TILCOTIL ® Tenoxicam

TILCOTIL ® is a drug based on Tenoxicam

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

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

Indications TILCOTIL ® Tenoxicam

TILCOTIL ® is indicated in the treatment of both acute and chronic inflammatory joint pain present during rheumatic and degenerative diseases.

Mechanism of action TILCOTIL ® Tenoxicam

Tenoxicam, the active ingredient of TILCOTIL ®, is one of the non-steroidal drugs with anti-inflammatory activity belonging to the very recent chemical oxicam group.

Starting from the progenitor Piroxicam, many other slightly different chemical-physical active ingredients have followed one another over time, which although sharing the same mechanism of action were more effective and advantageous from the pharmacokinetic point of view.

In this sense, the oral Tenoxicam is rapidly and completely absorbed by the gastro-intestinal mucosa, thus maintaining a bioavailability even higher than 90%, and subsequently distributed, through the bond with the plasma proteins, between the various tissues.

Focusing mainly on the synovial level, this drug is able to inhibit the cyclooxygenases induced by phlogistic events, reducing the production of chemical mediators, known as prostaglandins, responsible for the pro-inflammatory, histological and above all algogenic action.

For this reason, taking TILCOTIL ® results in a significant reduction in inflammatory pain, also accompanied by greater protection from oxidative damage induced by reactive oxygen species and by overexpressed proteolytic enzymes in such pathological conditions.

After its action, the tenoxicam is completely hydroxylated at the hepatic level and subsequently excreted in the form of inactive catabolites through the urine.

Studies carried out and clinical efficacy

1. TENOXICAM IN THE CONTROL OF POST-ARTHROCENTAL ARTICULAR PAIN

Int J Oral Maxillofac Surg. 2010 May; 39 (5): 440-5. Epub 2010 Mar 7.

Important work of maxillofacial surgery that demonstrates how the intra-articular injection of tenoxicam at the temporo-mandibular level can be effective in reducing pain following arthrocentesis, significantly improving the mobility of the joint involved.

2 . TENOXICAM IN THE PATHOLOGIES OF URINARY TRACKS

Urology. 2009 Aug; 74 (2): 431-5. Epub 2009 Jun 7.

An interesting study that has shown that the association between an alpha blocker and a COX2 non coxib inhibitor, such as tenoxicam, can be particularly effective in controlling the pain of the lower urinary tract present during benign prostatic hyperplasia.

3.TENOXICAM AND KNEE OSTEOARTRITIS

Orthopedics. 2007 Dec; 30 (12): 1039-42.

Study that demonstrates how the intraarticular injection of Tenoxicam can be effective during osteoarthritis, guaranteeing a rapid and intense improvement of the complained pain symptomatology

Method of use and dosage

TILCOTIL ®

Tenoxicam 20 mg coated tablets;

20 mg Tenoxicam solution for injection for 2 ml of solution.

The dosages normally used for the symptomatic treatment of inflammatory pain present during rheumatic and degenerative pathologies, should vary according to the clinical picture of the patient, his physio-pathological characteristics and tolerability towards therapy.

Generally the treatment of acute pain generally involves the intake of 20-40 mg of tenoxicam per day for very limited periods of time, while 10 -20 mg daily may be effective in controlling moderate pain symptoms.

An adjustment of the doses used should evidently be foreseen for elderly patients or those suffering contextually from liver and kidney diseases.

Warnings TILCOTIL ® Tenoxicam

Treatment with TILCOTIL ® should be defined and subsequently supervised by a doctor experienced in the treatment of rheumatic and degenerative inflammatory diseases.

Particular attention should be paid to patients suffering from cardiovascular, coagulative, renal, hepatic, allergic and gastrointestinal diseases due to the increased risk of developing adverse reactions following the use of NSAIDs.

For this reason the doctor should periodically evaluate the patient's general health and specifically the renal, hepatic, cardiac and gastro-intestinal function, suspending the therapy in progress in case of undesirable effects, including dermatological effects.

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

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

Please note that the use of TILCOTIL ® in vials is reserved exclusively for hospital healthcare personnel.

PREGNANCY AND BREASTFEEDING

The administration of TILCOTIL ® during pregnancy and in the subsequent period of breastfeeding is strongly contraindicated given the numerous studies present in the literature that show how the intake of NSAIDs in this period may:

Increase the risk of cardiovascular malformations in the unborn child;
Increase the risk of malformations of the respiratory and urinary system of the fetus;
Increase the incidence of waiting abortions;
Increase the risk of bleeding and complications in the pregnant woman at the time of delivery.

Furthermore, given the tendency of tenoxicam to accumulate in breast milk at clinically significant concentrations, it would be advisable to extend the contraindications to the subsequent breastfeeding period.

Interactions

Tenoxicam as well as other oxicams and more generally the other non-steroidal anti-inflammatory drugs is also susceptible to the action of other active ingredients administered simultaneously.

For this reason, in order to limit variations in the safety profile and therapeutic efficacy of tenoxicam, particular caution should be exercised in the contextual assumption 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 Tenoxicam;
Non-steroidal anti-inflammatory drugs and corticosteroids due to damage to the gastro-intesintale mucosa;
Lithium, given the increased toxic effects of the same;
Cimetidine, able to increase the plasma concentrations of Tenoxicam, thus increasing the incidence of side effects.

Contraindications TILCOTIL ® Tenoxicam

The use of TILCOTIL ® 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

Clinical trials show that taking tenoxicam is generally well tolerated and free of clinically relevant side effects.

Despite these evidences, it should be remembered that this active principle falls into the category of non-steroidal anti-inflammatory drugs, sharing with them the potential side effects, present above all in patients predisposed or treated for particularly long periods of time and at high doses.

In these cases adverse reactions may be of interest:

The gastrointestinal system with gastric pyrosis, gastralgia, nausea and vomiting, constipation and in more severe cases ulcers and hemorrhages;
The central nerve system with an increased risk of hearing and sight disorders, headache, insomnia, drowsiness, confusion and tremors;
The skin characterized by erythema, rash, urticaria and, in the most serious cases, blistering pathologies;
The cardiovascular system subject to hypertension, sloping edema and heart failure.