Piroxicam

Piroxicam is a non-steroidal anti-inflammatory drug (NSAID).

It has anti-inflammatory, analgesic, antipyretic and antiplatelet properties, as well as the ability to indiscriminately inhibit COX-1 and COX-2 (cyclooxygenase 1 and 2).

The drug is useful for the symptomatic treatment of inflammatory and degenerative diseases musculoskeletal system, soft tissue and spinal injuries, as well as some systemic diseases.

Clinical and pharmacological group

NSAIDs.

Conditions of leave from pharmacies

Released without a doctor's prescription.

Price list

How much does Piroxicam in pharmacies cost? The average price is at the level of70 rubles.

Form of issue and composition

Piroxicam is produced in the form of capsules with a dosage of active substance of 20 and 40 mg. Also, the preparation is in the form of a gel intended for external use in tubes of 30 and 50 g.

The main active substance of the drug is piroxicam, its content in one capsule is 10 or 20 mg.

In one gram of gel Piroxicam contains 0.5 g of the same substance. Additional components: ethanol 95%, carbomer, methyl parahydroxybenzoate, trolamine, propylene glycol, water.

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The Piroxicam tablet contains 20 mg of the active ingredient.

Pharmacological effect

The use of Pyroxicam has a complex effect on the body:

reduces pain after surgery and during recovery from injury;
reduces discomfort in algodismenorrhea;
reduces puffiness near the affected joint or vertebra;
Cures inflammation;
reduces pain syndrome in rheumatic and orthopedic pathologies;
reduces the local temperature in the lesion;
suppresses fever and febrile syndrome in inflammatory processes;
improves the mobility of joints after the disappearance of inflammation and swelling;
prevents the release of substances that cause an increase in pathological processes against the background of infectious and rheumatic pathologies of the joints, spine.

The active component of the drug Piroxicam is rapidly absorbed, the maximum concentration is noted after three to five hours. Binding to plasma proteins reaches 98%. Metabolism of piroxicam occurs in the liver, the greatest amount of metabolites is excreted in the urine.

Indications for use

What helps? Indications for the appointment of Pyroxicam are the following diseases and conditions:

Gout.
Lumbago, cervico-brachial syndrome, sciatica.
Cystitis, adnexitis, dysmenorrhea (in patients older than 12 years).
Diseases of soft tissues: tendinitis, bursitis, periarthritis.
Post-traumatic conditions (pain syndrome with fractures, dislocations, distension).
Pain after orthopedic, surgical, dental, gynecological interventions.
Diseases of the joints: ankylosing spondylitis, chronic polyarthritis, osteoarthritis, rheumatoid arthritis, Reiter's syndrome, Bechterew's disease, arthrosis (gonarthrosis, coxarthrosis, polyarthrosis and spondylarthrosis), psoriatic polyarthritis.

For tablets and gel in addition: acute infectious and inflammatory diseases of the upper respiratory tract, myalgia, neuralgia, pain in the spine.

Contraindications

Absolute (general):

III trimester of pregnancy;
Lactation period (breastfeeding);
Children and adolescence (for tablets, capsules, suppositories - up to 18 years, for the gel - up to 14 years);
Complete or partial combination of recurrent polyposis of nose and paranasal sinuses, bronchial asthma and anaphylactoid sensitivity to acetylsalicylic acid or other NSAIDs (including data in the anamnesis);
Severe impairment of renal function (CC (creatinine clearance) ≤ 30 mL / min);
Hypersensitivity to piroxicam and auxiliary components of the drug, as well as to acetylsalicylic acid and other NSAIDs.

Absolute (additionally for tablets, capsules, suppositories):

Bleeding, including cerebrovascular;
Decompensated stage of hepatic insufficiency or liver disease in the active phase;
Uncompensated heart failure;
Postoperative period after aortocoronary bypass surgery;
Erosive-ulcer pathologies of the gastric mucosa or duodenum, gastrointestinal bleeding in the active phase;
Inflammation of the intestine (ulcerative colitis, Crohn's disease);
Severe and chronic renal failure (CK ≤ 30 mL / min).

With caution, in view of the increased risk of negative side effects, Piroxicam is used for: coronary heart disease, cerebrovascular disease, congestive heart failure, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial diseases, smoking, frequent use of alcohol, prolonged use of NSAIDs, severe somatic diseases, KK ≤ 60 ml / min, data availability in the history of gastrointestinal ulcer pathologies, Helicobacter pylori infection and in old age. Also, care should be taken in the case of concomitant anticoagulant therapy (warfarin), antiaggregants (clopidogrel, acetylsalicylic acid), oral glucocorticosteroids (prednisolone), selective serotonin reuptake inhibitors (fluoxetine, paroxetine, citalopram, sertraline).

Use in pregnancy and lactation

Piroxicam is contraindicated for use in the 3rd trimester of pregnancy.

If it is necessary to apply in the first and second trimesters of pregnancy, the prospective benefit for the mother should be correlated with the potential risk for the fetus, due to the lack of reliable clinical data confirming the safety of piroxicam application in this period. Under the influence of NSAIDs, premature closure of the botulinum duct in the fetus is possible.

Piroxicam is excreted in breast milk. If it is necessary to use during the lactation period, the question of stopping breastfeeding should be solved.

Dosage and route of administration

Pills
Piroxicam is taken orally by squeezing a large amount of fluid, preferably during or after a meal.

Recommended dosage regimen (daily dose):

Rheumatoid arthritis, osteoarthritis, spondylitis: 20 mg;
Acute diseases of the musculoskeletal system: the first 2 days - 40 mg, then for 7-14 days - 20 mg;
Acute attack of gout: 40 mg, duration of the course - 5-7 days.

Film-coated tablets
Piroxicam is taken orally, preferably during meals.

The scheme of application is determined by the doctor individually.

Recommended dosage regimen (daily dose):

Diseases of the musculoskeletal system: the first 2 days - 40 mg (once or several times), maintaining a dose of 20 mg;
Rheumatoid arthritis, deforming osteoarthritis, ankylosing spondylitis: initial and maintenance dose is 20 mg (sometimes for maintenance therapy is sufficient 10 mg, in exceptional cases, it is possible to increase the dose to 30 mg once or in divided doses);
Pains of postoperative and post-traumatic etiology: initial dose - 20 mg (sometimes - 40 times or in divided doses); maximum - 40 mg per day.

Capsules
Piroxicam is taken internally.

Recommended dosage regimen (daily dose):

Acute diseases of skeletal musculature: the first 2 days - 40 mg in 1 or several doses, then for 7-10 days - 20 mg;
Rheumatoid arthritis, osteoarthritis and Bechterew's disease: 10-30 mg per 1 reception, long;
Algodismenorea: the first 2 days (when the first symptoms appear) - 40 mg in 1 or 2 doses, then for 1-3 days - 20 mg;
Gout attacks: the first 2 days - 40 mg once, then for 4-6 days at 40 mg in 1 or 2 doses;
Juvenile rheumatoid arthritis: children from 14 years old with a body weight of 46 kg - 20 mg.

Gel
The gel should be applied to skin areas in the area of pain. The dose is determined by the size of the site (on the average - a column 3 cm long). Piroxicam should be evenly distributed and rubbed into the skin.

Multiplicity of application - 3-4 times a day.

Suppositories
Piroxicam in suppositories is applied rectally.

The drug is prescribed at 20 mg per day (1 suppository of 20 mg or with a break of 12 hours 2 suppositories of 10 mg).

At attacks of a gout - every 12 hours on 1 suppository 20 mg.

Side effects

Side effects develop with prolonged use of Piroxicam, as well as when it is taken in large doses. The most frequent side effects are the effects of the digestive system. Often there is nausea, sometimes vomiting, epigastric pain, diarrhea. When there is a gastric bleeding drug is canceled.

The following symptoms may occur:

itching;
impaired vision;
angioedema;
manifestations of vasculitis;
headache;
insomnia;
swelling of the legs;
cutaneous manifestations in the form of urticaria;
bronchospasm.

Also, the appearance of such side effects:

On the part of the hematopoiesis system, anemia is observed, mainly leukopenia and a decrease in platelet aggregation.
From the side of the cardiovascular system, fluctuations in blood pressure, palpitations, and dyspnea are noted.
On the part of the hepatobiliary system, functional disorders and an increase in the level of liver transaminases can occur.

When rectal suppositories are used, irritation of the rectal mucosa, bleeding, bloody stools can occur.

With external application often itching, redness of the skin, manifestations of local dermatitis symptoms.

It must be remembered that the incidence of side effects directly depends on the level of the daily dose of the drug.

Overdose

Symptoms: drowsiness, visual impairment, when using large doses, loss of consciousness is possible.

Symptomatic treatment is performed. Piroxicam can not be evacuated from the body by hemodialysis.

special instructions

Before you start using the drug, read the special instructions:

During the period of taking the drug, simultaneous intake of alcohol should be avoided.
During the period of taking the drug, one should not perform work requiring increased attention and speed of psychomotor reactions.
With caution and only under the supervision of a doctor, the drug is prescribed for patients with bronchial asthma, allergic rhinitis, polyposis of the nose, chronic obstructive airways diseases.
With special caution should prescribe the drug to patients with gastrointestinal diseases (ulcerative colitis, Crohn's disease) in history, arterial hypertension, chronic heart failure, infectious diseases, and elderly patients.

Drug Interactions

When using the drug, it is necessary to take into account the interaction with other drugs:

With the simultaneous use of Piroxicam can weaken the action of diuretics and antihypertensive agents.
With the simultaneous use of lithium drugs with Pyroxicam, an increase in the lithium content in blood plasma is possible.
With simultaneous use with other NSAIDs, SCS increases the risk of allergic reactions and side effects from the gastrointestinal tract.
With the simultaneous use of Piroxicam with oral anticoagulants, sulfonamides, nalidixic acid, oral hypoglycemic drugs, triiodothyronine, cyclophosphamide may increase their concentration in the blood plasma.

Reviews

We picked up some reviews of people who used Piroxicam tablets:

Margarita. I am often concerned about pain in the lumbar region, especially during the session, when you rarely get up from the table. I'm saved from unpleasant sensations with the help of Pyroxicam. I use a gel, rubbing according to the instructions with a small amount of the lower back. It helps very well, although the price of the drug is low. Pain is literally a day.
Sasha. Used according to the instructions for the treatment of pain in the leg. He was so strong that I could not even walk. One tablet was enough for 24 hours. The drug is inexpensive, copes well with the task of anesthesia in a short time. No side effects were observed in a few days of admission.
Artem. I take Piroxicam 20 mg once a day for several years, mainly due to pain in my knees and as a general anti-inflammatory drug. I so accept, in the morning with a breakfast. The drug works very well for me, without side effects. I am very careful, I always take it with food and milk, and I use enzymes for the liver.

Analogues

Pharmacy networks receive a lot of drugs-synonyms of Pyroxicam. The substitute and the optimal dosage form is determined by a rheumatologist or vertebrologist. It is important to take into account the age of the patient: many types of non-steroid indiscriminate compounds are not suitable for children.

Effective preparations: