New restrictions on piroxicam prescribing
New restrictions on the use of piroxicam have been issued by the European Medicines Agency (EMEA) because of the risk of gastrointestinal side effects and serious skin reactions. The restrictions apply to the oral, injectable and suppository forms of the drug but not to topical preparations.
The new prescribing advice is based on the opinion of the EMEA’s
Committee for Medicinal Products for Human Use (CHMP), that piroxicam
should no longer be used for the short-term treatment of painful and
inflammatory conditions. The drug can still be prescribed for long-term
relief of
osteoarthritis, rheumatoid arthritis and
ankylosing spondylitis but should not be first-line non-steroidal anti-inflammatory
drug therapy.
The Medicines and Healthcare products Regulatory Agency advises
that there is no need for urgent action but that patients
being treated for long-term conditions with piroxicam should have their
treatment reviewed at their next routine appointment. An alternative
treatment should be considered if appropriate.
Patients who have previously received piroxicam for short-term use should
receive an alternative medicine if similar treatment is needed in the
future.
The MHRA also advises that, for all NSAIDS, the lowest effective dose
should be used for the shortest period necessary to control symptoms.
Prescribers will receive a letter to inform them of these changes in
the near future. Summaries of product characteristics will be updated
when the CHMP opinion is ratified by the European Commission.
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