Piroxicam - instructions for use, reviews, analogs and forms of release (capsules or tablets 10 mg and 20 mg, gel, ointment or cream, rectal suppositories) for the treatment of gout, arthritis and before IVF in adults and children. Composition

In this article, you can read the instructions for using the drug Piroxicam. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Piroxicam in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Piroxicam in the presence of existing structural analogues.Use for the treatment of gout, arthritis and before the planning of pregnancy and IVF in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Piroxicam - non-steroidal anti-inflammatory drug (NSAID), belongs to the group of oxycam. Has anti-inflammatory, analgesic and antipyretic effect.

The mechanism of action is associated with inhibition of the enzyme COX, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.

Suppresses the aggregation of platelets.

With systemic application reduces pain syndrome.

With external application weakens or stops inflammation and joint pain at rest and during movement, reduces morning stiffness and swelling of the joints, contributes to an increase in the volume of movements.

Analgesic effect occurs 30 minutes after ingestion. The anti-inflammatory effect is manifested by the end of the first week of treatment. After a single dose, the effect lasts for 24 hours.

Composition

Piroxicam + auxiliary substances.

Pharmacokinetics

After ingestion piroxicam is well absorbed from the digestive tract. Binding to plasma proteins is 99%.Piroxicam penetrates the placental barrier, excreted in breast milk. Metabolized in the liver by hydrolysis and conjugation. Piroxicam is excreted from the body in unchanged form (up to 5%) and in the form of metabolites, which are excreted mainly by the kidneys and in small amounts with feces.

Indications

For system and outdoor use:

• articular syndrome (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout);
• pain in the spine;
• neuralgia;
• myalgia;
• traumatic inflammation of soft tissues and musculoskeletal system.

For systemic use:

• dysmenorrhoea in patients older than 12 years;
• preparation for IVF in pregnancy planning (reduction of spasticity before embryo implantation);
• acute infectious-inflammatory diseases of the upper respiratory tract.

Forms of release

Capsules 10 mg and 20 mg.

Tablets 10 mg and 20 mg.

Gel for external use 0,5% and 1% (sometimes mistakenly called ointment or cream).

Instructions for use and dosing regimen

Capsules and tablets

For oral administration, the dose is 10-30 mg once a day. Rectally - 20-40 mg 1-2 times a day. In acute gout, the initial dose is 40 mg once a day for the first 2 days, then 40 mg once a day or 20 mg twice a day for 4-6 days.

In acute conditions or exacerbation of the chronic process can be administered intramuscularly at a dose of 20-40 mg once a day. After relief of the acute process, they switch to maintenance therapy with oral forms.

Gel

External apply 3-4 times a day.

Side effect

• nausea;
• loss of appetite;
• stomatitis;
• pain in epigastrium;
• diarrhea or constipation;
• flatulence;
• bleeding gums (due to inhibition of platelet aggregation);
• erosive and ulcerative lesions of the gastrointestinal tract with possible bleeding and perforations;
• transient increase in hepatic transaminase activity;
• jaundice or necrosis of the liver with a lethal outcome;
• anemia (less often, aplastic anemia or hemolytic anemia), thrombocytopenia, leukopenia, eosinophilia;
• dizziness;
• headache;
• drowsiness;
• sleep disorders;
• depression;
• nervousness;
• hallucinations;
• mood changes;
• weakness;
• sensitivity disorders;
• swelling of the eyes;
• impaired vision;
• signs of eye irritation;
• changes in body weight;
• uremia with hyperkalemia;
• acute renal failure (with signs of hemorrhagic vasculitis);
• acute interstitial nephritis;
• itching;
• redness;
• rash;
• allergic swelling of the skin of the face and hands;
• Stevens-Johnson syndrome;
• Lyell's syndrome;
• anaphylactic reactions;
• bronchospasm;
• angioedema;
• vasculitis;
• serum sickness;
• photosensitization;
• onycholysis;
• alopecia;
• nose bleed;
• irritation of the rectal mucosa;
• tenesmus;
• erythema and itching at the place of application.

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract in the phase of exacerbation;
• indication in the history of bronchial asthma in connection with the use of NSAIDs;
• disturbances of porphyrin metabolism;
• marked violations of the liver and kidneys;
• pregnancy;
• lactation period;
• children's age till 14 years;
• proctitis (for rectal administration);
• increased sensitivity to piroxicam.

Application in pregnancy and lactation

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

If it is necessary to apply in 1 and 2 trimesters of pregnancy, the expected benefit for the mother and the potential risk for the fetus should be correlated with the lack of reliable clinical data confirming the safety of piroxicam application during 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.

Use in children

Contraindicated in children under 14 years.

special instructions

Use with caution in case of erosive and ulcerative lesions and bleeding from the gastrointestinal tract in anamnesis, dyspeptic symptoms, chronic heart failure, violations of liver and kidney function, bronchial asthma, blood coagulation disorders, concomitant administration of oral anticoagulants, allergic reactions to Acetylsalicylic acid and other NSAIDs in anamnesis.

In the process of treatment, it is necessary to monitor the functional state of the liver and the pattern of peripheral blood.

Do not use topically if the integrity of the skin. Avoid contact with eyes or mucous membranes.

It is not recommended to use piroxicam concomitantly with acetylsalicylic acid and other NSAIDs.

Drug Interactions

With the simultaneous use of piroxicam can weaken the action of diuretics and antihypertensive agents.

With the simultaneous use of potassium-sparing diuretics and potassium preparations, hyperkalemia is possible.

With simultaneous use with NSAIDs, glucocorticosteroids (GCS) increases the risk of bleeding from the gastrointestinal tract.

With the simultaneous use of lithium salts, it is possible to increase the lithium content in blood plasma.

With simultaneous use with oral anticoagulants, blood clotting disorders are possible; with acetylsalicylic acid - a decrease in the content of piroxicam in the blood plasma.

When piroxicam is used 24 hours before or after taking methotrexate, its concentration in the blood plasma increases and toxicity increases.

With simultaneous application with phenytoin, an increase in the concentration of phenytoin in the blood plasma is possible; with Phenobarbital - a decrease in the concentration of piroxicam in the blood plasma; with cimetidine, probenecid, sulfinpyrazone - an increase in the concentration of piroxicam in the blood plasma is possible.

Analogues of the drug Piroxicam

Structural analogs for the active substance:

• Vero Piroxicam;
• Kalmopyrene;
• Pirokam;
• Piroxicam Stade;
• Piroxicam Acry;
• Piroxicam Verte;
• Piroxicam ratopharm;
• Piroximeter;
• Revmadore;
• Remoxicam;
• Sanik;
• Feldoral;
• Velden;
• Finalal;
• Hotemin.

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