Lorno

Approved Indications:

• Acute Pain: Management of moderate to severe acute pain, including:
• Post-operative pain
• Musculoskeletal pain
• Dental pain
• Traumatic pain
• Chronic Inflammatory Conditions:
• Osteoarthritis (OA)
• Rheumatoid arthritis (RA)
• Ankylosing spondylitis (AS)
• Low Back Pain and Sciatica
• Primary Dysmenorrhea

Clinically Accepted Off-Label Uses:

• Acute Gout Flares
• Post-traumatic Inflammation
• Painful Soft Tissue Disorders

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Adults:

• Oral: 4 mg to 8 mg twice daily (Maximum: 16 mg/day)
• Parenteral (IM/IV): 8 mg once or twice daily for a short duration (usually not exceeding 2–3 days)

Pediatrics:

• Not recommended for individuals under 18 years due to lack of safety and efficacy data.

Elderly:

• Initiate treatment at the lower end of the dosing range (e.g., 4 mg twice daily). Monitor closely for gastrointestinal, renal, and cardiovascular complications.

Renal Impairment:

• Mild to moderate impairment (CrCl 30–60 mL/min): Use with caution
• Severe impairment (CrCl <30 mL/min): Contraindicated

Hepatic Impairment:

• Mild to moderate: Use with caution
• Severe hepatic dysfunction: Contraindicated

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Lornoxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class. It acts by non-selectively inhibiting both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which are responsible for the biosynthesis of prostaglandins. Prostaglandins mediate inflammation, pain, and fever. By reducing prostaglandin production, lornoxicam exerts anti-inflammatory, analgesic, and antipyretic effects. It also modulates peripheral and central pain pathways, contributing to its analgesic efficacy.

• Absorption: Rapidly and almost completely absorbed after oral administration
• Bioavailability: Approximately 90–100%
• Time to Peak Concentration (Tmax): 1–2 hours
• Protein Binding: >99% (mainly to albumin)
• Metabolism: Hepatically metabolized via CYP2C9 to inactive metabolites
• Half-life: Approximately 3–5 hours
• Excretion:
• ~42% in urine (mostly as metabolites)
• ~54% in feces
• Steady-State: No accumulation due to short half-life

Pregnancy:

• FDA Category C (up to 30 weeks of gestation): Use only if clearly needed
• FDA Category D (after 30 weeks): Contraindicated due to risk of fetal renal dysfunction and premature closure of the ductus arteriosus

Lactation:

• It is unknown whether lornoxicam is excreted in human milk.
• Use is not recommended during breastfeeding due to the potential for serious adverse effects in the infant.

• Primary Class: Non-Steroidal Anti-Inflammatory Drug (NSAID)
• Subclass: Oxicam derivative
• Generation: Traditional (non-selective COX inhibitor)

• Known hypersensitivity to lornoxicam or any oxicam derivative
• History of NSAID-induced asthma, urticaria, or other allergic-type reactions
• Active gastrointestinal ulcer, bleeding, or perforation
• Severe renal or hepatic impairment
• Severe cardiac failure (NYHA Class III–IV)
• Third trimester of pregnancy
• Concomitant use with other NSAIDs or aspirin
• Known bleeding disorders or active bleeding
• Children and adolescents under 18 years

• Gastrointestinal Risks: Increased risk of GI ulceration, bleeding, and perforation, especially in elderly or those on corticosteroids or anticoagulants
• Cardiovascular Risks: May increase risk of thrombotic events such as myocardial infarction or stroke
• Renal Effects: Risk of fluid retention, hypertension, and renal impairment—use with caution in patients with compromised renal function
• Hepatic Effects: Monitor liver function tests in patients receiving long-term therapy
• Hypersensitivity Reactions: Can occur even without prior exposure; discontinue immediately if severe reaction occurs
• Use with Caution in: Elderly, dehydrated patients, patients with history of GI disease, or those with cardiovascular risk factors

Common Side Effects (≥1%):

• Gastrointestinal: Nausea, vomiting, abdominal pain, dyspepsia, diarrhea, flatulence
• Central Nervous System: Headache, dizziness, fatigue
• Skin: Rash, itching
• General: Edema

Serious or Rare Side Effects:

• Gastrointestinal: GI bleeding, ulceration, perforation
• Renal: Acute kidney injury, nephritis
• Cardiovascular: Hypertension, arrhythmia, thromboembolism
• Hepatic: Hepatitis, elevated liver enzymes
• Hematologic: Anemia, leukopenia, thrombocytopenia
• Allergic: Anaphylaxis, angioedema, Stevens-Johnson syndrome

Onset & Severity:

• Gastrointestinal symptoms often appear early in therapy
• Serious events may be dose-dependent or occur with prolonged use

• Anticoagulants (e.g., warfarin): Increased risk of bleeding; monitor INR closely
• Antiplatelets (e.g., aspirin, clopidogrel): Additive GI toxicity
• Other NSAIDs or corticosteroids: Increased risk of GI and renal adverse effects
• Methotrexate: Risk of increased methotrexate toxicity
• ACE inhibitors/ARBs/Diuretics: Increased risk of renal impairment
• Lithium: May elevate serum lithium levels; monitor closely
• CYP2C9 inhibitors (e.g., fluconazole): May increase plasma levels of lornoxicam
• Alcohol: Increases risk of GI bleeding and ulceration

• NSAID Use in Pregnancy: Updated FDA and international guidance discourages NSAID use from 20 weeks of gestation onward due to risks of oligohydramnios and fetal renal dysfunction
• Clinical Guidelines: International rheumatology and pain management guidelines recommend using the lowest effective dose of lornoxicam for the shortest duration
• No recent changes to indications or major safety profile for lornoxicam specifically

• Temperature: Store below 25°C (77°F)
• Humidity: Protect from moisture; store in a dry place
• Light: Store in original packaging to protect from light
• Handling Precautions:
• Do not freeze parenteral formulations
• Keep out of reach of children
• Discard unused injectable solutions after opening
• Shelf Life: Follow manufacturer’s instructions (typically 2–3 years if unopened)