Tenoxicam

Tenoxicam
Clinical data
AHFS/Drugs.com International Drug Names
Routes of
administration		 Oral
ATC code M01AC02 (WHO)
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
Pharmacokinetic data
Protein binding High
Biological half-life 30–140 hours
Identifiers
PubChem (CID) 5282194
ChemSpider 4471584 N
UNII Z1R9N0A399 YesY
KEGG D01767 YesY
ChEBI CHEBI:32192 N
ECHA InfoCard 100.149.365
Chemical and physical data
Formula C13H11N3O4S2
Molar mass 337.376 g/mol
 NYesY (what is this?)  (verify)

Tenoxicam is a non-steroidal anti-inflammatory drug (NSAID). It was originated by Roche but as of 2008 is sold by Meda AB under the trade name Mobiflex. It is available as a prescription-only drug in the United Kingdom and other countries, but not in the US. Outside of the United Kingdom, tenoxicam is also marketed under brand names including Tilatil, Tilcitin, and Alganex.[1][2] Tenoxicam belongs to the class of NSAIDs known as oxicams. It is used to relieve inflammation, swelling, stiffness, and pain associated with rheumatoid arthritis, osteoarthritis, ankylosing spondylitis (a type of arthritis involving the spine), tendinitis (inflammation of a tendon), bursitis (inflammation of a bursa, a fluid-filled sac located around joints and near the bones), and periarthritis of the shoulders or hips (inflammation of tissues surrounding these joints).[1]

Mechanism of action

Like all non-steroidal anti-inflammatory drugs, the exact mechanism of action of tenoxicam in unknown. Involved in the mechanism of action is inhibition of cyclooxygenase (COX-1 and COX-2) which leads to the potential adverse effect of increased bleeding.[3]

Contraindications

The drug is contraindicated for patients who are seniors who have been given anesthesia or surgery; are at risk of increased bleeding or kidney failure; have an active inflammatory disease involving the stomach or intestine (like ulcerative colitis); have an active stomach or intestinal ulcer; have had an acute asthmatic attack, hives, rhinitis (inflammation of the inner lining of the nasal passage), or other allergic reactions caused by Aspirin or other nonsteroidal anti-inflammatory drugs (for example diclofenac, ibuprofen, indomethacin, naproxen).[4][5]

Common side effects that have been observed with tenoxicam include peptic ulceration, dyspepsia, nausea, constipation, abdominal pain, diarrhea, rash, headache, edema, renal failure, and vertigo.[3][5][6] In rare cases, tenoxicam and other NSAIDs can contribute to thrombotic events, Stevens-Johnson Syndrome, and toxic epidermal necrolysis.[7][8][9]

Pregnancy and breastfeeding

It is not recommended that women who are trying to conceive, who are pregnant, or who are breastfeeding take tenoxicam. Tenoxicam can be taken in the first and second trimester when necessary, but it is a contraindication in the third trimester. Some studies have looked at whether or not NSAIDs are able to enter the breast milk and the first few studies have found evidence that NSAIDs can be found in breast milk. Therefore, it is not recommended that women take tenoxicam while breastfeeding.[3][5][6]

Interactions

Taking tenoxicam with other drugs can increase the chance of side effects or alter the therapeutic effect of tenoxicam or the other drug, depending on the combination. Drug types the tenoxicam may interact with include: other analgesic NSAIDs, salicylates such as aspirin, antacids, anticoagulants, cardiac glycosides, ciclosporin, quinolone antibiotics, lithium therapy, diuretics and anti-hypertensives, methotrexate, oral anti-diabetics, colestyramine, dextromethorphan, mifepristone, corticosteroids, anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs), tacrolimus, zidovudine, and gold/penicillamine.[3][5][6]

Research

The first members of the oxicam family of NSAIDs were brought to market in France in 1982.[10] Shortly thereafter, tenoxicam went to phase III clinical trials for approval as use as an analgesic began in the 1980s. The general consensus from clinical studies is that tenoxicam has about equal analgesic effect as other NSAIDs and does not elicit any important side effects. More recent clinical trials for tenoxicam are examining the use of tenoxicam independently and in combination with other drugs for more specialized analgesic purposes in surgical operations such as third molar extraction and labor pains.[11][12][13]

Society and culture

Tenoxicam is sold in the form of 20 milligram tablets with the price of treatment ranging from US$1.29-2.73 per tablet.[14] Recommended dosing calls for tenoxicam to be taken once daily with food. One week is the typical length for treatment, but the treatment length may be extended.[3]

In 2008, the reported sales level for Tilcotil (tenoxicam) was 70 million SEK (approximately $10.5 million USD).[14][15]

See also

References

  1. 1 2 NHS Medicines A-Z - Tenoxicam Page accessed July 3, 2015
  2. ↑ Drugs.com Drugs.com international listings for Tenoxicam Page accessed July 3, 2015
  3. 1 2 3 4 5 "Incepta Pharmaceuticals | Product details". www.inceptapharma.com. Retrieved 2015-12-07.
  4. ↑ NHS Patient warnings Page accessed July 3, 2015
  5. 1 2 3 4 "Mobiflex Tablets 20mg - Summary of Product Characteristics (SPC) - (eMC)". www.medicines.org.uk. Retrieved 2015-12-07.
  6. 1 2 3 Tilcotil. (2010). New Zealand Consumer Medicine Information. http://www.medsafe.govt.nz/consumers/cmi/t/tilcotil.pdf
  7. ↑ Mockenhaupt, Maja; Viboud, Cecile; Dunant, Ariane; Naldi, Luigi; Halevy, Sima; Bavinck, Jan Nico Bouwes; Sidoroff, Alexis; Schneck, Jürgen; Roujeau, Jean-Claude (2007-09-06). "Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: Assessment of Medication Risks with Emphasis on Recently Marketed Drugs. The EuroSCAR-Study". Journal of Investigative Dermatology. 128 (1): 35–44. doi:10.1038/sj.jid.5701033. ISSN 0022-202X.
  8. ↑ Harr, Thomas; French, Lars E. (2010-12-16). "Toxic epidermal necrolysis and Stevens-Johnson syndrome". Orphanet Journal of Rare Diseases. 5 (1): 39. doi:10.1186/1750-1172-5-39. ISSN 1750-1172. PMC 3018455Freely accessible. PMID 21162721.
  9. ↑ Assessment report for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and cardiovascular risk. (2012, Oct. 18). European Medicines Agency. http://www.ema.europa.eu/docs/en_GB/document_library/Report/2012/11/WC500134717.pdf
  10. ↑ Penso, D (1986). "Toxic epidermal necrolysis after oxicam use.". Journal of the American Academy of Dermatology. 14: 275–6. doi:10.1016/s0190-9622(86)80342-5. PMID 3485122.
  11. ↑ "Search of: tenoxicam - List Results - ClinicalTrials.gov". www.clinicaltrials.gov. Retrieved 2015-12-07.
  12. ↑ Agacayak, Kamil Serkan (January 2014). "A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction.". Medical Science Monitor. 20: 147–52. doi:10.12659/MSM.890239. PMC 3915002Freely accessible. PMID 24473372.
  13. ↑ Mathias Filho, Annibal Pires (1985). "Long-term study with Ro 12-0068 (tenoxicam) in the treatment of rheumatoid arthritis.". European Journal of Rheumatology and Inflammation. 8: 3–8. PMID 3915886.
  14. 1 2 "Tenoxicam 20 mg Price Comparisons - Online Pharmacies and Discount Coupons". www.pharmacychecker.com. Retrieved 2015-12-07.
  15. ↑ "Exchange Rate Average (Swedish Krona, US Dollar) - X-Rates". www.x-rates.com. Retrieved 2015-12-07.
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