පිරොක්සිකාම්

පිරොක්සිකාම්

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

Piroxicam Tablet Uses

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

Additionally, Piroxicam finds applications in managing:

• Joint pain and swelling in gouty arthritis
• ඇන්කයිසෝසින් ස්පොන්සිිලයිටිස්
• Muscle pain and swelling
• ඔසප් වේදනාව
• 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:

• ඉදිමීම
• Bloody or black, tarry stools
• Burning upper stomach pain
• වලාකුළු සහිත මුත්රා
• මලබද්ධය
• මුත්රා පිටවීම අඩු වීම
• හිසරදය
• හෘද වස්තුව
• ධමනි
• Itching skin or rash
• ආහාර රුචිය නැතිවීම
• වමනය හෝ වමනය
• සුදුමැලි සම
• Severe stomach pain, cramping, or burning
• Severe and continuing nausea
• Swelling of the face, fingers, feet, or lower legs
• ආශ්වාස ප්රශ්වාස
• අසාමාන්ය ලේ ගැලීම හෝ තැලීම්
• අසාමාන්ය වෙහෙස හෝ දුර්වලකම
• Vomiting of blood or particles that look like coffee grounds
•  බර වෙනස් වේ

පූර්වාරක්ෂාව

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 ආඝාතය, 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, අක්මාව 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 ඇදුම, 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.

ක්රියාවලියේ යාන්ත්රණය

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 ලියුකෝසයිට් (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 ඔස්ටියෝ ආතරයිටිස්.

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.

නිතර අසනු ලබන ප්රශ්න

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 දැවිල්ල.

2. Who should not use Piroxicam?

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

• මෑත හෘදයාබාධ
• ගර්භණී ආබාධ
• ඉතිහාසය ආමාශයේ වණ හෝ ලේ ගැලීම
• Liver disease, as Piroxicam can cause liver damage (hepatotoxicity)
• Advanced or severe kidney disease
• Asthma triggered by aspirin
• ගර්භනී කාලය සහ මව්කිරි දීම
• වැඩිහිටි රෝගීන්

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 රූමටික ආතරයිටිස්, osteoarthritis, and other inflammatory disorders.

4. Is piroxicam stronger than diclofenac?

Piroxicam සහ diclofenac යන දෙකම වේදනා සහන සහ දැවිල්ල අඩු කිරීම සඳහා ප්‍රබල NSAID වේ. ඒවා දෙකම ඵලදායී වුවද, ඒවායේ සාපේක්ෂ ශක්තිය සහ විභවය වෙනස් විය හැකි අතර නිශ්චිත තත්ත්වය සහ තනි රෝගියාගේ සාධක මත රඳා පවතී. සාමාන්‍යයෙන්, වේදනා සහන සහ ප්‍රති-ගිනි අවුලුවන බලපෑම් සඳහා diclofenac Piroxicam වලට වඩා තරමක් බලවත් වේ. 

5. Is Piroxicam good for kidney pain?

වකුගඩු වේදනාව හෝ වකුගඩු ආශ්‍රිත තත්වයන්ට ප්‍රතිකාර කිරීම සඳහා වෛද්‍යවරු සාමාන්‍යයෙන් Piroxicam නිර්දේශ නොකරති. Piroxicam සහ අනෙකුත් ස්ටෙරොයිඩ් නොවන ප්‍රති-ගිනි අවුලුවන ඖෂධ (NSAIDs) විශේෂයෙන් දිගු කාලීන හෝ ඉහළ මාත්‍රාවක් භාවිතා කිරීමෙන් වකුගඩු වලට හානි සිදුවිය හැකිය.

6. Is Piroxicam harmful to the liver?

ඔව්, පිරොක්සිකැම් අක්මාවට හානිකර විය හැකි නමුත්, අනෙකුත් සමහර ස්ටෙරොයිඩ් නොවන ප්‍රති-ගිනි අවුලුවන ඖෂධ (NSAIDs) හා සසඳන විට අක්මාවට හානි වීමේ හැකියාව සාපේක්ෂව අඩුය. අනෙකුත් NSAIDs මෙන්, පිරොක්සිකැම් ද ඖෂධ-ප්‍රේරිත අක්මා තුවාල (DILI) සමඟ සම්බන්ධ වී ඇති අතර, එය මෘදු අක්මා එන්සයිම ඉහළ යාමේ සිට දරුණු අක්මා හානි හෝ අක්මාව අසමත් වීම දක්වා පරාසයක පැවතිය හැකිය.