Indications

Ankylosing spondylitis, Osteoarthritis, Pain and inflammation

Contraindication

Hypersensitivity or asthma-type reactions to piroxicam, aspirin or other NSAIDs. History or active GI ulceration, bleeding and perforation; history of GI disorders that predispose to bleeding disorders (e.g. ulcerative colitis, Crohn's disease, GI cancers or diverticulitis). Treatment of perioperative pain in the setting of CABG surgery. Concomitant use w/ aspirin, other NSAIDs and anticoagulants.

Special Precautions

Patient w/ known CV disease or risk factors for CV disease, fluid retention or heart failure, cerebrovascular disease, uncontrolled HTN, asthma. Elderly. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, drowsiness, fatigue or visual disturbance, if affected, do not drive or operate machinery. Monitoring Parameters Monitor occult blood loss, Hb, haematocrit, electrolytes, renal and hepatic function; periodic ophthalmologic exams w/ chronic use. Closely monitor BP during initiation and throughout therapy.

Side Effects

Oedema, CHF, HTN, syncope, tachycardia; anorexia, abdominal pain, constipation, diarrhoea, dyspepsia, flatulence, heartburn, nausea, vomiting, dry mouth, esophagitis, gastritis, glossitis, haematemesis, melaena, stomatitis; anaemia, increased bleeding time, ecchymosis, eosinophilia, epistaxis, leucopenia, thrombocytopenia; cystitis, dysuria, haematuria, hyperkalaemia, interstitial nephritis, nephritic syndrome, oliguria/polyuria, proteinuria, renal failure; dizziness, headache, anxiety, asthenia, confusion, depression, dream abnormalities, drowsiness, insomnia, malaise, nervousness, paraesthesia, somnolence, tremors, vertigo; tinnitus, blurred vision; elevated LFT results; pruritus, rash, alopecia, bruising, desquamation, erythema, petechial rash, photosensitivity, purpura, sweating, serum sickness-like reactions; fever, infection, sepsis, wt changes, asthma, dyspnoea.

Drug Interactions

Increased risk of GI bleeding w/ anti-platelets and SSRIs. May exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels. Increased risk of nephrotoxicity w/ ciclosporin and tacrolimus. Increased absorption w/ cimetidine. Increased risk of GI ulceration w/ corticosteroids. May interfere w/ the natriuretic action of diuretics. May displace other highly protein-bound drugs. May increase steady state plasma lithium levels. May antagonise the effect of antihypertensives. May reduce the excretion of methotrexate, leading to acute toxicity. Increased risk of convulsions w/ quinolones. May interfere w/ mifepristone-mediated termination of pregnancy.

Route of Administration

Oral, Topical

Dosage

As directed by the physician