Symptoms following acute NSAID overdoses have been typically limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with supportive care. Gastrointestinal bleeding has occurred. Hypertension, acute renal failure, respiratory depression, and coma have occurred, but were rare .
Manage patients with symptomatic and supportive care following an NSAID overdose. There are no specific antidotes. Consider emesis and/or activated charcoal (60–100 grams in adults, 1–2 grams per kg of body weight in pediatric patients) and/or osmotic cathartic in symptomatic patients seen within four hours of ingestion or in patients with a large overdosage (5 to 10 times the recommended dosage).
The long plasma half-life of Antiflog should be considered when treating an overdose with Antiflog. Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding.
For additional information about overdosage treatment contact a poison control center (1-800-222-1222).
Antiflog can increase your risk of fatal heart attack or stroke. Do not use Antiflog just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Antiflog may also cause stomach or intestinal bleeding, which can be fatal.
See Table 1 for clinically significant drug interactions with Antiflog.
How to store Antiflog
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Other uses for this medicine
Antiflog is also sometimes used to treat gouty arthritis (attacks of severe joint pain and swelling caused by a build-up of certain substances in the joints) and ankylosing spondylitis (arthritis that mainly affects the spine). It is also sometimes used to relieve muscle pain and swelling, menstrual pain, and pain after surgery or childbirth. Talk to your doctor about the risks of using this medication for your condition.
Mechanism of Injury
The mechanism of Antiflog induced liver injury is not known, but may be due to a toxic metabolic intermediate of Antiflog metabolism, which occurs largely in the liver. Cases with allergic manifestations (fever, rash, eosinophilia) may also have a component of hypersensitivity.
What is the dosage for Antiflog?
The recommended dose is 20 mg once daily or 10 mg twice daily. Antiflog should be taken with food.
Antiflog is a member of the oxicam family of NSAIDs. In vitro data suggest that Antiflog is COX-2 selective in dogs. 14,104 However, in vivo data are not available to confirm these results. Antiflog has an elimination half-life of approximately 40 hours in the dog. 105 Antiflog has been used as an antineoplastic agent to treat transitional cell neoplasia in dogs. Although antineoplastic activity has been linked to COX-2 inhibitory activity, other factors may also play a role in the antineoplastic activity of Antiflog. Based on clinical response and this long elimination half-life, once daily or once every other day dosing has been successfully used in the dog. Antiflog has been administered at a dose of 0.3 mg/kg orally once daily for many months for the treatment of canine transitional cell neoplasia. At this dose, approximately 18% of patients demonstrated adverse GI signs. 106 Gastroendoscopic evaluation of healthy dogs given Antiflog at a dose of 0.3 mg/kg orally once daily for 28 days failed to demonstrate a difference in gastroduodenal lesion development between treated and control dogs. 107 Additional data are needed before sweeping recommendations on use in pain management can be made. Pharmacokinetic data are available in cats given single and multiple doses of Antiflog. However, until efficacy and long-term safety studies are completed in cats, Antiflog cannot be recommended. 108,109
Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
In patients taking Antiflog or other NSAIDs, the most frequently reported adverse experiences occurring in approximately 1% to 10% of patients are:
Cardiovascular System: Edema
Digestive System: Anorexia, abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting
Nervous System: Dizziness, headache, vertigo
Skin and Appendages: Pruritus, rash
Special Senses: Tinnitus
Additional adverse experiences reported occasionally include:
Cardiovascular System: Palpitations
Digestive System: Stomatitis Nervous System: Drowsiness Special Senses: Blurred vision
What should I avoid while taking Antiflog?
Avoid drinking alcohol. It may increase your risk of stomach bleeding.
Avoid taking aspirin while you are taking Antiflog.
Ask a doctor or pharmacist before using other medicines for pain, fever, swelling, or cold/flu symptoms. They may contain ingredients similar to Antiflog (such as aspirin, ibuprofen, ketoprofen, or naproxen).
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Taking warfarin with Antiflog increases your risk of stomach and intestinal bleeding.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Cardiovascular Thrombotic Events
Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI), and stroke, which can be fatal. Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease. However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate. Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment. The increase in CV thrombotic risk has been observed most consistently at higher doses.
To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible. Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms. Patients should be informed about the symptoms of serious CV events and the steps to take if they occur.
There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use. The concurrent use of aspirin and an NSAID, such as Antiflog, increases the risk of serious gastrointestinal (GI) events .
Disease-modifying anti-inflammatory drug
Taking methotrexate with Antiflog can lead to dangerous levels of methotrexate in your body. This may cause side effects such as nausea, vomiting, diarrhea, mouth sores, fever, and hair loss.
Antiflog (PIRO) is a nonselective NSAID used for its anti-inflammatory properties as well and for its value as a chemopreventive and antitumor agent.