Pivoxicam

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Pivoxicam

Drug Information
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Identifiers ChEBI		Chemical Data

Pivoxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is used to relieve pain and reduce inflammation. It is a derivative of piroxicam, a well-known NSAID, and shares similar pharmacological properties. Pivoxicam is primarily used in the treatment of rheumatoid arthritis, osteoarthritis, and other musculoskeletal disorders.

Pharmacology

Pivoxicam works by inhibiting the enzyme cyclooxygenase (COX), which is responsible for the formation of prostaglandins. Prostaglandins are lipid compounds that play a key role in the inflammatory process, pain sensation, and fever. By reducing the production of prostaglandins, pivoxicam alleviates symptoms of inflammation and pain.

Mechanism of Action

Pivoxicam selectively inhibits the COX-2 isoform of the cyclooxygenase enzyme, which is primarily involved in the inflammatory response. This selective inhibition helps to minimize gastrointestinal side effects that are commonly associated with non-selective COX inhibitors.

Pharmacokinetics

Pivoxicam is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 3 to 5 hours after oral administration. It is extensively metabolized in the liver and excreted primarily in the urine. The half-life of pivoxicam is approximately 30 to 60 hours, allowing for once-daily dosing.

Clinical Uses

Pivoxicam is indicated for the management of:

• Rheumatoid arthritis
• Osteoarthritis
• Acute musculoskeletal disorders
• Postoperative pain

Adverse Effects

Common adverse effects of pivoxicam include:

• Gastrointestinal disturbances (e.g., nausea, dyspepsia, abdominal pain)
• Headache
• Dizziness
• Skin rash

Serious adverse effects, although rare, may include:

• Gastrointestinal bleeding
• Hepatotoxicity
• Renal impairment

Contraindications

Pivoxicam is contraindicated in patients with:

• Known hypersensitivity to pivoxicam or other NSAIDs
• Active gastrointestinal bleeding or peptic ulcer disease
• Severe hepatic or renal impairment

Interactions

Pivoxicam may interact with other medications, including:

• Anticoagulants (e.g., warfarin)
• Antihypertensives (e.g., ACE inhibitors)
• Diuretics

Also see

• Piroxicam
• Nonsteroidal anti-inflammatory drug
• Cyclooxygenase
• Rheumatoid arthritis
• Osteoarthritis