FLEXILOR SR 16MG SUSTAINED RELEASE TABLET

Indications

• Osteoarthritis
• Rheumatoid arthritis
• Postoperative pain
• Acute pain conditions
• Musculoskeletal pain

Dosage

Children: Refer to BNF for Children for specific dosing recommendations.

Adults: Refer to BNF for specific dosing recommendations.

Mechanism of action

Lornoxicam exerts its pharmacological effects by inhibiting the cyclooxygenase (COX) enzymes, COX-1 and COX-2, which are responsible for the conversion of arachidonic acid to prostaglandins. Prostaglandins are mediators of inflammation, pain, and fever. By reducing the synthesis of these mediators, lornoxicam alleviates pain and inflammation.

Pharmacodynamics

Lornoxicam demonstrates a rapid onset of action and provides effective relief from pain and inflammation. It has a relatively high potency compared to other NSAIDs and is well absorbed after oral administration. The drug's analgesic effects are thought to be due to its ability to inhibit both central and peripheral prostaglandin synthesis, contributing to its efficacy in pain management.

Pharmacokinetics

Lornoxicam is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 2 hours after oral administration. It has a high plasma protein binding rate, mainly to albumin, which affects its distribution in the body. The drug undergoes extensive hepatic metabolism, primarily through cytochrome P450 enzymes, leading to the formation of metabolites that are excreted via the kidneys. The elimination half-life of lornoxicam ranges from 3 to 5 hours, allowing for multiple dosing throughout the day.

Contra-indications

• Hypersensitivity to lornoxicam or any of its components
• Active peptic ulcer disease or gastrointestinal bleeding
• Severe hepatic impairment
• Severe renal impairment
• History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs

Adverse effects

• Gastrointestinal disturbances such as nausea, vomiting, and abdominal pain
• Headache
• Dizziness
• Hypertension
• Renal impairment
• Skin reactions including rash and pruritus
• Increased liver enzymes

Interactions

• Increased risk of gastrointestinal bleeding when used with other NSAIDs, anticoagulants, or antiplatelet agents
• May enhance the effects of antihypertensive medications
• Caution is advised when used with diuretics as it may reduce their effectiveness
• Potential interaction with lithium, leading to increased lithium levels

Precautions

• Use with caution in patients with cardiovascular disease or risk factors for cardiovascular events
• Monitor renal function in patients with pre-existing renal conditions or those on diuretics
• Caution in elderly patients who may be more susceptible to adverse effects
• Assess for signs of gastrointestinal bleeding

Pregnancy

Lornoxicam is not recommended during pregnancy due to potential risks to the fetus, especially in the third trimester.

Breast-feeding

Caution is advised as lornoxicam may pass into breast milk; consult a healthcare provider before use.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Oral tablets
• Injection solution