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, stiffness, tenderness, and swelling.

Piroxicam Tablet Uses

Piroxicam tablets are primarily used to treat the pain, joint swelling, tenderness, and stiffness caused by osteoarthritis and rheumatoid arthritis. These conditions involve inflammation 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
• Menstrual pain
• 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:

• Bloating
• Bloody or black, tarry stools
• Burning upper stomach pain
• Cloudy urine
• Constipation
• Decreased urine output
• Headache
• Heartburn
• Indigestion
• Itching skin or rash
• Loss of appetite
• Nausea or vomiting
• Pale skin
• Severe stomach pain, cramping, or burning
• Severe and continuing nausea
• Swelling of the face, fingers, feet, or lower legs
• Trouble breathing
• Unusual bleeding or bruising
• Unusual tiredness or weakness
• Vomiting of blood or particles that look like coffee grounds
•  Weight changes

Precautions

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 stroke, 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, liver 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 asthma, 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.

Mechanism of Action

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 leukocytes (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.

FAQs

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 inflammation.

2. Who should not use Piroxicam?

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

• Recent heart attack
• Bleeding disorders
• History of stomach ulcers or bleeding
• Liver disease, as Piroxicam can cause liver damage (hepatotoxicity)
• Advanced or severe kidney disease
• Asthma triggered by aspirin
• Pregnancy and breastfeeding
• Elderly patients

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?

Both Piroxicam and diclofenac are potent NSAIDs for pain relief and reducing inflammation. While they are both effective, their relative strength and potency can vary and depend on the specific condition and individual patient factors. In general, diclofenac is slightly more potent than Piroxicam for pain relief and anti-inflammatory effects. 

5. Is Piroxicam good for kidney pain?

Doctors typically do not recommend Piroxicam for treating kidney pain or kidney-related conditions. Piroxicam and other nonsteroidal anti-inflammatory drugs (NSAIDs) can potentially cause kidney damage, especially with long-term or high-dose use.

6. Is Piroxicam harmful to the liver?

Yes, Piroxicam can potentially be harmful to the liver, although the possibility of liver injury is relatively low compared to some other nonsteroidal anti-inflammatory drugs (NSAIDs). Piroxicam, like other NSAIDs, has been associated with cases of drug-induced liver injury (DILI), which can range from mild liver enzyme elevations to severe liver damage or even liver failure.