Piroxicam-beta-cyclodextrin is a complex of the established nonsteroidal antiinflammatory
drug (
NSAID)
piroxicam and an inert cyclic macromolecule,
beta-cyclodextrin. In clinical trials in patients with
rheumatic diseases or
pain arising from other conditions, it was as effective an
analgesic as standard
piroxicam, and showed a faster onset of action on the first day of treatment. In short term pharmacodynamic studies in healthy volunteers,
piroxicam-beta-cyclodextrin was equivalent to or tended to show less gastrointestinal mucosal toxicity than standard
piroxicam, as assessed by endoscopy and faecal blood loss. However, no data are available on its comparative gastrointestinal mucosal effects from long term clinical trials using similar measures. Preliminary findings from a clinical study suggest
piroxicam-beta-cyclodextrin caused fewer gastroduodenal lesions than
tenoxicam. As with other
NSAIDs, the majority of adverse events associated with
piroxicam-beta-cyclodextrin in clinical trials were gastrointestinal in origin, with epigastric
pain,
heartburn and
nausea the most common. Thus,
piroxicam-beta-cyclodextrin is an effective agent in patients with
rheumatic diseases or other
pain states. When rapid
analgesia is required in the initial treatment of
acute pain, the faster onset of action of
piroxicam-beta-cyclodextrin may be an advantage over the parent compound; however, this is unlikely to be important during long term
therapy. The results of further long term trials are awaited before firm conclusions can be reached regarding the gastrointestinal tolerability of
piroxicam-beta-cyclodextrin compared with that of standard
piroxicam and other
NSAIDs.