Generic Name  : Piroxicam.

Trade Name      : Feldene.

Drug Class        : NSAIDs.

Source               : Enolic Acid (Oxicams) Derivatives.

Classification    : Non-Selective COX Inhibitors.

Forms of The Drug

  1. Oral Tablets/Capsules: 10mg, 20mg.
  2. Topical Gel/Cream.
  3. Injectable Solution: Via intramuscular (IM) or intravenous (IV) injection.

Mechanism of Action

Piroxicam acts as a non-selective inhibitor of both COX-1 and COX-2 enzymes, although it exhibits greater selectivity towards COX-1 at lower doses. By inhibiting COX enzymes, piroxicam interferes with the synthesis of prostaglandins, which are lipid mediators involved in pain, inflammation, and fever. The primary mechanism by which piroxicam exerts its anti-inflammatory effects is through the inhibition of prostaglandin synthesis. Prostaglandins are produced from arachidonic acid, which is released from cell membranes upon tissue damage or inflammation. COX enzymes catalyze the conversion of arachidonic acid into prostaglandin H2, which is further converted into various prostaglandins involved in the inflammatory response. Piroxicam inhibits COX enzymes by binding reversibly to their active sites. By blocking COX activity, piroxicam reduces the production of prostaglandins, thereby diminishing pain, inflammation, and fever associated with various conditions.

Indications

  1. Arthritis.
  2. Musculoskeletal disorders such as sprains, strains, bursitis, tendonitis, and gouty arthritis.
  3. Acute pain such as postoperative pain, dental pain, or pain resulting from minor injuries.
  4. Dysmenorrhea.
  5. Migraine.

Contraindications

  1. Hypersensitivity.
  2. Asthma, nasal polyps, and aspirin sensitivity.
  3. Active peptic ulcer or gastrointestinal bleeding.
  4. Severe heart failure.
  5. Severe renal impairment.
  6. Pregnancy and lactation.

Side Effects

  1. Edema
  2. Anorexia
  3. Abdominal pain
  4. Constipation
  5. Diarrhea
  6. Flatulence
  7. Nausea
  8. Vomiting
  9. Dizziness
  10. Headache
  11. Vertigo
  12. Pruritus
  13. Rash
  14. Tinnitus

Drug Interaction:

Other drugs that can interact with it.

  1. Other NSAIDs such as aspirin, ibuprofen, or naproxen.
  2. Anticoagulants and antiplatelet drugs such as warfarin or heparin, as well as antiplatelet drugs like clopidogrel.
  3. Diuretics such as furosemide and hydrochlorothiazide.
  4. ACE Inhibitors and angiotensin receptor blockers (ARBs).
  5. Lithium.
  6. Methotrexate.
  7. Corticosteroids.

Precautions

  1. Pregnancy: Category C
  2. Lactation: Piroxicam is excreted into breast milk, and its use during lactation is generally not recommended.

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