Tenoxicam
Indications
Tenoxicam is used for:
Pain and inflammation associated w/ musculoskeletal and joint disorders
Adult Dose
Oral
Acute musculoskeletal disorders; Osteoarthritis; Rheumatoid arthritis
Adult: 20 mg as a single dose, taken at the same time each day. Max: 40 mg/day (short term use).
Treatment duration: Up to 7 days for acute musculoskeletal disorders and up to 14 days for severe cases.
Elderly: Use the lowest effective dose for the shortest possible duration.
Child Dose
Renal Dose
Administration
Should be taken with food. Take w/ or immediately after meals.
Contra Indications
Active or history of recurrent GI bleed or peptic ulcer, hypersensitivity to NSAIDs, severe heart failure, haemorrhagic diathesis, asthma, pregnancy (3rd trimester).
Precautions
Patient w/ history of or active bronchial asthma, uncontrolled HTN, CHF, established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, risk factors for CV disease (e.g. HTN, hyperlipidaemia, DM, smoking), history of GI disease, fluid retention and oedema. Patient who will undergo major surgery (e.g. joint replacement). Elderly. Renal and hepatic impairment. Monitoring Parameters Monitor renal, hepatic and cardiac functions.
Pregnancy-Lactation
Interactions
Increased risk of adverse effects (particularly GI) w/ salicylates and other NSAIDs. May enhance the anticoagulant effect of warfarin and other anticoagulants. May reduce the effect of antihypertensive drugs. Increased risk of nephrotoxicity w/ ciclosporin. Increased risk of convulsions w/ quinolones. May decrease the elimination of lithium. May interfere w/ the natriuretic action of diuretics. May enhance the toxicity of methotrexate. May reduce the effects of mifepristone. Increased risk of GI bleeding w/ corticosteroids.
Adverse Effects
Side effects of Tenoxicam :
Dyspepsia, nausea, abdominal pain and discomfort, constipation, diarrhoea, flatulence, indigestion, epigastric distress, stomatitits, anorexia; peripheral oedema; headache, dizziness; allergic reactions, asthma, bronchospasm, dyspnoea, rash, pruritus; decreased Hb, anaemia, thrombocytopenia, non-thrombocytopenic purpura, leucopenia, eosinophilia, epistaxis; increased serum transaminase levels; swollen eyes, blurred vision, eye irritation, malaise, tinnitus; oedema, HTN, cardiac failure.
Potentially Fatal: Peptic ulceration, GI bleeding, anaphylaxis, Lyell's syndrome, Stevens-Johnson syndrome, exfoliative dermatitis, nephrotoxicity, arterial thrombotic events (e.g. MI or stroke), hepatitis, jaundice.
Mechanism of Action
Tenoxicam is a potent inhibitor of prostaglandin synthesis by blocking the enzyme cyclo-oxygenase. Additional actions contributing to its anti-inflammatory effect includes inhibition of leucocyte function including phagocytosis and chemotaxis, and scavenging free O2 radicals. It has no effect on renal function at the usual doses.