A pharmacokinetic study of piroxicam in children.
Feldene Melt (piroxicam) is commonly used for analgesia following day case surgery. The manufacturer's recommended paediatric dose is 0.4 mg.kg(-1) once daily. In children, plasma piroxicam levels of 3-5 microg.ml(-1) are associated with effective analgesia. However, in adults a single dose of 20 mg piroxicam (0.4 mg.kg(-1) for a 50-kg adult) produces plasma levels of only 1.5-2.2 microg.ml(-1). We therefore studied plasma levels achieved by 0.4 mg.kg(-1) or 1.0 mg.kg(-1) piroxicam in 22 children aged between 3 and 16 years, undergoing elective orthopaedic surgery, in order to investigate the adequacy of single dosing. The first 12 patients received 0.4 mg.kg(-1) Feldene Melt pre-operatively. Following assay of plasma piroxicam levels, a further 10 patients received 1.0 mg.kg(-1) Feldene Melt. In both groups, five blood samples were taken at 2-hourly intervals. The mean (95% CI) piroxicam level following 0.4 mg.kg(-1) was 2.90 (2.33-3.54) microg.ml(-1), compared to 5.87 (4.58-7.16) microg.ml(-1) following 1.0 mg.kg(-1) (p = 0.0003).
Department of Anaesthesia, Royal Devon & Exeter Hospital (Wonford), Barrack Road, Exeter, EX2 5DW, UK. Philippa@dixracwil.demon.co.uk
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D000293:Adolescent; D000698:Analgesia / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000097:blood / Q000517:prevention & control; D010894:Piroxicam / Q000008:administration & dosage / Q000097:blood*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam