Disclaimer Notice:

Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Tenoxicam (Mobiflex) - Uses, Dose, Side effects

Tenoxicam (Mobiflex) is a reversible inhibitor of the COX-1 and COX-2 enzymes. It is used to treat inflammatory conditions.

Indications of Tenoxicam (Mobiflex):

Ankylosing spondylitis:
- It is indicated for symptomatic treatment of ankylosing spondylitis.
Extra-articular inflammation:
- It is used for symptomatic treatment of extra-articular inflammation such as tendonitis, bursitis, and peri-arthritis of the shoulders or hips.
Osteoarthritis:
- It is advised for symptomatic management of osteoarthritis.
Rheumatoid arthritis:
- It is used in the symptomatic treatment of rheumatoid arthritis.

Tenoxicam (Mobiflex) dose in adults:

Tenoxicam (Mobiflex) dose in the treatment of inflammatory arthritis:

(Ankylosing spondylitis, rheumatoid arthritis, osteoarthritis, and/or extra-articular inflammation)

10 to 20 mg per oral once daily (higher doses associated with increased risk of adverse effects and usually do not offer greater clinical benefit)

Use in Children:

The safety and efficacy of Tenoxicam (Mobiflex) in children is not established.

Pregnancy Risk Category C/D (D in the third trimester)

Women who use NSAIDs regularly may experience infertility that is reversible, miscarriage, or other birth defects.
Nonteratogenic consequences have been noted in the foetus, such as prenatal ductus arteriosus constriction, patent ductus arteriosus, persistent newborn pulmonary hypertension, oligohydramnios, necrotizing enterocolitis, renal failure, and intracranial haemorrhage.

Tenoxicam use during breastfeeding:

The manufacturer does not recommend breast-feeding.

Tenoxicam (Mobiflex) Dose adjustment in renal disease:

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Alternatively, KDIGO 2012 guidelines provide the following recommendations for NSAIDs:
- Estimated glomerular filtration rate 30 to <60 mL/minute/1.73 m² :
  - In individuals with co-existing conditions that raise the risk of acute renal injury, temporarily cease.
- Estimated glomerular filtration rate <30 mL/minute/1.73 m²:
  - Avoid use.

Tenoxicam (Mobiflex) Dose adjustment in liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling; use with caution.

Side Effects of Tenoxicam (Mobiflex):

Cardiovascular:
- Edema
Central Nervous System:
- Headache
- Dizziness
Dermatologic:
- Pruritus
- Skin Rash
Gastrointestinal:
- Dyspepsia
- Nausea
- Epigastric Pain
- Abdominal Pain
- Constipation
- Abdominal Distress
- Heartburn
- Diarrhea
- Flatulence
- Vomiting

Frequency of side effects not known:

Endocrine & Metabolic:
- Fluid Retention
Genitourinary:
- Nephrotoxicity
Hypersensitivity:
- Hypersensitivity Reaction
Ophthalmic:
- Blurred Vision
Renal:
- Acute Interstitial Nephritis

Contraindications to Tenoxicam (Mobiflex):

Hypersensitivity to tenoxicam and any component of the formulation
For the elderly
Active peptic ulcer and active GI inflammatory disease
Higher risk of bleeding
Risis of kidney failure increases
After taking aspirin and other NSAIDs, you may experience rhinitis, urticaria, or asthma.

Warnings and precautions

Anaphylactoid reactions
- Those who have bronchospasm, asthma, rhinitis, or urticaria with NSAID or aspirin medication shouldn't be administered it.
Cardiovascular events
- NSAIDs can cause adverse cardiovascular events such as stroke and MI.
- It should not be used in cardiac failure.
CNS effects
- Patients should be aware that NSAIDs can cause blurred vision, drowsiness, dizziness, and other neurologic effects.
Gastrointestinal events:
- NSAIDs can increase the risk for gastrointestinal inflammation, ulceration and bleeding as well as perforation.
- Patients who are elderly, smokers, or an alcoholic should be cautious.
- A protective therapy with proton pump inhibitors is advised.
Hematologic effects
- It can lead to anemia, prolonged bleeding times, decreased platelet adhesion, and aggregation, and occasionally, severe blood dyscrasias like thrombocytopenia, angranulocytosis, and aplastic anemia. Therefore, it is important to monitor closely.
Hepatic effects
- Tenoxicam can cause transaminitis and hepatitis.
Hyperkalemia:
- Old age, renal illness, concurrent use of ACE inhibitors, beta-blockers, or certain diuretics are also risk factors.
Ophthalmic events
- Because of the possibility of vision impairment/blurring, long-term therapy requires a periodic ophthalmic exam.
Effects on the renal system:
- NSAIDs can cause decreased renal blood flow, renal glomerulonephritis and interstitial nephritis.
Reactions to skin:
- In the event of Stevens-Johnson syndrome or exfoliative dermatology, you should immediately stop using the drug.
Aseptic meningitis
- Aseptic meningitis may be more common in those who take NSAIDs, especially if they are taking systemic lupus or mixed connective tissue diseases (SLE).

Tenoxicam (United States: Not available): Drug Interaction

Risk Factor C (Monitor therapy)
5-Aminosalicylic Acid Derivatives	Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of 5-Aminosalicylic Acid Derivatives.
Agents with Antiplatelet Properties (e.g., P2Y12 inhibitors, NSAIDs, SSRIs, etc.)	May enhance the antiplatelet effect of other Agents with Antiplatelet Properties.
Alcohol (Ethyl)	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of GI bleeding may be increased with this combination.
Aliskiren	Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of Aliskiren. Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of Aliskiren. Management: Monitor renal function periodically in patients receiving aliskiren and any nonsteroidal anti-inflammatory agent. Patients at elevated risk of renal dysfunction include those who are elderly, are volume depleted, or have pre-existing renal dysfunction.
Aminoglycosides	Nonsteroidal Anti-Inflammatory Agents may decrease the excretion of Aminoglycosides. Data only in premature infants.
Aminolevulinic Acid (Topical)	Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical).
Angiotensin II Receptor Blockers	May enhance the adverse/toxic effect of Nonsteroidal AntiInflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Angiotensin II Receptor Blockers. The combination of these two agents may also significantly decrease glomerular filtration and renal function.
Angiotensin-Converting Enzyme Inhibitors	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the combination may result in a significant decrease in renal function. Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of Angiotensin-Converting Enzyme Inhibitors.
Anticoagulants	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Anticoagulants. Exceptions: Bemiparin; Enoxaparin; Heparin.
Anticoagulants	Nonsteroidal Anti-Inflammatory Agents may enhance the anticoagulant effect of Anticoagulants. Exceptions: Bemiparin; Enoxaparin; Heparin.
Beta-Blockers	Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of Beta-Blockers. Exceptions: Levobunolol; Metipranolol.
Bisphosphonate Derivatives	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Bisphosphonate Derivatives. Both an increased risk of gastrointestinal ulceration and an increased risk of nephrotoxicity are of concern.
Cephalothin	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Cephalothin. Specifically, the risk for bleeding may be increased.
Collagenase (Systemic)	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Collagenase (Systemic). Specifically, the risk of injection site bruising and/or bleeding may be increased.
Corticosteroids (Systemic)	May enhance the adverse/toxic effect of Nonsteroidal AntiInflammatory Agents (Nonselective).
Dasatinib	May enhance the anticoagulant effect of Agents with Antiplatelet Properties. Management: Drugs listed as exceptions to this monograph are discussed in further detail in separate drug interaction monographs.
Deferasirox	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Deferasirox. Specifically, the risk for GI ulceration/irritation or GI bleeding may be increased.
Deoxycholic Acid	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Deoxycholic Acid. Specifically, the risk for bleeding or bruising in the treatment area may be increased.
Desmopressin	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Desmopressin.
Digoxin	Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of Digoxin.
Drospirenone	Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Drospirenone.
Eplerenone	Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of Eplerenone. Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Eplerenone.
Fat Emulsion (Fish Oil Based)	May enhance the adverse/toxic effect of Agents with Antiplatelet Properties.
Felbinac	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Glucosamine	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Haloperidol	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Haloperidol. Specifically including drowsiness and confusion.
HydrALAZINE	Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of HydrALAZINE.
Ibritumomab Tiuxetan	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Ibritumomab Tiuxetan. Both agents may contribute to impaired platelet function and an increased risk of bleeding.
Ibrutinib	May enhance the adverse/toxic effect of Agents with Antiplatelet Properties.
Inotersen	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Limaprost	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
MiFEPRIStone	Tenoxicam may diminish the therapeutic effect of MiFEPRIStone.
Multivitamins/Fluoride (with ADE)	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Multivitamins/Minerals (with ADEK, Folate, Iron)	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Multivitamins/Minerals (with AE, No Iron)	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Naftazone	May enhance the antiplatelet effect of Nonsteroidal Anti-Inflammatory Agents.
Obinutuzumab	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Obinutuzumab. Specifically, the risk of serious bleeding-related events may be increased.
Omega-3 Fatty Acids	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Pentosan Polysulfate Sodium	May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Specifically, the risk of bleeding may be increased by concurrent use of these agents.
Pentoxifylline	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Porfimer	Photosensitizing Agents may enhance the photosensitizing effect of Porfimer.
Potassium-Sparing Diuretics	Nonsteroidal Anti-Inflammatory Agents may diminish the antihypertensive effect of Potassium-Sparing Diuretics. Nonsteroidal Anti-Inflammatory Agents may enhance the hyperkalemic effect of Potassium-Sparing Diuretics.
PRALAtrexate	Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of PRALAtrexate. More specifically, NSAIDS may decrease the renal excretion of pralatrexate. Management: Closely monitor for increased pralatrexate serum levels and/or toxicity if used concomitantly with an NSAID. Monitor for decreased pralatrexate serum levels with NSAID discontinuation.
Probenecid	May increase the serum concentration of Nonsteroidal Anti-Inflammatory Agents.
Prostacyclin Analogues	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Prostaglandins (Ophthalmic)	Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Prostaglandins (Ophthalmic). Nonsteroidal Anti-Inflammatory Agents may also enhance the therapeutic effects of Prostaglandins (Ophthalmic).
Quinolones	Nonsteroidal Anti-Inflammatory Agents may enhance the neuroexcitatory and/or seizure-potentiating effect of Quinolones. Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of Quinolones.
Salicylates	Agents with Antiplatelet Properties may enhance the adverse/toxic effect of Salicylates. Increased risk of bleeding may result.
Serotonin/Norepinephrine Reuptake Inhibitors	May enhance the antiplatelet effect of Nonsteroidal Anti-Inflammatory Agents (Nonselective).
Tacrolimus (Systemic)	Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of Tacrolimus (Systemic).
Thiazide and Thiazide-Like Diuretics	May enhance the nephrotoxic effect of Nonsteroidal AntiInflammatory Agents. Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Thiazide and Thiazide-Like Diuretics.
Thrombolytic Agents	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Thrombolytic Agents.
Tipranavir	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Tolperisone	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Tolperisone. Specifically, the risk of hypersensitivity reactions may be increased. Tolperisone may enhance the therapeutic effect of Nonsteroidal Anti-Inflammatory Agents.
Tricyclic Antidepressants (Tertiary Amine)	May enhance the antiplatelet effect of Nonsteroidal Anti-Inflammatory Agents (Nonselective).
Vancomycin	Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of Vancomycin.
Verteporfin	Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin.
Vitamin E (Systemic)	May enhance the antiplatelet effect of Agents with Antiplatelet Properties.
Zidovudine	Tenoxicam may enhance the adverse/toxic effect of Zidovudine.
Risk Factor D (Consider therapy modification)
Apixaban	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the adverse/toxic effect of Apixaban. Specifically, the risk of bleeding may be increased. Management: A comprehensive risk to benefit assessment should be done for all patients before any concurrent use of apixaban and nonsteroidal anti-inflammatory drugs (NSAIDs). If combined, monitor patients extra closely for signs and symptoms of bleeding.
Bemiparin	Nonsteroidal Anti-Inflammatory Agents may enhance the anticoagulant effect of Bemiparin. Management: Avoid concomitant use of bemiparin and nonsteroidal anti-inflammatory agents (NSAIDs) due to the increased risk of bleeding. If concomitant use is unavoidable, monitor closely for signs and symptoms of bleeding.
Bemiparin	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Bemiparin. Management: Avoid concomitant use of bemiparin with antiplatelet agents. If concomitant use is unavoidable, monitor closely for signs and symptoms of bleeding.
Bile Acid Sequestrants	May decrease the absorption of Nonsteroidal Anti-Inflammatory Agents.
CycloSPORINE (Systemic)	Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of CycloSPORINE (Systemic). Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of CycloSPORINE (Systemic). CycloSPORINE (Systemic) may increase the serum concentration of Nonsteroidal Anti-Inflammatory Agents. Management: Consider alternatives to nonsteroidal anti-inflammatory agents (NSAIDs). Monitor for evidence of nephrotoxicity, as well as increased serum cyclosporine concentrations and systemic effects (eg, hypertension) during concomitant therapy with NSAIDs.
Dabigatran Etexilate	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the adverse/toxic effect of Dabigatran Etexilate. Specifically, the risk of bleeding may be increased. Management: A comprehensive risk to benefit assessment should be done for all patients before any concurrent use of dabigatran and nonsteroidal anti-inflammatory drugs (NSAIDs). If combined, monitor patients extra closely for signs and symptoms of bleeding.
Edoxaban	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the adverse/toxic effect of Edoxaban. Specifically, the risk of bleeding may be increased. Management: A comprehensive risk to benefit assessment should be done for all patients before any concurrent use of edoxaban and nonsteroidal anti-inflammatory drugs (NSAIDs). If combined, monitor patients extra closely for signs and symptoms of bleeding.
Enoxaparin	Nonsteroidal Anti-Inflammatory Agents may enhance the anticoagulant effect of Enoxaparin. Management: Discontinue nonsteroidal anti-inflammatory agents (NSAIDs) prior to initiating enoxaparin whenever possible. If concomitant administration is unavoidable, monitor closely for signs and symptoms of bleeding.
Enoxaparin	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Enoxaparin. Management: Discontinue antiplatelet agents prior to initiating enoxaparin whenever possible. If concomitant administration is unavoidable, monitor closely for signs and symptoms of bleeding.
Heparin	Nonsteroidal Anti-Inflammatory Agents may enhance the anticoagulant effect of Heparin. Management: Decrease the dose of heparin or nonsteroidal anti-inflammatory agents (NSAIDs) if coadministration is required.
Heparin	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Heparin. Management: Decrease the dose of heparin or agents with antiplatelet properties if coadministration is required.
Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry)	May enhance the adverse/toxic effect of Agents with Antiplatelet Properties. Bleeding may occur. Management: Avoid combination when possible. If used, monitor more closely for evidence of bleeding. Discontinue herbal products with anticoagulant or antiplatelet actions 2 weeks prior to surgical, dental, or invasive procedures.
Herbs (Anticoagulant/Antiplatelet Properties) (eg, Alfalfa, Anise, Bilberry)	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents. Bleeding may occur. Management: Concomitant treatment with these agents should generally be avoided. If used concomitantly, increased diligence in monitoring for adverse effects (eg, bleeding, bruising, altered mental status due to CNS bleeds) must be employed.
Lithium	Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of Lithium.
Loop Diuretics	Nonsteroidal Anti-Inflammatory Agents may diminish the diuretic effect of Loop Diuretics. Loop Diuretics may enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Management: Monitor for evidence of kidney injury or decreased therapeutic effects of loop diuretics with concurrent use of an NSAID. Consider avoiding concurrent use in CHF or cirrhosis. Concomitant use of bumetanide with indomethacin is not recommended.
Methotrexate	Nonsteroidal Anti-Inflammatory Agents may increase the serum concentration of Methotrexate. Management: Alternative anti-inflammatory therapy should be considered whenever possible, especially if the patient is receiving higher, antineoplastic doses of methotrexate.
Rivaroxaban	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the adverse/toxic effect of Rivaroxaban. Specifically, the risk of bleeding may be increased. Management: A comprehensive risk to benefit assessment should be done for all patients before any concurrent use of rivaroxaban and nonsteroidal anti-inflammatory drugs (NSAIDs). If combined, monitor patients extra closely for signs and symptoms of bleeding.
Salicylates	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the adverse/toxic effect of Salicylates. An increased risk of bleeding may be associated with use of this combination. Nonsteroidal Anti-Inflammatory Agents (Nonselective) may diminish the cardioprotective effect of Salicylates. Salicylates may decrease the serum concentration of Nonsteroidal Anti-Inflammatory Agents (Nonselective). Exceptions: Choline Magnesium Trisalicylate.
Selective Serotonin Reuptake Inhibitors	May enhance the antiplatelet effect of Nonsteroidal AntiInflammatory Agents (Nonselective). Nonsteroidal Anti-Inflammatory Agents (Nonselective) may diminish the therapeutic effect of Selective Serotonin Reuptake Inhibitors. Management: Consider alternatives to NSAIDs. Monitor for evidence of bleeding and diminished antidepressant effects. It is unclear whether COX-2-selective NSAIDs reduce risk.
Sincalide	Drugs that Affect Gallbladder Function may diminish the therapeutic effect of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction.
Sodium Phosphates	May enhance the nephrotoxic effect of Nonsteroidal Anti-Inflammatory Agents. Specifically, the risk of acute phosphate nephropathy may be enhanced. Management: Consider avoiding this combination by temporarily suspending treatment with NSAIDs, or seeking alternatives to oral sodium phosphate bowel preparation. If the combination cannot be avoided, maintain adequate hydration and monitor renal function closely.
Tenofovir Products	Nonsteroidal Anti-Inflammatory Agents may enhance the nephrotoxic effect of Tenofovir Products. Management: Seek alternatives to these combinations whenever possible. Avoid use of tenofovir with multiple NSAIDs or any NSAID given at a high dose.
Vitamin K Antagonists (eg, warfarin)	Nonsteroidal Anti-Inflammatory Agents (Nonselective) may enhance the anticoagulant effect of Vitamin K Antagonists.
Risk Factor X (Avoid combination)
Acemetacin	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Aminolevulinic Acid (Systemic)	Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic).
Dexibuprofen	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Dexibuprofen.
Dexketoprofen	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Floctafenine	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Ketorolac (Nasal)	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Ketorolac (Systemic)	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Macimorelin	Nonsteroidal Anti-Inflammatory Agents may diminish the diagnostic effect of Macimorelin.
Mifamurtide	Nonsteroidal Anti-Inflammatory Agents may diminish the therapeutic effect of Mifamurtide.
Morniflumate	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Nonsteroidal Anti-Inflammatory Agents	Tenoxicam may enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Omacetaxine	Nonsteroidal Anti-Inflammatory Agents may enhance the adverse/toxic effect of Omacetaxine. Specifically, the risk for bleeding-related events may be increased. Management: Avoid concurrent use of nonsteroidal antiinflammatory drugs (NSAIDs) with omacetaxine in patients with a platelet count of less than 50,000/uL.
Pelubiprofen	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Phenylbutazone	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Talniflumate	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.
Urokinase	Agents with Antiplatelet Properties may enhance the anticoagulant effect of Urokinase.
Zaltoprofen	May enhance the adverse/toxic effect of Nonsteroidal Anti-Inflammatory Agents.

Monitoring parameters:

Blood pressure
Complete blood count
Liver function tests
Renal function tests
Serum electrolytes
Occult blood loss
Ophthalmic exams with prolonged therapy

How to administer Tenoxicam (Mobiflex)?

It should be administered orally, preferably at the same time every day, with or after food.

Mechanism of action of Tenoxicam (Mobiflex):

It results in a decrease of prostaglandin precursors due to reversible inhibitions of cyclooxygenase-1 (COX-1) enzymes.
It possesses analgesic, anti-inflammatory, and antipyretic qualities.
Chemotaxis inhibition, lymphocyte activity change, preventing neutrophil aggregation/activation, and lowering pro-inflammatory cytokine levels are some other hypothesised mechanisms for NSAIDS that have not yet been fully explained.

Absorption:

Oral: Rapid and complete, delayed with food

Protein binding:

98% to 99%

Metabolism:

Occurs in liver

Bioavailability:

Oral: 100%

Half-life elimination:

72 hours (± 28 hours)

Time to peak, serum:

0.5 to 6 hours (median: 1.25 hours)

Excretion:

Occurs in urine (primary route; mainly as metabolite), feces

International Brands of Tenoxicam:

ALTI-Tenoxicam
NU-Tenoxicam
Admiral
Alganex
Analcam
Anoxicam
Arthirinal
Arthrinal
Artricom
Artrocam
Aspagin
Bart
Bioflam
Cotixil
Doxican
Enocam
Epicotil
Fenkil
Ilkoten
Legil
Liman
Mefenix
Memzotil
Mittrotil
Mobicam
Mobiflex
Neo-Endusix
Novotil
Oksamen
Oxaflam
Pavmin
Pycifil
Reumotec
Reutenox
Rheuflex
Rodix
Sinoral
Soral
Teflan
Teksamen
Tenalgin
Tenax
Tenocam
Tenoflam
Tenotec
Tenotil
Tenox
Tenoxil
Tenoxim
Tenoxin
Texamen
Texicam
Tilarco
Tilatil
Tilcitin
Tilcotil
Titenil
Tobitil
Tobitill

Tenoxicam Brands in Pakistan:

Tenoxicam 20 mg Tablets
Fenkil	Standpharm Pakistan (Pvt) Ltd.
Jexim	Bloom Pharmaceuticals (Pvt) Ltd.
Neo-Endusix	A.J. & Company.
Ostacs	Gray`S Pharmaceuticals
Paumin	Adfa San Pharmaceuticals.
Senoxi	Tagma Pharma (Pvt) Ltd.
Tenoxam	Pearl Pharmaceuticals
Tenoxim	Bloom Pharmaceuticals (Pvt) Ltd.
Tenoxitil	Fynk Pharmaceuticals
Tilcotil	Roche Pakistan Ltd.
Tobitil	Wilshire Laboratories (Pvt) Ltd.

Disclaimer Notice:

Emedz.net is not an online pharmacy:

We are not affiliated with any pharmaceutical companies:

Tenoxicam (Mobiflex) - Uses, Dose, Side effects

Indications of Tenoxicam (Mobiflex):

Ankylosing spondylitis:

Extra-articular inflammation:

Osteoarthritis:

Rheumatoid arthritis:

Tenoxicam (Mobiflex) dose in adults:

Tenoxicam (Mobiflex) dose in the treatment of inflammatory arthritis:

Use in Children:

Pregnancy Risk Category C/D (D in the third trimester)

Tenoxicam use during breastfeeding:

Tenoxicam (Mobiflex) Dose adjustment in renal disease:

Alternatively, KDIGO 2012 guidelines provide the following recommendations for NSAIDs:

Tenoxicam (Mobiflex) Dose adjustment in liver disease:

Side Effects of Tenoxicam (Mobiflex):

Cardiovascular:

Central Nervous System:

Dermatologic:

Gastrointestinal:

Frequency of side effects not known:

Endocrine & Metabolic:

Genitourinary:

Hypersensitivity:

Ophthalmic:

Renal:

Contraindications to Tenoxicam (Mobiflex):

Warnings and precautions

Anaphylactoid reactions

Cardiovascular events

CNS effects

Gastrointestinal events:

Hematologic effects

Hepatic effects

Hyperkalemia:

Ophthalmic events

Effects on the renal system:

Reactions to skin:

Aseptic meningitis

Monitoring parameters:

How to administer Tenoxicam (Mobiflex)?

Mechanism of action of Tenoxicam (Mobiflex):

International Brands of Tenoxicam:

Tenoxicam Brands in Pakistan:

Tenoxicam 20 mg Tablets

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