Tenoxim 20Tablet

Generic

Tenoxicam

Indications

Tenoxicam is used to treat the symptoms of the following musculoskeletal conditions that are painful, inflammatory, and degenerative:

• Rheumatoid arthritis is a type of arthritis that affects the joints.
• Osteoarthritis.
• Arthrosis.
• Ankylosing spondylitis is a type of arthritis that affects the spine.
• Tendinitis, bursitis, periarthritis of the shoulders (shoulder-hand syndrome) or hips, strains, and sprains are examples of extraarticular illnesses.
• Gout that is acute.

Pharmacology

Tenoxicam could be a non-steroidal anti-inflammatory medicate (NSAID) with anti-inflammatory, pain relieving and antipyretic properties and it too restrains platelet conglomeration. Tenoxicam represses prostaglandin biosynthesis. In-vitro tests of leukocyte peroxidase propose that tenoxicam may act as a forager for dynamic oxygen at the location of irritation. Tenoxicam could be a powerful in-vitro inhibitor of human metalloproteinases (stromelysin and collagenase), which induce cartilage breakdown. These pharmacological impacts clarify, at slightest in portion, the restorative good thing about Tenoxicam within the treatment of excruciating incendiary and degenerative clutters of the musculoskeletal framework. Tenoxicam appeared no mutagenic, carcinogenic or teratogenic impacts in creatures. As with other prostaglandin inhibitors, renal and gastrointestinal impacts, expanded frequency of dystocia and postponed parturition were watched in creature security ponders.

Dosage & Administration

• Standard dosage: For all indications except acute gout, a daily dosage of 20 mg should be given at the same time of day.
• In acute attacks of gout: The recommended dose for acute attacks of gout is 40 mg once daily for two days followed by 20 mg once daily for a further five days.
• In the treatment of chronic disorders: The therapeutic effect of tenoxicam is evident early in treatment but there is a progressive increase in response over time. In chronic disorders, daily doses higher than 20 mg should be avoided since this would increase the frequency and intensity of unwanted reactions without significantly increasing efficacy. For patients needing long-term treatment, a reduction to a daily oral dose of 10 mg may be tried for maintenance.
• Special dosage instructions: In principle, the above dosage recommendations also apply to elderly patients and to patients suffering from kidney or liver disease. Because of lack of clinical experience, no dosage recommendations have so far been established for children and adolescents.

Interaction

As within the case of other NSAIDs, salicylate uproots tenoxicam from protein-binding destinations and increments clearance and volume of dissemination of tenoxicam. Concurrent treatment with salicylate or other NSAIDs ought to be maintained a strategic distance from since of expanded chance of gastrointestinal undesirable responses. The co-administration of a few NSAIDs and methotrexate has been related with diminished renal tubular discharge of methotrexate, higher plasma concentrations of methotrexate, and serious methotrexate poisonous quality. Hence, caution ought to be worked out when Tenoxicam is managed concurrently with methotrexate. No clinically relevant interaction was found within the little number of patients accepting concomitant treatment with gold, penicillamine or probenecid. As Tenoxicam may diminish the renal clearance of lithium, their concomitant organization may lead to expanded plasma levels and poisonous quality of lithium.

The plasma levels of lithium ought to be closely checked. As with NSAIDs in common, Tenoxicam ought to not be managed concurrently with K-sparing diuretics. There's a known interaction between these two classes of compounds, which may cause hyperkalemia and renal disappointment. No clinically noteworthy interaction between Tenoxicam and furosemide was famous, but Tenoxicam constricts the blood pressure-lowering impact of hydrochlorothiazide. As known from other NSAIDs, Tenoxicam might constrict the antihypertensive impacts of alpha-adrenergic blockers and ACE-inhibitors. No intelligent have been detailed between NSAIDs and centrally-acting alpha agonists or calcium channel blockers. There was no clinically important interaction when Tenoxicam was administered in conjunction with atenolol. Amid clinical trials no interaction was detailed for patients treated concomitantly with digitalis items.

Contraindications

Tenoxicam should not be given to patients who are known to be hypersensitive to the drug; in whom salicylates or other non-steroidal anti-inflammatory drugs (NSAIDs) cause symptoms of asthma, rhinitis, or urticaria; or who are suffering from or have previously suffered from upper gastrointestinal tract disease such as gastritis, gastric, or duodenal ulcer.

Tenoxicam was found to be well tolerated in the indicated dose in clinical trials involving large numbers of individuals. In most cases, the negative effects were minor and only lasted a short time. Treatment has to be interrupted in a limited number of patients due to unfavorable side effects. Tenoxicam taken parenterally has a good local tolerance. The following are some of the side effects that have been reported:

• Gastrointestinal tract: gastric, epigastric, and abdominal discomfort, dyspepsia, heartburn, and nausea are all common.
• Dizziness and headaches are symptoms of the central nervous system.
• The frequency is less than 1%. Constipation, diarrhea, stomatitis, gastritis, vomiting, ulcers, Gl-bleeding, including hematemesis and melena
• Fatigue, sleep difficulties, appetite loss, dry mouth, and vertigo are all symptoms of the central nervous system.
• Itching, erythema, exanthema, dermatitis, and urticaria on the skin (especially in the anal region following rectal administration).
• Edema and a rise in BUN or creatinine in the urinary tract and kidneys.
• Increased hepatic enzyme activity in the liver and biliary tract.
• Palpitations are a symptom of the cardiovascular system.

Pregnancy & Lactation

NSAIDs have an inhibitory impact on prostaglandin union and, when given amid late pregnancy, may cause the closure of the fetal ductus arteriosus, draw out labor and delay parturition. Treatment amid the third trimester of pregnancy ought to be maintained a strategic distance from. Based on discoveries from single-dose organization, an awfully little sum (roughly 0.2%) of tenoxicam passes into breast drain. There's no prove of antagonistic responses in breast-fed newborn children of moms taking Tenoxicam. In any case, newborn children ought to be weaned or the medicate discontinued.

Precautions & Warnings

NSAIDs hinder renal prostaglandin amalgamation and thus may have an undesirable impact on renal hemodynamics and on salt and water adjust. It is fundamental to satisfactorily screen the persistent with a uncommon accentuation on cardiac and renal work (BUN, creatinine, improvement of edema, weight pick up, etc.) when giving Tenoxicam to patients with conditions that may increment their hazard of creating renal disappointment, such as pre-existing renal infection, disabled renal work in diabetics, hepatic cirrhosis, congestive heart disappointment, volume exhaustion or concomitant treatment with possibly nephrotoxic drugs, diuretics and corticosteroids. Tenoxicam hinders platelet accumulation and may influence hemostasis. Tenoxicam has no noteworthy impact on blood coagulation variables, coagulation time, prothrombin time or enacted thromboplastin time. Patients having coagulation clutters or getting medicate treatment that meddling with hemostasis ought to, be that as it may, be carefully watched when Tenoxicam is managed. Any understanding being treated with Tenoxicam who presents with side effects of gastrointestinal illness ought to be closely checked. In case peptic ulceration or gastrointestinal dying happens, Tenoxicam ought to be instantly pulled back. In case extreme skin responses (e.g. Lyell's or Stevens-Johnson disorder) happen, the treatment ought to be ceased quickly. Unfavorable eye discoveries have been detailed with Tenoxicam.

Therapeutic Class

Non-steroidal anti-inflammatory drugs, drugs for osteoarthritis, drugs for rheumatoid arthritis (NSAIDs).

Storage Conditions

Do not store above 30°C, protect from light & moisture. Keep out of the reach of children.

Pharmaceutical Name

Eskayef Pharmaceuticals Ltd.