Tenoxicam is a nonsteroidal anti-inflammatory drug (NSAID) with anti-inflammatory, analgesic, and antipyretic actions, and it can also inhibit platelet aggregation. By blocking prostaglandin synthesis it helps reduce inflammation, pain, and fever, making it effective in treating degenerative and inflammatory musculoskeletal disorders.
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Tenoxicam is prescribed for rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, acute gout, and extra-articular inflammatory conditions such as tendinitis, bursitis, and periarthritis of the shoulders or hips. It is also indicated for managing musculoskeletal pain, post-surgical pain, and primary dysmenorrhea.
Generally well tolerated at prescribed doses, but possible side effects include mild, temporary gastrointestinal discomfort, abdominal pain, indigestion, heartburn, nausea, dizziness, headache, skin rashes, itching, swelling, elevated BUN or creatinine, and palpitations. Rarely, serious effects like GI perforation, asthma, angioedema, or hypertension may occur.
The typical adult dose for most indications (except primary dysmenorrhea, post-operative pain, and acute gout) is 20 mg once daily, taken at the same time each day. In rheumatoid arthritis, nighttime dosing may help ease morning stiffness.
Primary dysmenorrhea: 20–40 mg once daily
Post-operative pain: 40 mg once daily for up to 5 days
Acute gout: 40 mg once daily for 2 days, then 20 mg once daily for the next 5 days
Tenoxicam is not recommended for patients under 16 years of age.
Salicylates can increase the clearance and distribution of tenoxicam by displacing it from protein-binding sites, so concurrent use with salicylates or other NSAIDs is discouraged due to higher side-effect risks. When used with methotrexate, it may reduce renal tubular secretion of methotrexate. It should not be combined with potassium-sparing diuretics and may reduce the antihypertensive effects of beta-blockers and ACE inhibitors. It may also enhance the effect of sulfonylurea antidiabetic drugs.
Tenoxicam should not be used in patients with active peptic ulcers, gastrointestinal inflammation, known hypersensitivity to the drug, or a history of asthma, urticaria, rhinitis, or other allergic reactions to aspirin or other NSAIDs, as severe allergic reactions may occur. It is contraindicated in elderly patients at risk of renal failure, those with a high bleeding risk before surgery, or those with significant liver disease.
Safety during pregnancy has not been established, so it should only be used if the benefits outweigh the risks. Due to a lack of safety data during breastfeeding, it is not recommended while nursing.
Use cautiously in patients with gastrointestinal disorders. Discontinue immediately if ulcers or bleeding occur. Monitor patients at risk of renal impairment, including those with diabetes, hepatic cirrhosis, or heart failure. Closely watch patients with bleeding disorders or on medications affecting clotting. Consider discontinuing in women with fertility issues or undergoing infertility evaluation.
Store in a cool, dry place, away from light and out of reach of children.
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