indication

For the treatment of rheumatoid arthritis, osteoarthritis, backache, and pain.

pharmacology

Tenoxicam, an antiinflammatory agent with analgesic and antipyretic properties, is used to treat osteoarthritis and control acute pain.

mechanism of action

The antiinflammatory effects of tenoxicam may result from the inhibition of the enzyme cycooxygenase and the subsequent peripheral inhibition of prostaglandin synthesis. As prostaglandins sensitize pain receptors, their inhibition accounts for the peripheral analgesic effects of tenoxicam. Antipyresis may occur by central action on the hypothalamus, resulting in peripheral dilation, increased cutaneous blood flow, and subsequent heat loss.

biotransformation

Tenoxicam is metabolized in the liver to several pharmacologically inactive metabolites (mainly 5'-hydroxy-tenoxicam).

absorption

Oral absorption of tenoxicam is rapid and complete (absolute bioavailability 100%).

half life

72 hours (range 59 to 74 hours)

drug interactions

Acenocoumarol: The NSAID, tenoxicam, may increase the anticoagulant effect of acenocoumarol.

Alendronate: Increased risk of gastric toxicity

Anisindione: The NSAID, tenoxicam, may increase the anticoagulant effect of anisindione.

Chlorthalidone: Tenoxicam may antagonize the blood pressure lowering effect of Chlorthalidone. Monitor for changes in the therapeutic effect of Chlorthalidone if Tenoxicam is initiated, discontinued or dose changed.

Cholestyramine: Cholestyramine may decrease the serum concentration of Tenoxicam by increasing clearance. Monitor for changes in Tenoxicam therapeutic and adverse effects if Cholestyramine is initiated, discontinued or dose changed.

Cyclosporine: Monitor for nephrotoxicity

Dicumarol: The NSAID, tenoxicam, may increase the anticoagulant effect of dicumarol.

Hydrochlorothiazide: Tenoxicam may antagonize the blood pressure lowering effect of Hydrochlorothiazide. Monitor for changes in the therapeutic effect of Hydrochlorothiazide if Tenoxicam is initiated, discontinued or dose changed.

Lithium: Tenoxicam may increase the serum concentration of Lithium. A dose adjustment of Lithium may be required. Monitor for changes in Lithium therapeutic and adverse effects if Tenoxicam is initiated, discontinued or dose changed.

Methotrexate: Tenoxicam may increase the serum concentration of Methotrexate by reducing renal tubular secretion of Methotrexate. Monitor for changes in Methotrexate therapeutic and adverse effects if Tenoxicam is initiated, discontinued or dose changed.

Metolazone: Tenoxicam may antagonize the blood pressure lowering effect of Metolazone. Monitor for changes in the therapeutic effect of Metolazone if Tenoxicam is initiated, discontinued or dose changed.

Warfarin: The NSAID, tenoxicam, may increase the anticoagulant effect of warfarin.