Summary
Age-dependent changes in pharmacokinetics are considered a possible factor contributing to a higher risk of side-effects from drug treatment in the elderly. However, very little is known about the kinetics and metabolism of most NSAI agents in geriatric subjects. In a prospective age-comparison study, the single dose and steady-state pharmacokinetics of piroxicam 20 mg once daily were determined in 44 subjects ranging in age from 30 to 80 years. Plasma concentrations, elimination half-life, AUC, and volume of distribution were not influenced by age or sex and were in agreement with previously reported results in young adults. Pharmacokinetic parameters in 18 patients with evidence of mild or moderate renal impairment at study entry were not different from those in patients without impairment. Based on this and other studies, elderly patients receiving the recommended dose of piroxicam are not exposed to undue risk related to pharmacokinetic considerations.
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References
Shand DG (1982) Biological determinants of altered pharmacokinetics in the elderly. Gerontology 28 [Suppl 1]: 8–17
Herman RA (1982) Drug therapy considerations in the elderly. South Afr Med J 61: 544–546
Crooks J (1983) Pharmacokinetics in the elderly. In: Gibaldi M and Prescott L (eds) Handbook of clinical pharmacokinetics. Adis, New York, Sec II, pp 169–187
Reidenberg MM (1982) Drugs in the elderly. Med Clin North Am 66: 1073–1078
Vestal RE (1979) Aging and pharmacokinetics: impact of altered physiology in the elderly. In: Cherkin A et al. (eds) Physiology and cell biology of aging (Aging, v.8) Raven Press New York: 185–201
Lamy PP (1982) Comparative pharmacokinetic changes and drug therapy in an older population. J Am Geriatr Soc 30 [Suppl to no. 11]: S 11–19
Boely L (1984) Prescribing antirheumatic drugs in special groups of patients. Rheumatic diseases: report 88. The Arthritis and Rheumatism Council, London
Anonymous (1984) Non-steroidal antiinflammatory drugs: have we been spoilt for choice? Lancet 1: 141–142
O'Malley K, Crooks J, Duke E, Stevenson IH (1971) Effect of age and sex on human drug metabolism. Br Med J 3: 607–609
Davies DM (1981) Textbook of adverse drug reactions, 2nd edn. Oxford University Press, New York
Hamdy RC, Murnane B, Perera N, Woocock K, Koch IM (1982) The Pharmacokinetics of benoxaprofen in elderly subjects. Eur J Rheumatol 5: 69–75
Kamal A, Koch, IM (1982) Pharmacokinetic studies of benoxaprofen in geriatric patients. Eur J Rheumatol 5: 76–81
Brogard JM, Comte F, Madon M, Spach MO (1982) Pharmacokinetic profile of benoxaprofen in subjects with normal and impaired renal function, prediction of multiple-dose kinetics. Eur J Rheumatol 5: 113–123
Advenier C, Roux A, Gobert C, Massias P, Varoquaux O, Flouvat B (1983) Pharmacokinetics of ketoprofen in the elderly. Br J Clin Pharmacol 16: 65–70
Brogden RN, Heel RC, Speight TM, Avery GS (1981) Piroxicam: a review of its pharmacological properties and therapeutic efficacy. Drugs 22: 165–187
Hobbs DC (1983) Pharmacokinetics of piroxicam in man. Eur J Rheumatol 6: 46–55
Balant L, Gorgia A, Dayer P, Dupont D, Fabre J (1980) Comportement du piroxicam chez l'homme en bonne sante et le malade en insufficiance renale. Riv Med Suizz Ital 6: 239–244
Woolf AD, Rogers HJ, Bradbrook ID, Corless D (1983) Pharmacokinetic observations on piroxicam in young adults, middle-aged, and elderly patients. Br J Clin Pharmacol 16: 433–437
Prescott LF (1982) Assessment of nephrotoxicity. Br J Clin Pharmacol 13: 303–311
Twomey TM, Bartolucci SR, Hobbs DC (1980) Analysis of piroxicam in plasma by high-performance liquid chromatography. J Chromatogr 183: 104–108
Pitts NE, Proctor RR (1978) Efficacy and safety of piroxicam. Proc R Soc Med Int Congr Symp Ser 1: 97–108
Verbeek RK, Blackburn JL, Loewen GR (1983) Clinical pharmacokinetics of NSAI drugs. Clin Pharmacol 8: 297–331
Dukes MNG (Ed) (1980) Meyler's side-effects of drugs, 9th edn. Excerpta Medica, Amsterdam, pp 126–134
Langloh N (1983) Experience with Feldene in general practice. Results of a German multicentre study on 18,888 patients. Eur J Rheumatol Inflamm 6: 84–89
Boardman PL, Burke MJ, Camp JH, Cuddigan LG et al. (1983) Treatment of osteoarthritis with piroxican. Eur J Rheumatol Inflamm 6: 73–83
Bressler R (1982) Adverse drug effects in the elderly patient. Otolaryngol Clin North Am 15: 451–463
Greenblatt DJ, Sellers EM, Shader RI (1982) Drug disposition in old age. N Engl J Med 306: 1081–1088
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Darragh, A., Gordon, A.J., O'Byrne, H. et al. Single-dose and steady-state pharmacokinetics of piroxicam in elderly vs young adults. Eur J Clin Pharmacol 28, 305–309 (1985). https://doi.org/10.1007/BF00543328
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DOI: https://doi.org/10.1007/BF00543328