Tonmex

Tonmex Uses, Dosage, Side Effects, Food Interaction and all others data.

Tonmex is an NSAID, belonging to the oxicam group. It reversibly inhibits cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, which results in decreased formation of prostaglandin precursors.

Tonmex is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Tonmex works by reducing hormones that cause inflammation and pain in the body. Tonmex is used to reduce the pain, inflammation, and stiffness caused by rheumatoid arthritis and osteoarthritis.

Trade Name Tonmex
Availability Prescription only
Generic Piroxicam
Piroxicam Other Names Piroxicam, Piroxicam betadex, Piroxicamum, Pyroxycam
Related Drugs Humira, Buprenex, aspirin, prednisone, ibuprofen, acetaminophen, tramadol, meloxicam, naproxen, diclofenac
Type
Formula C15H13N3O4S
Weight Average: 331.346
Monoisotopic: 331.062676609
Groups Approved, Investigational
Therapeutic Class Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Manufacturer
Available Country Taiwan
Last Updated: September 19, 2023 at 7:00 am
Tonmex
Tonmex

Uses

Carefully consider the potential benefits and risks of Tonmex and other treatment options before deciding to use Tonmex. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals. Tonmex is used for relief of the signs and symptoms of osteoarthritis, for relief of the signs and symptoms of rheumatoid arthritis.

Tonmex is also used to associated treatment for these conditions: Ankylosing Spondylitis (AS), Osteoarthritis (OA), Rheumatoid Arthritis

How Tonmex works

The antiinflammatory effect of Tonmex may result from the reversible inhibition of cyclooxygenase, causing the peripheral inhibition of prostaglandin synthesis. The prostaglandins are produced by an enzyme called Cox-1. Tonmex blocks the Cox-1 enzyme, resulting into the disruption of production of prostaglandins. Tonmex also inhibits the migration of leukocytes into sites of inflammation and prevents the formation of thromboxane A2, an aggregating agent, by the platelets.

Dosage

Tonmex dosage

Oral-

Ankylosing spondylitis, Osteoarthritis, Rheumatoid arthritis:

  • Adult: 20 mg daily as a single dose, divided doses may be used if necessary. Treatment should be reviewed w/in 14 days of starting.
  • Elderly: Use the lowest effective dose for the shortest duration.

Should be taken with food.

Side Effects

Oedema, CHF, HTN, syncope, tachycardia; anorexia, abdominal pain, constipation, diarrhoea, dyspepsia, flatulence, heartburn, nausea, vomiting, dry mouth, esophagitis, gastritis, glossitis, haematemesis, melaena, stomatitis; anaemia, increased bleeding time, ecchymosis, eosinophilia, epistaxis, leucopenia, thrombocytopenia; cystitis, dysuria, haematuria, hyperkalaemia, interstitial nephritis, nephritic syndrome, oliguria/polyuria, proteinuria, renal failure; dizziness, headache, anxiety, asthenia, confusion, depression, dream abnormalities, drowsiness, insomnia, malaise, nervousness, paraesthesia, somnolence, tremors, vertigo; tinnitus, blurred vision; elevated LFT results; pruritus, rash, alopecia, bruising, desquamation, erythema, petechial rash, photosensitivity, purpura, sweating, serum sickness-like reactions; fever, infection, sepsis, wt changes, asthma, dyspnoea.

Toxicity

Symptoms of overdose include drowsiness, nausea, stomach pain, and/or vomiting.

Precaution

Patient with known CV disease or risk factors for CV disease, fluid retention or heart failure, cerebrovascular disease, uncontrolled HTN, asthma. Elderly. Renal and hepatic impairment. Pregnancy and lactation.

Interaction

Increased risk of GI bleeding with anti-platelets and SSRIs. May exacerbate cardiac failure, reduce GFR and increase plasma glycoside levels. Increased risk of nephrotoxicity with ciclosporin and tacrolimus. Increased absorption with cimetidine. Increased risk of GI ulceration with corticosteroids. May interfere with the natriuretic action of diuretics. May displace other highly protein-bound drugs. May increase steady state plasma lithium levels. May antagonise the effect of antihypertensives. May reduce the excretion of methotrexate, leading to acute toxicity. Increased risk of convulsions with quinolones. May interfere with mifepristone-mediated termination of pregnancy.

Food Interaction

  • Avoid alcohol.
  • Take with food.

Tonmex Alcohol interaction

[Moderate] GENERALLY AVOID:

The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss.

The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.



Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

Tonmex Hypertension interaction

[Major] Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure.

Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.

Hypertension interaction

[Moderate] Nonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events.

NSAIDs should be used with caution in patients with hypertension.

Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.

Volume of Distribution

  • 0.14 L/kg

Elimination Route

Well absorbed following oral administration.

Half Life

30 to 86 hours

Elimination Route

Tonmex and its biotransformation products are excreted in urine and feces, with about twice as much appearing in the urine as in the feces. Approximately 5% of a piroxicam dose is excreted unchanged. However, a substantial portion of piroxicam elimination occurs by hepatic metabolism. Tonmex is excreted into human milk.

Pregnancy & Breastfeeding use

Pregnancy catagort C (in 1st & 2nd trimester), D (in 3rd trimester)

Contraindication

Hypersensitivity or asthma-type reactions to piroxicam, aspirin or other NSAIDs. History or active GI ulceration, bleeding and perforation; history of GI disorders that predispose to bleeding disorders (e.g. ulcerative colitis, Crohn’s disease, GI cancers or diverticulitis). Treatment of perioperative pain in the setting of CABG surgery. Concomitant use with aspirin, other NSAIDs and anticoagulants.

Acute Overdose

Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding, anaphylactoid reactions. Rarely, HTN, acute renal failure, resp depression and coma.

Management: Symptomatic and supportive treatment. Emesis and/or activated charcoal (60-100 g in adults, 1-2 g/kg in childn) and/or osmotic cathartic may be indicated. If patient is comatose, having seizures or lacks the gag reflex, gastric lavage may be done if an endotracheal tube w/ cuff inflated is in place to prevent aspiration of gastric contents.

Innovators Monograph

You find simplified version here Tonmex

FAQ

What is Tonmex used for?

Tonmex is used to relieve pain, tenderness, swelling, and stiffness caused by osteoarthritis and rheumatoid arthritis.

How does Tonmex work?

Tonmex works by stopping the body's production of a substance that causes pain, fever, and inflammation.

What are the common side effects of Tonmex?

The common side effects of are include:

  • diarrhea.
  • constipation.
  • gas.
  • headache.
  • dizziness.
  • ringing in the ears.

Is Tonmex a painkiller?

Tonmex is a nonsteroidal anti-inflammatory drug used for the treatment of osteoarthritis and rheumatoid arthritis pain and inflammation.

When should be taken of Tonmex?

Tonmex is usually taken once or twice a day. Take Tonmex at around the same time every day.

Is Tonmex safe during pregnancy?

Tonmex capsules are not recommended for use in pregnant women since safety has not been established in humans.Tonmex should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

Is Tonmex safe during breastfeeding?

Tonmex passes through breast milk and may cause side effects in a child who is breastfed. It's not recommended to breastfeed while taking this medication.

Can I drink alcohol with Tonmex?

Avoid drinking alcohol. It may increase your risk of stomach bleeding. Avoid taking aspirin while you are taking Tonmex.

Can I drive after taking Tonmex?

Tonmex may cause drowsiness, dizziness, tiredness, and vision disturbances, do not drive or operate heavy machinery if you feel dizzy.

How long does Tonmex take to work?

Tonmex usually begins to work within 1 week, but in severe cases up to two weeks or even longer may pass before you begin to feel better.

Can I take Tonmex at night?

Tonmex was equally effective when administered in the morning or at night, evidence for the view that a single daily dose relieves symptoms for at least 24 hours.

Is Tonmex a muscle relaxant?

Tonmex helps relieve pain and swelling of various joints and muscles. 

Can I take Tonmex on an empty stomach?

You do not need to take Tonmex with food. However, if you experience some stomach upset, Tonmex can be taken with food. Ask your doctor or pharmacist if you have any other concerns about your diet and this medicine.

How quickly does Tonmex work?

Tonmex usually begins to work within 1 week, but in severe cases up to two weeks or even longer may pass before you begin to feel better.

Is Tonmex good for back pain?

Tonmex can provide effective relief of acute low-back pain with good toleration; it should be considered for use in the initial treatment of this condition.

Does Tonmex cause weight gain?

Tonmex can causes weight gain also with other side effects.

Can I take Tonmex for a long time?

Tonmex usually begins to work within 1 week, but in severe cases up to two weeks or even longer may pass before you begin to feel better.

Who should not take?

Tonmex can increase your risk of fatal heart attack or stroke. Do not use Tonmex just before or after heart bypass surgery . Tonmex may also cause stomach or intestinal bleeding, which can be fatal.

What happens if I miss a dose?

Take Tonmex as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose on Tonmex?

Seek emergency medical attention.Overdose symptoms may include nausea, vomiting, stomach pain, black or bloody stools, or coughing up blood.

*** Taking medicines without doctor's advice can cause long-term problems.
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