Laxico Special Precautions

Care should be taken and after careful analysis, the drug should be used for patients with hypertension and/or heart failure, because due to NSAID use, edema and fluid retention in the body are possible.
Patients with uncontrolled arterial hypertension, congestive heart failure, coronary heart disease, cerebrovascular disorders, as well as patients with elevated risk factors for cardiovascular disease (hypertension, hyperlipidemia, diabetes, smoking) should be treated after careful analysis.
Concomitant use of NSAIDs and heparin increases the risk of spinal/epidural hematoma with spinal or epidural anesthesia.
Due to intake of NSAIDs, especially at the beginning of treatment, in rare cases serious skin adverse reactions, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, were noted. Treatment with the drug should be discontinued at the first appearance of symptoms (skin rashes, lesions of the mucous membranes and other sign of hypersensitivity).
Caution is required if administered to patients suffering from, or with a previous history of, bronchial asthma since NSAIDs have been reported to precipitate bronchospasm in such patients.
In patients with systemic lupus erythematosus (SLE) and mixed connective tissue disorders there may be an increased risk of aseptic meningitis.
Lornoxicam inhibits platelet aggregation, increasing clotting time. The drug should be administered with caution to patients who are prone to bleeding.
Co-administration of NSAIDs and tacrolimus may increase the risk of nephrotoxicity due to impaired prostacyclin synthesis in the kidneys. With this combination therapy, it is a need to carefully monitor the kidney function.
Like other NSAIDs, lornoxicam can cause occasional increases in transaminases, serum bilirubin, and an increase in the concentration of urea and creatinine in the blood. Should any such abnormality prove significant or persist the administration of Lornoxicam (Laxico) Tablet should be stopped and appropriate investigations prescribed.
Patients who have a rare hereditary intolerance to galactose, lactase deficiency, or impaired absorption of glucose-galactose should not use the drug.
It is advisable to avoid use of lornoxicam in case of varicella.
Patients with blood coagulation disorders: Careful clinical monitoring and laboratory assessment is recommended (e.g. APTT), as lornoxicam decreases aggregation of thrombocytes, increasing bleeding time.
Long term treatment (longer than 3 months): Regular laboratory assessments of haematology (haemoglobin), renal functions (creatinine) and liver enzymes are recommended.
Effects on ability to drive and use machines: Patients who experience dizziness or other central nervous disturbances while taking NSAIDs should refrain from driving or operating machinery.
Renal impairment: Lornoxicam should be administered with precaution in patients with mild (serum creatinine 150-300 μmol/l) to moderate (serum creatinine 300-700 μmol/l) renal impairment due to dependency on renal prostaglandins for maintenance of renal blood flow. Treatment with lornoxicam should be discontinued if renal function deteriorates during treatment.
Renal functions should be monitored in patients who undergo major surgery, with cardiac failure, receiving treatment with diuretics, receiving concomitant treatment with drugs that are suspected to or known to be able to cause kidney damage.
Hepatic impairment (e.g. liver cirrhosis): Clinical monitoring and laboratory assessments at regular intervals should be considered in patients with hepatic impairment as accumulation of lornoxicam (increase in AUC) may occur after treatment with daily doses of 12-16 mg. Apart from that, hepatic impairment does not seem to affect pharmacokinetic parameters of lornoxicam as compared to healthy subjects.
Use in Pregnancy & Lactation: Lornoxicam, like other drugs that inhibit the synthesis of cyclooxygenase, can weaken fertility. It is not recommended in women attempting to conceive.
Use in the Elderly: Elderly patients above 65 years: Monitoring of renal and hepatic function is recommended. Precaution is advised in elderly postoperative patients.
The use of lornoxicam with concomitant NSAIDs including cyclooxygenase-2 selective inhibitors should be avoided.
Undesirable effects may be minimized by using lowest effective dose. GI bleeding, ulceration or perforation, which can be fatal, during treatment with NSAIDs.
Care should be taken to use Lornoxicam tablets to treat patients taking drugs that increase the risk of ulcers and bleeding (see Interactions).
For patients who need co-therapy, treatment can be performed against a background of simultaneous administration of proton pump inhibitors and close monitoring.
In elderly patients, the risk of adverse reactions increases during the administration of NSAIDs, in particular gastrointestinal bleeding and perforation. If any adverse reactions occur on the part of the digestive tract, stop taking the medication and consult a doctor.