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• Dolonex DT indications
• Uses of Dolonex DT in details
• Dolonex DT description
• Dolonex DT dosage
• Dolonex DT interactions
• Dolonex DT side effects
• Dolonex DT contraindications

What is Dolonex DT?

Dolonex DT is in a group of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). Dolonex DT works by reducing hormones that cause inflammation and pain in the body.

Dolonex DT is used to treat pain or inflammation caused by arthritis.

Dolonex DT may also be used for other purposes not listed in this medication guide.

Dolonex DT indications

Carefully consider the potential benefits and risks of Dolonex DT and other treatment options before deciding to use Dolonex DT. Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.

Dolonex DT is indicated:

• For relief of the signs and symptoms of osteoarthritis.
• For relief of the signs and symptoms of rheumatoid arthritis.

How should I use Dolonex DT?

Use Dolonex DT as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Dolonex DT comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Dolonex DT refilled.
• Take Dolonex DT by mouth. It may be taken with food if it upsets your stomach. This may not lower the risk of stomach or bowel problems (eg, bleeding, ulcers). Talk with your doctor if you have persistent stomach upset.
• Take Dolonex DT with a full glass (8 oz [240 mL]) of water as directed by your doctor.
• If you miss a dose of Dolonex DT and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose. Go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Dolonex DT.

Uses of Dolonex DT in details

Use: Labeled Indications

Arthritis: Relief of signs and symptoms of osteoarthritis and rheumatoid arthritis.

Off Label Uses

Ankylosing spondylitis

In a systematic review and metaanalysis of trials evaluating the treatment of ankylosing spondylitis, the use of Dolonex DT was shown to be safe and effective (Kroon 2015). The American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network recommend NSAIDS in the treatment of ankylosing spondylitis (Ward 2016).

Dolonex DT description

Dolonex DT is 4-Hydroxy-2-methyl-N-2-pyridinyl-2H-1,2-benzothiazine-3-carboxamide 1,1-dioxide, an oxicam. Members of the oxicam family are not carboxylic acids, but they are acidic by virtue of the enolic 4-hydroxy substituent. Dolonex DT occurs as a white crystalline solid, sparingly soluble in water, dilute acid and most organic solvents. It is slightly soluble in alcohols and in aqueous alkaline solution. It exhibits a weakly acidic 4-hydroxy proton (pKa 5.1) and a weakly basic pyridyl nitrogen (pKa 1.8).

It has a molecular formula of C₁₅H₁₃N₃O₄S and molecular weight of 331.35.

Dolonex DT dosage

Dolonex DT Dosage

Generic name: Dolonex DT 10mg

Dosage form: capsule

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Carefully consider the potential benefits and risks of Dolonex DT and other treatment options before deciding to use Dolonex DT. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.

After observing the response to initial therapy with Dolonex DT, the dose and frequency should be adjusted to suit an individual patient's needs.

For the relief of rheumatoid arthritis and osteoarthritis, the dosage is 20 mg given orally once per day. If desired, the daily dose may be divided. Because of the long half-life of Dolonex DT, steady-state blood levels are not reached for 7–12 days. Therefore, although the therapeutic effects of Dolonex DT are evident early in treatment, there is a progressive increase in response over several weeks and the effect of therapy should not be assessed for two weeks.

More about Dolonex DT (Dolonex DT)

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Consumer resources

• Dolonex DT
• Dolonex DT (Advanced Reading)

Professional resources

• Dolonex DT (AHFS Monograph)
• Dolonex DT (FDA)

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Dolonex DT interactions

See also:
What other drugs will affect Dolonex DT?

Acetylsalicylic Acid: As with other NSAIDs, the use of Dolonex DT in conjunction with acetylsalicylic acid or the concomitant use of 2 NSAIDs is not recommended because data are inadequate to demonstrate that the combination produces greater improvement than that achieved with the drug alone and the potential for adverse reactions is increased.

Studies in man have shown that the concomitant administration of Dolonex DT and acetylsalicylic acid resulted in a reduction of plasma levels of Dolonex DT to about 80% of the normal values.

Dolonex DT interferes with the antiplatelet effect of low-dose aspirin, and thus may interfere with aspirins prophylactic treatment of cardiovascular disease.

Anticoagulants: Bleeding has been reported rarely when Dolonex DT has been administered to patients on coumarin type anticoagulants. Patients should be monitored closely if Dolonex DT and oral anticoagulants are administered together.

Dolonex DT, like other NSAID, decreases platelet aggregation and prolongs bleeding time. This effect should be kept in mind when bleeding times are determined.

Antacids: Concomitant administration of antacids had no effect on Dolonex DT plasma levels.

Antihypertensives Including Diuretics, Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin II Antagonists (AIIA) and β-Blockers: NSAIDs can reduce the efficacy of diuretics and other antihypertensive drugs including ACE inhibitors, AIIA and β-blockers.

In patients with impaired renal function (eg, dehydrated patients or elderly patients with the renal function compromised), the co-administration of an ACE inhibitor or an AIIA with a cyclooxygenase inhibitor can increase the deterioration of the renal function, including the possibility of acute renal failure, which is usually reversible.

The occurrence of these interactions should be considered in patients taking Dolonex DT with an ACE inhibitor or an AIIA and/or diuretics. Therefore, the concomitant administration of these drugs should be done with caution, especially in elderly patients. Patients should be adequately hydrated and the need to monitor the renal function should be assessed in the beginning of the concomitant treatment and periodically thereafter.

Cardiac Glycosides (Digoxin and Digitoxin): NSAIDs may exacerbate cardiac failure, reduce glomerular filtration rate (GFR) and increase plasma glycoside levels. Concomitant administration of digoxin or digitoxin had no effect on the plasma levels of Dolonex DT or either drug.

Cimetidine: Results of 2 separate studies indicate a slight increase in the absorption of Dolonex DT following cimetidine administration but no significant changes in elimination parameters. Cimetidine increases the AUC_0-120hrs and C_max of Dolonex DT by approximately 13-15%. Elimination rate constants and t_½ show no significant differences. The small but significant increase in absorption is unlikely to be clinically significant.

Cholestyramine: Cholestyramine has been shown to enhance the oral clearance and decrease the t_½ of Dolonex DT. To minimize this interaction, it is prudent to administer Dolonex DT at least 2 hrs before or 6 hrs after cholestyramine.

Corticosteroids: Increased risk of gastrointestinal ulceration or bleeding.

Cyclosporine: Increased risk of nephrotoxicity.

Lithium and Other Protein-Bound Agents: Dolonex DT is highly protein-bound and therefore, might be expected to displace other protein-bound drugs. The physician should closely monitor patients for change in dosage requirements when administering Dolonex DT to patients on highly protein-bound drugs. NSAID, including Dolonex DT, have been reported to increase steady-state plasma lithium levels. It is recommended that these levels be monitored when initiating, adjusting and discontinuing Dolonex DT.

Methotrexate: When methotrexate is administered concurrently with NSAIDs, including Dolonex DT, NSAIDs may decrease elimination of methotrexate resulting in increased plasma levels of methotrexate. Caution is advised, especially in patients receiving high doses of methotrexate.

Tacrolimus: Possible increased risk of nephrotoxicity when NSAIDs are given with tacrolimus.

Dolonex DT side effects

See also:
What are the possible side effects of Dolonex DT?

Dolonex DT is generally well tolerated. Gastrointestinal symptoms are the most commonly encountered side effects but in most instances do not interfere with the course of therapy.

Objective evaluations of gastric mucosal appearances and intestinal blood loss show that Dolonex DT 20 mg/day administered either in single or divided daily doses is significantly less irritating to the gastrointestinal tract than acetylsalicylic acid.

Blood and Lymphatic System Disorders: Anemia, aplastic anemia, eosinophilia, hemolytic anemia, leucopenia, thrombocytopenia.

Immune System Disorders: Anaphylaxis, serum sickness.

Metabolism and Nutrition Disorders: Anorexia, hyperglycemia, hypoglycemia, fluid retention.

Psychiatric Disorders: Depression, dream abnormalities, hallucinations, insomnia, mental confusion, mood alterations, nervousness.

Nervous System Disorders: Aseptic meningitis, dizziness, headache, paresthesia, somnolence, vertigo.

Eye Disorders: Blurred vision, eye irritations, swollen eyes.

Ear and Labyrinth Disorders: Hearing impairment, tinnitus.

Cardiac Disorders: Palpitations.

Vascular Disorders: Vasculitis, hypertension.

Respiratory, Thoracic and Mediastinal Disorders: Bronchospasm, dyspnea, epistaxis.

Gastrointestinal Disorders: Abdominal discomfort and pain, constipation, diarrhea, epigastric distress, flatulence, gastritis, gastrointestinal bleeding (including hematemesis and melena), indigestion, nausea, pancreatitis, perforation, stomatitis, ulceration, vomiting.

Hepatobiliary Disorders: Fatal hepatitis, jaundice. Although such reactions are rare, if abnormal liver function tests persist or worsen, if clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (eg, eosinophilia, rash), Dolonex DT should be discontinued.

Reproductive System and Breast Disorders: Decreased female fertility.

Skin and Subcutaneous Tissue Disorders: Alopecia, angioedema, dermatitis exfoliative, erythema multiforme, non-thrombocytopenic purpura (Henoch-Schonlein), onycholysis, photoallergic reactions, pruritus, skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis (Lyell's disease), urticaria, vesiculo bullous reactions.

Renal and Urinary Disorders: Nephrotic syndrome, glomerulonephritis, interstitial nephritis; renal failure.

General Disorders and Administration Site Conditions: Edema (mainly of the ankle), local adverse reactions (burning sensation) or tissue damage (sterile abscess formation, fatty tissue necrosis) at the site of injection, malaise, transient pain upon injection.

Investigations: Positive ANA, reversible elevations of BUN and creatinine, decreases in hemoglobin and hematocrit unassociated with obvious gastrointestinal bleeding, increased serum, transaminase levels, increased and decreased weight.

Dolonex DT contraindications

See also:
What is the most important information I should know about Dolonex DT?

This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use Dolonex DT. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG).

Seek emergency medical help if you have symptoms of heart or circulation problems, such as chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance.

This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking Dolonex DT. Older adults may have an even greater risk of these serious gastrointestinal side effects.

Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds.

Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to Dolonex DT (such as ibuprofen, ketoprofen, or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen.

Do not drink alcohol while taking Dolonex DT. Alcohol can increase the risk of stomach bleeding caused by Dolonex DT.

Avoid exposure to sunlight or artificial UV rays. Dolonex DT can make your skin more sensitive to sunlight and sunburn may result.

Active ingredient matches for Dolonex DT:

Piroxicam

References

1. DailyMed. "PIROXICAM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. PubChem. "piroxicam". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
3. DrugBank. "piroxicam". http://www.drugbank.ca/drugs/DB00554 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology