Roxen
Generic Name
Lornoxicam
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| roxen 250 mg tablet | ৳ 4.02 | N/A |
| roxen 500 mg tablet | ৳ 7.03 | ৳ 70.33 |
Description
Overview of the medicine
Roxen (Lornoxicam) is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class with analgesic, anti-inflammatory, and antipyretic properties. It is used for the symptomatic relief of pain and inflammation.
Uses & Indications
Dosage
Adults
For pain: Initially 8-16 mg daily in 2-3 divided doses. Max 16 mg/day. For osteoarthritis/rheumatoid arthritis: 8 mg daily in 1-2 divided doses. Max 16 mg/day.
Elderly
No specific dose adjustment is required unless renal or hepatic impairment is present. Monitor closely.
Renal_impairment
Use with caution. Consider reduced doses in patients with mild to moderate renal impairment. Contraindicated in severe renal impairment.
How to Take
Roxen tablets should be swallowed with sufficient liquid before meals. For injections, administer intravenously or intramuscularly.
Mechanism of Action
Lornoxicam is an NSAID with analgesic and anti-inflammatory properties. Its mechanism of action is primarily related to the inhibition of prostaglandin synthesis through the inhibition of cyclo-oxygenase (COX) enzymes, leading to reduced inflammation, pain, and fever. It inhibits both COX-1 and COX-2.
Pharmacokinetics
Onset
Analgesic effect usually within 30 minutes to 1 hour after oral administration.
Excretion
Approximately 33% is excreted via the kidneys and 66% via the bile and faeces as inactive metabolites.
Half life
Approximately 3 to 5 hours.
Absorption
Rapidly and almost completely absorbed from the gastrointestinal tract. Peak plasma concentrations are reached in 1-2 hours after oral administration.
Metabolism
Extensively metabolized in the liver, primarily by cytochrome P450 2C9 (CYP2C9), into inactive or weakly active hydroxylated metabolites.
Side Effects
Contraindications
- Hypersensitivity to Lornoxicam or any of its excipients
- Patients with active gastrointestinal bleeding, ulceration, or a history of recurrent peptic ulcers
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- Patients in whom aspirin or other NSAIDs induce symptoms of asthma, rhinitis, urticaria or angioedema
Drug Interactions
Lithium
Increased plasma lithium levels.
Methotrexate
Increased plasma methotrexate levels and toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Other NSAIDs or aspirin
Increased risk of adverse effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, stomach pain, dizziness, somnolence, and in rare cases, liver or kidney damage. Treatment is symptomatic and supportive; there is no specific antidote. Gastric lavage and activated charcoal may be considered soon after ingestion.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester. During the first and second trimesters, use only if clearly needed and the potential benefits outweigh the risks. Lactation: Not recommended during breastfeeding as it is excreted in human milk.
Side Effects
Contraindications
- Hypersensitivity to Lornoxicam or any of its excipients
- Patients with active gastrointestinal bleeding, ulceration, or a history of recurrent peptic ulcers
- Severe renal or hepatic impairment
- Severe heart failure
- Third trimester of pregnancy
- Patients in whom aspirin or other NSAIDs induce symptoms of asthma, rhinitis, urticaria or angioedema
Drug Interactions
Lithium
Increased plasma lithium levels.
Methotrexate
Increased plasma methotrexate levels and toxicity.
Corticosteroids
Increased risk of gastrointestinal ulceration or bleeding.
Other NSAIDs or aspirin
Increased risk of adverse effects.
Anticoagulants (e.g., Warfarin)
Increased risk of bleeding.
Diuretics, ACE inhibitors, Angiotensin II receptor antagonists
Reduced antihypertensive effect and increased risk of renal impairment.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms may include nausea, vomiting, stomach pain, dizziness, somnolence, and in rare cases, liver or kidney damage. Treatment is symptomatic and supportive; there is no specific antidote. Gastric lavage and activated charcoal may be considered soon after ingestion.
Pregnancy & Lactation
Pregnancy: Contraindicated in the third trimester. During the first and second trimesters, use only if clearly needed and the potential benefits outweigh the risks. Lactation: Not recommended during breastfeeding as it is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved in Bangladesh by DGDA
Patent Status
Generically available
Clinical Trials
Extensive clinical trials have demonstrated Lornoxicam's efficacy in various pain and inflammatory conditions, with good tolerability compared to other NSAIDs.
Lab Monitoring
- Liver function tests (LFTs) periodically, especially in long-term use.
- Kidney function tests (renal function tests) periodically, especially in long-term use or in at-risk patients.
- Complete blood count (CBC) to monitor for blood dyscrasias.
Doctor Notes
- Always assess patient's cardiovascular and gastrointestinal risk factors before prescribing.
- Use the lowest effective dose for the shortest duration necessary.
- Consider gastroprotective agents in high-risk patients.
- Monitor renal function, especially in elderly or patients with pre-existing renal conditions.
Patient Guidelines
- Take with food if stomach upset occurs.
- Do not exceed the recommended dose.
- Report any signs of gastrointestinal bleeding (e.g., black, tarry stools) immediately.
- Avoid concomitant use with other NSAIDs or aspirin.
- Inform your doctor about all other medications you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Roxen may cause dizziness or somnolence. Patients should be warned not to drive or operate machinery if they experience these symptoms.
Lifestyle Advice
- Maintain a healthy diet and stay hydrated.
- Limit alcohol consumption to reduce GI risks.
- Regular exercise, if appropriate for your condition, can help manage pain and inflammation.
- Discuss pain management strategies with your doctor.
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