Piroxicam instructions for use. Piroxicam - instructions for use, composition, contraindications and side effects. When you need analogues

Piroxicam is a drug that belongs to the group of NSAIDs (non-steroidal anti-inflammatory drugs). The drugs of this group are widely used in traditional medicine, are popular among patients and, as a rule, are dispensed without a prescription from a doctor.

NSAIDs, which include Piroxicam, are broad-spectrum agents used for a wide variety of pathologies, which are accompanied by painful symptoms, inflammatory processes and fever.

In this article, we will look at why doctors prescribe Piroxicam, including instructions for use, analogues and prices for this drug in pharmacies. Real REVIEWS of people who have already used Piroxicam can be read in the comments.

Piroxicam is available in the form of capsules and tablets for oral administration, as well as in the form of a gel for external use.

One capsule of Piroxicam (including Piroxicam Akri) contains 10 or 20 mg of the active ingredient of the same name. Additional components: wheat starch, MCC, talc, glycine, colloidal silicon dioxide, magnesium stearate.
Capsule components: gelatin, indigo carmine, iron oxide, titanium dioxide, sunset yellow.

Pharmacological action: non-steroidal anti-inflammatory agent.

Indications for use

Piroxicam is prescribed by a doctor for spinal injuries, diseases of soft tissues and joints. If we consider the indications for the use of this substance in more detail, we can distinguish:

extra-articular rheumatism;
ankylosing spondylitis;
rheumatoid arthritis and osteoarthritis;
injuries of tendons, muscles and spine, fractures, sprains, bruises;
postoperative syndromes;
neuralgia;
gout and psoriatic arthropathy;
tendinitis;
deforming osteoarthritis.

It is important to note that Piroxicam effectively relieves pain and reduces the intensity of the inflammatory process at the time of use, but does not affect the progression of the disease.

pharmachologic effect

The active substance of Piroxicam capsules is a representative of non-steroidal anti-inflammatory drugs of the oxicam group. It inhibits (suppresses) the activity of the enzyme cyclooxygenase (COX), which catalyzes the conversion of arachidonic acid to prostaglandins (inflammatory mediators).

Piroxicam is known as an antipyretic, analgesic, anti-inflammatory and antiplatelet agent (reduces the likelihood of thrombosis). When taken orally, it is rapidly absorbed, reaching a maximum effect after 2-3 hours after ingestion.

The tool significantly reduces pain in case of systemic use. The analgesic effect of the drug is felt within half an hour after ingestion.

Instructions for use

According to the instructions for use, Piroxicam Capsules are taken orally after meals. They are not chewed and washed down with a sufficient amount of water.

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

In acute conditions or exacerbation of a chronic process, it can be administered intramuscularly at a dose of 20-40 mg 1 time / day. After stopping the acute process, they switch to maintenance therapy with oral forms.

Externally applied 3-4 times / day.

Contraindications

The use of Piroxicam should be excluded under such conditions as:

the age of the patient is younger than 15 years;
hemophilia;
duodenal ulcer, stomach;
bleeding from the gastrointestinal tract;
hemorrhagic diathesis;
bronchial asthma, which is caused by other NSAIDs;
recurring polyposis;
proctitis, intestinal bleeding (for the drug, in the form of rectal suppositories);
hepatic, renal, cardiac insufficiency;
Crohn's disease;
the period of bearing a child;
breast-feeding;
intolerance to the active or one of the auxiliary components of the drug.

Limitations in the use of Piroxicam - previously transferred erosive and ulcerative lesions of the gastrointestinal tract; bronchial asthma, allergic diseases, heart failure and other diseases accompanied by edema, arterial hypertension.

Side effects

Side effects develop with long-term use of Piroxicam, as well as when it is taken in large doses.

Digestive organs: nausea, vomiting, belching, dry mouth, stomatitis, pain in the epigastric region, loss of appetite, diarrhea or constipation, flatulence, erosive and ulcerative lesions (up to perforation) and / or bleeding (in exceptional cases up to anemia) of the digestive tract , increased activity of liver enzymes, liver failure, increased plasma nitrogen concentration;
Nervous system: insomnia, dizziness, headache, drowsiness, lethargy, depression, irritability, paresthesia, hallucinations, mood changes;
Cardiovascular system: increase or decrease in blood pressure, rarely - shortness of breath, palpitations;
Urinary system: renal failure, interstitial nephritis, nephrotic syndrome, nephrosis, proteinuria, erythrocyturia, hyperkalemia, papillary necrosis, glomerulonephritis, increased plasma concentrations of creatinine and urea;
Hemopoietic organs and hemostasis system: aplastic, hemolytic and other types of anemia, thrombocytopenia, eosinophilia, leukopenia, hemorrhagic vasculitis (Schonlein-Genoch disease), a decrease in hematocrit;
Allergic reactions: skin rashes, dermatitis with desquamation of the stratum corneum, pruritus, erythema multiforme exudative, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), anaphylactic shock, bronchospasm, vasculitis, photosensitivity, serum sickness, likely angioedema;

Others: swelling of the feet and legs, increased sweating, hypoglycemia, increased urea concentration.

Piroxicam's analogues

Structural analogues for the active substance:

Vero Piroxicam;
Calmopyrol;
Pirocam;
Piroxicam Stada;
Piroxicam Acri;
Piroxicam Verte;
Piroxicam ratiopharm;
Pyroxifer;
Revmador;
Remoxicam;
Saniks;
Feldoral;
Felden;
Finalgel;
Hotemin.

Attention: the use of analogues must be agreed with the attending physician.

Price

The average price of Piroxicam in pharmacies (Moscow) is 80 rubles.

Terms of dispensing from pharmacies

Latin name: Piroxicam
ATX code: M01AC01
Active substance:
Manufacturer: Sopharma, Bulgaria/
Ozone, Russia/Red Star, Ukraine, etc.
Pharmacy leave condition: On prescription

For the effective treatment of arthritis, sciatica, osteoarthritis, the drug "Piroxicam" is used. This is a non-steroidal agent with anti-inflammatory, antipyretic action. A variety of forms of release of the drug allows you to use it in relation to various categories of patients.

Indications for use

The drug "Piroxicam" is prescribed for the treatment of problems with the joints, with injuries of soft tissues, tendons, as well as for the treatment of certain systemic ailments.

With pain syndrome (pain in tissues, muscles, tendons; sprains, bruises, fractures; inflammation of soft tissues; nerve damage; to reduce postoperative pain
In rheumatic diseases and joint problems (arthritis, osteoarthritis, gout, tendonitis, Bechterew's disease, extra-articular rheumatism, lupus erythematosus, acute lower back pain, pinched sciatic nerve
For systemic use (painful menstruation in patients older than 12 years; preparation for IVF; inflammatory diseases of the pharynx, appendages; cystitis.

The drug "Piroxicam" is available in 4 forms:

Tablets
Injection
Rectal suppositories.

The average price is from 10 to 30 rubles.

Tablets "Piroxicam"

One tablet contains 20 mg or 10 mg of the active substance (piroxicam). Auxiliary components are: lactose, cellulose, starch, magnesium stearate, sodium zucrin, silicon dioxide, sodium starch glycolate, polyvinylpyrrolidone, water.

Round tablets of white or yellowish color, flat, have a dividing strip.

Mode of application

The tablets inhibit platelet aggregation and phagocytosis. The pills are well absorbed from the gastrointestinal tract, their maximum concentration is achieved after 5 hours. For 12 days, the concentration of tablets in the blood is balanced. The half-life is about 50 hours. Tablets are excreted by the intestines and kidneys. It does not accumulate in the body. Tablets eliminate pain, swelling of the joints. It is taken orally from 1 to 4 tablets at a time.

The average price is from 90 to 150 rubles.

Gel "Piroxicam"

The gel has an antipyretic, anti-inflammatory, analgesic effect. Equilibrium concentration is obtained after 7-12 days.

0.5 g of piroxicam in 100 g of gel. Additional elements: carbomer, propylene glycol, trolamine, ethanol, water, methyl parahydroxybenzoate.

The color is transparent, from light yellow to greenish. Has a characteristic smell.

Mode of application

Ointment (gel) is applied to the skin over the problem area up to 4 times a day, gently rubbed. Duration of application - no more than 2 weeks. It has a quick local effect, bypassing the gastrointestinal tract and thus does not negatively affect the internal organs.

The average price is from 30 to 70 rubles.

Capsules "Piroxicam"

Ingredients: piroxicam, wheat starch, magnesium stearate, talc, glycine, colloidal silicon dioxide, MCC

Looks like hard gelatin. Cream-orange body, white powder inside the capsule

Mode of application

Inside from 1 to 4 pieces at a time. The duration of treatment is from 1 week to 4 months. A distinctive feature is that the drug is quickly absorbed into the stomach without negative consequences.

Capsules have the same properties as tablets. The result is achieved 30 minutes after administration. Prolongation of action - 24 hours after taking 1 capsule.

The average price is from 40 to 70 rubles.

Rectal suppositories "Piroxicam"

Rectal suppositories are yellowish-green in color and cigar-shaped. Contains 20 mg of active substance in 1 suppository. Other Ingredients: Semi-synthetic glycerides.

Mode of application

Rectally. 1 suppository once a day after a colon cleansing enema. Before insertion, moisten the suppository with water, lubricate the anus with cream. Duration of treatment - from 1 to 2 weeks

Candles increase the excretion of uric acid from the body. Concentrate in plasma within 3 hours after administration. Displayed within 30-86 hours.

Solution for injection "Piroxicam"

The average price is from 25 to 50 rubles.

Solution for injection contains 20 mg of active ingredient per ml. The ampoule itself is dark glass, 1 ml. Packed in contour cells of 10 pieces and in cardboard packs.

Mode of application

Inject the drug 1 time per day. If the pain symptom is strong - then 40 mg of the substance, with moderate - 20 mg. The maximum amount of substance for administration is 40 mg.

Injections spend 1-2 days. After switching to tablets or capsules.

Contraindications

You can not drink the medicine in such cases:

In case of violations of kidney and liver function, it is forbidden to take tablets and capsules. Gel and suppositories should be used with caution
Children under 12 years old (and in any form of release)
With individual intolerance to the drug
With ulcers, open wounds at the sites of application of the gel
3rd trimester of pregnancy.

With caution, you need to take the drug in such cases:

During lactation, as well as in the 1st and 2nd trimester of pregnancy
Together with other anti-inflammatory drugs
With ulcers, erosions in the gastrointestinal tract
For the elderly
Patients with bronchial asthma
For chronic kidney disease
If there is a tendency to bleed
With hemorrhagic diathesis.

During pregnancy and breastfeeding

In the 3rd trimester, the drug is contraindicated in any form of release
In the 1st and 2nd trimesters, the question of using the medicine is decided only with the doctor
Tablets and capsules are excreted in breast milk. At the time of therapy, you need to stop feeding the baby or refuse the medication.

Interaction with other drugs

Simultaneous use of the drug "Piroxicam" with certain drugs leads to:

The development of side effects from the gastrointestinal tract, as well as allergic reactions, if the patient takes glucocorticoids along with the described medicine
Weakening the effect of diuretics if they are taken together with Piroxicam
An increase in the concentration of lithium in the blood plasma, if Piroxicam tablets or capsules are taken in parallel with lithium medications
An increased risk of bleeding when taking Piroxicam and anticoagulants.

Side effects and overdose

Undesirable effects may occur with prolonged or uncontrolled use of the drug.

From tablets and capsules, such problems may appear: nausea, vomiting, diarrhea, headache, insomnia, anemia, bronchospasm, vision problems

The following undesirable effects may occur from the gel: itching, dermatitis, redness of the skin

Rectal suppositories may cause itching in the anus, bloody stools, and bleeding.

Storage rules

Store tablets, gel (ointment) and capsules in a dry, dark place at a temperature of +8 to +25 degrees. Shelf life - 3 years
Candles. Keep refrigerated. Shelf life - 2 years.

"Piroxicam" in IVF: truth or myth?

IVF is in vitro fertilization carried out in a test tube. Indications for IVF are ovarian diseases, obstruction of the fallopian tubes, male infertility, etc. IVF is prescribed for couples who have already tried all possible methods of infertility treatment, but none have brought results.

Some reproductologists prescribe the drug "Piroxicam" when replanting the fetus (embryos). It is noted that the tablets can reduce the contractile activity of the uterus. And this can lead to a high probability of pregnancy. Doctors prescribing the drug to infertile couples prescribe it to women 1 pill three times a day, before the procedure (one day before embryo transfer) and on the day of IVF (1 tablet in the morning).

Piroxicam may improve the rheological properties of blood. This means that the tablets are able to increase the blood flow in the uterus, which can have a positive effect on the attachment of embryos during IVF.

Not in all IVF clinics, doctors prescribe Piroxicam. There is no reliable data on the positive impact of this drug on pregnancy. Studies were conducted and the results showed that Piroxicam tablets are able to reduce the contractile activity of the uterus. This may increase the chance of pregnancy, but does not guarantee it. And the study, which was conducted a long time ago, did not receive any official confirmation over the next 5 years. Only in 2009, scientists conducted a second study, which refuted the assumption regarding the effect of the drug on embryos.

Taking the pill before IVF has no effect on pregnancy in patients who take progesterone in the luteal phase after IVF.

Analogues

Substitutes for the drug "Piroxicam" abound. Among the analogues, one can single out the gel "Finalgel", the tablets "Revmoxicam".

Boehringer Ingelheim Pharma, Germany.
Price from 300 to 400 rubles.

The main substance of the drug is piroxicam. The gel is sold in tubes of different volumes: 35 or 50 g. It looks light yellow with a slight smell of isopropyl alcohol.

pros

Rapid absorption into the skin
economical spending

Minuses

High price
It helps only with minor injuries (bruises, minor injuries). For more serious problems, it does not always help.
Name. Many confuse with Finalgon. Both drugs relieve pain, but they work in different ways. Finalgon burns the skin. And Finalgel, on the contrary, cools her. If you confuse 2 drugs similar in name, the result can be disastrous.

Tablets " "

OJSC Farmak, Ukraine.
Price from 270 to 320 rubles.

The active ingredient of the drug is meloxicam. Available in various forms: tablets, solutions, suppositories. Not approved for use in Russia.

pros

Quickly relieves inflammation and pain
Can be bought without a prescription

Minuses

A large number of side effects
This is a drug that does not spare the stomach (may cause abdominal pain, cramps)
High price. If you take 2 tablets a day, then packages for 300 rubles. Enough for just 5 days.

One Piroxicam capsule(including in the preparation Piroxicam Acri) contains 10 or 20 mg of the active ingredient of the same name. Additional components: wheat starch, MCC, talc, glycine, colloidal silicon dioxide, magnesium stearate. Capsule components: gelatin, indigo carmine, iron oxide, titanium dioxide, sunset yellow.

in one gram gel Piroxicam contains 0.5 g of the active ingredient of the same name. Additional components: ethanol 95%, carbomer, methyl parahydroxybenzoate, trolamine, propylene glycol, water.

Piroxicam tablet contains 20 mg of active ingredient.

Release form

Twenty tablets in a contour pack, one pack in a carton pack.
Hard capsules, cylindrical shape, odorless white powder inside. Five such capsules in a contour pack; two or four packs in a carton pack. Seven of these capsules in a blister pack; two or four packs in a carton pack. Ten of these capsules in a blister pack; one or two packs in a carton box. Ten such capsules in a blister; ten, twenty, three, one or two blisters in a pack of cardboard.
Transparent yellow gel with a characteristic odor; air bubbles may be present. 10, 15, 20, 25, 30 or 50 grams of gel in a tinted glass jar, one jar in a carton pack. 30 or 50 grams of gel in an aluminum tube, one tube in a cardboard pack.

pharmachologic effect

Non-steroidal anti-inflammatory agent.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Non-steroidal anti-inflammatory agent from the group oxicams . Possesses anti-inflammatory, analgesic and antipyretic action . Inhibits enzyme cyclooxygenase , which leads to a slowdown in the biosynthesis of molecules arachidonic acid . When used systemically, it suppresses pain. Inhibits platelet aggregation.

When used externally, it weakens or reduces the severity of inflammation and pain in the joints during movement and at rest, relieves morning stiffness and swelling of the joints, helps to increase the amplitude and range of motion in the joints. The analgesic effect is fixed half an hour after oral administration. The anti-inflammatory effect is observed after 5-7 days. After a single dose of the drug, the effect lasts for a day.

Pharmacokinetics

Well absorbed from the intestines. The maximum concentration in the blood is reached after 4 hours. Binding to plasma proteins reaches 99%. Penetrates through the placenta and is excreted during lactation. It is metabolized in the liver due to hydrolysis and conjugation reactions.

It is excreted unchanged and in the form of derivatives, mainly by the kidneys and in small amounts with feces. The half-life is about two days.

In patients with liver damage, this period may increase.

Indications for use Piroxicam

Indications for use Piroxicam in the form of capsules (tablets) and gel:

articular syndrome ( , );
back pain, myalgia, neuralgia , traumatic inflammation.

Indications for capsules and tablets only:

in females from 12 years;
acute lesions of the upper respiratory tract of an infectious-inflammatory nature.

Contraindications

Use is contraindicated in:

gastrointestinal disorders that can cause bleeding ( Crohn's disease , cancer of the gastrointestinal tract, ulcerative, diverticulitis );
ulcer of the gastrointestinal tract, perforations or bleeding, including history; inflammatory diseases of the digestive system; active peptic ulcer ;
combined use with other drugs from the group non-steroidal anti-inflammatory ;
simultaneous use with anticoagulants ;
reports from the anamnesis of previous severe, especially skin, such as Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis;
to auxiliary components;
severe renal, cardiac or liver failure;
pregnancy and lactation;
children under 14 years old.

Side effects

Reactions from digestive systems: loss of appetite, nausea, stomatitis pain in the epigastric region, flatulence , or, erosive and ulcerative changes in the digestive tract with possible complications in the form of bleeding and perforations, jaundice , temporary increase in content hepatic transaminases, liver necrosis with a possible fatal outcome. These side effects usually develop with prolonged use of the drug at a dose of more than 30 mg per day.
Reactions from hematopoietic system: anemia, leukopenia, thrombocytopenia, eosinophilia.
Reactions from metabolism: hypo- or hyperglycemia, hyperkalemia, weight changes, transient increase in concentration creatinine and residual nitrogen, uremia on the background hyperkalemia.
Reactions from nervous system: , nervousness, mood changes, hallucinations , weakness, swelling of the eyes, sensory disturbances, visual disturbances and symptoms of eye irritation.
Reactions from genitourinary system: , interstitial acute nephritis.
allergic reactions: redness, itching, rash, swelling of the face and hands, pemphigus vulgaris , Stevens-Johnson syndrome, bronchospasm, Lyell's syndrome, vasculitis, serum sickness.
Dermatological reactions: onycholysis, photosensitivity, .
Local reactions: tenesmus , irritation of the rectum.
Other reactions: nose bleed.
Reactions with external use: erythema or at the point of use.

Instructions for use Piroxicam (Method and dosage)

Instructions for use on the gel (ointment)

Piroxicam tablets, instructions for use

Instructions for tablets (and capsules) of all Piroxicam manufacturers recommend the same treatment regimens, including instructions for use Piroxicam Acry . The drug is taken orally during meals. Do not exceed the recommended daily doses, because this increases the risk of developing unwanted side effects.

With lesions of the musculoskeletal system or diseases of the joints ( osteoarthritis , rheumatoid arthritis, spondylitis ) is recommended to take 10-20 mg per day for one or two times. In case of urgent need, it is allowed to temporarily increase the dose taken to 30 mg per day, once or in several doses, or lower it to 10 mg per day.

At acute lesions of the musculoskeletal system in the first few days, take 40 mg per day once or divided into several doses, then - 20 mg per day for a crescent.

With acute gout use 40 mg per day for three to five days.

At dysmenorrhea therapy should be initiated at the onset of the first symptoms at an initial dose of 40 mg per day for one or more times over two days. Then - 20 mg per day once for one to three days.

At post-traumatic pain the initial dose includes 20 mg of the drug once a day. If necessary, you can increase the dose taken in the first few days to 40 mg.

The maximum daily permitted dose for adults is no more than 40 mg.

Overdose

Symptoms: drowsiness, blurred vision, when using large doses, loss of consciousness is possible.

Symptomatic treatment is carried out. Piroxicam cannot be evacuated from the body with hemodialysis .

Interaction

When used together, Piroxicam may reduce the effect antihypertensive drugs and diuretics .

When used together with drugs potassium and potassium-sparing diuretics possible development hyperkalemia.

When used together with others non-steroidal anti-inflammatory or glucocorticosteroid drugs increases the risk of bleeding from the digestive tract.

When used in conjunction with lithium salts content rises lithium in blood.

When used together with anticoagulants (tablets) possible changes in blood clotting; c - decrease in concentration piroxicam in blood.

When taking Piroxicam 24 hours before or after use, its concentration in the blood increases and toxicity increases.

When used together with phenobarbital - a decrease in the concentration of Piroxicam in the blood is possible; With phenytoin - possible increase in concentration phenytoin in blood; With Probenecid, cimetidine, sulfinpyrazone - an increase in the concentration of Piroxicam in the blood is possible.

Terms of sale

On prescription.

Storage conditions

Keep away from children. Store at temperatures up to 25 degrees in a dark, dry place.

Best before date

Three years.

special instructions

Looking through the prism of safety, the drug is not the drug of choice if other options are available. antirheumatic or non-steroidal anti-inflammatory drugs.

Side effects can be reduced by using the lowest effective dose for the shortest period of time necessary to monitor clinical results.

Piroxicam is a non-steroidal anti-inflammatory drug (NSAID), used for rheumatoid arthritis or osteoarthritis, to relieve symptoms of pain and inflammation. It can also be used to treat other diseases as prescribed by a doctor.

Piroxicam reduces the synthesis of prostaglandins, substances that support inflammation and increase the sensitivity of nerve fibers to pain impulses. With articular syndrome, it reduces or relieves inflammation and pain in the joints at rest and during movement, reduces morning stiffness and swelling of the joints. Non-steroidal anti-inflammatory agent. It has an analgesic, antipyretic effect.

Piroxicam: Instructions for use

Composition and form of release

The contents of the capsule are represented by a yellowish powder. Capsules of 10 mg, have halves of blue and white. Capsules of 20 mg have green and white halves.

Active substance: Piroxicam, in one capsule is 10 or 20 mg.

Excipients: wheat starch; magnesium stearate; microcrystalline cellulose; colloidal silicon dioxide; talc; glycine; titanium dioxide; indigo carmine or iron oxide as a dye; gelatin.

Package: Blisters of 10 pieces, 2 blisters, in a cardboard box.

Excipients for capsules: potato starch, cellulose, talc, silicon dioxide. The capsule consists of gelatin, yellow iron oxide, titanium dioxide, dye and water.

Gel for external use

Gel in tubes of 30, 50 and 100 g.

Description: transparent gel / cream / ointment from light yellow to greenish-yellow color with a characteristic odor. Air bubbles are allowed.

Piroxicam gel contains 1% active ingredient. They are additional components. Excipients: trolamine; ethanol 95%; carbomer; propylene glycol; water; methyl parahydroxybenzoate.

Injection

Solution for injection Piroxicam is available in ampoules of 1 ml (0.02 g of active substance) or 2 ml (0.04 g of active substance).

Packing: Dark glass ampoules 10 pcs in contour cells in a cardboard box.

Rectal suppositories

Rectal suppositories contain: active substance: Piroxicam - 0.02 gr.; excipients: polyethylene oxide 400 and polyethylene oxide 1500.

The powder is crystalline white or white with a slightly yellowish tint. Soluble in chloroform (1:100), in warm ethanol and methanol (1:1000), sparingly soluble in water.

pharmachologic effect

NSAIDs, belongs to the group of oxycams. It has anti-inflammatory, analgesic and antipyretic effects.

Non-steroidal anti-inflammatory drugs - a group of medicines that have analgesic, antipyretic and anti-inflammatory effects, reduce pain, fever and inflammation.

The mechanism of action is associated with inhibition of the COX enzyme, which leads to inhibition of the synthesis of prostaglandins from arachidonic acid.
Suppresses platelet aggregation.
When used systemically, it reduces pain.
When applied externally, it reduces or relieves inflammation and pain in the joints at rest and during movement, reduces morning stiffness and swelling of the joints, and increases the range of motion.
The 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.

Indications for use

Spine and joints

Degenerative vertebral and articular inflammation with pain syndromes:

rheumatism and rheumatoid arthritis;
osteoarthritis and chronic arthritis;
tendovaginitis and tendinitis (inflammation of the tendon and its synovial membranes), periarthritis of the shoulder joint;
acute gouty attack.
acute back pain (lumbago).

Muscles and tendons

Swelling and pain in the muscles (myalgia), tendons, joints due to overexertion.
Post-traumatic pain syndromes - sprains, ruptures of ligaments or tendons, dislocations or bruises.
Inflammatory pathologies of the musculoskeletal system.

Neuralgia (nerve damage).
Acute forms of inflammation and infections of the respiratory system.
Postoperative pain.
Primary dysmenorrhea (excessively painful menstruation).
Inflammation of the appendages (adnexitis).
Bladder pathology of inflammatory genesis (cystitis).
Pinched sciatic nerve (sciatica).
Pain caused by dental intervention.

Dosage and administration

Inside orally

During or immediately after a meal; degenerative-dystrophic and inflammatory diseases of the joints: 20 mg once a day (from 10 mg 1 time per day to 30 mg / day in 1-2 doses); active phase of rheumatism and rheumatoid arthritis: 40 mg / day in 1-2 doses for 2 days, the maintenance dose is 20 mg / day; post-traumatic and postoperative pain syndrome: 1 time per day 20 mg (if necessary - in 1-2 doses 40 mg / day); acute attack of gout: 1 time per day 40 mg for 2 days, then 2 times a day for 20 mg for 4-6 days; for adults, the maximum daily dose is 40 mg.

Intramuscular

1 time per day, with moderate pain syndrome - 20 mg, with severe pain syndrome - 40 mg, the maximum daily dose is 40 mg; intramuscular injections are carried out within 1-2 days, after the removal of the acute stage of the process, it is necessary to switch to maintenance treatment using oral dosage forms.

An ointment or gel is applied to the area of the painful area on the skin and rubbed 3-4 times a day, the duration of treatment depends on the nature of the damage and the severity of the disease. Rectally: 1-2 times a day for 10-40 mg, for adults the maximum daily dose is 40 mg.

Need to take into account

The use of Piroxicam causes an increased risk for those with heart or blood vessel problems (eg, heart attack, stroke) and is also contraindicated for those with internal bleeding (eg, ulcers). The risk may be higher if you use piroxicam for a long time.

Before using Piroxicam (including local), patients with allergic rhinitis, bronchial asthma, chronic obstructive airways disease, polyps of the nasal mucosa should consult a doctor.

During therapy, it is necessary to monitor the functional state of the liver and kidneys, the cellular composition of the blood. During therapy with piroxicam, you should not drink alcoholic beverages. It is necessary to avoid getting the ointment or gel into the eyes, mucous membranes, open wounds.

Pregnancy and lactation

Piroxicam is contraindicated for use in the third trimester of pregnancy.

If necessary, use in the I and II trimesters of pregnancy should correlate the expected benefit to the mother and the potential risk to the fetus, due to the lack of reliable clinical data confirming the safety of using piroxicam during this period. Under the influence of NSAIDs, premature closure of the ductus arteriosus in the fetus is possible.

Piroxicam is excreted in breast milk. If necessary, use during lactation should decide on the termination of breastfeeding.

Application in childhood

Contraindicated in children under 14 years of age.

Contraindications

Hypersensitivity, incl. to other NSAIDs, peptic ulcer of the stomach and duodenum, liver and kidney disease, cardiovascular insufficiency, bronchial asthma, children, old age (over 65 years).

Side effects

From the nervous system and sensory organs:

Dizziness, headache, irritability, drowsiness or insomnia, weakness, depression, hallucinations, tinnitus, blurred vision, eye irritation.

From the side of the cardiovascular system and blood(hematopoiesis, hemostasis):

Increase or decrease in blood pressure, palpitations, anemia, thrombopenia, leukopenia, eosinophilia, decrease in hemoglobin and hematocrit, hemorrhages.

From the digestive tract:

Dry mouth, stomatitis, gastrointestinal irritation, nausea, belching, anorexia, diarrhea or constipation, flatulence, bleeding gums, pain in the epigastric region, erosive and ulcerative lesions of the gastrointestinal tract and the occurrence of bleeding, impaired liver function (increased activity of liver transaminases).

From the genitourinary system:

Renal failure, acute interstitial nephritis.

Allergic reactions (itching, redness of the skin; edema, including the face, hands; Stevens-Johnson syndrome, Lyell's syndrome, very rarely - anaphylactic reactions, bronchospasm, photosensitivity, rash), edema (mainly of the lower extremities in patients with impaired function heart), sweating, increased urea, hyperkalemia, hypo- or hyperglycemia, weight gain or loss.

Local reactions:

Irritation of the mucous membrane of the rectum, tenesmus, pain and an unpleasant feeling of heaviness in the anal region (suppositories); when applied to the skin - irritation, incl. itching, redness, rash, burning (with prolonged use).

drug interaction

Piroxicam displaces other drugs from association with blood proteins. Piroxicam reduces the effectiveness of antihypertensive drugs. Against the background of taking corticosteroids and other non-steroidal anti-inflammatory drugs, the risk of ulcerogenic effects of piroxicam increases. The risk of developing hyperkalemia increases with the combined use of piroxicam with potassium-containing drugs and potassium-sparing diuretics. Piroxicam increases the concentration of lithium and phenytoin in the blood. With the combined use of piroxicam and anticoagulants, the risk of bleeding increases. Acetylsalicylic acid reduces blood levels of piroxicam by 20%.

Overdose

With an overdose of piroxicam, blurred vision, drowsiness develop, with very large doses - coma, loss of consciousness. Necessary: gastric lavage, taking antacids, activated charcoal, symptomatic therapy.

Piroxicam's analogs

Vero-Piroxicam
Calmopyrol
Pirocam
Piroxicam Jenafarm
Piroxicam Stada
Piroxicam-Verte
Piroxicam-Altpharm
Piroxicam-Acri
Piroxicam-ratiopharm
Pyroxifer
Saniks
Feldoral SEDICO
Felden
Finalgel
Hotemin
Revmador
Remoxicam

Piroxicam: instructions for use and reviews

Latin name: Piroxicam

ATX code: M02AA07

Active substance: piroxicam (piroxicam)

Producer: OZON, LLC (Russia), Obolenskoe - a pharmaceutical enterprise, CJSC (Russia), Sopharma, JSC (Bulgaria), VERTEKS, JSC (Russia), Production of medicines (Russia), Lekhim-Kharkov, JSC (Ukraine), Khimfarmzavod Krasnaya star (Ukraine)

Description and photo update: 09.09.2019

Piroxicam is a non-steroidal anti-inflammatory drug (NSAID) that has analgesic, antipyretic and anti-inflammatory effects.

Release form and composition

Film-coated tablets (20 pieces in blister packs, 1 pack in a carton box);
Capsules: No. 3, gelatin hard; dosage 0.01 g - white body and blue cap, dosage 0.02 g - cream body and orange cap; the contents of the capsule are creamy-white to white powder, the formation of a cylindrical shape is allowed, easily disintegrating when touched (10 pcs in PVC / aluminum foil blisters, 2 blisters in a carton box);
Rectal suppositories: bullet-shaped, greenish-yellow in color, marbling is allowed (5 pcs in a blister, 2 blisters in a cardboard box);
Gel for external use 0.5% and 1%: transparent, from greenish-yellow to light yellow, with the smell of ethanol, air bubbles and opalescence are allowed (30, 50 or 100 g in aluminum tubes, 1 tube in cardboard box).

Each pack also contains instructions for using Piroxicam.

Composition of 1 tablet:

Auxiliary components: dibasic calcium phosphate, magnesium stearate, sodium lauryl sulfate, starch, hydroxypropyl cellulose.

Composition of 1 capsule:

Active ingredient: piroxicam - 0.01 or 0.02 g;
Auxiliary components: wheat starch, microcrystalline cellulose, glycine, talc, colloidal silicon dioxide, magnesium stearate;
Capsule shell: titanium dioxide, gelatin, indigo carmine Fd&C Blue 2 (dosage 0.01 g), iron oxide yellow and Sunset yellow (dosage 0.02 g).

Composition of 1 suppository:

Active ingredient: piroxicam - 0.02 g;
Auxiliary components: polyethylene oxide 400, polyethylene oxide 1500.

Composition of 1 g of gel:

Active ingredient: piroxicam - 0.005 or 0.01 g;
Auxiliary components: propylene glycol, triethanolamine (trolamine), ethyl alcohol 95% (ethanol 95%), carbomer, methyl parahydroxybenzoate (nipagin, methylparaben), purified water - up to 1 g.

Pharmacological properties

Pharmacodynamics

Piroxicam is a non-steroidal anti-inflammatory drug from the oxicam group. It has analgesic, anti-inflammatory and antipyretic effects.

The mechanism of action of piroxicam is based on inhibition of prostaglandin synthesis due to inhibition of cyclooxygenase activity.

Thanks to the use of the drug, the pain syndrome is weakened. Piroxicam stops or weakens the severity of the inflammatory process and pain in the joints at rest and during movement, helps to reduce morning stiffness and swelling of the joints, and increases the range of motion.

The analgesic effect develops within 30 minutes after taking Piroxicam inside. Anti-inflammatory properties appear by the end of the first week of therapy. The duration of action after a single oral dose is 24 hours.

Pharmacokinetics

Tablets and capsules

Piroxicam after oral administration is well absorbed from the gastrointestinal tract. C max (maximum concentration of the substance) in plasma is reached in 3-5 hours. C max after a single dose of piracetam at a dose of 20 mg is 1.5–2 μg / ml, with regular administration of the same dose - 3–8 μg / ml. In the case of taking Piroxicam with food, the rate of absorption slows down, but without affecting the amount of absorption. Bioavailability - about 100%. Equilibrium concentration is reached in 7-12 days.

It binds to plasma proteins at the level of 98%. V d (volume of distribution) is in the range from 0.12 to 0.14 l/kg. Penetrates into the synovial fluid within 40-50%, excreted in breast milk from 1 to 3%.

Metabolism occurs in the liver by conjugation and hydrolysis to form inactive metabolites.

Excretion is carried out in the form of conjugates mainly with urine (2/3 of the dose taken) and in a small amount with feces. About 5% is excreted unchanged. T 1/2 (half-life) - from 36 to 45 hours. T 1/2 in patients with liver disease may be lengthened.

Suppositories rectal

Piroxicam is well absorbed from the intestine. Cmax in blood plasma is achieved within 3-5 hours after application.

T 1/2 has a significant individual variability within 30-86 hours (average - 50 hours). About 5% of the substance is excreted unchanged.

Stable plasma concentration is achieved within 7-12 days, the maximum effective concentration - within 14 days after the start of therapy.

Gel for external use

Piroxicam, when applied externally, penetrates through the skin surface into the underlying tissues of the joints and muscles.

After applying the gel, the equilibrium between the concentrations of the substance in the skin and muscles (or synovial fluid) is achieved in a few hours. When applied for 14 days at a daily dose of the gel, which is equivalent to 20 mg of piroxicam for oral administration, the plasma concentration of the active substance in the blood slowly increases and reaches 200 ng / mg on the fourth day. The equilibrium plasma concentration of piroxicam in the blood is 300-400 ng / ml. This is approximately 5% of the concentration that is achieved when piroxicam preparations are administered orally in the corresponding dosage forms.

T 1/2 from blood plasma - 79 hours.

Indications for use

Piroxicam is intended for the symptomatic treatment of diseases of the musculoskeletal system: osteoarthritis, rheumatoid arthritis, spondylitis, gout, sciatica, tendovaginitis, bursitis, neuralgia, myalgia, ankylosing spondylitis (Bechterew's disease), pain in the spine, inflammation of soft tissues, post-traumatic pain and to reduce pain syndrome in primary dysmenorrhea. The drug reduces inflammation and pain, but does not affect the course of the disease.

Piroxicam gel is used to relieve pain in sports injuries (bruises, sprains, dislocations, damage to muscles and ligaments), ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, chronic juvenile arthritis, tendinitis, tendovaginitis, shoulder-shoulder syndrome.

Contraindications

Capsules

Absolute:

Active gastrointestinal bleeding, erosive and ulcerative changes in the mucous membrane of the stomach or duodenum, cerebrovascular or other bleeding;
Hemophilia and other bleeding disorders;
Inflammatory bowel disease (Crohn's disease, ulcerative colitis) in the acute phase;
Decompensated heart failure;
Severe renal failure (creatinine clearance less than 30 ml / min), progressive kidney disease, confirmed hyperkalemia;
liver failure or any active liver disease;
The period after coronary artery bypass grafting;
Age up to 15 years;

Diseases of peripheral arteries;
Cerebrovascular disease, ischemic heart disease, congestive heart failure;
Diabetes;
Renal failure with creatinine clearance 30–60 ml/min;
Hyperlipidemia/dyslipidemia;
The presence of Helicobacter pylori;
Arterial hypertension;
Bronchial asthma;
hepatic porphyria;
Postoperative period;
Dehydration;
Frequent use of alcohol;
Smoking;
Anamnestic data on the development of ulcerative lesions of the gastrointestinal tract;
Prolonged use of NSAIDs;
Severe somatic diseases;
Simultaneous use with anticoagulants, antiaggregants, oral glucocorticosteroids, selective serotonin reuptake inhibitors;
Age over 65 years.

Tablets and suppositories

Aggravated history of gastrointestinal ulcer, bleeding or perforation;
active peptic ulcer, inflammatory gastrointestinal disease, or gastrointestinal bleeding;
A burdened history of gastrointestinal disorders that led to bleeding, for example, Crohn's disease, ulcerative colitis, diverticulitis, cancer of the gastrointestinal tract;
Combined use with other NSAIDs, including selective COX-2 inhibitors and acetylsalicylic acid in analgesic doses;
A history of serious allergic reactions of any type, especially skin reactions such as erythema multiforme, toxic epidermal necrolysis, Stevens-Johnson syndrome;
Severe renal/liver failure;
severe heart failure;
Simultaneous use with anticoagulants;
Burdened history of manifestations of bronchial asthma, rhinitis, urticaria, nasal polyps or Quincke's edema with the use of acetylsalicylic acid and other NSAIDs;
Hemorrhagic diathesis, changes in the blood picture of unclear etiology (including aggravated anamnesis);
Age up to 18 years;
Pregnancy and lactation;
Individual intolerance to the components of Piroxicam (in the form of short-term skin reactions), other NSAIDs and antirheumatic drugs.

Elderly patients (over 65 years), especially in the presence of impaired liver, kidney or heart function, Piroxicam is prescribed with caution.

Gel for external use

Absolute:

Complete or partial combination of bronchial asthma, recurrent polyposis of the mucous membrane of the paranasal or sinuses and intolerance to acetylsalicylic acid and other NSAIDs (currently and in history);
Violations of the integrity of the skin at the site of the intended application;
Severe renal failure with creatinine clearance less than 30 ml / min;
Age up to 14 years;
III trimester of pregnancy and lactation;
Individual intolerance to the components of the drug, as well as other NSAIDs.

Relative (Piroxicam is prescribed under medical supervision):

Exacerbation of hepatic porphyria;
Exacerbation of erosive and ulcerative diseases of the gastrointestinal tract, including peptic ulcer of the stomach and duodenum, Crohn's disease, ulcerative colitis;
Severe liver failure or active liver disease;
Confirmed hyperkalemia;
progressive kidney disease;
Chronic heart failure;
Bronchial asthma;
Condition after coronary artery bypass grafting;
Combined use with other NSAIDs;
Violation of blood coagulation, including hemophilia, bleeding tendency, prolongation of bleeding time, hemorrhagic diathesis;
Elderly age;
I-II trimesters of pregnancy.

Piroxicam, instructions for use: method and dosage

Piroxicam is not a drug of first choice due to its safety profile, therefore, the initial prescription of the drug should be carried out by a physician with experience in the diagnostic evaluation and treatment of inflammatory or degenerative rheumatic diseases.

With the simultaneous use of various forms of Piroxicam (tablets, capsules, gel, suppositories) or other drugs based on piroxicam, its total dose should not exceed 0.04 g per day.

Tablets and capsules

Piroxicam capsules and tablets are for oral use and should be taken with food.

The duration of the course of therapy and the dosage of the drug is determined by the attending physician.

Diseases of the musculoskeletal system and / or joints (osteoarthritis, rheumatoid arthritis, spondylitis): 0.01-0.02 g per day once or in 2 doses; if necessary, the daily dose can be temporarily increased to 0.03 g (once or in several doses) or reduced to 0.01 g;
Acute diseases of the musculoskeletal system: the first 2 days - 0.04 g per day (once or in several doses), then for 1-2 weeks - 0.02 g per day;
Acute attack of gout: 0.04 g per day for 3-5 days;
Dysmenorrhea (with the appearance of the first symptoms): the first 2 days - 0.04 g per day (once or in several doses), in the next 1-3 days - 0.02 g per day for 1 dose;
Post-traumatic pain: initial dose - 0.02 g 1 time per day; it is allowed, if necessary, to increase the dose in the first 2 days to 0.04 g (once or in several doses).

For adults, the maximum daily dose of Piroxicam is 0.04 g.

Suppositories rectal

Piroxicam suppositories are used rectally after a cleansing enema; before administration, it is recommended to moisten the suppository with water.

The effect of the use and tolerability of Piroxicam should be assessed every 2 weeks. When prolonged therapy is needed, this evaluation should be done more frequently. The use of piroxicam has been shown to increase the risk of gastrointestinal complications, so combination therapy with gastroprotective agents (misoprostol or proton pump inhibitors) must be carefully weighed, especially in elderly patients.

Before using the suppository, it is required to tear off 1 piece from the blister pack. in the primary packaging along the perforation line, then pull the edges of the film in different directions and, tearing it, release the suppository from the primary packaging.

Gel for external use

Piroxicam gel is intended for external use.

A column of gel 5-10 mm long is applied to the skin over the painful area 3-4 times a day and gently rubbed.

The duration of therapy, depending on the severity of symptoms, averages:

Tendinitis, tendovaginitis and shoulder-shoulder syndrome - 2 weeks;
Sports injuries - 1-2 weeks.

The maximum duration of therapy is 2 weeks.

Side effects

Tablets, capsules, suppositories

Digestive organs: nausea, vomiting, belching, dry mouth, stomatitis, pain in the epigastric region, loss of appetite, diarrhea or constipation, flatulence, erosive and ulcerative lesions (up to perforation) and / or bleeding (in exceptional cases up to anemia) of the digestive tract , increased activity of liver enzymes, liver failure, increased plasma nitrogen concentration;
Urinary system: renal failure, interstitial nephritis, nephrotic syndrome, nephrosis, proteinuria, erythrocyturia, hyperkalemia, papillary necrosis, glomerulonephritis, increased plasma concentrations of creatinine and urea;
Central nervous system: drowsiness, headache, dizziness, tinnitus; less often - insomnia, depression, irritability, paresthesia, lethargy, hallucinations, emotional lability;
Hematopoietic system and hemostasis system: leukopenia, eosinophilia, anemia (including aplastic and hemolytic), decreased hematocrit; rarely - hemorrhages, thrombocytopenia, Schonlein-Genoch disease (thrombocytopenic purpura);
Cardiovascular system: hypertension or hypotension, symptoms of heart failure; rarely - shortness of breath, palpitations;
Allergic reactions: skin rashes, dermatitis with desquamation of the stratum corneum, pruritus, erythema multiforme exudative, malignant exudative erythema (Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome), anaphylactic shock, bronchospasm, vasculitis, photosensitivity, serum sickness, likely angioedema;
Other reactions: hyper- and hypoglycemia, blurred vision, swelling of the feet and legs, hyperhidrosis, weight gain or decrease.

The most common side effects are from the digestive system; with an increase in the daily dose of piroxicam, the likelihood of these reactions increases.

Symptoms of an overdose with oral forms of the drug are: nausea, vomiting, abdominal pain, blurred vision, drowsiness; in case of taking very large doses - fainting, coma. Therapy of the condition is symptomatic, it is required to wash the stomach with activated charcoal, antacids are used to slow absorption. With a severe degree of poisoning, the patient is hospitalized. There is no specific antidote.

Gel for external use

Local reactions (in the area of application of the gel): redness, inflammation, itching, peeling, contact dermatitis, photosensitivity, eczema;
Systemic reactions (due to the low concentration in the systemic circulation of piroxicam): extremely rarely - abdominal pain, nausea, dyspepsia, gastritis; sometimes - shortness of breath; isolated reports - malignant exudative erythema (Stevens-Johnson syndrome) and toxic epidermal necrolysis (Lyell's syndrome);
Hypersensitivity reactions: rhinitis, bronchospasm, urticaria, angioedema.

With the development of any (including local) side effects, the use of Piroxicam should be discontinued.

Overdose with external use of the gel is practically impossible due to the low systemic absorption of piroxicam.

As a result of accidental ingestion of the gel, nausea, vomiting, burning in the mouth, salivation, systemic adverse reactions (shortness of breath, epigastric pain, headache), interstitial nephritis with impaired renal function and nephrotic syndrome can be observed. It is required to do a gastric and oral lavage, if necessary, to carry out symptomatic therapy. Hemodialysis in this case is ineffective.

Overdose

Main symptoms: blurred vision, drowsiness, vomiting, nausea, epigastric pain, bleeding in the gastrointestinal tract; rarely - acute renal failure, coma, respiratory depression, arterial hypertension; when using large doses - loss of consciousness.

Therapy: gastric lavage with activated charcoal, antacids are prescribed to slow down absorption. In case of severe poisoning, hospitalization is indicated.

Symptomatic treatment is carried out. There is no specific antidote.

special instructions

The drug is used only as directed by a doctor in the shortest possible course at the lowest effective dose in order to prevent unwanted side effects. Prolonged use of piroxicam at a daily dose of more than 0.03 g increases the risk of adverse reactions, primarily from the gastrointestinal tract.

The use of several NSAIDs at the same time increases the risk of side effects, but does not improve the therapeutic effect.

The function of the liver and kidneys, as well as the cellular composition of the blood, is required to be monitored in patients with impaired function of the gastrointestinal tract, after extensive surgical interventions, with bronchial asthma, as well as a history of chronic broncho-obstructive diseases, in old age.

Peptic ulcer or bleeding from the gastrointestinal tract requires discontinuation of treatment; when the use of piroxicam is absolutely necessary, therapy is continued under medical supervision.

In case of visual impairment, a specialist should be consulted.

Since piroxicam affects the tone of the myometrium in women, it is possible to reduce the contraceptive effect of the intrauterine device.

Patients with bronchial asthma, allergic rhinitis, recurrent polyposis of the nose and paranasal sinuses, chronic obstructive pulmonary disease or chronic pulmonary infections are usually more sensitive to NSAIDs. They may have more frequent attacks of bronchial asthma, observed urticaria, Quincke's edema.

It is required to exclude the use of alcohol during therapy with piroxicam.

The gel is applied only to intact skin, avoiding contact with open wound surfaces, mucous membranes and eyes. It is impossible to apply an occlusive dressing on the area treated with the gel.

Influence on the ability to drive vehicles and complex mechanisms

You should refrain from activities that require quick psychomotor reactions and increased concentration.

Use during pregnancy and lactation

Piroxicam in the form of capsules, tablets and suppositories during pregnancy / lactation is not prescribed.

Gel application:

III trimester of pregnancy and breastfeeding period: therapy is contraindicated;
I-II trimesters of pregnancy: Piroxicam can be used after assessing the ratio of the expected benefit to the possible risk.

Application in childhood

Contraindication:

Capsules: up to 15 years;
Tablets and suppositories: up to 18 years;
Gel for external use: up to 14 years.

For impaired renal function

Capsules

Severe renal failure (creatinine clearance less than 30 ml / min), progressive kidney disease, confirmed hyperkalemia: therapy is contraindicated;
Renal failure with creatinine clearance 30–60 ml/min: Piroxicam should be used with caution.

Tablets and suppositories

In severe renal failure, the use of suppositories and Piroxicam tablets is contraindicated.

Gel for external use

Severe renal failure with creatinine clearance less than 30 ml / min: therapy is contraindicated;
Progressive kidney disease: Piroxicam should be used with caution.

For impaired liver function

Capsules

Liver failure or any active liver disease: therapy is contraindicated;
Hepatic porphyria: Piroxicam should be used with caution.

Tablets and suppositories

In severe hepatic insufficiency, the use of Piroxicam is contraindicated.

Gel for external use

With exacerbation of hepatic porphyria, severe liver failure or liver disease in the active stage, the drug is prescribed under medical supervision.

Use in the elderly

Elderly patients Piroxicam is prescribed with caution.

drug interaction

Tablets, capsules, suppositories

Glucocorticosteroids and / or NSAIDs - increases the risk of side effects from the gastrointestinal tract (including bleeding);
Phenobarbital - reduces the level of concentration of piroxicam in the blood serum;
Cimetidine, probenecid and sulfinpyrazone - can increase the level of piroxicam concentration in the blood serum, as a result of which its side effects may increase;
Phenytoin and / or lithium, as well as potassium-sparing diuretics and K + donators - it is possible to increase the plasma level of lithium, phenytoin and potassium;
Diuretics and antihypertensive substances / drugs - piroxicam weakens their effect;
Anticoagulants - blood clotting control is required;
Acetylsalicylic acid - the level of piroxicam concentration in the blood serum decreases, the likelihood of the formation of erosive and ulcerative lesions of the gastrointestinal tract increases;
Selective serotonin reuptake inhibitors (fluoxetine, citalopram, sertraline, paroxetine) - increase the likelihood of erosive and ulcerative lesions of the gastrointestinal tract;
Methotrexate - it is possible to increase its concentration and increase the toxic effect.

Gel for external use

No clinically significant interaction of piroxicam in the form of a gel with other medicinal substances / preparations was noted, but the possibility of enhancing the effects of photosensitizing agents is not excluded.

Analogues

Piroxicam's analogues are: Aroxicam, Xefocam, Oxyten, Movalis, Piroxicam, Meloxicam Sopharma, Fedin-20, Finalgel, Aspicam, Lorakam, Melox.

Terms and conditions of storage

Store in a dark, dry place, out of the reach of children, at temperatures up to 25 °C.

Best before date:

Tablets, capsules - 3 years;
Gel, suppositories - 2 years.