NOXON ® Lornoxicam

NOXON ® is a Lornoxicam based drug

THERAPEUTIC GROUP: Non-steroidal anti-inflammatory and antirheumatic drugs

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications NOXON ® Lornoxicam

NOXON ® is indicated for the treatment of moderate or severe pain associated with inflammatory states of rheumatic and degenerative origin.

Mechanism of action NOXON ® Lornoxicam

Lornoxicam, active ingredient of NOXON ®, is a drug belonging to the recent oxicam family, known for its marked analgesic and anti-inflammatory activities.

Like other non-steroidal anti-inflammatory drugs, Lornoxicam, taken orally, is also absorbed at the intestinal level, reaching its maximum plasma concentration after about 2 hours from oral administration.

By skipping the first-pass metabolism, this active ingredient is able to maintain a bioavailability even higher than 90%, thus being able to carry out an intense therapeutic activity that is also effective in the treatment of severe pain symptoms.

The main mechanism of action of Lornoxicam is represented by the selective inhibition of cyclooxygenases 2, enzymes involved in the conversion of arachidonic acid into chemical mediators known as prostaglandins and endowed with activity:

Proinflammatory, linked to the chemotactic, vasopermeabilizing and edemigena action;
Algogenic, due to the ability to activate peripheral nociceptive endings while reducing the central pain threshold;
Pyrogenic, linked to the ability to raise the thermal set point to the hypothalamic level.

At the end of its half-life, the drug is metabolised to the liver level, and excreted in the form of hydroxylated catabolites, mainly via the kidney.

Studies carried out and clinical efficacy

1. THE LORNOXICAM IN THE CONTROL OF POST-OPERATIVE PAIN

World J Surg. 2012 May 15.

A very recent study demonstrating that Lornoxicam, especially when administered intravenously, may be significantly more effective than paracetamol in reducing post-operative pain following abdominal surgery.

2 . RENAL COLICAS AND ANALGESIC EFFECTIVENESS OF LORNOXICAM

Am J Emerg Med. 2012 Feb 3.

The colic pain present during renal calculosis, represents one of the most intense acute pains experienced by man. The symptomatic treatment in this case constitutes a very important therapy for the quality of life of the patient. For this reason the pain-relieving efficacy of Lornoxicam could be very useful in the management of patients suffering from renal colic.

3.GRAVI GASTRO-ENTERICA REACTIONS TO LORNOXICAM

Schweiz Arch Tierheilkd. 2011 May; 153 (5): 223-9.

Experimental study that also showed for lornoxicam the incidence of serious side effects following therapies carried out incorrectly.

Duodenal ulcers accompanied by chronic anemia and in more severe cases hematemesis and melena represent the most serious side effects for which emergency treatment is required.

Method of use and dosage

NOXON ®

8 mg Lornoxicam coated tablets.

Treatment with NOXON ® should be defined by a specialist doctor in the treatment of rheumatic diseases.

The dosing schedule could include an attack phase for a maximum daily dose of 32 mg of Lornoxicam followed by a maintenance period at 8 - 16 mg daily.

A dosage adjustment should necessarily be envisaged for elderly patients or those suffering from liver and kidney diseases.

Warnings NOXON ® Lornoxicam

Treatment with NOXON ® should be preceded by a careful medical examination aimed at assessing the prescriptive appropriateness, the absence of conditions incompatible with the therapy and the possible individual susceptibility to NSAIDs.

In order to minimize the incidence of side effects, the doctor should set the therapy with the lowest possible dose and for the time strictly necessary to ensure an improvement in the symptomatology in place.

Patients suffering from cardiovascular, coagulative, renal, hepatic, allergic and gastrointestinal diseases should also pay special attention to the use of NSAIDs, given the greater susceptibility to the side effects of anti-inflammatory therapy.

If undesired effects appear, the patient, after contacting his doctor, should seriously consider suspending therapy.

Lornoxicam intake may alter some blood chemistry parameters, masking existing pathological patterns.

NOXON ® contains lactose, therefore its intake is contraindicated in patients with lactose intolerance, glucose-galactose malabsorption syndrome and lactase enzyme deficiency.

PREGNANCY AND BREASTFEEDING

Taking NOXON ® is severely contraindicated during pregnancy and in the subsequent breastfeeding period.

These limitations derive from numerous experimental evidences that have shown how the intake of NSAIDs during pregnancy can significantly increase the appearance of birth defects of the cardiovascular and respiratory system as well as the number of unexpected abortions.

Interactions

As with other non-steroidal anti-inflammatory drugs, the hepatic metabolism of Lornoxicam could expose the active ingredient to drug interactions capable of varying its therapeutic efficacy and relative safety.

For this reason, patients taking NOXON ® should pay particular attention to the concomitant intake of:

Oral anticoagulants and inhibitors of serotonin reuptake, due to the increased risk of bleeding;
Diuretics, ACE inhibitors, angiotensin II antagonists, methotrexate and cyclosporin, due to their ability to enhance the hepatotoxic and nephrotoxic effects of Lornoxicam;
Non-steroidal anti-inflammatory drugs and corticosteroids due to damage to the gastro-intesintale mucosa;
Lithium, given the increased toxic effects of the same;
Cimetidicin, able to increase plasma concentrations of Lornoxicam, thus increasing the incidence of side effects.

Contraindications NOXON ® Lornoxicam

The use of NOXON ® is contraindicated in case of hypersensitivity to the active ingredient or to one of its excipients or to chemically and functionally related active ingredients, angioedema, peptic ulcer, history of intestinal bleeding, ulcerative colitis, Crohn's disease or previous history for the same pathologies, cerebrovascular bleeding, hemorrhagic diathesis or concomitant anticoagulant therapy, renal and hepatic failure.

Undesirable effects - Side effects

Therapy with Lornoxicam, as performed according to the appropriate therapeutic schemes, was generally well tolerated and free of clinically relevant side effects.

The incidence and severity of these adverse reactions was proportional to the duration of therapy and the dosages used.

The most frequent side effects were observed:

Gastrointestinal symptoms such as heartburn, gastralgia, nausea and vomiting, constipation and in severe cases ulcers and bleeding;
Nervous symptoms such as hearing and sight disorders, headache, insomnia, drowsiness, confusion and tremors;
Dermatological reactions characterized by erythema, rash, urticaria and in more serious cases, bullous diseases;
Cardiovascular symptoms such as hypertension, sloping edema and heart failure.