Neo-Endusix (Tenoxicam)

• Tenoxicam is indicated for inflammatory and painful conditions affecting the musculoskeletal system.
• Rheumatoid arthritis: reduces joint pain and swelling, improving functional ability.
• Osteoarthritis: alleviates chronic joint discomfort and stiffness.
• Acute musculoskeletal pain: provides rapid analgesia for injuries or post‑operative pain.
• Post‑operative pain: diminishes surgical site pain and inflammatory response.
• Ankylosing spondylitis: helps control spinal inflammation and pain.

• Tenoxicam exerts its anti‑inflammatory and analgesic actions by reversibly inhibiting both cyclooxygenase‑1 (COX‑1) and cyclooxygenase‑2 (COX‑2) enzymes. This inhibition blocks the conversion of arachidonic acid to prostaglandins, thereby decreasing prostaglandin synthesis at sites of inflammation. The reduced prostaglandin levels lead to diminished sensitisation of nociceptors and lower inflammatory edema, producing pain relief and swelling reduction. The effect is dose‑dependent and persists for several hours after administration.

Tenoxicam may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia, or abdominal pain that may be transient.
• Headache: mild to moderate intensity, often resolving without intervention.
• Dizziness: transient sensation of light‑headedness, especially after rapid administration.
• Injection site reactions: erythema, swelling, or mild pain at the intramuscular or intravenous site.

Serious or Rare Side Effects

• Severe gastrointestinal ulceration or bleeding: may present with melena, hematemesis, or severe abdominal pain.
• Renal impairment: sudden decrease in kidney function, manifested by elevated creatinine or reduced urine output.
• Hypersensitivity reactions: rash, Stevens‑Johnson syndrome, or anaphylaxis requiring immediate medical attention.

When prescribing Tenoxicam, clinicians should consider several precautionary measures to minimise risk.

• Assess renal function: avoid use in patients with severe renal impairment or acute kidney injury.
• Monitor gastrointestinal risk: use with caution in individuals with history of ulcers or bleeding.
• Evaluate cardiovascular status: NSAIDs may increase risk of thrombotic events in susceptible patients.
• Check for concomitant anticoagulant therapy: heightened bleeding risk requires careful monitoring.
• Avoid use in late pregnancy: safety data are insufficient for the third trimester.
• Store below 25°C: keep in original container, protect from light and moisture.

Tenoxicam can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• Lithium: NSAIDs may raise lithium serum concentrations, risking toxicity.
• Methotrexate (high dose): reduced clearance leading to enhanced toxicity.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may diminish renal protective effects and worsen kidney function.
• Diuretics: combined use can precipitate renal insufficiency.
• Corticosteroids: heightened risk of gastrointestinal ulceration.