Ten investigators in Austria, Belgium, Denmark, Germany and Switzerland participated in an open trial of intramuscular
piroxicam involving 135 patients with selected acute
sprains,
tendinitis or
low back pain. The
drug was given in the recommended regimen of 40 mg once daily for 2 days and 20 mg once daily thereafter. Statistically significant improvement from baseline in
pain was evident within 1 hour of the initial dose, an effect which was enhanced over a 12-hour period and which lasted for 24 hours. After 3 days of
intramuscular injections,
pain, tenderness, morning stiffness and back elongation were markedly improved. Subsequent treatment with either intramuscular or oral
piroxicam further improved these symptoms and most patients recovered their normal physical activity within a week. The
drug was well tolerated; twenty-five patients (18.5%) reported side-effects possibly related to
piroxicam. Nearly all were mild or moderate in severity with only six resulting in disruption of
therapy. Most adverse reactions involved the upper gastrointestinal tract, but there were no reports of gastric
bleeding. Except for a few patients with injection site
pain, the side-effect profile was similar to that established with the oral
dosage form. Toleration was regarded as excellent or good in about 84% of the patients. The results indicate that intramuscular
piroxicam can provide rapid and effective
therapy with good toleration in the treatment of acute musculoskeletal disorders.