Comparative Pharmacology
Head-to-head clinical analysis: ARTHROTEC versus PIROXICAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ARTHROTEC versus PIROXICAM.
ARTHROTEC vs PIROXICAM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Arthrotec is a combination of diclofenac, a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, and misoprostol, a synthetic prostaglandin E1 analog that protects the gastric mucosa by increasing mucus and bicarbonate secretion, enhancing mucosal blood flow, and promoting epithelial repair.
Nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, thereby decreasing inflammation, pain, and fever.
One tablet (diclofenac 50 mg / misoprostol 200 mcg) orally twice daily with food.
10-20 mg orally once daily; maximum 20 mg/day.
None Documented
None Documented
Clinical Note
moderatePiroxicam + Gatifloxacin
"Piroxicam may increase the neuroexcitatory activities of Gatifloxacin."
Clinical Note
moderatePiroxicam + Rosoxacin
"Piroxicam may increase the neuroexcitatory activities of Rosoxacin."
Clinical Note
moderatePiroxicam + Levofloxacin
"Piroxicam may increase the neuroexcitatory activities of Levofloxacin."
Clinical Note
moderatePiroxicam + Trovafloxacin
"Piroxicam may increase the neuroexcitatory activities of Trovafloxacin."
Diclofenac: ~2 hours (range 1-4 h); misoprostol: 20-40 minutes (acid metabolite 1.5 h). No accumulation with repeated dosing.
Terminal elimination half-life is 50 hours (range 30-86 hours), allowing once-daily dosing. Prolonged in elderly (up to 80 hours) and in hepatic impairment.
Renal: ~95% as metabolites (diclofenac: ~65% as glucuronide conjugates; misoprostol: ~80% as inactive metabolites). Biliary/fecal: <5%.
Approximately 60-70% renal (glomerular filtration and tubular secretion) as unchanged drug and metabolites; 30-40% fecal via biliary excretion. Less than 5% as unchanged drug in urine.
Category C
Category D/X
NSAID
NSAID