Lornoxicam

Non-steroidal anti-inflammatory drug, oxicam

ATC code: M01AC05

Updated 23 Sep 2026 · Methodology

Indications

Mild to moderate pain in adults

First line

The AEMPS Lornoxicam Rapid Meiji label states the indication tightly: short-term symptomatic relief of acute mild to moderate pain in adults. After the first day the daily dose stays at or below 16 mg, and in renal or hepatic impairment dosing drops to once daily. Food delays absorption and cuts it by roughly 20%, so in acute pain the tablet does not go down with a meal. The interaction section lists what real prescriptions carry all the time: another NSAID and an antiplatelet drug raise gastrointestinal bleeding risk, a corticosteroid raises ulcer and bleeding risk, a quinolone antibiotic raises seizure risk. Lithium, methotrexate, ciclosporin and tacrolimus call for level monitoring or renal function checks.

Sources

AEMPS: Ficha técnica Lornoxicam Rapid Meiji 8 mg comprimidos recubiertos con película EFG (2023)

ICD-10: R52 · ICD-11: MG31

Osteoarthritis

Second line

The AEMPS Acabel label names symptomatic treatment of pain and inflammation in osteoarthritis in adults. On pain and stiffness lornoxicam works as well as other NSAIDs; on cartilage destruction it does nothing at all. The 2019 and Arthritis Foundation guideline keeps loading, movement and weight at the base of treatment, which makes long-term NSAID use look like a substitute rather than therapy. The risk arithmetic is simple: the older the patient and the more drugs in the list that touch mucosa and platelets, the shorter the course should be. The label names the corticosteroid combination directly: ulcer and bleeding risk goes up.

Sources

ICD-10: M19 · ICD-11: FA0Z

Pain control in rheumatoid arthritis

Adjunct

The AEMPS Acabel label covers symptomatic treatment of pain and inflammation in rheumatoid arthritis. Lornoxicam plays a supporting part: methotrexate and biologics drive the disease course, while the NSAID covers pain in between. The practical knot is that a patient with rheumatoid arthritis almost always carries methotrexate and a systemic corticosteroid alongside. The label addresses both: lornoxicam raises serum methotrexate levels and its toxicity, and with a corticosteroid ulcer and bleeding risk rises. What follows is not dropping the NSAID but monitoring: blood counts on methotrexate, gastroprotection when a corticosteroid is present, the shortest possible course.

Sources

ICD-10: M06.9 · ICD-11: FA20.Z

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Chronic musculoskeletal pain

Not recommended

In Russia lornoxicam is often prescribed as long courses and infusions for chronic back pain, sometimes for weeks on end. The AEMPS Lornoxicam Rapid Meiji label limits the drug to short-term treatment of acute pain, and the Spanish register holds no injectable forms. NG59 on low back pain and sciatica says the same in other words: an oral NSAID is prescribed at the lowest effective dose for the shortest possible period, and for sciatica it warns separately about limited evidence of benefit and the risk of harm. A long course does not make the effect stronger; it accumulates ulcers, bleeding and kidney injury, especially in older patients and alongside a diuretic, an ACE inhibitor or an anticoagulant. If a lornoxicam course has been planned in weeks, consider seeking a second opinion.

Sources

ICD-10: M79.1 · ICD-11: MG30.3

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Lornoxicam is an oxicam with a short half-life: it suppresses COX-1 and COX-2 as strongly as the rest of the group yet does not accumulate the way piroxicam does. Analgesia follows the fall in prostaglandins both in the inflamed tissue and in the dorsal horn of the spinal cord, while the anti-inflammatory effect comes from the same blockade in tissue. Metabolism runs through CYP2C9, so inducers and inhibitors of that enzyme shift the concentration, and the label says so directly. Clinically another point weighs more: up to 20% of patients report adverse reactions, nearly all gastrointestinal, and inhibited platelet aggregation adds bleeding risk on top of an anticoagulant, an antiplatelet drug or an SSRI.

Safety

Contraindications

Hypersensitivity to lornoxicam or to any excipient
Thrombocytopenia
Hypersensitivity to other NSAIDs including acetylsalicylic acid: asthma, rhinitis, angioedema, urticaria
Acute heart failure
Gastrointestinal, cerebrovascular or other active bleeding
Gastrointestinal perforation or bleeding on previous NSAID treatment
Active or recurrent peptic ulcer and bleeding: two or more confirmed episodes
Acute hepatic failure
Acute renal failure with serum creatinine above 700 micromol/L
Third trimester of pregnancy, breastfeeding

Serious adverse effects

Ulcer, perforation and gastrointestinal bleeding, at times fatal
Anaemia, thrombocytopenia, leucopenia, prolonged bleeding time
Oedema, hypertension, heart failure
Arterial thrombotic events with high doses and long treatment
Severe skin and soft tissue infections during varicella
Acute kidney injury

Common adverse effects

Nausea, dyspepsia, abdominal pain, vomiting, diarrhoea; in trials in fewer than 10% of patients
Headache, dizziness
Rash, pruritus, increased sweating
Raised liver enzymes

Pregnancy: can you take Lornoxicam?

Lornoxicam is contraindicated in the third trimester and is not used in the first or second, nor during labour, unless strictly necessary: clinical data are scarce, and epidemiological work links prostaglandin synthesis inhibitors in early pregnancy with miscarriage and cardiac malformation. From week 20 oligohydramnios from fetal renal dysfunction has been described, and after second-trimester treatment, ductus arteriosus constriction. For women planning pregnancy the label advises discussing withdrawal: like other NSAIDs, lornoxicam may interfere with ovulation.

Breastfeeding: can you take Lornoxicam?

There are no human data on lornoxicam in breast milk, and in rats milk concentrations are relatively high, so the AEMPS Lornoxicam Rapid Meiji label rules it out for breastfeeding women.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Label mentions19 mentions

Verbatim lines from the interaction sections, in the language of the label

From this drug’s label

ModerateAcetylsalicylic acid
«Se recomienda precaución en el caso de los pacientes que estén tomando medicamentos concomitantes que puedan incrementar el riesgo de úlcera o hemorragia, como corticoesteroides orales…»
AEMPS, section 4.4 · Open on CIMA
Moderateanticoagulantesclass named in the label
«Anticoagulantes: los AINEs pueden potenciar los efectos de los anticoagulantes, como la warfarina (ver sección 4.4). Se debe controlar con atención la RNI.»
AEMPS, section 4.5 · Open on CIMA
ModerateCiclosporin
«Ciclosporina: incremento de las concentraciones séricas de ciclosporina. La nefrotoxicididad de la ciclosporina puede verse aumentada por mediación de la prostaglandina renal. Durante el tratamiento…»
AEMPS, section 4.5 · Open on CIMA
ModerateISRSclass named in the label
«Se recomienda precaución en el caso de los pacientes que estén tomando medicamentos concomitantes que puedan incrementar el riesgo de úlcera o hemorragia, como corticoesteroides orales…»
AEMPS, section 4.4 · Open on CIMA
ModerateTacrolimus
«Tacrolimus: incrementa el riesgo de nefrotoxicidad debido a la reducción de la síntesis de la prostaciclina en el riñón. Durante el tratamiento combinado, es preciso controlar la función renal (ver…»
AEMPS, section 4.5 · Open on CIMA
ModerateWarfarin
«Anticoagulantes: los AINEs pueden potenciar los efectos de los anticoagulantes, como la warfarina (ver sección 4.4). Se debe controlar con atención la RNI.»
AEMPS, section 4.5 · Open on CIMA
antiácidosclass named in the label
«Cimetidina: incremento de las concentraciones plasmáticas de lornoxicam (no se ha demostrado que haya interacción entre lornoxicam y ranitidina, ni entre lornoxicam y los antiácidos).»
AEMPS, section 4.5 · Open on CIMA
betabloqueantesclass named in the label
«Bloqueantes beta adrenérgicos: la eficacia antihipertensora disminuye.»
AEMPS, section 4.5 · Open on CIMA
Digoxin
«Digoxina: reducción de la eliminación renal de la digoxina.»
AEMPS, section 4.5 · Open on CIMA
diuréticosclass named in the label
«Diuréticos: disminución d el efecto diurético y antihipertensor de los diuréticos de asa , los diuréticos tiazídicos y l os diuréticos ahorradores de potasio .»
AEMPS, section 4.5 · Open on CIMA
diuréticos ahorradores de potasioclass named in the label
«Diuréticos: disminución d el efecto diurético y antihipertensor de los diuréticos de asa , los diuréticos tiazídicos y l os diuréticos ahorradores de potasio .»
AEMPS, section 4.5 · Open on CIMA
diuréticos del asaclass named in the label
«Diuréticos: disminución d el efecto diurético y antihipertensor de los diuréticos de asa , los diuréticos tiazídicos y l os diuréticos ahorradores de potasio .»
AEMPS, section 4.5 · Open on CIMA
Glibenclamide
«Sulfonilureas: (ej. glibenclamida) mayor riesgo de hipoglucemia.»
AEMPS, section 4.5 · Open on CIMA
Lithium
«Litio: los AINEs inhiben la eliminación renal del litio, por lo que la concentración sérica del litio puede superar los límites de toxicidad. Por eso es preciso supervisar los niveles de litio…»
AEMPS, section 4.5 · Open on CIMA
Methotrexate
«Metotrexato: incremento de las concentraciones séricas de metotrexato. Puede aumentar la toxicidad. Si es necesario el tratamiento concomitante, deben realizarse controles exhaustivos.»
AEMPS, section 4.5 · Open on CIMA
sulfonilureasclass named in the label
«Sulfonilureas: (ej. glibenclamida) mayor riesgo de hipoglucemia.»
AEMPS, section 4.5 · Open on CIMA
tiazidasclass named in the label
«Diuréticos: disminución d el efecto diurético y antihipertensor de los diuréticos de asa , los diuréticos tiazídicos y l os diuréticos ahorradores de potasio .»
AEMPS, section 4.5 · Open on CIMA

From other drugs’ labels

ModerateFluconazole
«Aunque no se ha estudiado específicamente, fluconazol tiene el potencial de aumentar la exposición sistémica de otros AINEs que se metabolizan por el CYP2C9 (p. ej. naproxeno, lornoxicam, meloxicam…»
AEMPS, section 4.5 · Open on CIMA
Warfarin
«Inhibidores enzimáticos: pueden potenciar el efecto anticoagulante, con riesgo de hemorragias, debido a una inhibición de su metabolismo hepático, cuando se administra conjuntamente con: alopurinol…»
AEMPS, section 4.5 · Open on CIMA

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Frequently asked

What is Lornoxicam used for?

Lornoxicam is evaluated for the following indications with varying evidence strength: Mild to moderate pain in adults (evidence tier A), Osteoarthritis (evidence tier B), Pain control in rheumatoid arthritis (evidence tier B). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Lornoxicam?

Common side effects of Lornoxicam (≥ 1 in 100): Nausea, dyspepsia, abdominal pain, vomiting, diarrhoea; in trials in fewer than 10% of patients, Headache, dizziness, Rash, pruritus, increased sweating, Raised liver enzymes. See the Safety section for uncommon and serious reactions.

Is Lornoxicam safe during pregnancy?

Is Lornoxicam compatible with breastfeeding?

There are no human data on lornoxicam in breast milk, and in rats milk concentrations are relatively high, so the AEMPS Lornoxicam Rapid Meiji label rules it out for breastfeeding women.

Who should not take Lornoxicam?

Lornoxicam is contraindicated in: Hypersensitivity to lornoxicam or to any excipient; Thrombocytopenia; Hypersensitivity to other NSAIDs including acetylsalicylic acid: asthma, rhinitis, angioedema, urticaria; Acute heart failure; Gastrointestinal, cerebrovascular or other active bleeding. Full list in the Safety section.

Official sources

Direct links to regulator labels. Open in a new tab.

AEMPS / CIMALabel dated 10/16/2023
GRLS

Other drugs in this group

Meloxicam, Naproxen, Stinging nettle leaf, Nimesulide, Aceclofenac, Diclofenac, Glucosamine + Chondroitin, Proteolytic enzyme complex (bromelain, papain, pancreatin, trypsin, chymotrypsin, rutoside)