Brands of Lornoxicam in Kenya
Flexilor®, Glenmark Pharmaceuticals Limited
Noxicam®, Medisel Kenya Ltd
MODE OF ACTION
The mode of action of lornoxicam is partly based on the inhibition of prostaglandin synthesis (inhibition of cyclo-oxygenase enzyme). The inhibition of cyclo-oxygenase does not result in an increased formation of leukotriene. As with other non-steroidal anti-inflammatory drugs, the mechanism of the analgesic action of Lornoxicam has not been fully determined
Lornoxicam is indicated for:
- -Short term treatment of moderate pain, such as pain after dental surgery.
- -Short term treatment of mild to moderate pain associated with extra-articular inflammation.
- -Treatment of pain associated with acute lumbar-sciatica.
- -Symptomatic treatment of pain and inflammation in osteoarthritis and rheumatoid arthritis
DOSAGE AND ADMINISTRATION:
For all patients, the appropriate dosing regimen should be based upon individual response to treatment.
Dosage for the Treatment of Pain
A dose of 8mg to 16mg per day is recommended and should be taken in 2 single doses.
The daily dose should not exceed 16mg.
Dosage for the Treatment of Rheumatoid Arthritis and Osteoarthritis
The recommended daily dose is 8mg-16mg preferably given as 8mg twice daily.
Dosage in case of Impaired Kidney or Liver Function
For patients with a renal or hepatic impairment, the maximal recommended daily dose is reduced to 8mg.
Special population Elderly
No special dosage modification is required for elderly patients unless the renal or hepatic function is impaired, in which case the daily dosage should be restricted.
Lornoxicam is contraindicated in the following conditions:
- Patients allergic to lornoxicam or any of the components of the product.
- Patients who have suffered from hypersensitivity reactions(Asthma, rhinitis, angioedema or urticaria) to other nonsteroidal anti-inflammatory medicines, including acetylsalicylic acid.
- Patients with gastrointestinal bleeding, cerebrospinal bleeding, or other bleeding disorders.
- Patients with active peptic ulceration or with a history of recurrent peptic ulceration.
- Patients with severe liver impairment.
- Patients with severe renal impairment (serum creatinine>700μmol/L).
- Patients with severe heart insufficiency.
- Patients with severe thrombocytopenia.
- Patients who are elderly (>65 years) and weighing less than 50kg and undergoing acute surgery
- Pregnancy or lactation
- Patients under 18 years of age
Concomitant administration of Lornoxicam and anticoagulants or platelet aggregation inhibitors: may prolong the bleeding time.
Sulphonylureas: may increase the hypoglycaemic effect.
Other non-steroidal anti-inflammatory medicines and aspirin: increased risk of adverse reactions.
Diuretics: decreased efficacy of loop diuretic drugs, NSAIDs counteract the diuretic effect of furosemide.
ACE inhibitors: the effect of the ACE inhibitor may decrease and there is a risk of acute renal insufficiency.
Lithium: might lead to an increase in the lithium peak concentration and thus to a possible increase in adverse events. Avoid concomitant use if frequent analysis of lithium concentration in plasma cannot be performed.
Methotrexate: increased serum concentration of high dose methotrexate; avoid concomitant use. Special caution must be taken if both NSAIDs and methotrexate are administered within 24 hours.
Cimetidine: higher plasma concentrations of Lornoxicam (No interaction between Lornoxicam and Ranitidine, or Lornoxicam and antacids has been demonstrated).
Digoxin: decreased renal clearance of digoxin.
Cyclosporin: increased renal toxicity.
Lornoxicam has interactions with known inducers and inhibitors of CYP2C9 isoenzymes such as phenytoin, amiodarone, miconazole, tranylcypromine, and rifampicin.
General: Headache, dizziness, somnolence, changes in appetite, increased sweating, loss of weight, edema, allergic reactions, debility, weight increase.
The central nervous system (CNS): Depression, insomnia.
Eyes: Conjunctivitis, vision disorders.
Gastro-intestinal: Abdominal pain, diarrhea, dyspepsia, nausea, vomiting, flatulence, dysphagia,
constipation, gastritis, dry mouth, stomatitis, gastro-esophageal reflux, peptic ulceration with or without bleeding, esophagitis, haemorrhoidal or rectal bleeding.
Haematological: Anemia, ecchymosis, prolonged bleeding time, thrombocytopenia.
Liver: Increased transaminases.
Musculoskeletal: Cramps in the leg, myalgia.
Neurological: Migraine, paraesthesia, taste perversion, tinnitus, and tremor.
Respiratory: Dyspnoea, symptoms of irritation in the upper respiratory tract.
Skin: Allergic skin reactions such as dermatitis, flushing and pruritis, loss of hair.
Urogenital: Micturition disorders.
Vascular: Palpitations, tachycardia, changes in blood pressure.
Reporting of suspected adverse reactions:
The PPB Department of Pharmacovigilance was set up with a vision to develop, implement and continuously upgrade an appropriate system for detecting, reporting, and monitoring adverse drug reactions (ADRs) and other relevant problems with medicines in Kenya. The department strives to ensure the safety and efficacy of pharmaceutical products in Kenya.
Reporting suspected adverse reactions after authorization of the medicinal product are important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals/ Patients are encouraged to report any suspected adverse reactions via Pharmacovigilance Yellow Form, firstname.lastname@example.org or clicking below button:
Gastrointestinal ulceration and bleeding in medical history:
Clinical monitoring at regular intervals is recommended. Patients developing peptic ulceration and/or gastrointestinal bleeding while taking Lornoxicam should discontinue medicine administration with appropriate therapeutic actions being taken.
Patients with mild renal impairment (serum creatinine 150-300 micromol/L) should be monitored quarterly, patients with moderate renal impairment (serum creatinine 300-700 micromol/L) should be monitored at 1 to 2-month intervals. Should renal function deteriorate during treatment Lornoxicam should be discontinued.
Patients with coagulation disorders:
Careful clinical monitoring and laboratory assessment are recommended (e.g. PTT).
Liver diseases (e.g. liver cirrhosis)
Clinical monitoring and laboratory assessment at regular intervals are recommended (e.g. liver enzymes).
Long term treatment (longer than 3 months)
Regular laboratory assessments of hematology (hemoglobin), renal functions (creatinine) and liver enzymes are recommended.
Elderly patients (65 years or above)
There is no clinical experience with this dosage form in this patient group.
Lornoxicam in Kenya Cost
Lornoxicam in Kenya prices
Brands of Lornoxicam in Kenya
uses of Lornoxicam in Kenya
Clinical | Pharmacokinetic data
Pregnancy Category: Not recommended; Contraindicated in months 7–9
Routes of Administration: By mouth, Parenteral
Protein Binding: 99%
Onset of Action: Not Available
Elimination Half life: 3–4 hours
Excretion: 2/3 liver, 1/3 kidney
Legal Status | Dosage forms & Strengths
Prescription only Medicine (POM) , ℞-only
Narcotic Drugs and Psychotropic Substances (Control ) Act Schedule:
This drug is not a controlled substance under Narcotic Drugs and Psychotropic Substances (Control ) Act
Dosage Forms | Strengths:
|CompTox Dashboard (EPA)|
- PPB Drugs Retention Register
- Balfour, Julia A., Andrew Fitton, and Lee B. Barradell. “Lornoxicam.” Drugs 51.4 (1996): 639-657.
- Skjodt, Neil M., and Neal M. Davies. “Clinical pharmacokinetics of lornoxicam.” Clinical pharmacokinetics 34.6 (1998): 421-428.
- Pruss, T. P., et al. “Overview of the pharmacological properties, pharmacokinetics and animal safety assessment of lornoxicam.” Postgraduate medical journal 66 (1990): S18-21.