Overdosage of piroxicam

Area of Science:

• Gastroenterology
• Clinical Pharmacology

Background:

• Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation.
• NSAID overdose can lead to gastrointestinal complications.

Observation:

• A 54-year-old female ingested 1800 mg of piroxicam.
• She presented with nausea and abdominal pain.

Findings:

• Endoscopy revealed superficial ulcerations in the pyloric antrum and duodenum.
• Peak serum piroxicam concentration reached 241.6 mg/L, significantly exceeding therapeutic levels (5-10 mg/L).
• No other organ system involvement was noted.

Implications:

• High-dose piroxicam can cause significant upper gastrointestinal mucosal damage.
• Prompt medical evaluation is crucial for managing NSAID overdose.
• The gastrointestinal tract is a primary target for NSAID toxicity.