Adult: 20 mg as a single dose, taken at the same time each day. Treatment duration: Up to 7 days for acute musculoskeletal disorders and up to 14 days for severe cases. Elderly: Use the lowest effective dose for the shortest possible duration.
Adult: Initially, 20 mg IM/IV as a single dose given for 1-2 days, to be continued w/ the oral form, administered at the same time each day. Treatment duration: Up to 7 days for acute musculoskeletal disorders and up to 14 days for severe cases. Elderly: Use the lowest effective dose for the shortest duration.
Administration
Should be taken with food. Take w/ or immediately after meals.
Reconstitution
Dissolve lyophilisate in 2 mL of sterile water for inj.
Contraindications
Hypersensitivity to tenoxicam, aspirin or other NSAIDs. History of or active peptic ulceration, GI bleeding (melaena, haematemesis) or severe gastritis; severe heart failure. Last trimester of pregnancy.
Special Precautions
Patient w/ history of or active bronchial asthma, uncontrolled HTN, CHF, established ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, risk factors for CV disease (e.g. HTN, hyperlipidaemia, DM, smoking), history of GI disease, fluid retention and oedema. Patient who will undergo major surgery (e.g. joint replacement). Elderly. Renal and hepatic impairment.
Parenteral/PO: Z (NSAIDs caused foetal ductus arteriosus premature closure, foetal renal impairment and persistent pulmonary hypertension. Avoid near term, else use lowest dose for shortest time.)
Monitoring Parameters
Monitor renal, hepatic and cardiac functions.
Overdosage
Symptoms: Headache, nausea, vomiting, epigastric pain, GI bleeding, rarely diarrhoea, disorientation, excitation, coma, drowsiness, dizziness, tinnitus, fainting, occasionally convulsions. Acute renal failure and liver damage may occur. Management: Symptomatic treatment. Ensure good urine output. Frequent or prolonged convulsions should be treated w/ IV diazepam. May administer an H2-antagonist.
Drug Interactions
Increased risk of adverse effects (particularly GI) w/ salicylates and other NSAIDs. May enhance the anticoagulant effect of warfarin and other anticoagulants. May reduce the effect of antihypertensive drugs. Increased risk of nephrotoxicity w/ ciclosporin. Increased risk of convulsions w/ quinolones. May decrease the elimination of lithium. May interfere w/ the natriuretic action of diuretics. May enhance the toxicity of methotrexate. May reduce the effects of mifepristone. Increased risk of GI bleeding w/ corticosteroids.
Food Interaction
Food may delay the rate of absorption.
Action
Description: Tenoxicam is an NSAID which has marked anti-inflammatory and analgesic activity and some antipyretic activity. As w/ other NSAIDs, the precise mode of action is unknown, though it is probably multifactorial, involving inhibition of prostaglandin biosynthesis and reduction of leucocyte accumulation at the inflammatory site. Pharmacokinetics: Absorption: Well absorbed from the GI tract. Rapidly absorbed after IM inj. Food may delay the rate (to approx 6 hr) of absorption. Time to peak plasma concentration: Approx 2 hr. Distribution: Penetrates synovial fluid. Plasma protein binding: Approx 99%. Metabolism: Completely metabolised to inactive metabolites. Excretion: Mainly via urine, some via bile as glucoronide conjugates of the metabolites. Plasma elimination half-life: 42-81 hr.
Chemical Structure
Tenoxicam Source: National Center for Biotechnology Information. PubChem Database. Tenoxicam, CID=54677971, https://pubchem.ncbi.nlm.nih.gov/compound/Tenoxicam (accessed on Jan. 23, 2020)
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