Piroxicam
- Atc Codes:M01AC01#M02AA07#S01BC06
- CAS Codes:36322-90-4
- PHARMGKB ID:36322-90-4
Table of contents
- Brand Names
- Drug Combinations
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Caution and personalized dose adjustment in patients with the following genotypes
- Other genes that may be involved
- Substrate of
- Inhibits
- Drug Interactions
- Nutrition/Nutraceutical Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Felden, Pirocam, Piroxistad; Belgium: Brexine, Docpiroxi, Feldene, Piromed, Piroxicam, Polydene, Solicam; Bulgaria: Feldene, Finalgel, Flamexin, Hotemin, Piroxicam, Reumador; Cyprus: Brexin, Feldene, Piroxim, Roxicam, Sotilen, Unicam; Czech Republic: Flamexin, Hotemin, Piroxicam; Denmark: Pirom, Piroxicam; Estonia: Brexin; Finland: Felden, Piroxin; France: Brexin, Cycladol, Feldene, Flexirox, Geldene, Piroxicam, Proxalyoc, Zofora; Germany: Brexidol, Fasax, Felden, Feldene, Flexase, Jenapirox, Mobilat akut Piroxicam, Mtefel, Piro, Pirobeta, Pirocutan, Piroflam, Pirowieb, Pirox, Piroxicam; Greece: Bleduran, Calmopyrol, Conzila, Euredes, Felcam, Feldene, Fidinor, Flodeneu, Flostigrel, Grecotens, Inflamase-N, Neo Axedil, Nilvo, Oximezin, Painrelipt-D, Pedifan, Piroxicam, Proponol, Pyrcost, Reumaplus, Ruvamed, Santafort, Valopon, Viapred, Zerospasm, Zitumex; Ireland: Feldene; Italy: Antiflog, Artroxicam, Brexidol, Brexin, Brexivel, Bruxicam, Cicladol, Clevian, Feldene, Flodol, Ipsoflog, Kinski, Lampoflex, Lenotac, Pirobec, Piroftal, Piroxicam, Reumagil, Roxiden, Sinartrol; Luxembourg: Brexine, Feldene, Piroxicam, Polydene; Netherlands: Brexine, Piroxicam; Poland: Brexin, Feldene, Flamexin, Hotemin, Piroxicam; Portugal: Brexin, Feldene, Flexar, Flogocan, Piroxicam, Remisil, Reumoxican, Roxazin; Romania: Bruxicam, Feldene, Finalgel, Flamexin, Hotemin, Piroxicam, Piroxsal; Slovakia: Hotemin; Spain: Feldene, Improntal, Piroxicam, Salvacam; Sweden: Brexidol, Piroxicam; UK: Feldene, Piroxicam.
North America
Canada: Pirocam, Pirox, Piroxicam; USA: Feldene, Piroxicam.
Latin America
Argentina: Benisán, Brionot, Maxtol, Micar, Nac, Piroxicam, Samaruc, Solocalm, Tirovel, Trixicam; Brazil: Anflene, Feldanax, Feldene, Flamostat, Floxicam, Inflamene, Inflanán, Inflax, Pirogreen, Piroxene, Piroxicam, Piroxifar, Piroxil, Piroxín, Piroxinid, Prodoxidil; Mexico: Arlexicam, Artyflam, Axtrim, Bapixied, Bioximil, Brexicam, Brexodín, Brucam, Campirex, Citokén, Dixonal, Dolzycam, Facicam, Feldene, Glandicín, Osteral, Oxicanol, Oxi-Reul, Pirodax, Piroxicam, Reucam, Reutricam, Ripox, Serpicam, Tripirol, Vatrem.
Asia
Japan: Alvilack, Amtenen, Arudein, Baxo, Bonbicol, Boues, Drafton, Feldene, Kimetazin, Kyowacalm, Kyumate, Lumeleem, Palpasin, Pioparu, Pipethanen, Pirokiparl, Veries.
Drug combinations
Piroxicam and Ascorbic Acid (Vitamin C)
Piroxicam and Carisoprodol
Piroxicam and Cyanocobalamin (Vitamin B~12~)
Piroxicam, Carisoprodol, and Dexamethasone
Piroxicam, Carisoprodol, and Dipyrone
Piroxicam, Carisoprodol, Dexamethasone, Hydroxocobalamin (Vitamin B~12a~), and Pyridoxine (Vitamin B~6~)
Chemistry
Piroxicam: C~15~H~13~N~3~O~4~S. Mw: 331.35. 2H-1,2-Benzothiazine-3-carboxamide, 4-hydroxy-2-methyl-N-2-pyridinyl-, 1,1-dioxide. CAS-36322-90-4 (1974).
Pharmacologic Category
Other Nonsteroidal Anti-inflammatory Agents. (ATC-Code: M01AC01; M02AA07; S01BC06).
Mechanism of action
Reversibly inhibits cyclooxygenase-1 and 2 (COX-1/PTGS1 and COX-2/PTGS2) enzymes, which result in decreased formation of prostaglandin precursors. Has antipyretic, analgesic, and anti-inflammatory properties.
Therapeutic use
Symptomatic treatment of acute and chronic rheumatoid arthritis and osteoarthritis.
Pregnancy and lactiation implications
Avoid use in 3^rd^ trimester due to possible premature closure of ductus arteriosus. Enters breast milk (small amounts).
Unlabeled use
Ankylosing spondylitis.
Contraindications
Hypersensitivity to piroxicam, aspirin, other NSAIDs or any component of the formulation. Perioperative pain in setting of coronary artery bypass graft surgery.
Warnings and precautions
Even without prior exposure, anaphylactoid reactions may occur (do not use in asthma, bronchospasm, rhinitis, or urticaria with NSAID or aspirin therapy). Platelet adhesion and aggregation may be decreased (may prolong bleeding time). Anemia may occur. NSAIDs associated with increased risk of adverse cardiovascular thrombotic events, including MI, stroke, and new onset or worsening of pre-existing hypertension (use caution with fluid retention, heart failure, or hypertension). NSAIDs may increase risk of GI irritation, inflammation, ulceration, bleeding, and perforation (use caution with history of GI disease (bleeding or ulcers), concurrent therapy with aspirin, anticoagulants and/or corticosteroids, smoking, use of alcohol, elderly or debilitated patients). When used concomitantly with ≤325 mg of aspirin, substantial increase in risk of GI complications (e.g. ulcer) occurs. Serum sickness-like reaction (arthralgias, pruritus, fever, fatigue, and rash) can rarely occur. NSAIDs may cause serious skin adverse events including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Do not administer to patients with aspirin-sensitive asthma (severe bronchospasm may occur). Use caution in other forms of asthma. Use contraindicated for treatment of perioperative pain in setting of coronary artery bypass graft surgery. Risk of MI and stroke may be increased with use following coronary artery bypass graft surgery. Use with caution in decreased hepatic function. Severe hepatic reactions (e.g. fulminant hepatitis, liver failure) occurred with NSAID use, rarely. NSAID use may compromise existing renal function (patients with impaired renal function, dehydration, heart failure, liver dysfunction, those taking diuretics, and ACEIs, and the elderly are at greater risk of renal toxicity). Not recommended for use in advanced renal disease. Long-term NSAID use may result in renal papillary necrosis. The elderly are at increased risk for adverse effects (especially peptic ulceration, CNS effects, renal toxicity) from NSAIDs even at low doses. Withhold prior to surgical or dental procedures.