Piroxicam beta-cyclodextrin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Ankylosing spondylitis; Osteoarthritis; Rheumatoid arthritis 20 mg/day as a single dose.
Dosage Details
Oral
Ankylosing spondylitis, Osteoarthritis, Rheumatoid arthritis
Adult: 20 mg daily as a single dose.
Elderly: 10 mg daily and limit the duration of treatment.
Contraindications
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/ uncontrolled HTN, CHF, established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, risk factors for CV disease, cardiac impairment, history of bronchial asthma. Elderly. Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Ulcerative stomatitis, anorexia, epigastric or abdominal discomfort or pain, nausea, constipation, flatulence, diarrhoea, vomiting, dyspepsia, melaena, haematemesis; non-specific allergic reactions, asthma, aggravated asthma, bronchospasm, dyspnoea, photosensitivity reactions; interstitial nephritis, glomerulo-nephritis, nephrotic syndrome, renal failure; thrombocytopenia, non-thrombocytopenic purpura, leucopenia, eosinophilia; increased transaminase levels, jaundice; oedema, HTN, cardiac failure; dizziness, headache, somnolence, insomnia, depression, nervousness, hallucinations, mood alterations, dream abnormalities, mental confusion, paraesthesias, vertigo, visual disturbances, optic neuritis, tinnitus, malaise, fatigue, drowsiness, palpitations, hypoglycaemia, wt increase/decrease, positive antinuclear antibodies, hearing impairment.
Potentially Fatal: GI bleeding, ulceration and perforation, exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, anaphylaxis, hepatitis, arterial thrombotic events (e.g. MI or stroke).
PO: C (prior to 30 weeks gestation), D (starting at 30 weeks gestation)
Overdosage
Symptoms: Headache, vomiting, drowsiness, dizziness and fainting. Management: Supportive and symptomatic treatment including gastric lavage and the use of activated charcoal to reduce absorption. Correction of severe electrolyte abnormalities may be considered.
Drug Interactions
May reduce the effect of antihypertensive drugs. May interfere w/ the natriuretic effect of diuretics. May increase plasma levels of cardiac glycoside. May displace other protein bound drugs (e.g. sulfonamides, hydantoins). Increased risk of GI bleeding w/ anti-platelet agents and SSRIs. May decrease the elimination of lithium. Increased risk of convulsions associated w/ quinolones. May reduce the effect of mifepristone. May decrease the elimination of methotreaxate. May increase ciclosporin nephrotoxicity. Increased risk of GI ulceration or bleeding w/ corticosteroids. Reduced metabolism and elimination w/ probenecid. May inhibit the metabolism of sulfonylureas resulting to increased risk of hypoglycaemia.
Potentially Fatal: May enhance the effect of anticoagulants (e.g. warfarin). Increased risk of adverse effects, particularly GI effects w/ aspirin and other NSAIDs.
Action
Description: Piroxicam β-cyclodextrin is the product of supermolecular encapsulation of piroxicam w/ the cyclic oligosaccharide β-cyclodextrin. Its action as an analgesic is more rapid than standard piroxicam.
Pharmacokinetics:
Absorption: More rapidly absorbed than unmodified piroxicam. Time to peak plasma concentration: 30-60 min.
Metabolism: Converted to various sugars in the colon.
Excretion: Plasma half-life: Approx 50 hr.
Chemical Structure

Chemical Structure Image
Piroxicam beta-cyclodextrin

Source: National Center for Biotechnology Information. PubChem Database. Piroxicam-beta-cyclodextrin, CID=54697648, https://pubchem.ncbi.nlm.nih.gov/compound/Piroxicam-beta-cyclodextrin (accessed on Jan. 22, 2020)

References
Dolci G, Ripari M, Pacifici L, Umile A. Analgesic Efficacy and the Tolerance for Piroxicam-Beta-Cyclodextrin Compared to Piroxicam, Paracetamol and Placebo in the Treatment of Postextraction Dental Pain. Minerva Stomatol. 42(5). Accessed 24/11/2014. PMID: 8413108

Buckingham R (ed). Piroxicam. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/11/2014.

Disclaimer: This information is independently developed by MIMS based on Piroxicam beta-cyclodextrin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • Nysa
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in