Xten 20mg Tablet

Uses of Xten 20mg Tablet

• Pain Relief

How does Xten 20mg Tablet work?

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

Side Effects of Xten 20mg Tablet

• Common (>1%): Gastrointestinal discomfort, dizziness, headache.
• Less Common (<1%): Constipation, diarrhea, stomatitis, gastritis, vomiting, ulcers, etc.

Quick Suggestions:

• Follow prescribed instructions and dosage.
• Benefits may take time, especially in certain arthritis types.
• Only for conditions prescribed by the doctor.
• Do not share with others.
• Discontinue only under the doctor's guidance.

Indications:

• Rheumatoid Arthritis: Relieves inflammation, swelling, stiffness, and pain associated with rheumatoid arthritis.
• Osteoarthritis: Alleviates symptoms of inflammation, swelling, and pain in osteoarthritis.
• Ankylosing Spondylitis: Used for the management of inflammation and stiffness in ankylosing spondylitis.
• Tendonitis: Addresses inflammation of tendons.
• Bursitis: Manages inflammation of bursae (fluid-filled sacs around joints).
• Periarthritis of Shoulders or Hips: Treats inflammation of tissues around shoulder or hip joints.

Pharmacology

• Mechanism of Action: Anti-inflammatory, analgesic, antipyretic NSAID; inhibits platelet aggregation; inhibits prostaglandin biosynthesis.
• Additional Actions: Acts as a scavenger for active oxygen; inhibits human metalloproteinases (stromelysin and collagenase).

Dosage & Administration:

• Standard Dosage: 20 mg once daily for all indications except acute gout.
• Acute Gout: 40 mg once daily for two days, followed by 20 mg once daily for another five days.
• Chronic Disorders: Daily doses >20 mg in chronic disorders should be avoided. Consider reducing to a daily oral dose of 10 mg for maintenance in long-term treatment.

Special Dosage Instructions:

• Apply dosage recommendations to elderly patients and those with kidney or liver disease.
• No established dosage recommendations for children and adolescents due to a lack of clinical experience.

Interaction

• Salicylate and NSAIDs: Increased risk of gastrointestinal side effects; avoid concurrent therapy.
• Methotrexate: Exercise vigilance due to potential interactions.
• Gold, Penicillamine, Probenecid: No clinically significant interactions observed.
• Lithium: Tenoxicam may reduce lithium clearance; monitor lithium levels.
• K-sparing diuretics and NSAIDs: Interaction reported, leading to hyperkalemia and renal failure.

Contraindications

• High sensitivity to the medication.
• Symptoms of asthma, rhinitis, or urticaria after using salicylates or other NSAIDs.
• Active upper gastrointestinal tract diseases (gastritis, gastric, and duodenal ulcers).

Pregnancy & Lactation

• Avoid in the third trimester of pregnancy.
• Use cautiously in breastfeeding; consider weaning or discontinuation.

Precautions & Warnings

Renal Effects:

• NSAIDs, including Xten 20 mg, can inhibit renal prostaglandin synthesis, affecting renal hemodynamics and salt-water balance.
• Monitoring patients with conditions predisposing to renal failure (e.g., pre-existing renal disease, impaired renal function in diabetics, hepatic cirrhosis, congestive heart failure) is crucial.
• Special attention to cardiac and renal function, including BUN, creatinine, and signs of fluid retention (edema, weight gain), is recommended.
• Caution in patients on concomitant treatment with potentially nephrotoxic drugs, diuretics, and corticosteroids.

Platelet Aggregation and Hemostasis:

• Xten 20 mg inhibits platelet aggregation, potentially affecting hemostasis.
• No significant influence on blood coagulation factors, coagulation time, prothrombin time, or activated thromboplastin time.
• Careful observation is advised for patients with coagulation disorders or those on drug therapy affecting hemostasis.

Gastrointestinal Safety:

• Close monitoring for patients presenting symptoms of gastrointestinal disease is essential during Xten 20 mg treatment.
• Immediate withdrawal of Xten 20 mg if peptic ulceration or gastrointestinal bleeding occurs.

Skin Reactions:

• Discontinue Xten 20 mg immediately if severe skin reactions, such as Lyell's or Stevens-Johnson syndrome, are observed.

Adverse Eye Findings:

• Adverse eye findings have been reported; therefore, ophthalmic evaluation is recommended for patients developing visual disturbances.

Plasma Protein Binding:

• Caution when administering Xten 20 mg in patients with markedly reduced plasma albumin levels due to high plasma protein binding.

Masking Signs of Infection:

• Xten 20 mg, like other anti-inflammatory drugs, may mask the usual signs of infection. Caution is advised.

Intolerance to Milk Products:

• Xten 20 mg Tablets should not be given to patients who either dislike or do not tolerate milk products.

Storage Conditions

• Store below 25°C, and protect from light and moisture.
• Keep out of reach of children.