The article discusses the use of Piroxicam medication instructions for use, reviews and analogues. The drug belongs to the class of anti-inflammatory non-steroid medicines, antipyretic, analgesic and suppresses the occurrence of the inflammatory process of exposure.
Dosage Forms
According to the instructions for use, Piroxicam is produced in several pharmacological forms:
- Tablets (20 pieces each, packaged in blister packs one at a time in a cardboard box), which are coated with a special film coating. Instructions for use with Piroxicam tablets are available in each pack.
- Capsules - hard, gelatinous; dosage of 0.01 g with a white case and a blue cap (for a dosage of 0.01 g), and a cream case and an orange cap (for a dosage of 0.02 g). The creamy white powder is contained in capsules. Instructions for use with Piroxicam confirms this.
- Rectal suppositories are yellow-greenish in color, bullet-shaped - 5 pieces each in a blister pack, 2 blisters in a cardboard bundle.
- The gel for external use is 1% and 0.5% transparent, yellowish, with a smell of alcohol - 100, 50 and 30 g each in aluminum tubes in a cardboard box. People in pharmacies often ask for Piroxicam ointment. In the instructions for use, this form is not indicated.
- Solution for injection - in ampoules of 2 or 1 ml. Ampoules are made of tinted glass, packaged in 10 pieces in contour cells and in cardboard packaging.
Structure
The tablets contain the main substance piroxicam and additional components: disubstituted calcium phosphate, magnesium stearate, sodium lauryl sulfate, hydroxypropyl cellulose, starch.
Capsule composition: the main element is piroxicam and auxiliary: wheat starch, talc, microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, glycine. The capsule shell contains titanium dioxide, gelatin, indigo carmine, yellow iron oxide.
The composition of the suppository: the main element of piroxicam and additional: polyethylene oxide and polyethylene oxide.
The composition of the gel includes: the main substance piroxicam, additional components: triethanolamine, propylene glycol, ethyl alcohol, carbomer, methyl parahydroxybenzoate, water.
The composition of the solutions for injection includes the main substance piroxicam and purified water.
Pharmacological properties
According to the instructions for use, "Prixikam" is an NSAID from the group of oxycams. The mechanism of action is associated with the suppression of the COX enzyme, which causes inhibition of the synthesis of prostaglandins from arachidonic acid. The medication inhibits platelet aggregation, with systemic use it reduces pain.
During external use, it stops inflammation and pain in the joints at rest and in movement, eliminates their morning swelling and stiffness, and increases the range of motion.
An analgesic property is realized approximately 30 minutes after administration, anti-inflammatory effect - by the end of the first week of the therapeutic course. After a single application, the effect of the drug continues throughout the day.
Indications for appointment
In accordance with the instructions for use, Piroxicam in any form is intended for the symptomatic treatment of diseases of the musculoskeletal system:
- osteoarthritis;
- rheumatoid arthritis;
- spondylitis;
- gout
- sciatica;
- tenosynovitis;
- bursitis;
- neuralgia;
- myalgia;
- ankylosing spondylitis (ankylosing spondylitis);
- pain in the spine;
- soft tissue inflammation;
- post-traumatic pain and to eliminate pain in dysmenorrhea.
This medication reduces inflammation, but does not affect the course of the disease. Gels are used to relieve pain in injuries (bruising, sprain, dislocation, damage to muscles and ligaments), osteoarthritis, ankylosing spondylitis, juvenile arthritis, rheumatoid arthritis, tendonitis, shoulder-shoulder syndrome, tenosynovitis.
Indications for piroxicam tablets in the instructions for use are described in detail.
Contraindications
Absolute limitations for the use of this medical product are:
- a combination of recurrent polyposis of the paranasal sinuses and nose, anaphylactoid sensitivity to aspirin and bronchial asthma;
- severe renal impairment;
- third trimester pregnancy, lactation;
- adolescence and childhood (for tablets, suppositories and capsules - up to 18 years, for gels - up to 14 years);
- high sensitivity to piroxicam and additional components of the drug, as well as other NSAIDs;
- uncompensated heart failure;
- after coronary artery bypass grafting;
- erosive pathologies of the stomach or duodenum;
- intestinal inflammation (Crohn's disease);
- gastric or intestinal bleeding in the acute phase;
- cerebrovascular bleeding;
- liver failure.
This medication in the form of a gel is contraindicated for use in violation of the integrity of the skin. So it is said in the instructions for use with Piroxicam.
Careful reception
With extreme caution, due to the increased likelihood of negative side effects, the medication is prescribed in the following conditions:
- coronary artery disease;
- pathologies of cerebrovascular nature;
- heart failure with stagnation;
- dyslipidemia;
- diabetes;
- pathology of peripheral arteries;
- smoking;
- frequent drinking;
- prolonged use of NSAIDs;
- severe somatic diseases;
- Helicobacter pylori infection in the elderly.
In addition, certain care must be taken with concomitant treatment with anticoagulants (Warfarin), glucocorticosteroids (Prednisolone), antiplatelet agents (Clopidogrel), serotonin uptake inhibitors (Fluoxetine, Sertraline, Paroxetine).
Caution should be exercised during the application of the gel with other NSAIDs, with hepatic porphyria (in the acute stage), liver failure, erosive gastrointestinal lesions, kidney diseases, hyperkalemia, asthma, heart failure, blood clotting disorders and in old age.
Dosage regimen and method of application
The Piroxicam drug is not considered the first choice medicine due to safety conditions, therefore, its appointment should be carried out by a specialist with experience in the treatment of degenerative and inflammatory rheumatic pathologies.
With the simultaneous use of various forms of this drug (or other drugs based on piroxicam), its total dosage should not be higher than 0.04 g per day.
Tablets and capsules are intended for oral administration, they should be taken with food.
The duration of the therapeutic course and dosage of the medicine is determined by the attending physician. The recommended dosage regimen is as follows:
- In diseases of the musculoskeletal system (osteoarthritis, arthritis, spondylitis): 0.01-0.02 g in a single dose or in two doses.
- In acute pathologies of the bone and muscle apparatus: in the first two days - 0.04 g at, and subsequently for 2 weeks - 0.02 g.
- Acute gout attacks: 0.04 g per day for 3-5 days.
- With dysmenorrhea (from the first symptoms): two days at 0.04 g (once or in two doses), in the next three days - 0.02.
- In case of post-traumatic pain: initial dosage - 0.02 g per day; it is allowed to increase in the first two days to 0.04 g.
Dosage of other forms of the drug
In case of exceeding daily dosages, the likelihood of adverse reactions increases. The maximum dose per day is 0.04 g.
Suppositories of this medication are used rectally after an enema; Before use, it is recommended to moisten the candle in water. The recommended dose regimen is 1 suppository once a day. The duration of the course is determined by a specialist taking into account the severity and course of the disease, the achieved effect and treatment tactics.
It has been proven that the use of piroxicam increases the risk of gastric and intestinal complications, in this regard, it is necessary to weigh the need for complex therapy with gastroprotective medications ("Misoprostol"), especially in elderly patients.
According to the instructions for use, Piroxicam gel for external use must be applied to the painful area of the skin 3-4 times a day and gently rub. The gel column should be approximately 5-10 mm in length. The duration of therapy, depending on the severity of symptoms, is on average: for tendovaginitis, tendonitis and shoulder-shoulder syndrome - 14 days, after sports injuries - 7-14 days.
Piroxicam injections according to the instructions for use put once a day. With severe pain symptom - 40 mg, with moderate - 20 mg. Maximum - 40 mg.
Injections are carried out within 1-2 days. Then you will need to switch to capsules or tablets.
Side effects
Instructions for use and reviews of “Piroxicam” confirm that the following negative reactions may occur during treatment with this medication:
- Digestive system: nausea, belching, vomiting, dry mouth, pain in the epigastric region, stomatitis, decreased appetite, diarrhea, constipation, flatulence, erosive lesions or bleeding of the digestive system, increased liver enzyme functionality, liver failure, increased blood levels of nitrogen.
- Urinary system: kidney failure, interstitial nephritis, nephrosis, nephrotic syndrome, erythrocyturia, proteinuria, papillary necrosis, hyperkalemia, glomerulonephritis, an increase in blood levels of urea and creatinine.
- CNS: drowsiness, cephalalgia, dizziness, noise in the head, insomnia, depressive disorders, paresthesia, irritability, lethargy, emotional lability, hallucinations.
- Hemopoietic system: leukopenia, anemia (aplastic and hemolytic), eosinophilia, low hematocrit, hemorrhage, thrombocytopenia, thrombocytopenic purpura.
- Vascular and heart: changes in blood pressure, signs of heart failure, shortness of breath, palpitations.
- Allergic symptoms: skin rashes, dermatitis, pruritus, exudative erythema multiforme, malignant erythema, epidermal toxic necrolysis, anaphylactic shock, vasculitis, bronchospasm, serum sickness, photosensitivity, angioedema.
- Other reactions: hypoglycemia, decreased vision, swelling of the feet and legs, weight change, hyperhidrosis.
Drug interaction
It is not recommended to take this medication with the following drugs:
- With glucocorticosteroids - the risk of side effects from digestion increases.
- With "Phenobarbital" - the concentration of piroxicam in the blood decreases.
- With "Cimetidine", "Probenecid" and "Sulfinpyrazone" - the concentration of piroxicam in the blood rises.
- With diuretics and antihypertensive drugs - their effect is weakened.
- With anticoagulants - monitoring of blood coagulation is required.
- With acetylsalicylic acid - the level of piroxicam decreases, the risk of ulcerative lesions increases.
We will not consider in detail instructions for use with Piroxicam analogues.
Analogs
Analogues of the drug are:
- Xefocam;
- "Aroksikam";
- Occiten
- "Meloxicam";
- Movalis
- Sopharma
- "Final gel"
- Fedin-20;
- Lorakam
- Aspikam
- "Melox."
Reviews
This drug is widely used for severe pain associated with injuries and diseases of the bone, joint and muscle system. Patients are satisfied with the effect of this medicine and note that it quickly relieves pain, eases the general condition. However, reviews about this remedy are more negative than positive, since it causes many pronounced side effects that are difficult to tolerate by patients. Because of this, experts prescribe "Piroxicam" only in extreme cases, when the benefit from it is higher than the harm to health.
While taking this medication, patients had serious digestive disorders, pronounced reactions associated with the central nervous system (cephalgia, fatigue, blurred consciousness, etc.). In addition, problems with the kidneys, liver and gall bladder often occurred. Some changes in the clinical picture of blood are also noted - a change in its composition.