Piroxicam

Piroxicam is a non-steroidal anti-inflammatory drug of the oxicam class used to relieve the symptoms of rheumatoid and osteoarthritis, primary dysmenorrhoea, postoperative pain; and act as an analgesic, especially where there is an inflammatory component. It is manufactured by Pfizer under the tradename Feldene, and is available in the UK, Spain, Australia, Italy, Brazil and the United States. It is also manufactured by Bosnalijek under the tradename Roxam, and is available in Eastern Europe, Africa, and the Middle East.

It is also used in veterinary medicine to treat certain neoplasias expressing cyclooxygenase (COX) receptors, such as bladder, colon, and prostate cancers.

Other brand names for Piroxicam include "Brexidol", "Brexin", "Erazon", "Exipan", "Faxiden", "Felden", "Feldoral", "Flamexin", "Hotemin", "Lubor", "Mobilis", "Pirox von ct", "Proponol", "Reumador", "Roxam", "Sinartrol", "Toricam", "Tracam", "Ugesic", "Veral" and "Vurdon".

Mechanism of action
Piroxicam is an NSAID and, as such, is a non-selective COX inhibitor possessing both analgesic and antipyretic properties. It undergoes enterohepatic circulation.

Dosage and Administration
For adults, it is 20-40mg daily as a single or in divided doses. In children, the maximum daily dose is 1/3 mg per kg of body weight (should not be used below 6 yrs of age). Apart from oral, Piroxicam is available in injectable and ointment forms also.

Adverse effects
Piroxicam use can result in gastrointestinal toxicity, tinnitus, dizziness, headache, rash, and pruritus. The most severe adverse reactions are peptic ulceration, gastrointestinal bleeding, and severe skin reactions including Stevens-Johnson syndrome and toxic epidermal necrolysis. Approximately 30% of all patients receiving daily doses of 20 mg of piroxicam experience side effects.

Piroxicam may cause skin to become more sensitive to sunlight. Avoidance of sunlight and use of sunscreen is recommended.