Tenoxicam is a non-steroidal anti-inflammatory drug (NSAID) belonging to the oxicam class. It is primarily used for its anti-inflammatory, analgesic, and antipyretic properties. Tenoxicam is employed in the management of various musculoskeletal and joint conditions, such as arthritis and other inflammatory disorders, by alleviating pain and reducing inflammation.

Dosage Forms and Strengths

Tenoxicam is available in the following dosage forms:

• Tablets: Common strengths include 20 mg.
• Injection: Available in powder form for reconstitution, typically 20 mg vials.
• Topical Gel/Cream: In some formulations, it is also available as a gel or cream for external application.

Brand and Generic Names

• Generic Name: Tenoxicam
• Brand Names: Common brand names include Mobiflex, Tilcotil, and Tenoril.

Indications for Use

Tenoxicam is indicated for the treatment of:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Acute musculoskeletal disorders, such as sprains and strains
• Post-operative pain management
• Other inflammatory conditions where pain and swelling are present

Mechanism of Action

Tenoxicam works by inhibiting the enzyme cyclooxygenase (COX), particularly COX-1 and COX-2, which are involved in the synthesis of prostaglandins. Prostaglandins are lipid compounds that play a key role in promoting inflammation, pain, and fever. By reducing the levels of prostaglandins, Tenoxicam helps to decrease inflammation, alleviate pain, and lower fever.

Administration and Dosage

• For oral administration (tablets): The usual recommended dose is 20 mg once daily. It is advised to take Tenoxicam with food to reduce gastrointestinal side effects.
• For intramuscular or intravenous injection: 20 mg can be given once daily, particularly for managing acute pain.
• Topical application: When used as a gel or cream, it is applied to the affected area, typically two to three times per day.

The duration of treatment with Tenoxicam depends on the condition being treated and the patient's response to the medication. Long-term use should be monitored by a healthcare provider.

Side Effects and Precautions

Common side effects:

• Gastrointestinal discomfort, including nausea, vomiting, dyspepsia, and stomach pain
• Diarrhea or constipation
• Headache and dizziness
• Skin reactions, such as rash or itching

Serious side effects:

• Gastrointestinal bleeding or ulcers
• Elevated liver enzymes, indicating potential liver damage
• Renal impairment or worsening of kidney function
• Cardiovascular events, such as hypertension or increased risk of heart attack and stroke

Precautions:

• Gastrointestinal risks: Tenoxicam can cause ulcers or gastrointestinal bleeding, especially with long-term use or in patients with a history of gastrointestinal disorders.
• Cardiovascular risks: Caution should be exercised in patients with cardiovascular diseases or risk factors.
• Renal and hepatic impairment: Dose adjustments may be required in patients with kidney or liver impairment.
• Allergic reactions: Patients with a known allergy to Tenoxicam or other NSAIDs should avoid this medication.
• Pregnancy and breastfeeding: Tenoxicam should be avoided during pregnancy, especially in the third trimester, and during breastfeeding unless deemed necessary by a healthcare provider.

Conclusion

Tenoxicam is an effective NSAID used to treat a variety of inflammatory and pain-related conditions. Its once-daily dosing makes it convenient for patients, although its potential gastrointestinal, cardiovascular, and renal risks require careful monitoring, especially in long-term use. As with other NSAIDs, its use should be guided by a healthcare provider, particularly in individuals with pre-existing health conditions.