Piroxicam

Description

What is Piroxicam?

Piroxicam is a nonsteroidal oxicam derivative with anti-inflammatory, antipyretic and analgesic properties. As a non-selective, nonsteroidal anti-inflammatory drug (NSAID), piroxicam binds and chelates both isoforms of cyclooxygenases (COX1 and COX2), thereby stalling phospholipase A2 activity and conversion of arachidonic acid into prostaglandin precursors at the rate limiting cyclooxygenase enzyme step. This results in inhibition of prostaglandin biosynthesis. As a second, independent effect, piroxicam inhibits the activation of neutrophils thereby contributing to its overall anti-inflammatory effects.

Piroxicam is indicated for the treatment of rheumatoid arthritis and osteoarthritis. Piroxicam is a nonspecific COX inhibitor that has a much higher affinity for COX-1 than COX-2. This may account for the large proportion (over 30%) of patients receiving long-term therapy who have reported side effects.Adverse GI reactions have been the most frequently reported side effect, but edema, dizziness, headache, rash, and changes in hematological parameters have also occurred in 1 to 6% of patients. Piroxicam can cause serious GI bleeding, ulceration, and perforation, particularly in the elderly, if the recommended dosage is exceeded or if aspirin is being taken concurrently.

Drug-related effects of piroxicam

1 When drinking alcohol or taking with other anti-inflammatory drugs, gastrointestinal adverse reactions increase;

2 When used together with anticoagulants such as dicoumarin, the latter has an enhanced effect and a significant bleeding tendency, so the dosage should be adjusted;

3 When used with aspirin, the blood concentration of this product can be reduced to 80% of the general concentration, and the risk of gastrointestinal ulcer formation and bleeding tendency increases.

Side effects of piroxicam

1.The most common gastrointestinal adverse reactions such as nausea, stomach pain, reduced appetite and indigestion, 3.5% of which require withdrawal for this purpose. The incidence of gastric ulcer is significantly increased when the dosage of the drug is greater than 20 mg per day, and some are combined with bleeding or even perforation;

2.Neutropenia, eosinophilia, increased blood urea nitrogen, dizziness, dizziness, tinnitus, headache, general weakness, edema, rash or itching, etc.;

3.Abnormal liver function, thrombocytopenia, hyperhidrosis, skin ecchymosis, peeling, erythema multiforme, toxic epithelial necrosis, bullous erythema multiforme (Stevens-Johnson syndrome), skin allergic reaction to light, blurred vision, Red and swollen eyes, high blood pressure, hematuria, hypoglycemia, depression, insomnia and mental stress.