicam can range from mild to severe, such as:

• Kembung
• Bloody or black, tarry stools
• Burning upper stomach pain
• Urine keruh
• Sembelit
• Penurunan output urin
• Sakit kepala
• mulas
• Gangguan pencernaan
• Itching skin or rash
• Kehilangan selera makan
• Mual atau muntah
• Kulit pucat
• Severe stomach pain, cramping, or burning
• Severe and continuing nausea
• Swelling of the face, fingers, feet, or lower legs
• Kesulitan bernafas
• Pendarahan yang tidak biasa atau memar
• Keletihan atau kelemahan yang tidak biasa
• Vomiting of blood or particles that look like coffee grounds
•  Perubahan berat badan

Kewaspadaan

When taking Piroxicam, it is crucial to follow certain precautions to minimise the risk of adverse effects and ensure safe and effective use. Here are some important considerations:

• Cardiovascular Risk: Nonsteroidal anti-inflammatory drugs (NSAIDs) like Piroxicam may increase the risk of serious cardiovascular thrombotic events, congestive heart failure (CHF), heart attack (myocardial infarction), and pukulan, which can be fatal. This risk may increase with prolonged use. Patients with existing cardiovascular disease (CVDs) may be at greater risk. 
• Gastrointestinal Risk: Piroxicam and other NSAIDs increase the risk of serious gastrointestinal (GI) adverse events, including but not limited to bleeding, ulceration, and perforation of the stomach or intestines, which can be life-threatening. 
• Kidney Disease Risk: Long-term administration of NSAIDs like Piroxicam may cause kidney problems especially in high-risk patients, such as older adults, those with impaired kidney function, hypovolemia, heart failure, hati dysfunction, salt depletion & individuals taking diuretics, ACE inhibitors, or ARBs.
• Skin Conditions: NSAIDs, including Piroxicam, can cause severe skin adverse events such as Stevens-Johnson Syndrome (SJS), exfoliative dermatitis & toxic epidermal necrolysis (TEN), which can be life-threatening.
• Risk of Other Medical Conditions: Piroxicam may increase the risk of asma, hepatic impairment, high blood pressure (hypertension), and renal impairment. Doctors generally do not recommend Piroxicam for patients who have experienced aspirin anaphylactoid reactions. NSAIDs like Piroxicam may cause anaemia and prolong bleeding time, so monitoring is necessary.
• Pregnancy and Lactation: Piroxicam should be used with caution during the first & second trimesters of pregnancy if the benefits outweigh the risks, as animal studies show potential risks and human studies are lacking. During the third trimester, Piroxicam should only be used in life-threatening emergencies when no safer alternative is available, as it may cause premature closure of the ductus arteriosus, posing a risk to the foetus.

How Piroxicam Works

Piroxicam works by reducing the blood levels of hormones responsible for inflammation and pain in the body. The anti-inflammatory effect of piroxicam develops from the reversible inhibition of cyclooxygenase, an enzyme involved in the production of prostaglandins.

Mekanisme aksi

Prostaglandins are hormone-like substances produced by an enzyme called cyclooxygenase-1 (COX-1). Piroxicam blocks the COX-1 enzyme, disrupting the production of prostaglandins. This inhibition of prostaglandin synthesis reduces inflammation and pain.

Additionally, Piroxicam inhibits the migration of leukosit (white blood cells) into sites of inflammation and prevents the formation of thromboxane A2, an aggregating agent produced by platelets. By targeting these pathways, Piroxicam effectively reduces inflammation, pain & swelling associated with conditions like rheumatoid arthritis and osteoarthritis.

Can I Take Piroxicam with Other Medicines?

There are 386 drugs known to interact with Piroxicam; of the total drug interactions, 95 are major, 280 are moderate, and 11 are minor.
It is crucial to inform your doctor about any prescription or over-the-counter (OTC) medications, vitamins or minerals, herbal products, and supplements you are using before taking Piroxicam. Certain medications can interact with Piroxicam, potentially increasing the possibility of side effects or altering the effectiveness of the treatment.

Pertanyaan Umum (FAQ)

1. What is the difference between Piroxicam and diclofenac?

Piroxicam and diclofenac are both nonsteroidal anti-inflammatory drugs (NSAIDs), but they differ in their chemical structure and pharmacokinetics. Piroxicam has a longer half-life, allowing for once-daily dosing, while diclofenac typically requires more frequent dosing due to its shorter half-life. Both are used to treat pain and peradangan atau pembengkakan.

2. Who should not use Piroxicam?

Piroxicam should be avoided or used with caution in certain individuals, including:

• Serangan jantung baru-baru ini
• Gangguan pendarahan
• Sejarah radang perut atau berdarah
• Liver disease, as Piroxicam can cause liver damage (hepatotoxicity)
• Advanced or severe kidney disease
• Asthma triggered by aspirin
• Kehamilan dan menyusui
• Pasien lanjut usia

3. Is Piroxicam a strong painkiller?

Yes, Piroxicam is considered a strong painkiller. It is put under nonsteroidal anti-inflammatory drugs (NSAIDs) and is effective in relieving moderate to severe pain and inflammation associated with several conditions, like rheumatoid arthritis, osteoarthritis, and other inflammatory disorders.

4. Is piroxicam stronger than diclofenac?

Baik Piroksikam maupun diklofenak merupakan NSAID yang ampuh untuk meredakan nyeri dan mengurangi peradangan. Meskipun keduanya efektif, kekuatan dan potensi relatifnya dapat bervariasi dan bergantung pada kondisi spesifik dan faktor individu pasien. Secara umum, diklofenak sedikit lebih ampuh daripada Piroksikam dalam hal pereda nyeri dan efek antiinflamasi. 

5. Is Piroxicam good for kidney pain?

Dokter biasanya tidak merekomendasikan Piroxicam untuk mengobati nyeri ginjal atau kondisi terkait ginjal. Piroxicam dan obat antiinflamasi nonsteroid (NSAID) lainnya berpotensi menyebabkan kerusakan ginjal, terutama jika digunakan dalam jangka panjang atau dosis tinggi.

6. Is Piroxicam harmful to the liver?

Ya, Piroksikam berpotensi berbahaya bagi hati, meskipun kemungkinan kerusakan hati relatif rendah dibandingkan dengan beberapa obat antiinflamasi nonsteroid (NSAID) lainnya. Piroksikam, seperti NSAID lainnya, telah dikaitkan dengan kasus kerusakan hati akibat obat (DILI), yang dapat berkisar dari peningkatan enzim hati ringan hingga kerusakan hati berat atau bahkan gagal hati.