mobiflex and Pain

A meta-analysis was done with the final data from three trials that provided the first results relating to efficacy and safety of the new sustained-release (SR) formulation of etodolac versus established nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA) of the knee. The studies were 4-week, double-blind, randomized, parallel-group comparisons of etodolac SR 600 mg (119 patients) against diclofenac SR 100 mg (54 patients), tenoxicam 20 mg (46 patients), or piroxicam 20 mg (18 patients). The primary efficacy parameters (assessed after 2 and 4 weeks of treatment) were physicians' and patients' overall assessments of patients' condition, night pain, and pain intensity. All patients had radiographic and clinical evidence of OA of the knee. For the meta-analysis, the data from the individual etodolac SR studies were pooled and compared with the pooled data for diclofenac SR, tenoxicam, and piroxicam. The homogeneity of the treatments across studies and the changes from baseline between groups were tested using a Cochran-Mantel-Haenszel test and an analysis of variance, including "study," "treatment," and "center within treatment" effects and their interaction. The analysis for the efficacy parameters was based on the final assessment during therapy (last visit). At baseline, the two treatment groups were comparable. Improvement rates were high in both groups (range, 68-81%), indicating that treatments were effective for most patients. No significant treatment difference was observed for the patients' overall assessment, night pain, or pain intensity. Both etodolac SR and the reference preparations were well tolerated. No clinically significant changes were noted in the laboratory data.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Delayed-Action Preparations; Diclofenac; Double-Blind Method; Etodolac; Female; Humans; Knee Joint; Male; Middle Aged; Osteoarthritis; Pain; Piroxicam; Random Allocation

Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative disease and manifests itself with pain and limitation of movement in the jaws. Arthrocentesis alone or in combination with intraarticular injections is one of the most commonly used treatment methods in these patients. The aim of the study is to examine the effectiveness of arthrocentesis plus tenoxicam injection and to compare it with arthrocentesis alone in patients with TMJ-OA.. Thirty patients with TMJ-OA who were treated randomly with either arthrocentesis plus tenoxicam injection (TX group) or arthrocentesis alone (control group) were examined. Maximum mouth opening (MMO), visual analog scale (VAS) pain values, and joint sounds were the outcome variables, which were evaluated at pre-treatment and at 1, 4, 12, and 24 weeks after treatment. Statistical significance was set at p < 0.05.. The gender distribution and mean age were not significantly different between the two groups. Pain values (p < 0.001), MMO (p < 0.001), and joint sounds (p < 0.001) improved significantly in both groups. However, there was no significant difference between the groups in terms of outcome variables [pain (p = 0.085), MMO (p = 0.174), joint sounds (p = 0.131)].. Arthrocentesis plus tenoxicam injection showed no better outcomes in terms of MMO, pain, and joint sounds compared with arthrocentesis alone in patients with TMJ-OA.. Injection of Tenoxicam Versus Arthrocentesis Alone in the Treatment of Temporomandibular Joint Osteoarthritis, NCT05497570. Registered 11 May 2022. Retrospectively registered, https://register.. gov/prs/app/action/SelectProtocol?sid=S000CD7A&selectaction=Edit&uid=U0006FC4&ts=6&cx=f3anuq.

Topics: Arthrocentesis; Humans; Hyaluronic Acid; Injections, Intra-Articular; Osteoarthritis; Pain; Range of Motion, Articular; Temporomandibular Joint; Temporomandibular Joint Disorders; Treatment Outcome

Symptoms such as nausea, vomiting, tightness of the chest, bradycardia, and shoulder or abdominal discomfort, caused by vagotonia occurring during uterus manipulation, have concerned healthcare professionals for some time. Patients sometimes report these symptoms when undergoing spinal anesthesia for cesarean sections (CSs). We designed a prospective, double-blind study to investigate the effectiveness of tenoxicam in preventing these symptoms of discomfort.. A total of 105 American Society of Anesthesiologists (ASA) class I-II nulliparous pregnant women, who were scheduled for a CS, were enrolled into this prospective, double-blind study. Spinal anesthesia was conducted to reach a peak dermatome level of no more than T3. The 100 patients were randomly divided into 2 groups having completed study course: Group T (N = 50) received a 20 mg dose of tenoxicam in 5 mL of normal saline (NS) immediately after skin incision and Group N (N = 50) only received 5 mL NS. The incidence and severity of the symptoms experienced by the patients were recorded by a nurse anesthetist who was blinded to the injection regimen the patients were receiving. A chi-square test was used for statistical analysis t test and P < .05 was defined as significant.. The incidence and degree of severity of nausea and vomiting were same in both the groups. The incidence and degree of severity of bradycardia, nausea, vomiting, tightness of the chest, shoulder discomfort, and abdominal discomfort were lower in Group T than in Group N.. Tenoxicam might theoretically block the parasympathetic vagus pathway and decrease the visceral pain or visceral-specific symptoms, alleviating the symptoms caused by vagotonia. However, the prophylactic effect of tenoxicam in reducing the incidence and severity of nausea and vomiting was not statistically significant. This could be because nausea and vomiting are not solely caused by vagotonia, but also by other mechanisms.

Topics: Adult; Anesthesia, Spinal; Bradycardia; Cesarean Section; Double-Blind Method; Female; Humans; Incidence; Nausea; Nurse Anesthetists; Pain; Parasympatholytics; Piroxicam; Severity of Illness Index; Treatment Failure; Uterus; Vomiting

The aim of the present study was to compare the effects of preemptive intravenous tenoxicam and methylprednisolone administrations on extraction of impacted third molars.. This was a placebo-controlled, randomized, double-blind, clinical trial. A total of 60 adult patients ages 18-40 years with the complaints of impacted third molar teeth were included in the study.. The postoperative swelling ratios (p<0.05) and pain scores (p<0.05) were significantly better in both study groups than in the control group and there was no statistically significant difference between methylprednisolone and tenoxicam groups with regards to the edema and pain relief.. Preoperative administration of 80 mg methylprednisolone achieves better control of trismus than tenoxicam without any significant differences in edema and pain control in impacted third molar teeth extraction.

Topics: Administration, Intravenous; Adult; Analysis of Variance; Anti-Inflammatory Agents; Edema; Humans; Methylprednisolone; Molar, Third; Pain; Pain Measurement; Piroxicam; Preoperative Care; Tooth Extraction; Trismus; Turkey

This study was designed to compare efficacy of local administration of a nonsteroidal anti-inflammatory drug with systemic administration in patients with osteoarthritis (OA) of the knee. For this purpose, intra-articular tenoxicam and oral tenoxicam therapies were applied and the improvement in control of pain and physical functioning were evaluated. A total of 69 patients with OA of the knee were randomized into three groups. Patients in the first group (41 knees of 23 patients) were treated for 1-3 weeks with once weekly intra-articular injection of tenoxicam 20 mg. Patients in the second group (45 knees of 26 patients) received 20 mg/day tenoxicam orally for 3 weeks and only physical exercises were applied to the third group (32 knees of 20 patients). Physical examination of the knee joint, Western Ontario and McMaster Universities Index and the Lequesne Algofunctional Index were used as outcome measurements at baseline, and the 1st, 3rd and 6th months. More significant improvement in pain and disability parameters was observed in groups 1 and 2 than group 3 compared with baseline measures. Among the patients' responses a few of the differences were statistically significant, more in favour of tenoxicam, and tenoxicam seemed to be superior to exercise alone especially at the final evaluation. There was no significant difference between the oral and intra-articular tenoxicam treatment regimens. The results of this study showed that treatment of OA of the knee with intra-articular tenoxicam is as effective as that with oral tenoxicam. It can be thought that intra-articular administration can be preferred to oral therapy due to minimal possibility of systemic side effects.

Topics: Administration, Oral; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Exercise Therapy; Female; Humans; Injections, Intra-Articular; Male; Middle Aged; Osteoarthritis, Knee; Pain; Pain Measurement; Piroxicam; Radiography; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

This was conducted to evaluate the analgesic effect of intravenous tenoxicam (non-steroidal anti-inflammatory drug) in the treatment of biliary colic pain and compared with spasmolytics. Thirtytwo patients (26 women, 6 men, mean age 47, range 38-55 years) with acute biliary colic were entered for study. They were allocated randomly to receive either tenoxicam 20 mg i.v. or hyoscine N-butylbromide 20 mg i.v. The patients recorded their pain severity on 5 point scale. The results showed that tenoxicam caused significant pain relief in 10 out of 16 patients at 30 min (mean pain score decreased from 2.75 +/- 0.93 to 0.49 +/- 0.51, p < 0.05) and in other 4 patients at 60 min (mean pain score decreased to 0.58 + 5.7, p < 0.05). None of these patients developed acute cholecystitis or pain relapse over a period of 24 h follow up. With use of hyoscine N-butylbromide, 7 out 16 patients had significant pain relief at 30 min (mean pain score decreased from 2.62 +/- 1.01 to 0.57 +/- 0.53, p < 0.05) and 3 other patients relieved at 60 min (mean pain score decreased to 0.66 +/- 0.57, p < 0.05). Four patients showed pain relapse within 24 h and needed pethidine-rescue treatment, two of them developed acute cholecystitis. Three out of 6 patients who showed no response to hyoscine N-butylbropmide and treated with 100 mg pethidine progressed to acute cholecystitis. We concluded that intravenous tenoxicam has rapid and prolong analgesic effects in the treatment of acute biliary colic as compared to hyoscine N-butylbroimde and it prevents the progression to acute cholecystitis.

Topics: Acute Disease; Adult; Analgesics, Non-Narcotic; Anti-Inflammatory Agents, Non-Steroidal; Biliary Tract Diseases; Butylscopolammonium Bromide; Cholecystitis; Cholelithiasis; Colic; Double-Blind Method; Female; Humans; Injections, Intravenous; Male; Middle Aged; Pain; Parasympatholytics; Piroxicam

Eighty out-patients (50 F, 30 M), aged 58 +/- 12 years (range: 26-84) and weighing 72 +/- 10 kg (range: 50-97), presenting with an acute or subacute (< 3 months) episode of rotator cuff tendinitis without (n = 28) or with movement restriction (n = 52) of the shoulder and having a pain intensity of at least 4 on VAS for pain at rest or on active movement, were treated at random and in double blind conditions for 1 to 4 weeks with 1 weekly periarticular anterior injection of tenoxicam 20 mg or placebo. Tenoxicam treated patients improved more than placebo-injected patients in a statistically highly significant manner with regard to clinical index, pain on VAS during active movement and at rest, active mobility (degrees), pain or pressure and clinical global impression (assessed by investigator and patient). There was a nonsignificant opinion that placebo treated patients consumed more rescue medication. Safety assessments were not significantly better in the placebo-treated patients through local tolerability tended to be better in that group. These results indicate that tenoxicam 20 mg injected locally is effective in alleviating pain and in improving shoulder mobility in patients with a painful shoulder episode and suggest that such a treatment is safe and well tolerated. Local injection of tenoxicam seems to be a promising new treatment of acute, painful, local inflammatory processes in Rheumatology, Orthopaedics, Physical Medicine and Sports Medicine. Further studies in other pathologies are warranted.

Topics: Adult; Aged; Aged, 80 and over; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Injections, Intra-Articular; Male; Middle Aged; Pain; Pain Measurement; Piroxicam; Rotator Cuff Injuries; Shoulder Injuries; Tendinopathy; Treatment Outcome

Etodolac SR is the sustained-release formulation of etodolac, an effective anti-inflammatory drug used in the treatment of various rheumatic diseases. The efficacy and safety of etodolac SR were compared with those of tenoxicam in 120 elderly patients with radiographic and clinical evidence of active osteoarthritis (OA) of the knee and/or the hip. This was a double-blind, double-dummy, randomized, parallel-group, multicentre study conducted at 4 Italian rheumatic-disease units. Sixty patients received 600 mg of etodolac SR once daily (u.i.d.) for 8 weeks; the remaining 60 patients received 20 mg of tenoxicam u.i.d. Significant improvements in all 6 efficacy parameters (viso-analogic scale of the global pain, pain at active movements, night pain, joint tenderness, joint motility, and Lequesne's algofunctional index) were observed within each of the treatment groups even after the first 2 weeks of therapy. There were no significant differences in the therapeutic response between the two groups for any efficacy parameters. Adverse reactions, mostly regarding the G-I tract, were significantly more frequent in the tenoxicam group than in the etodolac group: 23.3% vs 8.3% respectively, albeit in the majority of the cases they were not considered to be so severe as to cause the interruption of the study. There were no clinically important changes from baseline in laboratory tests performed during the study. Endoscopy of the upper G-I tract was performed both at baseline and after 8 weeks of therapy in 30 patients per treatment group in order to obtain a reliable comparative evaluation of the G-I safety of the two drugs. Both drugs were found to be well tolerated; only 2 ulcers were observed after therapy in both groups, but minor lesions were more frequently detected in the mucosa of the stomach in the patients who received tenoxicam. The cumulative endoscopic index that reflected both the erosive and the haemorrhagic lesions found in the stomach taken as a whole was significantly (p < 0.03) higher after therapy in the tenoxicam group. These results indicate that 600 mg of etodolac SR u.i.d. for 8 weeks is as effective as 20 mg of tenoxicam u.i.d. in the treatment of OA of the knee and/or of the hip. Both the overall and the G-I specific safety profiles were found to be more favourable in patients treated with etodolac SR. Renal function was not substantially affected in either treatment group.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Analysis of Variance; Anti-Inflammatory Agents, Non-Steroidal; Delayed-Action Preparations; Digestive System; Double-Blind Method; Endoscopy; Endoscopy, Gastrointestinal; Etodolac; Female; Hip Joint; Humans; Knee Joint; Male; Osteoarthritis; Pain; Piroxicam; Radiography

To compare signal versus aggregate measurement strategies using the VA3.0S version of the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis (OA) Index.. Seventy patients with OA of the knee were asked to identify a signal item for each of the 3 dimensions of the WOMAC OA Index at baseline and termination of a 12-week, double blind, randomized, controlled trial.. The signal method detected statistically significant alterations in health status at relatively small sample sizes and with a relative efficiency close to or at unity. In addition to a low prevalence of deterioration in nonsignal items, we observed some inconsistency in signal selection.. Signal methods of measurement may provide an alternative approach to outcome measurement provided issues of nonsignal deterioration and the consistency of signal selection can be addressed.

Topics: Aged; Data Interpretation, Statistical; Diclofenac; Double-Blind Method; Health Status Indicators; Humans; Knee Joint; Osteoarthritis; Pain; Piroxicam; Severity of Illness Index; Surveys and Questionnaires; Treatment Outcome

The efficacy of an NSAID (tenoxicam) in the treatment of acute low back pain (LBP) was assessed in a double blind controlled study by using an objective functional evaluation. Seventy-three patients consulting for acute LBP were randomized into two groups: Group I was treated with tenoxicam for 14 days and Group II was given a placebo. Trunk function was measured with a computerized isoinertial dynamometric trunk testing device (Isostation B200). Isometric and dynamic torques, range of motion and movement velocities were measured before treatment and after 14 days. Clinical evaluation was realized by the patient on a pain visual analogue scale (VAS) on days 1, 8 and 15 and by the investigator on a five-point scale on days 8 and 15. The functional evaluation showed significant differences in favour of the tenoxicam treatment for velocity and extension isometric torque. VAS and investigator evaluations showed a significant difference in favour of tenoxicam on day 8 but no difference on day 15. This study shows that the use of tenoxicam in acute LBP is of interest. Tenoxicam has an effect on pain during the first part of the treatment and may help to restore full function even if the symptoms have disappeared.

Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Incidence; Low Back Pain; Male; Middle Aged; Outcome Assessment, Health Care; Pain; Piroxicam

The clinical relevance of piroxicam-beta-cyclodextrin (PBC) in the long-term treatment of osteoarthritis and rheumatoid arthritis is reviewed. Two hundred and twenty-five patients--one hundred with rheumatoid arthritis and one hundred and twenty five with osteoarthritis--were enrolled in a double-blind, randomised, controlled study versus piroxicam. Drugs were administered once-daily, for twelve weeks. The indices of efficacy (pain intensity, severity of inflammation, functional impairment evaluated at 0,2,4,8 and 12 weeks showed the good analgesic effect of piroxicam without significant differences between its two formulations. Tolerance appeared to be better in the group of patients treated with PBC than in the one treated with piroxicam. Both the incidence and severity of side effects were lower for patients treated with PBC. The majority of side effects were related to the gastrointestinal tract. The study suggests that PBC, used in the long term treatment of rheumatic diseases, improves the safety of piroxicam without affecting its efficacy. In another study, thirty patients with chronic osteoarthritis were randomly assigned to receive PBC or tenoxicam daily for eight weeks. Both drugs effectively reduced pain, inflammation, and functional limitation of the affected joints. Endoscopy revealed minor post-treatment mucosal lesions; these tended to be less severe with PBC than with tenoxicam. The clinical experience in the long-term treatment of rheumatic conditions indicates that the microencapsulation of piroxicam as piroxicam-beta-cyclodextrin has provided a new drug with a superior tolerability compared to the parent compound without affecting its high efficacy on the symptoms of the primary disease.

Topics: Adult; Aged; Aged, 80 and over; Antirheumatic Agents; Arthritis, Rheumatoid; beta-Cyclodextrins; Cyclodextrins; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Osteoarthritis; Pain; Piroxicam

Palliate care is concerned with oncologic patients and its aim is to reduce their suffering, i.e. in the first place to eliminate or reduce pain. As a rule, the WHO prescriptions are followed, administering progressively nonsteroid analgesic agents (NSAIDs), weak opioids, strong opioids. The most convenient channels of administration are oral and subcutaneous. So far, NSAIDs could not be given subcutaneously due to the local side effects (pain and irritation at the point of injection) they cause. On the basis of experience with tenoxicam in our Department, subcutaneous administration is suggested. Our study involved 27 subjects with treatment-refractory tumors, in order to assess topical tolerability. In all cases, the drug was administered via a subcutaneous permanent teflon needle-catheter. Tenoxicam was found to have better gastric tolerability compared to other NSAIDs. It can be concluded that for the palliative treatment of cancer patients tenoxicam ampoules are an additional drug that can be administered subcutaneously.

Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Drug Tolerance; Female; Humans; Injections, Subcutaneous; Male; Middle Aged; Neoplasms; Pain; Palliative Care; Piroxicam; Time Factors

The effectiveness and tolerability of tenoxicam and piroxicam, administered as a once-daily 20 mg suppository, were assessed in a comparative, randomised, double-blind trial in 48 subjects suffering from acute non-articular rheumatism. Both spontaneous and induced pain improved significantly with each of the treatments. There was no significant difference between the two treatments, whatever criterion of effectiveness was considered, i.e. spontaneous pain, induced pain or overall judgement. The incidence of undesirable side-effects was comparable for both treatments. Thirteen per cent of patients in the tenoxicam group and 16% of the patients in the piroxicam group experienced at least one undesirable side-effect. The majority of reported side-effects were of a digestive nature; however none of these were serious. The risk/benefit ratio of tenoxicam was found to be identical to that of piroxicam in the treatment of acute non-articular rheumatism.

Topics: Acute Disease; Adult; Aged; Anti-Inflammatory Agents, Non-Steroidal; Double-Blind Method; Female; Humans; Male; Middle Aged; Pain; Piroxicam; Randomized Controlled Trials as Topic; Suppositories; Tendinopathy; Tenosynovitis

Tenoxicam (20 mg/day) and piroxicam (20 mg/day) were compared in a double-blind, parallel group study over 4 weeks in 30 patients with ankylosing spondylitis. Both tenoxicam and piroxicam reduced spinal pain, but the improvement was greater with piroxicam. Tenoxicam and piroxicam were equally effective at improving duration of morning stiffness. Slight improvement was seen with other symptoms with both treatments. Patients were slightly more tolerant of piroxicam than tenoxicam and most patients elected to continue on their particular therapy at the end of the study.

Topics: Administration, Oral; Adult; Chromatography, High Pressure Liquid; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Pain; Piroxicam; Random Allocation; Spondylitis, Ankylosing; Thiazines

A randomized double-blind trial with tenoxicam 10 mg/d and 20 mg/d and placebo was carried out for 2 weeks in 90 patients suffering from various extra-articular inflammatory conditions. Statistical analysis revealed significant differences in favour of tenoxicam as regards improvement of all parameters with an intensity which was moderate or severe at baseline, e.g. tenderness, mobility pain, functional limitation. The efficacy of tenoxicam at both dosages was similar (no statistically significant difference). Tenoxicam was well tolerated but some mild adverse reactions were observed in all three treatment groups.

Topics: Adult; Aged; Anti-Inflammatory Agents; Clinical Trials as Topic; Double-Blind Method; Female; Fibromyalgia; Humans; Inflammation; Male; Middle Aged; Movement; Pain; Periarthritis; Piroxicam; Random Allocation; Rheumatic Diseases; Tendinopathy; Tennis Elbow; Thiazines

The comparative effects of tenoxicam and indomethacin are studied in 20 patients with rheumatoid arthritis. Ten evolutive parameters were studied after six weeks of treatment. Both drugs showed similar tolerance and efficacy on the evolution of the disease.

Topics: Adult; Aged; Arthritis, Rheumatoid; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Indomethacin; Locomotion; Male; Middle Aged; Pain; Piroxicam; Thiazines

The present study investigates the effects of pregabalin (PGB), acetaminophen (ACET) and tenoxicam (TNX) administration in somatic and visceral nociception, using the tail flick test and the writhing test in mice.. In the tail flick test, the substances were administered orally and the latency time response was recorded 15, 30, 60, 90 and 120 min after administration. In the writhing test, pain responses were scored every 5 min during a 30-min period after intraperitoneal injection of diluted acetic acid.. Our study demonstrated that oral administration of the combination PGB-ACET resulted in a stronger increase of latency reaction - statistically significant after 15 min compared to TNX and after 30 min compared to PGB in tail flick test. In the writhing test, the combination PGB-ACET, but also PGB-TNX, resulted in a stronger decrease of writhe numbers - statistically significant compared to the effects of the separate administration of each substance. This decrease was more intense in animals treated with the combination PGB-ACET than with PGB-TNX.. These results suggest an antinociceptive activity which may be a consequence of the synergic action of the substances.

Topics: Acetaminophen; Acetic Acid; Analgesics; Animals; Drug Combinations; Drug Synergism; gamma-Aminobutyric Acid; Hot Temperature; Male; Mice; Pain; Piroxicam; Pregabalin

The present study provides an important implication for the management of chronic neuropathic pain, focusing on prostaglandin (PG) and nitric oxide (NO) in the spinal cord. To determine if spinally administered cyclooxygenase (COX) inhibitor or nitric oxide synthase (NOS) inhibitor had preemptive analgesia on thermal hypersensitivity induced by chronic constrictive nerve injury, Sprague-Dawley rats were chronically implanted with an intrathecal (i.t.) catheter. The left sciatic nerve was loosely ligated with 2-mm polyethylene tubing to produce painful mononeuropathy. Animals received tenoxicam (7.5, 15 or 30 micromol/10 microl, i.t.), NS-398 (15 or 30 micromol), or L-NAME (30, 150 or 300 micromol) immediately before the nerve injury, followed by daily injection extending into the four postoperative days. The hindpaw was immersed into a hot (42 degrees C, 44 degrees C and 46 degrees C) or cold (10 degrees C) water bath. The paw immersion test revealed significant thermal hyperalgesia and allodynia 5 day after nerve injury in vehicle control animals. Tenoxicam (7.5, 15 or 30 micromol) or L-NAME (30, 150 or 300 micromol) dose-dependently attenuated hyperalgesia and allodynia. Equimolar dose of NS-398 (15 or 30 micromol) also diminished these nociceptive behaviors. Higher dose of either drug primarily produced longer duration of inhibition. The inhibitory effect of tenoxicam (30 micromol) on hyperalgesia was more effective than that of an equimolar dose of NS-398 or L-NAME. These results demonstrated that intrathecally administered COX inhibitor or NOS inhibitor provides preemptive analgesia on thermal hypersensitivity following chronic constrictive nerve injury in rats.

Topics: Animals; Cyclooxygenase Inhibitors; Disease Models, Animal; Dose-Response Relationship, Drug; Hindlimb; Hot Temperature; Hyperalgesia; Injections, Spinal; Male; NG-Nitroarginine Methyl Ester; Nitric Oxide Synthase; Nitric Oxide Synthase Type I; Nitrobenzenes; Pain; Pain Threshold; Piroxicam; Rats; Rats, Sprague-Dawley; Sciatic Nerve; Sulfonamides

Tenoxicam is a thienothiazine derivative with marked analgesic and anti-inflammatory activities. The parenteral application of tenoxicam is especially suitable for initial therapy in acute and painful rheumatic conditions. The pharmacokinetic behaviour of tenoxicam after i.m., i.v. and p.o. administration did not differ, with the exception that higher plasma concentrations were reached during the first two hours after the parenteral dose. After both i.m. and i.v. application, tenoxicam showed a rapid onset of action, and reliable improvement of pain status. Tenoxicam was well tolerated both systemically and locally. About 10% of all patients experienced adverse events characteristic of non-steroidal anti-inflammatory drugs (NSAIDs).

Topics: Administration, Oral; Anti-Inflammatory Agents, Non-Steroidal; Half-Life; Humans; Injections, Intramuscular; Injections, Intravenous; Joint Diseases; Pain; Piroxicam

Topics: Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Injections; Male; Middle Aged; Pain; Piroxicam; Rheumatic Diseases

Fourteen elderly subjects (10 women, 4 men) with a mean age of 81 (SD 6.7) years and in need of anti-inflammatory drug treatment were given a single dose of 20 mg tenoxicam. After a drug-free interval of 5 weeks, multiple dose treatment with 20 mg tenoxicam once daily for 56 days was initiated. The single and multiple dose kinetics of tenoxicam were investigated after HPLC determination of tenoxicam in the plasma. The elimination half-life of tenoxicam ranged from 44 to 132 h (mean 71.9 h) with no significant difference between the single and multiple dosage regimens. Tenoxicam reached maximum plasma concentrations after 1.4 and 1.1 h, with values of 3.6 and 15.5 micrograms.ml-1, for the single and multiple dosage regimen respectively. The corresponding trough values (24-h values) were 1.8 and 11.7 micrograms.ml-1. A mean accumulation ratio of 5.1 was calculated. The mean increase in the area under the plasma concentration time curves at steady-state was 21% more than predicted from the initial single dose. This deviation from linearity was considered to be of minor clinical significance. The kinetics of tenoxicam in elderly were similar to that published for young healthy volunteers.

Topics: Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal; Female; Half-Life; Humans; Male; Pain; Piroxicam