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Cytochrome polymorphs CYP2C8, CYP2C9 may produce
metabolites of piroxicam slower. But postoperative pain can be successfully
managed by 20 mg daily dose piroxicam.
The
presnt study by Calvo A M and colleagues assessed the possible
association between polymorphisms in the CYP2C8*3 and CYP2C9 genes with the
therapeutic effect of oral piroxicam (20 mg daily for 4 days) after lower third
molar surgeries with regard to postoperative pain, swelling, trismus, adverse
reactions, need for rescue medication and the volunteer’s overall satisfaction.
To achieve this CYP2C8*3 and CYP2C9 polymorphisms
on genotyped 102 volunteers and genomic
DNA was isolated from collected saliva subjected to invasive lower third molar
surgeries, and the data collected and analyzed from preoperative,
intraoperative and postoperative parameters. An equal amount of piroxicam
sufficiently managed postoperative pain and inflammatory symptoms, with visual
analog pain scores typically <40 mm for all genotypes investigated resulted.
Only 2 out of 102 volunteers heterozygous for CYP2C8*3 and CYP2C9*3 reported adverse side
effects. In general, slow
metabolizers of piroxicam, who were volunteers with mutant alleles, were
indifferent from normal metabolizers with the wild-type alleles and therefore, did not require specialized piroxicam doses to manage the
postoperative pain and inflammation.
Journal of Pain Research 2017, 10:1581-1589
Efficacy of piroxicam for postoperative pain after lower third molar surgery associated with CYP2C8*3 and CYP2C9
Adriana Maria Calvo et al.
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