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A pharmacokinetic study of piroxicam in children

P Dix1, D P Prosser, P Streete

  • 1Department of Anaesthesia, Royal Devon & Exeter Hospital (Wonford), Barrack Road, Exeter, EX2 5DW, UK. Philippa@dixracwil.demon.co.uk

Anaesthesia
|October 19, 2004
PubMed

Insights

A higher dose of piroxicam (Feldene Melt) is needed for effective paediatric analgesia. Doses of 1.0 mg.kg(-1) achieved therapeutic plasma levels in children, unlike the standard 0.4 mg.kg(-1) dose.

Area of Science:

  • Pharmacology
  • Paediatric Medicine
  • Pain Management

Background:

  • Feldene Melt (piroxicam) is frequently used for pain relief after day surgery.
  • The recommended pediatric dose is 0.4 mg.kg(-1) daily, but adult doses yield lower plasma levels than effective pediatric ranges (3-5 microg.ml(-1)).

Purpose of the Study:

  • To investigate the adequacy of single-dose piroxicam for paediatric analgesia.
  • To compare plasma levels achieved with 0.4 mg.kg(-1) and 1.0 mg.kg(-1) piroxicam in children undergoing surgery.

Main Methods:

  • A study involving 22 children (ages 3-16) undergoing elective orthopedic surgery.
  • Patients received either 0.4 mg.kg(-1) or 1.0 mg.kg(-1) of piroxicam pre-operatively.
  • Plasma piroxicam levels were measured at 2-hour intervals for 5 samples.

Main Results:

  • The mean plasma piroxicam level for the 0.4 mg.kg(-1) dose was 2.90 microg.ml(-1).
  • The mean plasma piroxicam level for the 1.0 mg.kg(-1) dose was 5.87 microg.ml(-1).
  • The 1.0 mg.kg(-1) dose resulted in significantly higher plasma levels (p = 0.0003).

Conclusions:

  • The standard 0.4 mg.kg(-1) piroxicam dose may be insufficient for effective analgesia in children.
  • A higher dose of 1.0 mg.kg(-1) piroxicam is required to achieve therapeutic plasma concentrations in paediatric patients.

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