Piroxicam è un composto chimico, un farmaco antinfiammatorio non steroideo (FANS) usato per trattare il dolore e l'infiammazione. 

Assumere solo sotto controllo medico

Il nome definisce la struttura della molecola

• "Piroxicam" è il nome chimico di un farmaco anti-infiammatorio non steroideo (FANS). Non si scompone ulteriormente in termini di significato derivato dal nome, poiché è un nome specifico per questa molecola.

Descrizione delle materie prime utilizzate nella produzione

• Reagenti chimici di base come  2-piridilammina e  cloruro di tiofenil.

Processo di sintesi chimica industriale passo per passo

• Reazione -  2-piridilammina reagisce con il cloruro di tiofenil in presenza di un catalizzatore e un solvente per formare un composto intermedio.
• Idrolisi - Il composto intermedio subisce un processo di idrolisi in presenza di un acido per formare piroxicam.
• Purificazione - Il piroxicam grezzo viene purificato attraverso cristallizzazione, filtrazione e altri metodi appropriati.
• Essiccazione - Il piroxicam purificato viene essiccato per rimuovere l'umidità residua.
• Controllo Qualità - Si effettua un controllo qualità del piroxicam per assicurarsi che soddisfi le specifiche desiderate.

A cosa serve e dove si usa

Medicina

Piroxicam è un potente inibitore delle prostaglandine che è utilizzato come:

Anti-infiammatorio. Utilizzato per ridurre l'infiammazione associata a diverse condizioni, come l'artrite.

Analgesico. Prescritto per alleviare il dolore acuto o cronico (1).

Osteoartrite. Indicato per il trattamento dei sintomi dell'osteoartrite (2).

Artrite Reumatoide. Usato per trattare i sintomi dell'artrite reumatoide (3).

Spondilite Anchilosante. Può essere prescritto anche per trattare i sintomi della spondilite anchilosante (4).

Formulazioni topiche. Disponibile in gel o creme per il trattamento topico di dolori muscolari e articolari (5).

Come tutti i farmaci può causare effetti collaterali. Consultare sempre il medico.

Si presenta in forma di polvere bianca.

• Molecular Formula  C₁₅H₁₃N₃O₄S
• Molecular Weight  331.3 g/mol
• CAS  36322-90-4
• UNII    13T4O6VMAM
• EC Number   252-974-3
• Nikkaji    J3.498C
• DTXSID5021170

Bibliografia_____________________________________________________________________

(1) Enthoven WT, Roelofs PD, Deyo RA, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database Syst Rev. 2016 Feb 10;2(2):CD012087. doi: 10.1002/14651858.CD012087. 

Abstract. Background: Chronic back pain is an important health problem. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to treat people with low back pain, especially people with acute back pain. Short term NSAID use is also recommended for pain relief in people with chronic back pain. Two types of NSAIDs are available and used to treat back pain: non-selective NSAIDs and selective COX-2 NSAIDs. In 2008, a Cochrane review identified a small but significant effect from NSAIDs compared to placebo in people with chronic back pain. This is an update of the Cochrane review published in 2008 and focuses on people with chronic low back pain....Authors' conclusions: Six of the 13 included RCTs showed that NSAIDs are more effective than placebo regarding pain intensity. NSAIDs are slightly more effective than placebo regarding disability. However, the magnitude of the effects is small, and the level of evidence was low. When we only included RCTs at low risk of bias, differences in effect between NSAIDs and placebo were reduced. We identified no difference in efficacy between different NSAID types, including selective versus non-selective NSAIDs. Due to inclusion of RCTs only, the relatively small sample sizes and relatively short follow-up in most included trials, we cannot make firm statements about the occurrence of adverse events or whether NSAIDs are safe for long-term use.

(2) Ishaq N, Ata N, Saqib M, Shaheen B, Zafar A, Malik A. Intra-Articular Piroxicam And Triamcinolone In A Ratmodel Of Osteoarthritis; Elevation And Comparison Of Chondroprotective Efficacy. J Ayub Med Coll Abbottabad. 2022 Jan-Mar;34(1):53-57. doi: 10.55519/JAMC-01-8924. 

Abstract. Background: Osteoarthritis is the most common chronic degenerative joint disease. Definite treatment of osteoarthritis is still undiscovered. This study was designed to evaluate and compare the chondroprotective efficacy of piroxicam and triamcinolone in rat model of osteoarthritis. Methods: This laboratory based experimental study was conducted in Pharmacology Department, Army Medical College, Rawalpindi, from April-June 2019. Osteoarthritis was induced by medial meniscectomy and anterior cruciate ligament resection in knee joints of twenty-four rats. They were divided in three groups with eight rats in each. Group I, II and III were control, piroxicam and triamcinolone groups that were treated by intra articular saline, piroxicam and triamcinolone once weekly for four weeks respectively and then gait pattern was scored. Animals were euthanized thereafter and samples were taken for histopathological analysis. Results: Comparison of gait score of control, piroxicam and triamcinolone groups exhibited a p-value of <0.01. Intergroup comparison of gait of group I and II, group I and III and group II and IV depicted pvalue of <0.001,0.013 and 0.013 respectively. Likewise histopathological comparison of control, piroxicam and triamcinolone groups showed p-value of <0.01. While Intergroup histopathological comparison of group I and II, group I and III and group II and IV showed p-value of <0.001, <0.001 and 0.008 respectively. Conclusion: Comparison of control group with treatment group proved chondroprotective efficacy of piroxicam and triamcinolone. On comparison of treatment groups, it was concluded that piroxicam has better chondroprotective efficacy as compared to triamcinolone.

(3) Blackburn WD Jr, Prupas HM, Silverfield JC, Poiley JE, Caldwell JR, Collins RL, Miller MJ, Sikes DH, Kaplan H, Fleischmann R, et al. Tenidap in rheumatoid arthritis. A 24-week double-blind comparison with hydroxychloroquine-plus-piroxicam, and piroxicam alone. Arthritis Rheum. 1995 Oct;38(10):1447-56. doi: 10.1002/art.1780381011.

Abstract. Objective: To compare the clinical efficacy, effect on serum C-reactive protein (CRP), serum amyloid A (SAA), and plasma interleukin-6 (IL-6) levels, and safety of tenidap with a combination of hydroxychloroquine-plus-piroxicam, and piroxicam alone, in the treatment of rheumatoid arthritis (RA) patients. Methods: A double-blind, randomized, multicenter study in which patients with active RA were treated with tenidap 120 mg/day, hydroxychloroquine 400 mg/day and piroxicam 20 mg/day, or piroxicam alone 20 mg/day, for 24 weeks. Results: At weeks 12 and 24, tenidap produced greater improvements than piroxicam based on 5 primary efficacy parameters; this improvement showed statistical significance in 4 of the 5 measures at week 12, and in 3 of the 5 measures at week 24. Clinical improvements in the hydroxychloroquine-plus-piroxicam-treated with tenidap. Compared with piroxicam, tenidap was associated with significantly greater reductions in serum CRP concentrations at 4, 12, and 24 weeks, and significantly greater reductions in SAA concentrations at weeks 12 and 24. The decrease in SAA concentrations was also significantly greater at weeks 4 and 24 in the tenidap-treated group than in the hydroxychloroquine-plus-piroxicam-treated group. Significant reductions in plasma IL-6 levels were observed at weeks 4, 12, and 24 within the tenidap group, and at week 24 within the hydroxychloroquine-plus-piroxicam-treated group. The overall occurrence of side effects, including gastrointestinal side effects, was similar in all 3 treatment groups. A small proportion of tenidap-treated patients (6.4%) manifested mild, nonprogressive, reversible proteinuria of presumed renal proximal tubular origin, and 3-4% of patients had elevated transaminase levels. Conclusion: In the treatment of patients with RA, tenidap is as effective as the combination of hydroxychloroquine-plus-piroxicam, and is more effective than piroxicam alone; moreover, tenidap's safety profile is comparable to that observed with piroxicam alone, and with hydroxychloroquine-plus-piroxicam. The clinical response observed in this study, as well as the prompt decreases in acute-phase protein levels of CRP and SAA, and in plasma IL-6 levels, suggest that tenidap represents a new type of antiarthritic medication, with properties similar to, but not identical to, a therapeutic combination of a nonsteroidal antiinflammatory drug with disease-modifying antirheumatic drugs.

(4) Gupta, M., Kanoujia, J., Tiwari, S., & Saraf, A. S. (2014). Development of piroxicam loaded nanostructured lipid carriers for spondylitis treatment. Advanced Science Letters, 20(5-6), 1066-1071.

Abstract. Aim of this work was to prepare and characterize Piroxicam (Prx) loaded nanostructured lipid carriers (NLC) for the treatment of spondylitis. NLCs were prepared by microemulsion technique followed by solidification through ice bath. Piroxicam-nanostructured lipid carrier (PNLCs) prepared under optimum conditions were found to be homogenous, and round with smooth surface. The mean particle size was determined to be 198.1 nm, entrapment efficiency to be 79.69±0.5% and zeta potential to be −22.4 mV, respectively. The in-vitro release profile of optimized formulation showed sustained release which was best explained by Higuchi's equation. Through permeation studies it was confined that PNLC showed a higher localization in skin as compared to conventional gel of picroxicam. A preliminary in-vivo study in Wistar albino rats showed prolonged anti-inflammatory activity (18% inhibition) upto 24 hr while the standard (marketed picroxicam gel) showed diminished activity (3%) upto 24 hr. These results revealed that PNLCs may serve as a promising carrier to increase therapeutic efficacy for the treatment of spondylitis.

(5) Gaber DA, Alsubaiyel AM, Alabdulrahim AK, Alharbi HZ, Aldubaikhy RM, Alharbi RS, Albishr WK, Mohamed HA. Nano-Emulsion Based Gel for Topical Delivery of an Anti-Inflammatory Drug: In vitro and in vivo Evaluation. Drug Des Devel Ther. 2023 May 15;17:1435-1451. doi: 10.2147/DDDT.S407475.

Abstract. Introduction: Arthritic disorder is a common disease in elderly patients and the most common cause of joint dysfunction. This study aims to design Piroxicam-loaded nanoemulsion (PXM-NE) formulations to enhance the analgesic and anti-inflammatory activity of the drug for topical use....Conclusion: The results showed good physicochemical properties, higher bioavailability, and a longer analgesic effect of PXM from nanoemulsion gel, as compared to the commercial product. © 2023 Gaber et al.