Introduction
Flexicam IM is a pain relieving medicine. It is used to treat moderate to severe pain in condition such as osteoarthritis and rheumatoid arthritis. It helps relieve pain and swelling in the joints and muscles.
Flexicam IM should be taken with food. This will prevent you from getting an upset stomach. The dose and duration will depend on what you are taking it for and how well it helps your symptoms. You should keep taking the medicine even if you feel better until the doctor says it is alright to stop using it.
The most common side effects of this medicine include mild vomiting, stomach pain, nausea, headache, and dizziness. If any of these side effects persist or get worse, you should let your doctor know. Your doctor may be able to suggest ways of preventing or reducing the symptoms.
Before using it, you should let your doctor know if you have a history of stomach ulcers, heart diseases, high blood pressure, and liver or kidney disease. Let your doctor also know about all the other medicines you are taking because they may affect, or be affected by, this medicine. Pregnant and breastfeeding mothers should consult their doctors before using the medicine.
Side effects of Flexicam IM
Common
- Vomiting
- Stomach pain
- Nausea
- Indigestion
- Diarrhea
How to use Flexicam IM
Take this medicine in the dose and duration as advised by your doctor. Dissolve it in a glass of water before taking it. Flexicam IM is to be taken with food.
How Flexicam IM works
Flexicam IM is a non-steroidal anti-inflammatory drug (NSAID). It works by blocking the release of certain chemical messengers that are responsible for inflammation (pain and swelling).
What if you forget to take Flexicam IM?
If you miss a dose of Flexicam IM, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Acute gout, Rheumatic disorders, Postoperative pain, Acute musculoskeletal conditions, Juvenile idiopathic arthritis
Administration
Should be taken with food.
Adult Dose
Adult:
Rheumatic disorders
Initial: 20 mg/day as a single dose. Maintenance: 10-30 mg in single or divided doses.
Acute gout
40 mg/day for 5-7 days.
Acute musculoskeletal conditions; Post-op pain
Initial: 40 mg/day for 2 days. Maintenance: 20 mg/day for 1-2 wk.
Child Dose
Juvenile idiopathic arthritis
Child: >6 yr: <15 kg: 5 mg,
16-25 kg: 10 mg,
26-45 kg: 15 mg,
>46 kg: 20 mg.
Doses to be taken once daily.
Contraindication
Hypersensitivity or asthma-type reactions to piroxicam, aspirin or other NSAIDs. History or active GI ulceration, bleeding and perforation; history of GI disorders that predispose to bleeding disorders (e.g. ulcerative colitis, Crohn's disease, GI cancers or diverticulitis). Treatment of perioperative pain in the setting of CABG surgery. Concomitant use w/ aspirin, other NSAIDs and anticoagulants.
Mode of Action
Piroxicam is a NSAID, belonging to the oxicam group. It inhibits prostaglandin synthesis, reduces fever by acting on the heat-regulating center of the hypothalamus, inhibits platelet-aggregating substance thromboxane A2 and reduces pain receptor sensitivity. It also exerts anti-inflammatory effect by lysosomal stabilisation, kinin and leukotriene production, alteration of chemotactic factors and neutrophil activation inhibition.
Precaution
Patient w/ known CV disease or risk factors for CV disease, fluid retention or heart failure, cerebrovascular disease, uncontrolled HTN, asthma. Elderly. Renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, drowsiness, fatigue or visual disturbance, if affected, do not drive or operate machinery. Monitoring Parameters Monitor occult blood loss, Hb, haematocrit, electrolytes, renal and hepatic function; periodic ophthalmologic exams w/ chronic use. Closely monitor BP during initiation and throughout therapy.
Lactation: excreted in breast milk; has adverse effect on the nursing infant
Side Effect
1-10%
Indigestion (3.8-9.5% ),Upper respiratory infection (up to 8.3% ),Headache (2.4-8.3% ),Diarrhea (1.9-7.8% ),Nausea (2.4-7.2% ),Abdominal pain (1.9-4.7%),Edema (0.6- 4.5%),Anemia (up to 4.1% ),Dizziness (1.1-3.8% ),Constipation (0.8-2.6% ),Vomiting,Fever,Angina (<2% ),Congestive heart failure (<2% ),Hypertension (<2% ),Myocardial infarction (<2% ),Gastrointestinal hemorrhage (< 2% ),Gastrointestinal perforation, gastrointestinal ulcer (< 2% ),Inflammatory disorder of digestive tract (<2% ),Decreased platelet aggregation, purpuric disorder (<2% ),Hepatitis (<2% )
<1%
Erythema multiforme, erythroderma,Stevens-Johnson syndrome,Toxic epidermal necrolysis,Jaundice, liver failure,Anaphylactoid reaction,Immune hypersensitivity reaction,Cerebrovascular accident,Interstitial nephritis, renal failure,Asthma, bronchospasm,Angioedema,Tinnitus, hearing loss
Potentially Fatal: Thrombocytopaenia and acute nephropathy. Toxic epidermal necrolysis and Stevens-Johnson syndrome.
Pregnancy Category Note
Pregnancy Category: C, D during third trimester of pregnancy (may cause premature closure of the ductus arteriosus)
Interaction
Increased risk of GI bleeding w/ anti-platelets and SSRIs. May exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels. Increased risk of nephrotoxicity w/ ciclosporin and tacrolimus. Increased absorption w/ cimetidine. Increased risk of GI ulceration w/ corticosteroids. May interfere w/ the natriuretic action of diuretics. May displace other highly protein-bound drugs. May increase steady state plasma lithium levels. May antagonise the effect of antihypertensives. May reduce the excretion of methotrexate, leading to acute toxicity. Increased risk of convulsions w/ quinolones. May interfere w/ mifepristone-mediated termination of pregnancy.
Potentially Fatal: May enhance the effect of anticoagulants (e.g. warfarin). Increased risk of serious GI events w/ aspirin and other NSAIDs.