Lornoxicam

Lornoxicam is a Cyclooxygenase-1 and 2 (COX-1 and 2) inhibitor / non-steroidal anti-inflammatory drugs (NSAIDs) belonging to Analgesic / anti-inflammatory.

Lornoxicam is an NSAID indicated in the treatment of mild to moderate pain, as well as rheumatoid arthritis and osteoarthritis.

Lornoxicam is Extensively absorbed from the GI tract. Peak plasma concentration is achieved within 1-2 hours (oral) or 25 min (IM). Lornoxicam is 99% bound to plasma proteins (almost exclusively to serum albumin). Lornoxicam is Metabolized to its inactive metabolite, and it is mainly Excreted in the faeces (as metabolites) and urine (as unchanged drug).

Lornoxicam shows common side effects like Fever and chills, Skin rash, Nausea and Vomiting, Headache, Dizziness, Ringing or buzzing in the ears, Photosensitivity, Sleeplessness.

Lornoxicam is available in the form of Oral tablet and Injectable solution.

Lornoxicam is available in India, Malaysia, Italy, Japan, Canada, Australia, China, and Russia.

Lornoxicam is an Analgesic / anti-inflammatory belonging to the class Cyclooxygenase-1 and2 (COX-1 and 2) inhibitor / non-steroidal anti-inflammatory drug (NSAIDs).

Like other NSAIDS, lornoxicam's anti-inflammatory and analgesic activity is related to its inhibitory action on prostaglandin and thromboxane synthesis through the inhibition of both COX-1 and COX-2. This leads to the reduction of inflammation, pain, fever, and swelling, which are mediated by prostaglandins. However, the exact mechanism of lornoxicam, like that of the other NSAIDs, has not been fully determined.

The onset and duration of action of Lornoxicam is about 30-60 minutes and 24 hours respectively.

Lornoxicam is available in the form of Oral tablet and Injectable solution.

Lornoxicam tablet is taken orally usually in 2 to 3 divided doses and Injectable solution is given via intravenous and intramuscular route.

Lornoxicam is a non-steroidal anti-inflammatory (NSAID) medicine used for temporary relief of swelling, stiffness, and pain associated with Rheumatoid Arthritis, Osteoarthritis, Spondylitis etc.

Lornoxicam is a Cyclooxygenase-1 and 2 (COX-1 and 2) inhibitor / non-steroidal anti-inflammatory drugs (NSAIDs) belonging to Analgesic / anti-inflammatory.

Lornoxicam having anti-inflammatory and analgesic activity is related to its inhibitory action on prostaglandin and thromboxane synthesis through the inhibition of both COX-1 and COX-2. This leads to the reduction of inflammation, pain, fever, and swelling, which are mediated by prostaglandins

Lornoxicam is approved for use in the following clinical indications

• For the treatment of acute mild to moderate pain, as well as pain and inflammation of the joints caused by certain types of rheumatic diseases.

• Acute pain

IM, IV: 8 mg as a single dose (maximum: 24 mg within the first 24 hours; 16 mg/day starting on day 2). Treatment should be limited to ≤2 days.

Oral: 8 to 16 mg/day in 2 to 3 divided doses (maximum: 16 mg/day)

• Osteoarthritis and rheumatoid arthritis

Initial dose: 12 mg/day in 2 to 3 divided doses (maximum: 16 mg/day)

Lornoxicam is available in various strengths as 4mg and 8mg.

Lornoxicam is contraindicated in patients with

• Peptic ulcer, severe kidney impairment, and hypersensitivity.

• Caution should be exercised in patients with a history of infections, asthma, any allergy, bleeding disorder, high blood pressure, impaired kidney, liver, heart function, during pregnancy and breastfeeding.
• It may cause drowsiness or dizziness, do not drive a car, or operate machinery while taking this medication.

Consumption of alcohol is not recommended during treatment with this medicine since it may increase the risk of severe adverse effects such as gastrointestinal bleeding, dizziness, drowsiness, etc.

Use of Lornoxicam should be avoided by nursing mothers as the risk of adverse effects on the infant is high.

Use of Lornoxicam should be avoided in Pregnant women and during the third trimester of pregnancy it should be strictly avoided.

Common

Abdominal pain, diarrhea, dizziness, dyspepsia, nausea, vomiting; headache; hematologic disorders, CNS effects, visual disturbance, tinnitus, nephrotoxicity, fluid retention, photosensitivity, alveolitis, pancreatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, colitis induction/exacerbation, stomatitis, hypertension, palpitation, insomnia, somnolence.

• Lornoxicam increases the effect of Methotrexate, Digoxin, Sulphonylureas and anticoagulants.
• Lornoxicam has a fatal impact with Lithium toxicity.
• Lornoxicam decreases the effect of blood pressure medicines of class ACE-inhibitors and water pills (Diuretics).
• Blood concentration of Lornoxicam rises when given along with Cimetidine.

The common side effects of Lornoxicam include the following

• Common side effects

Fever and chills, Skin rash, Nausea and Vomiting, Headache, Dizziness, Ringing or buzzing in the ears, Photosensitivity, Sleeplessness.

• Rare side effects

Increased blood pressure, Increased heartbeat, Gastrointestinal Bleeding, Visual disturbances, Fluid Retention, Kidney Impairment, Stevens-Johnson Syndrome, Difficulty in breathing.

• Pregnancy

Pregnancy Category

Use of Lornoxicam should be avoided in Pregnant women and during the third trimester of pregnancy it should be strictly avoided.

• Nursing Mothers

Use of Lornoxicam should be avoided by nursing mothers as the risk of adverse effects on the infant is high.

• Pediatric Use

Lornoxicam is not recommended for use in children as safety and effectiveness of use is not clinically established.

• Geriatric Use

Lornoxicam should be used with caution in elderly as the risk of adverse effects are significantly high.

• Pharmacodynamic

Lornoxicam is a non-steroidal anti-inflammatory drug (NSAID) that belongs to the oxicam class. As with other NSAIDS, lornoxicam is a potent inhibitor of the cyclooxgenase enzymes, which are responsible for catalyzing the formation of prostaglandins (act as messenger molecules in the process of inflammation) and thromboxane from arachidonic acid. Unlike some NSAIDS, lornoxicam's inhibition of cyclooxygenase does not lead to an increase in leukotriene formation, meaning that arachidonic acid is not moved to the 5-lipoxygenase cascade, resulting in the minimization of the risk of adverse events.

• Pharmacokinetics

Absorption

Lornoxicam is Extensively absorbed from the GI tract. Peak plasma concentration is achieved within 1-2 hours (oral) or 25 min (IM).

Distribution

Lornoxicam is 99% bound to plasma proteins (almost exclusively to serum albumin).

Metabolism and Excretion

There are some clinical studies of the drug Lornoxicam mentioned below:

2. Radhofer-Welte S, Rabasseda X. Lornoxicam, a new potent NSAID with an improved tolerability profile. Drugs Today (Barc). 2000 Jan 1;36(1):55-76.

3. Godara S, Srivastava RK, Godara R, Bhutani G. Lornoxicam: A review of its therapeutic potential in different clinical studies. Journal of Drug Delivery and Therapeutics. 2013 Mar 15;3(2).