Xicotil 20mg Tablet

✔️ Uses of Xicotil 20mg Tablet

• Ankylosing Spondylitis
• Osteoarthritis
• Rheumatoid Arthritis
• Post-operative pain
• Primary Dysmenorrhea
• Gout

✔️ How does Xicotil 20mg Tablet work?

It works by inhibiting chemical mediators that cause pain and inflammation.

✔️ Side Effects of Xicotil 20mg Tablet

• Sleeplessness
• Difficulty in breathing
• Skin rash
• Chest pain
• Increased heartrate
• Abdominal pain
• Nausea and vomiting
• Diarrhea
• Decreased appetite
• Dizziness
• Blurred vision
• Dry mouth
• Fatigue

✔️ Quick Suggestions:

• Inform your doctor if you have ever been diagnosed with kidney or liver problems.
• It should be taken with food or milk to avoid getting an upset stomach.
• It can cause serious complications like stomach bleeding and kidney problems if taken for a long time.
• Xicotil 20mg Tablet can raise your risk of blood clots, heart attack, or a stroke.
• For elderly patients, appropriate dose adjustments or replacement with a suitable alternative may be required in some cases

✔️ Indication

Xicotil 20mg Tablet is indicated for the symptomatic treatment of the following painful inflammatory and degenerative disorders of the musculoskeletal system:

1. Rheumatoid Arthritis
2. Osteoarthritis
3. Arthrosis
4. Ankylosing Spondylitis
5. Extra-articular Disorders:
   • Tendinitis
   • Bursitis
   • Periarthritis of the shoulders (shoulder-hand syndrome) or hips
   • Strains and Sprains
6. Acute Gout

✔️ Pharmacology

Tenoxicam is a potent inhibitor of prostaglandin synthesis by blocking the enzyme cyclo-oxygenase. Additional actions include inhibition of leucocyte function (phagocytosis and chemotaxis) and scavenging free O2 radicals.

✔️ Dosage & Administration of Xicotil 20mg Tablet

Standard Dosage:

• For all indications, except severe gout, a daily dose of 20 mg should be administered at the same time each day.
• The standard dosage should be maintained unless specific conditions require otherwise.

Acute Gout Episodes:

• In the case of acute gout episodes, the recommended dose is 40 mg once daily for two days.
• Subsequently, a reduced dose of 20 mg once daily should be continued for another five days.

Chronic Illnesses:

• Tenoxicam shows therapeutic effects in chronic illnesses with early onset, but improvement occurs progressively over time.
• Daily doses exceeding 20 mg are discouraged in chronic conditions as they may increase the frequency and intensity of undesired reactions without significant improvement in efficacy.
• Long-term treatment may involve exploring a reduction to a daily oral dose of 10 mg for maintenance.

Special Dosage Instructions:

• The provided dosage recommendations are generally applicable to older individuals and those with kidney or liver disease.
• Due to a lack of clinical experience, specific dosage recommendations for children and adolescents have not been established.

No significant effect on renal function at usual doses.

✔️ Interaction

Salicylate and Other NSAIDs:

• Salicylate, like other NSAIDs, displaces tenoxicam from protein-binding sites.
• Concurrent therapy with salicylate or other NSAIDs should be avoided due to the increased risk of gastrointestinal side effects.

Methotrexate Interaction:

• Co-administration of some NSAIDs, including tenoxicam, with methotrexate may reduce methotrexate renal tubular secretion, leading to increased plasma concentrations and severe toxicity.
• Caution is advised, and vigilant monitoring should be exercised when tenoxicam is used with methotrexate.

Interactions with Other Drugs:

• No clinically significant interactions were found in patients receiving gold, penicillamine, or probenecid concurrently with tenoxicam.

Lithium Interaction:

• Tenoxicam may decrease lithium clearance in the kidneys, resulting in increased plasma levels and potential toxicity.
• Regular monitoring of lithium levels in the blood is recommended.

Diuretics and Blood Pressure Medications:

• Tenoxicam should not be administered with K-sparing diuretics due to the risk of hyperkalemia and renal failure.
• While no clinically relevant interaction was noted with furosemide, tenoxicam attenuates the blood pressure-lowering effect of hydrochlorothiazide.

Interference with Antihypertensive Medications:

• Tenoxicam, like other NSAIDs, might attenuate the antihypertensive effects of beta-blockers and ACE inhibitors.

No Significant Interactions:

• No known interactions have been reported between NSAIDs, including tenoxicam, and calcium channel blockers or centrally acting alpha agonists.
• No clinically significant interaction was observed when tenoxicam was administered with atenolol.

Interactions with Digoxin and Other Medications:

• No clinically significant interactions were reported in patients treated concomitantly with tenoxicam and digoxin.
• Concomitant use with antacids, cimetidine, warfarin, and phenprocoumon at recommended dosages showed no interaction.
• Tenoxicam did not impact the clinical effect of oral antidiabetic medications.

Interaction with Low Molecular Weight Heparin:

• No clinically significant interactions were found between tenoxicam and low molecular weight heparin.

✔️ Contraindications

Active or history of recurrent GI bleeding or peptic ulcer, hypersensitivity to NSAIDs, severe heart failure, hemorrhagic diathesis, asthma, pregnancy (3rd trimester).

✔️ Pregnancy & Lactation

The safety of Xicotil 20mg Tablet during pregnancy has not been established therefore it should be used with caution during pregnancy and only if the benefit to the mother is greater than the risk to the fetus. There is no information available about the safety of Xicotil 20mg Tablet during breastfeeding therefore it should not be used during lactation.

✔️ Precautions & Warnings

• Patients with a history of or active bronchial asthma, uncontrolled hypertension, congestive heart failure, established ischemic heart disease, peripheral arterial disease, cerebrovascular disease, risk factors for cardiovascular disease (e.g., hypertension, hyperlipidemia, diabetes, smoking), history of gastrointestinal disease, fluid retention, and edema.
• Patients who will undergo major surgery (e.g., joint replacement).
• Elderly.
• Renal and hepatic impairment.
• Monitoring Parameters: Monitor renal, hepatic, and cardiac functions.

✔️ Storage Conditions

Keep below 30ºC temperature, protected from light & moisture. Keep out of the reach of children.