Indications
Flexicam IM Injection is used for:
Acute gout, Rheumatic disorders, Postoperative pain, Acute musculoskeletal conditions, Juvenile idiopathic arthritis
Adult Dose
Adult:
Rheumatic disorders
Initial: 20 mg/day as a single dose. Maintenance: 10-30 mg in single or divided doses.
Acute gout
40 mg/day for 5-7 days.
Acute musculoskeletal conditions; Post-op pain
Initial: 40 mg/day for 2 days. Maintenance: 20 mg/day for 1-2 wk.
Child Dose
Juvenile idiopathic arthritis
Child: >6 yr: <15 kg: 5 mg,
16-25 kg: 10 mg,
26-45 kg: 15 mg,
>46 kg: 20 mg.
Doses to be taken once daily.
Renal Dose
Administration
Should be taken with food.
Contra Indications
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.
Precautions
Patient w/ known CV disease or risk factors for CV disease, fluid retention or heart failure, cerebrovascular disease, uncontrolled HTN, asthma. Elderly. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, drowsiness, fatigue or visual disturbance, if affected, do not drive or operate machinery. Monitoring Parameters Monitor occult blood loss, Hb, haematocrit, electrolytes, renal and hepatic function; periodic ophthalmologic exams w/ chronic use. Closely monitor BP during initiation and throughout therapy.
Lactation: excreted in breast milk; has adverse effect on the nursing infant
Pregnancy-Lactation
Pregnancy Category: C, D during third trimester of pregnancy (may cause premature closure of the ductus arteriosus)
Lactation: excreted in breast milk; has adverse effect on the nursing infant
Interactions
Increased risk of GI bleeding w/ anti-platelets and SSRIs. May exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels. Increased risk of nephrotoxicity w/ ciclosporin and tacrolimus. Increased absorption w/ cimetidine. Increased risk of GI ulceration w/ corticosteroids. May interfere w/ the natriuretic action of diuretics. May displace other highly protein-bound drugs. May increase steady state plasma lithium levels. May antagonise the effect of antihypertensives. May reduce the excretion of methotrexate, leading to acute toxicity. Increased risk of convulsions w/ quinolones. May interfere w/ mifepristone-mediated termination of pregnancy.
Potentially Fatal: May enhance the effect of anticoagulants (e.g. warfarin). Increased risk of serious GI events w/ aspirin and other NSAIDs.
Side Effects
Side effects of Piroxicam :
1-10%
Indigestion (3.8-9.5% ), Upper respiratory infection (up to 8.3% ), Headache (2.4-8.3% ), Diarrhea (1.9-7.8% ), Nausea (2.4-7.2% ), Abdominal pain (1.9-4.7%), Edema (0.6- 4.5%), Anemia (up to 4.1% ), Dizziness (1.1-3.8% ), Constipation (0.8-2.6% ), Vomiting, Fever, Angina (<2% ), Congestive heart failure (<2% ), Hypertension (<2% ), Myocardial infarction (<2% ), Gastrointestinal hemorrhage (< 2% ), Gastrointestinal perforation, gastrointestinal ulcer (< 2% ), Inflammatory disorder of digestive tract (<2% ), Decreased platelet aggregation, purpuric disorder (<2% ), Hepatitis (<2% )
<1%
Erythema multiforme, erythroderma, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Jaundice, liver failure, Anaphylactoid reaction, Immune hypersensitivity reaction, Cerebrovascular accident, Interstitial nephritis, renal failure, Asthma, bronchospasm, Angioedema, Tinnitus, hearing loss
Potentially Fatal: Thrombocytopaenia and acute nephropathy. Toxic epidermal necrolysis and Stevens-Johnson syndrome.
Mode of Action
Piroxicam is a NSAID, belonging to the oxicam group. It inhibits prostaglandin synthesis, reduces fever by acting on the heat-regulating center of the hypothalamus, inhibits platelet-aggregating substance thromboxane A2 and reduces pain receptor sensitivity. It also exerts anti-inflammatory effect by lysosomal stabilisation, kinin and leukotriene production, alteration of chemotactic factors and neutrophil activation inhibition.
Note
Flexicam 40mg/2ml IM Injection generic name is Piroxicam. Flexicam 40mg/2ml IM Injection is manufactured by Renata LimitedFlexicam is availble in all over Bangladesh.
Mes BD drug index information on Flexicam IM Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.