Drugs brexin 20mg have composotion Piroxicam-β-Cyclodextrin. Brexin 20mg is indicated for symptomatic relief of osteoarthritis, rheumatoid arthritis …

1/ Composition:

Brexin Drug Information healthca.info

Each tablet containts: piroxicam -beta- cyclodextrin 191,2 mg

Equivalent to piroxicam 20mg

Excipients q.s to 400 mg

2/ Description:

– β-cyclodextrin, produced by enzymatic hydrolysis of common starch, has a particular chemical structure that enables it to form inclusion compounds with various drugs. In this way it is able to improve solubility, stability and bioavailability.

– Brexin 20mg is very soluble in water and has a more rapid and complete absorption than plain piroxicam after oral or rectal administration.
– The improved solubility leads to a rapid increase in plasma levels and peak value is reached earlier.

– In clinical terms this means a quicker and more intense analgesic and anti-inflammatoty effect. The long half life of Brexin, which is the same as that of plain piroxicam, allows for just one single daily dose.

– Due to its pharmacodynamic and pharmacokinetic properties, Brexin is particularly suitable for the treatment of rheumatic and/or inflammatory disorders with painful symptoms that could seriously affect the general conditions and normal activity of patients and where a rapid and intense efficacy is required

3/ Therapeutic Indications

Brexin 20mg is indicated for symptomatic relief of osteoarthritis, rheumatoid arthritis or ankylosing spondylitis.

4/ Dosage Recommendations

– The prescription of Brexin 20mg should be initiated by physicians with experience in the diagnostic evaluation and treatment of patients with inflammatory or degenerative rheumatic diseases.

– The maximum recommended daily dose is 20 mg, administered as one single daily dose, preferably with or after food.

– Undesirable effects may be minimised by using the minimum effective dose for the shortest duration necessary to control symptoms (see section 4.4). The benefit and tolerability of treatment should be reviewed within 14 days. If continued treatment is considered necessary, this should be accompanied by frequent review.

– Given that piroxicam has been shown to be associated with an increased risk of gastrointestinal complications, the possible need for combination therapy with gastroprotective agents (e.g. misoprostol or proton pump inhibitors) should be carefully considered, in particular for elderly patients.


– The use of Brexin 20mg in children is not recommended.

The Elderly

In elderly patients, it may be necessary to reduce the dosage (half a tablet/sachet), and limit the duration of treatment. Again, it is preferable to take the dose with or after food. NSAIDs should be used with particular caution in elderly patients who are more prone to adverse events.

4/ Undesirable Effects

Gastrointestinal symptoms associated with piroxicam administration are the most common side effects, but in most cases do not interfere with continuation of therapy.

These include ulcerative stomatitis, anorexia, epigastric or abdominal discomfort or pain, nausea, constipation, flatulence, diarrhoea and indigestion, vomiting, dyspepsia, melaena and haematemesis.

Gastric ulceration, duodenal ulcer and gastrointestinal perforation and gastrointestinal
bleeding, in rare cases fatal, have been reported with piroxicam.

Hypersensitivity Reactions

These reactions may also consist of respiratory tract reactivity comprising of asthma, aggravated asthma, bronchospasm or dyspnoea.

There may be other non-specific allergic reactions and anaphylaxis. Other hypersensitivity reactions such as vasculitis and serum sickness have been rarely reported.

Dermatological Reaction

Photosensitivity reactions occur infrequently.


Changes in various liver function parameters have been seen with piroxicam and, as with other NSAIDs, some patients may show an increase in serum transaminase concentration during piroxicam treatment; also, severe hepatic reactions, including jaundice and cases of fatal hepatitis have also occurred.


Oedema, hypertension, and cardiac failure, have been reported in association with NSAID treatment

5/ Overdose :

– Symptoms

The most likely symptoms of overdose are headache, vomiting, drowsiness, dizziness and fainting.

– Management

In the event of an overdose with Brexin, supportive and symptomatic management is necessary and may include gastric lavage and the use of oral activated charcoal to reduce absorption of piroxicam. The correction of severe electrolyte abnormalities may need to be considered


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