Tenoxicam

Contraindications

The drug is contraindicated for patients who are seniors who have been given anesthesia or surgery; are at risk of increased bleeding or kidney failure; have an active inflammatory disease involving the stomach or intestine (like ulcerative colitis); have an active stomach or intestinal ulcer; have had an acute asthmatic attack, hives, rhinitis (inflammation of the inner lining of the nasal passage), or other allergic reactions caused by aspirin or other nonsteroidal anti-inflammatory drugs (for example diclofenac, ibuprofen, indomethacin, naproxen).

Common side effects that have been observed with tenoxicam include peptic ulceration, dyspepsia, nausea, constipation, abdominal pain, diarrhea, rash, headache, edema, renal failure, and vertigo. In rare cases, tenoxicam and other NSAIDs can contribute to thrombotic events, Stevens-Johnson Syndrome, and toxic epidermal necrolysis.

Pregnancy and breastfeeding

It is not recommended that women who are trying to conceive, who are pregnant, or who are breastfeeding take tenoxicam. Tenoxicam can be taken in the first and second trimester when necessary, but it is a contraindication in the third trimester. Some studies have looked at whether or not NSAIDs are able to enter the breast milk and the first few studies have found evidence that NSAIDs can be found in breast milk. Therefore, it is not recommended that women take tenoxicam while breastfeeding.

Interactions

Taking tenoxicam with other drugs can increase the chance of side effects or alter the therapeutic effect of tenoxicam or the other drug, depending on the combination. Drug types the tenoxicam may interact with include: other analgesic NSAIDs, salicylates such as aspirin, antacids, anticoagulants, cardiac glycosides, ciclosporin, quinolone antibiotics, lithium therapy, diuretics and anti-hypertensives, methotrexate, oral anti-diabetics, colestyramine, dextromethorphan, mifepristone, corticosteroids, anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs), tacrolimus, zidovudine, and gold/penicillamine.

Mechanism of action

Like all NSAIDs, the exact mechanism of action of tenoxicam is unknown. Involved in the mechanism of action is inhibition of cyclooxygenase (COX-1 and COX-2) which leads to the potential adverse effect of increased bleeding.

Society and culture

Tenoxicam is sold in the form of 20 mg tablets with the price of treatment ranging from US$1.29–2.73 per tablet. Recommended dosing calls for tenoxicam to be taken once daily with food. One week is the typical length for treatment, but the treatment length may be extended.

In 2008, the reported sales level for Tilcotil (tenoxicam) was 70 million SEK (approximately US$10.5 million).

Research

The first members of the oxicam family of NSAIDs were brought to market in France in 1982. Shortly thereafter, tenoxicam went to phase III clinical trials for approval as use as an analgesic began in the 1980s. The general consensus from clinical studies is that tenoxicam has about equal analgesic effect as other NSAIDs and does not elicit any important side effects. More recent clinical trials for tenoxicam are examining the use of tenoxicam independently and in combination with other drugs for more specialized analgesic purposes in surgical operations such as third molar extraction and labor pains.

References

References

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