Clinical pharmacology of piroxicam-β-cyclodextrin -: Implications for innovative patient care

The potential advantages of the piroxicam-beta-cyclodextrin complex include more rapid absorption, more rapid onset of analgesia and improved gastrointestinal tolerability. These have been critically evaluated with reference to published work. In association with improved solubilisation, more rapid absorption of piroxicam has been clearly demonstrated, while its intrinsically long terminal half-life is maintained. There are several reports of improved gastrointestinal tolerability in comparison with conventional piroxicam: the dearest evidence for this has come from studies in healthy individuals, and it has not yet been established whether piroxicam-beta-cyclodextrin causes less gastrointestinal haemorrhage than conventional piroxicam in patients treated in routine clinical practice. Although not totally inert, the carrier beta-cyclodextrin appears to be safe for oral clinical use. Piroxicam-beta-cyclodextrin is clearly an effective analgesic with a rapid onset of effect, representing a promising approach towards more effective and safe delivery of NSAIDs.