Tenoxicam

M01A - NSAIDs and antirheumatic products, non-steroids ATC M01AC02 Small molecule Natural product

JFDA label: Tenox capsule

Indications

Approved

Rheumatic Diseases — rheumatic disease

Off-label

Pain

Class profile

cox1_IC50_uM	7.6
cox2_IC50_uM	11.0
cox2_selectivity	0.6909090909090909
inhibitionType	reversible
preferentialCOX2	0
selectiveCOX2	0
plateletEffect	1
source	Warner1999/Vane1996/ChEMBL

Pregnancy & Lactation

Pregnancy

Monitoring

Efficacy	Pain and inflammation control (VAS/NRS scores, joint mobility, functional status); minimum effective dose
Toxicity	Blood pressure (raises BP, antagonises antihypertensives); renal function (SCr, eGFR — especially in elderly, heart failure, CKD, dehydrated); Hb/faecal occult blood (GI bleeding); LFTs; oedema
Clinical pearl	Use the lowest effective dose for the shortest duration. Consider co-prescribing a proton pump inhibitor if GI risk factors present. COX-2 selective agents reduce GI but not CV risk.
Counseling	Take with food or milk to reduce GI upset. Report black stools, blood in urine, or significant ankle swelling. Monitor blood pressure regularly if hypertensive.

Chemistry & Properties

Formula	C13H11N3O4S2
Molecular weight	337.38 g/mol
IUPAC name	4-hydroxy-2-methyl-1,1-dioxo-N-pyridin-2-ylthieno[2,3-e]thiazine-3-carboxamide
CAS	59804-37-4
PubChem CID	54677971
InChIKey	`LZNWYQJJBLGYLT-UHFFFAOYSA-N`
logP	1.64 (XLogP 1.1)
Polar surface area	99.6 Å²
H-bond acceptors / donors	6 / 2
Drug-likeness (QED)	0.87
Lipinski violations	0

SMILES

CN1C(C(=O)Nc2ccccn2)=C(O)c2sccc2S1(=O)=O

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrant	No

Enzyme interactions

Enzyme	Role	Detail
CYP2C19	Inhibitor	—
CYP2C9	Inhibitor	—
CYP2C9	Substrate	—
CYP3A4	Substrate	—

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)MRP2 (Inhibitor)MRP3 (Inhibitor)MRP4 (Inhibitor)OAT3 (Inhibitor)OATP1B1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)MDR1 (Substrate)P-gp (Substrate)

Registered Products (2)

Brand	Form / strength	Pack	Agent	Citizen (JOD)
Tenox capsule	Capsule 20 mg	8 cap	THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN	3.000
Tenox Dispersible granules	Granules 20 mg	8 sachet	THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN	3.300