Tenoxicam

Tenoxicam is an anti-inflammatory used to treat pain and inflammation. Find out how to take it safely and possible side effects. Tenoxicam is also called Tilcotil.

On this page, you can find the following information:

What is tenoxicam?

Tenoxicam is one of a group of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs). Tenoxicam is used to treat different types of pain such as pain from goutosteoarthritis, rheumatoid arthritispainful periods and pain after surgery. Read more about pain. 

In New Zealand tenoxicam comes as tablets (20 mg) and as an injection.

Dose

  • The usual dose of tenoxicam is 1 or 2 tablets once a day.
  • If you are using tenoxicam for painful menstrual periods, take your first dose as soon as your period starts or pain begins until the pain eases.
  • Always take your tenoxicam exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions.

How to take tenoxicam

  • Take tenoxicam with food or immediately after food, to prevent stomach upset. Take it with a full glass of water. Swallow the tablets whole, don't crush or chew them. 
  • Avoid or limit alcohol while you are taking tenoxicam. Alcohol can increase the risk of side effects such as stomach upset.
  • Missed dose: If you forget to take a dose, take it when you next need pain relief and then continue as before. Don't take 2 doses together to make up for a forgotten dose.

When is taking tenoxicam a concern?

For most people taking tenoxicam is safe but extra care is needed in some situations, for example if:

  • you have high blood pressure
  • you have heart or kidney problems or asthma
  • you're aged 65 years or older
  • you smoke.

It can also be harmful to take tenoxicam when you are dehydrated or have been sick with diarrhoea (runny poos) or vomiting (being sick). Read more about the risks of NSAIDs.

When you should NOT take tenoxicam

Tenoxicam should NOT be used in some situations as it can be harmful. For example, if you:

  • have current or previous stomach problems such as ulcers or bleeding
  • are pregnant
  • have heart failure or chest pain (angina)
  • have had a stroke or heart attack
  • have chronic kidney disease
  • have had an allergic reaction (such as hives or trouble breathing) to ibuprofen, aspirin, or other similar medications (discuss with your healthcare provider)
  • are taking medicines to reduce blood clots (anticoagulants) such as warfarin, dabigatran and rivaroxaban
  • are also taking other anti-inflammatory medicines, eg, diclofenac (Voltaren®), ibuprofen (Brufen) or naproxen (Naprosyn®, Naprogesic®)
  • are taking some blood pressure medicines such as ACE inhibitors, ARBs, diuretics. Always check with your healthcare provider before taking NSAIDs.

Read more about the risks associated with NSAIDs

Taking tenoxicam with other pain medicines

Don't take other anti-inflammatory medicines such as diclofenacibuprofen or naproxen while taking tenoxicam. This can increase your risk of side effects.

It's safe to take tenoxicam with paracetamol because they work differently.

Taking tenoxicam with blood pressure medicines

Tenoxicam interacts with some medicines, especially those used for high blood pressure, so check with your doctor or pharmacist before you start taking tenoxicam.

Image credit: University of Otago, NZ

Taking NSAIDs together with blood pressure medicines can be harmful to your kidneys. This is called the ‘triple whammy’. If you are taking blood pressure medicines (ACE inhibitors or ARBs and diuretics) tell your doctor or pharmacist before starting tenoxicam.

  • Examples of ACE inhibitors are captopril, cilazapril, enalapril, lisinopril, perindopril and quinapril.
  • Examples of ARBs are candesartan, irbesartan and losartan.
  • Examples of diuretics are furosemide, bumetanide, bendroflumethiazide, chlortalidone, indapamide, spironolactone, eplerenone and metolazone.

Read more about the triple whammy. 

What are the side effects of tenoxicam?

Side effects What should I do?
  • Heartburn
  • Indigestion
  • Stomach discomfort
  • Runny poo (diarrhoea)
  • These are common and should settle within a few days.
  • Take tenoxicam with food.
  • Talk to your doctor if they're ongoing.
  • Serious stomach problems such as really bad stomach pain, blood in the stool or black stools, cough or vomit up blood or dark coloured vomit.
  • Stop taking tenoxicam.
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
  • Chest pain
  • Shortness of breath or trouble breathing
  • Weakness in one part or side of the body
  • Slurred speech
  • Stop taking tenoxicam.
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
  • Swollen ankles, blood in your pee or not peeing at all – these can be signs of a kidney problem.
  • Stop taking tenoxicam.
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
  • Signs of an allergic reaction such as skin rash, itching, swelling of your lips, face and mouth or difficulty breathing
 
  • Stop taking tenoxicam.
  • Tell your doctor immediately or ring Healthline on 0800 611 116.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

References

  1. Tenoxicam NZ Formulary

Additional resources for healthcare professionals

Avoiding the “triple whammy” in primary care: ACE inhibitor/ARB + diuretic + NSAID BPAC, NZ, 2018
NSAIDs and cardiovascular risk Medsafe, NZ
NSAIDs can SCAR (Severe Cutaneous Adverse Reaction) Medsafe, NZ
Reducing the risk of GI reactions with NSAIDs and/or COX-2 inhibitors Medsafe, NZ
Prescribing restrictions for all COX-2 Inhibitors Medsafe, NZ

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 12 Sep 2022