Piroxicam 20mg Domesco tablets reduce symptoms of rheumatoid arthritis (3 blisters x 10 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Piroxicam

Ingredient

Composition information	Content
Piroxicam	20mg

Uses

Indications

Piroxicam 20mg Domesco drugs are indicated to reduce symptoms of rheumatoid arthritis, osteoarthritis or joint spondylitis.

Due to its safety, Piroxicam is not the first selected nonsteroidal anti -inflammatory drug. Piroxicam prescription is based on assessing the overall risk of each patient.

Pharmacological

piroxicam is an nonsteroidal anti -inflammatory drug, which has analgesic and reducing fever. In experimental animals, piroxicam can inhibit edema, erythema, tissue hypertrophy, fever and pain. Effective on all causes of inflammation.

The mechanism of action of the drug has not been clear, independent studies in vitro as well as in vivo show that Piroxicam acts on some stages of immune response and inflammation through:

Prostanoid synthesis inhibitors, including prostaglandin through inhibition of cyclo-oxygenase recovery.

Inhibition of neutrophils.

Inhibition of polygamy leukemia and single nucleus moves to the inflammatory area.

Inhibiting the Lysosom enzyme inhibitors released from white blood cells.

Reduce the production of low -type factors in the epidemic and the whole body in patients with rheumatoid arthritis with positive serum.

Dynamic pharmacokinetics

absorption:

Piroxicam is well absorbed through the gastrointestinal tract or rectum. Food reduces the absorption rate but does not change the level of drug absorption after taken. The sale time of the drug in plasma is about 50 hours in men and the stable concentration of the drug is maintained all day at a dose once a day.

When treated continuously at a dose of 20 mg/day for 1 year, the blood concentration in the blood is similar to the concentration of the drug in a stable state.

Metabolism and elimination:

Piroxicam is widely metabolized and less than 5% of daily dose is eliminated in urine and feces in the form of unchanged. The main metabolism of piroxicam via cytochrom CYP 2C9 intermediaries in the liver. The important metabolic line is hydroxyl - chemical pyridine, followed by glucuronic acid and excreted in urine.

Before taking Piroxicam 20mg Domesco tablets reduce symptoms of rheumatoid arthritis (3 blisters x 10 tablets)

How to use

Take oral, take medicine with 1 glass of water.

Dosage

prescribed drugs based on diagnostic and treatment experience in patients with inflammation or osteoarthritis.

Maximum daily dose is 20 mg.

Unwanted effects can be reduced by minimum doses that are effective in the shortest time that can control symptoms. The benefits and tolerances of the treatment process should be considered within 14 days. If necessary to continue treatment, should monitor regularly.

Elderly: Like other nonsteroidal anti -inflammatory drugs, need to be cautious when used for elderly patients at risk of impaired renal, liver or heart function.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose? Studies indicate that taking activated carbon can reduce the reabsorption of piroxicam, thus reducing the remaining amount of drugs.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

Common, ADR> 1/100:

Blood and lymph: Anemia, Eosin cells like Eosin, leukemia, platelets.

Neurology: dizziness, headache, drowsiness, dizziness.

Vestibular and ears: Tinnitus.

skin: itching, rash.

General disorder: edema (mainly ankle).

digestion: abdominal discomfort, abdominal pain, constipation, diarrhea, epigastric pain, flatulence, nausea, vomiting, indigestion.

Metabolism and nutrition: weight gain, anorexia, hyperglycemia.

Uncommon, 1/1000

Metabolism and nutrition: Hypoglycemia.

eyes: blurred vision.

Cardiovascular: Brushing the chest. digestive: stomatitis.

Instructions on how to handle ADR:

Physicians should regularly monitor patients with signs of ulcerative syndrome and gastrointestinal bleeding, notify them closely monitor those signs. If it happens, it must be stopped.

Patients who are taking drugs that have vision disorders need to be tested and evaluated with eye.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

Piroxicam 20 mg contraindicated in the following cases:

History of ulcers, bleeding or gastric - intestinal perforation.

History of patients with digestive disorders leading to bleeding disorders such as ulcerative colitis, Crohn's disease, gastrointestinal cancer or excess bags.

Patients with progressive stomach ulcers, gastrointestinal inflammation or gastrointestinal bleeding.

Simultaneously used with other NSAIDs, including nonsteroidal anti-inflammatory drugs selective COX-2 and acetylsalicylic acid with analgesic dose.

Simultaneously used with anticoagulants.

History has any serious allergic reactions, especially the skin reaction such as diverse roses, Stevens-Johnson syndrome, toxic epidermis.

Hypersensitivity to piroxicam and other ingredients, previous skin reactions (regardless of the severity) with Piroxicam, other nonsteroidal anti -inflammatory drugs and other drugs.

History of bronchospasm, asthma, nasal polyps and quincke edema or jute due to Aspirin, or another nonsteroidal anti -inflammatory drug.

Severe heart failure.

In the last three months of pregnancy.

Be cautious when using drugs

Clinical benefits and ability to tolerate should be reassused periodically and stop using Piroxicam immediately when the skin reaction appears or digestive problems.

Non -steroid anti -inflammatory drugs, including piroxicam, can cause serious gastrointestinal complications including bleeding, ulcers and puncture of the gastric, small intestine or large intestine, which can be fatal.

The risk of serious digestive tract complications increases with age, 70 -year -old patients are at high risk of complications. Avoid use for elderly patients over 80 years old.

Simultaneous use of oral corticosteroids, selective inhibitors of Serotonin reabsorption (SSRIs) or platelet anti -platelets such as acetylsalicylic acid, low -dose, increases the risk of serious digestive tract complications. Like other nonsteroidal anti -inflammatory drugs, the therapy in combination with gastrointestinal protection drugs (eg Misoprostol or proton pump inhibitors) should be carefully considered, especially for high -risk patients.

Patients with uncontrolled hypertension, congestive heart failure, ischemic heart disease, peripheral artery disease and/or brain blood vessels should only be treated with piroxicam after careful evaluation. The same assessment should be done before the long -term treatment of patients with risk factors for cardiovascular complications (e.g. hypertension, hyperlipidemia, diabetes, smoking).

Caution in patients who are or have a history of bronchial asthma.

Patients who know or suspect have poor metabolism of CYP 2C9 based on a history/ experience with other substrates of CYP 2C9, so they should be cautious when using piroxicam because of the abnormal high piroxicam concentration due to reduction of clearance due to metabolism.

Life-threatening skin reactions (Stevens-Johnson syndrome (SJS) and toxic epidermal necrosis (ten) have been reported when using piroxicam.

Piroxicam 20 mg should be used carefully in patients with renal failure, liver and heart failure. In a rare case, Piroxicam can cause interstitial nephritis, glomerulonephritis, kidney necrosis and nephrotic syndrome.

Prostaglandin synthetic inhibitors play a supportive role in maintaining kidney perfusion in patients with flow and blood volume through the kidneys decreases. In these patients, Piroxicam may increase kidney complications, but will recover the condition before treatment when stopping piroxicam. Should be carefully monitored when there is the most severe risk such as congestive heart failure, cirrhosis, kidney syndrome and kidney disease when using piroxicam.

There have been a report on eye -catching reactions, eye tests are recommended when using piroxicam.

Non -steroid anti -inflammatory drugs (NSAIDs), non -aspirin, use systemic sugar, may increase the risk of cardiovascular thrombosis, including myocardial infarction and stroke, which can lead to death. This risk can appear early in the first few weeks of taking the drug and can increase over time. The risk of cardiovascular thrombosis is recorded mainly at high doses.

Piroxicam can reduce fertility in women. In women who have difficulty conceiving or people who are treating infertility, should stop using Piroxicam,

The ability to drive and operate machinery

The drug can cause dizziness, dizziness, drowsiness, fatigue and visual disorders. Therefore, cautious when driving and operating machinery.

Pregnancy

because Piroxicam inhibits Prostaglandin synthesis, it can cause harmful effects for pregnant women. Data from epidemiological studies shows an increase in the risk of natural miscarriage after using prostaglandin synthetic inhibitors during the early pregnancy. Piroxicam should not be used in the first 3 months of pregnancy or near labor unless the benefits are greater than the risk for the fetus.

The period of breastfeeding

A study shows that Piroxicam appears in breast milk about 1-3% of the mother's plasma concentrations. There is no accumulation of piroxicam in breast milk when used for more than 52 days. It is not recommended to use Piroxicam for mothers during breastfeeding due to unknown clinical safety.

Interactive drug

anticoagulant drugs: Piroxicam can increase the effects of anticoagulant drugs, like warfarin. Therefore, simultaneous use of piroxicam with anticoagulant drugs like warfarin.

Anti -platelet aggregation and selective inhibitors of Serotonin reabsorption (SSRI): Increased risk of stomach -intestinal bleeding.

Aspirin and other nonsteroidal anti -inflammatory drugs: Piroxicam, like other nonsteroidal anti -inflammatory drugs, reduces platelet aggregation and prolongs bleeding time. It is necessary to monitor this effect when determining bleeding time.

Cardia Glycosides: Piroxicam can worsen heart failure, reduce GFR glomerular filtration rate and increase glycosides in plasma.

ciclosporin, tacrolimus: increases the risk of kidney toxicity when using simultaneously piroxicam with ciclosporin or tacrolimus.

cimetidine: The results from two independent studies showed a slight increase but significantly the absorption of piroxicam after use simultaneously with cimetidine but did not have a significant change in the level or time of selling emissions.

corticosteroid: increases the risk of stomach or bleeding.

Diuretics: Piroxicam can cause water, sodium and potassium and can affect the excretion of diuretic sodium diuretic. It should be noted that this property when treating patients with heart failure or hypertension due to these diseases can make the disease worse.

High protein -bonding drugs: Because of high protein bonds, piroxicam can push other drugs from plasma proteins. Need closely monitoring to adjust the dose accordingly.

Lithi: Piroxicam increases lithium stability concentrations in plasma, so it is necessary to closely monitor lithium concentration in plasma when starting treatment, adjustment and stop use of piroxicam when necessary.

Like other nonsteroidal anti -inflammatory drugs, it is possible to interact with the following drugs/ groups of drugs:

Anti -blood pressure drugs: Antibiotics to the hypotension effect.

Methotrexate: Reducing the excretion of methotrexate, which can lead to acute poisoning.

Quinolon antibiotics: Increased risk of convulsions.

Mifepriston: Piroxicam will affect the effect of miscarriage through Mifepriston.

Storage

In a dry place, temperatures below 30 ° C, avoid light.

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