Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Piroxicam
General information
Piroxicam was the first of the oxicam compounds, and is by far the most widely used. It is an inhibitor of prostaglandin synthesis and platelet aggregation. Its long half-life (36–48 hours) allows it to be given in a single daily dose. Adverse reactions data from 46 trials in 3827 patients, 2716 on short-term treatment (less than 12 weeks), have been reviewed [ ]. In 20 controlled trials in 816 patients, adverse reactions occurred in 27%, causing withdrawal in 2.2%. However, an uncontrolled study registered adverse reactions in only 16% of patients. Allowing for all analyses and reviews, the overall adverse reactions profile of piroxicam seems to be qualitatively the same as that of other NSAIDs, with gastrointestinal complaints at the top of the list.
Cinnoxicam is the cinnamate ester of piroxicam, with similar adverse reactions. Gastrointestinal effects (81%), nervous system effects (4%), and cutaneous reactions (4%) were most common in a multicenter postmarketing surveillance study of 2969 patients; 12% had adverse effects [ ]. Cinnoxicam cream can cause itchy erythema, edema, vesicles, and exudation [ , ].
General adverse effects and adverse reactions
Reactions involving the gastrointestinal system occur in up to 40% of patients. The approximately 1% incidence of peptic ulcer rises to 7% in patients who take dosages higher than 20 mg/day for several weeks [ ]. Nervous system reactions are the second most frequent types of adverse reaction. Changes in laboratory findings (creatinine, aspartate aminotransferase, alanine aminotransferase) are frequent, but they have little clinical relevance. Hypersensitivity reactions do not seem to be a problem with piroxicam treatment, although skin or mucosal reactions have been reported. Shock has been described. Tumor-inducing effects have not been reported.
Organs and systems
Respiratory
In two cases piroxicam caused pulmonary infiltrates and eosinophilia [ ].
Nervous system
Adverse reactions in about 11% of patients include headache, dizziness, drowsiness, fatigue, and sweating [ ].
Sensory systems
Vision
Blurred vision and burning eyes have been described with piroxicam [ ].
Hearing
Permanent sensorineural hearing loss and tinnitus have been described with piroxicam [ ].
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here