Piroxicam dosage

Renai function impairment NSAID metabolites are eliminated primarily by kidneys use with caution in those with renal function impairment. In cases of advanced kidney disease, treatment with piroxicam and meloxicam is not recommended. Reduce dosage to avoid excessive accumulation. 

Piroxicam is a new NSAID and has anti-inflammatory, analgesic and antipyretic activity. It provides effective and long-lasting relief of pain and stiffness. Its convenient once daily dosage provides round the clock relief of symptoms. 

Piroxicam can be used for the usual rheumatic indications. When piroxicam is used in dosages higher than 20 mg/d, an increased incidence of peptic ulcer and bleeding is encountered. Epidemiologic studies suggest that this risk is as much as 9.5 times higher with piroxicam than with other NSAIDs (see common adverse effects above). 

Reduced piroxicam excretion increases the risk of gastrointestinal adverse effects. Most reports of these effects refer to elderly women, since impaired renal function in the elderly can lower excretion of the drug by 33%. Dosages should be as low as possible, and certainly not above 20 mg/day in these patients. 

Norris E, Guttadauria M. Piroxicam new dosage forms. Eur J Rheumatol Inflamm 1987 8 94-104. 

Joseph NJ, Lakshmi S, Jayakrishnan A. A floating-type oral dosage form for piroxicam based on hollow polycarbonate microspheres In vitro and in vivo evaluation in rabbits. Journal of Controlled Release. February 19, 2002 79(l-3) 71-79. PubMed PMID 11853919. 

Printable dosage formulations have been developed for a poorly-soluble drug, piroxicam (54). The critical parameters for the development of such dosage forms were elucidated. Piroxicam is shown in Figure 7.2. 

There are numerous examples of medicinal products in which dissolution rate enhancing technologies are applied to increase the bioavailabiUty or absorption rate of an active substance. Cardiac glycosides should be given as micronised particles in a solid oral dosage form because otherwise their dissolution rate and hence their bioavaUability is too low. Piroxicam was shown to be absorbed faster when given as a cyclodextrin complex, which increases the dissolution rate. Similarly, the bioavailabiUty of albendazole as a cyclodextrin complex was increased compared to crystalline non-complexed albendazole, based on the same mechanism. And finally, the bioavailabiUty of amorphous chloramphenicol is higher than that of crystalline chloramphenicol. 

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