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| Pronunciation | /paɪˈrɒksɪˌkæm/ |
| Trade names | Feldene, others[1] |
| Other names | Piroksikam, piroxikam |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a684045 |
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| Routes of administration | By mouth |
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| Pharmacokinetic data | |
| Protein binding | 99%[3] |
| Metabolism | Liver-mediatedhydroxylation andglucuronidation[3] |
| Eliminationhalf-life | 50 hours[3] |
| Excretion | Urine, faeces |
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| ECHA InfoCard | 100.048.144 |
| Chemical and physical data | |
| Formula | C15H13N3O4S |
| Molar mass | 331.35 g·mol−1 |
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Piroxicam is anonsteroidal anti-inflammatory drug (NSAID) of theoxicam class used to relieve the symptoms of painful inflammatory conditions likearthritis.[3][4] Piroxicam works by preventing the production of endogenousprostaglandins which are involved in the mediation of pain, stiffness, tenderness and swelling.[3] The medicine is available ascapsules,tablets and, in some countries, as a prescription-freegel 0.5%.[5] It is also available in abetadex formulation, which allows a more rapid absorption of piroxicam from the digestive tract.[3] Piroxicam is one of the few NSAIDs that can be givenparenteral routes.[citation needed]
It was patented in 1968 byPfizer and approved for medical use in 1979.[6] It became generic in 1992,[7] and is marketed worldwide under many brand names.[1]
It is used in the treatment of certain inflammatory conditions likerheumatoid andosteoarthritis, primarydysmenorrhoea, and postoperative pain; it acts as ananalgesic, especially where there is aninflammatory component.[3] TheEuropean Medicines Agency issued a review of its use in 2007 and recommended that its use be limited to the treatment of chronic inflammatory conditions, as it is only in these circumstances that its risk-benefit ratio proves to be favourable.[5][8]
As with other NSAIDs the principal side effects include: digestive complaints likenausea, discomfort,diarrhoea and bleeds or ulceration of thestomach, as well asheadache, dizziness, nervousness,depression, drowsiness,insomnia, vertigo, hearing disturbances (such astinnitus),high blood pressure,oedema, light sensitivity, skin reactions (including, albeit rarely,Stevens–Johnson syndrome andtoxic epidermal necrolysis) and rarely,kidney failure,pancreatitis,liver damage, visual disturbances, pulmonaryeosinophilia andfibrosing alveolitis.[5] Compared to other NSAIDs it is more prone to causing gastrointestinal disturbances and serious skin reactions.[5]
In October 2020, the U.S.Food and Drug Administration (FDA) required theprescribing information to be updated for all nonsteroidal anti-inflammatory medications to describe the risk of kidney problems in unborn babies that result in low amniotic fluid.[9][10] They recommend avoiding NSAIDs in pregnant women at 20 weeks or later in pregnancy.[9][10]
Piroxicam is an NSAID and, as such, is a non-selectiveCOXinhibitor possessing both analgesic andantipyretic properties.[5]
Piroxicam exists asalkenoltautomer in organic solvents and aszwitterionic form in water.[11] Piroxicam features asultam, a cyclicsulfonamide.
The project that produced piroxicam began in 1962 atPfizer; the first clinical trial results were reported in 1977, and the product launched in 1980 under the brand name "Feldene".[7][12] Major patents expired in 1992[7] and the drug is marketed worldwide under many brandnames.[1]
This article incorporates text from this source, which is in thepublic domain. This article incorporates text from this source, which is in thepublic domain.| pyrazolones / pyrazolidines | |
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| salicylates | |
| acetic acid derivatives and related substances | |
| oxicams | |
| propionic acid derivatives (profens) |
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| n-arylanthranilic acids (fenamates) | |
| COX-2 inhibitors (coxibs) | |
| other | |
| NSAID combinations | |
Key:underline indicates initially developed first-in-class compound of specific group;#WHO-Essential Medicines;†withdrawn drugs;‡veterinary use. | |
