Oxicam

Indications

Tenoxicam (also spelled Tanoxicam) is a non-steroidal anti-inflammatory drug (NSAID). It is used to relieve pain, swelling and stiffness in osteoarthritis, rheumatoid arthritis and ankylosing spondylitis (inflammatory arthritis of the spine). It is also used for short-term treatment of soft tissue injuries such as sprains, strains, tendinitis and bursitis.

How It Works

Tenoxicam blocks the cyclo-oxygenase (COX) enzymes that make prostaglandins, chemicals that cause pain, swelling and fever. Lowering prostaglandins reduces inflammation and pain. It stays in the body a long time, so one dose a day is enough.

Dosage and Administration

The usual adult dose is 20 mg once daily, taken at the same time each day with or after food and a glass of water. For soft tissue injuries it is usually taken for up to 7 days, and not more than 14 days. Higher doses do not give better relief and increase side effects. The injection form is given by a doctor or nurse. Not recommended for children.

Interactions

• Other NSAIDs, including Aspirin: more risk of stomach ulcers and bleeding.
• Warfarin, Clopidogrel and other blood thinners, and SSRIs such as Fluoxetine: more risk of bleeding.
• Corticosteroids such as Prednisolone: more risk of stomach ulcers.
• Blood pressure medicines and diuretics (e.g. Enalapril, Losartan, Furosemide): their effect may be reduced and kidney problems may occur.
• Lithium and Methotrexate: blood levels may rise.
• Oral diabetes medicines of the sulfonylurea type: blood sugar should be watched.

Contraindications

Do not take if you are allergic to Tenoxicam, or if Aspirin or other NSAIDs have caused asthma, nasal swelling, hives or other allergy. Do not take if you have, or have had, a stomach or duodenal ulcer or bleeding, severe heart failure, severe kidney or liver disease, or in the last three months of pregnancy.

Side Effects

Common side effects include indigestion, stomach pain, nausea, heartburn, diarrhoea or constipation, headache and dizziness. Less common are swelling of the ankles, raised blood pressure, skin rash and itching. Rarely, stomach ulcers or bleeding, kidney problems, liver problems or serious skin reactions may occur.

Get urgent medical help if you have black or tarry stools, vomit blood or material like coffee grounds, severe stomach pain, chest pain, sudden weakness on one side, a blistering or peeling rash, yellowing of the skin or eyes, or swelling of the face or throat with difficulty breathing.

Pregnancy and Lactation

Avoid in pregnancy unless clearly needed and prescribed by a doctor, and do not use in the last three months, as it may harm the baby's heart and kidneys and delay labour. It may also make it harder to become pregnant. It passes into breast milk in small amounts; use during breastfeeding only on medical advice.

Precautions and Warnings

• Use the lowest effective dose for the shortest time.
• NSAIDs may slightly increase the risk of heart attack and stroke, especially with long use or existing heart disease.
• Use with caution in older people and in those with asthma, high blood pressure, heart, kidney or liver problems, or a history of stomach problems.
• Stop and see a doctor at the first sign of a skin rash.

Overdose

Overdose may cause nausea, vomiting, stomach pain, drowsiness, dizziness and, rarely, stomach bleeding, kidney problems or fits. Seek medical help straight away.

Therapeutic Class

Non-steroidal anti-inflammatory drug (NSAID), oxicam group.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.