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piroxicam suppositories (Riacen)

✓ Approved

Chiesi Farmaceutici S.p.A. · PTGS1 · Small Molecule

What is piroxicam suppositories?

piroxicam suppositories is a small molecule developed by Chiesi Farmaceutici S.p.A.. It is approved for therapeutic indications via rectal.

Drug Profile

Brand NamesRiacen
CompanyChiesi Farmaceutici S.p.A.
Drug ClassSmall Molecule
Molecular TargetPTGS1, PTGS2
RouteRectal
StatusApproved
Sources: ClinicalTrials.gov, Chiesi Farmaceutici S.p.A.

Mechanism of Action

Molecular Targets

piroxicam suppositories acts on 2 molecular targets:

PTGS1prostaglandin-endoperoxide synthase 1 (COX3, PCOX1)
PTGS2prostaglandin-endoperoxide synthase 2 (GRIPGHS, hCox-2)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

piroxicam suppositories is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Hepatobiliary disordersHepatitis✓ Approved

Related Research Articles

PubMedThe journal of vascular access2026-11-11

Comparative short-term effects of topical piroxicam gel, diclofenac gel, and EMLA cream on pain reduction during intravenous cannulation: A randomized clinical trial.

Amini Nazanin N, Mohammadi Elham E, Babaei Parvin P, Modir Hesameddin H et al.

Intravenous (IV) cannulation is a common invasive procedure associated with pain and discomfort. This study compared the short-term effects of topical Piroxicam gel, Diclofenac gel, and EMLA cream on pain during IV cannulation. This participant- and outcome assessor-blinded randomized clinical trial included 123 hospitalized patients randomly allocated to three equal groups receiving topical Diclofenac gel, Piroxicam gel, or EMLA cream (n = 41/group). Pain intensity was assessed using the Visual Analogue Scale immediately after cannulation and at 5, 10, 15, 30, and 45 min. Data were analyzed using linear mixed-effects models, with Kruskal-Wallis/Dunn and Friedman tests performed as sensitivity analyses. Categorical variables were analyzed using Chi-square or Fisher's exact tests. Baseline characteristics were comparable among groups (all p > .05). The linear mixed-effects model showed significant effects of treatment group (p = .002), time (p < .001), and treatment-by-time interaction (p < .001). Bonferroni-adjusted pairwise comparisons showed lower pain intensity in the Diclofenac and EMLA groups than in the Piroxicam group immediately after cannulation and at 5 min; no significant pairwise differences were observed from 10 to 45 min. Sensitivity analyses supported the overall temporal decline in pain but showed some differences in individual pairwise comparisons. No serious adverse events were reported. Pain intensity declined substantially over time in all groups. In the primary analysis, Diclofenac and EMLA were associated with lower early pain intensity than Piroxicam, although some pairwise findings were sensitive to the analytical approach. Because no placebo control was included, findings should be interpreted as relative rather than absolute treatment effects. The trial was prospectively registered with the Iranian Registry of Clinical Trials (IRCT) under registration number IRCT20180107038251N8 on June 12, 2023 (1402/03/22), prior to the initiation of participant recruitment in October 2025. Available at: https://www.irct.ir/search/result?query=IRCT20180107038251N8.

PMID 43012328
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PubMedSkeletal radiology2026-11-09

Glycerin suppositories as inexpensive multi-sequence MRI skin markers.

Blum Alain A, Clara Maxime M, Taihi Amina A, Noureddine Raja R et al.

To assess MRI conspicuity and clinical usability of a commercially available glycerin suppository as a low-cost skin marker for musculoskeletal MRI across routine sequences. A glycerin suppository was compared in vivo with vitamin E, water, olive oil, and diluted gadoteric acid solution across routine musculoskeletal MRI sequences. Conspicuity was scored independently by two musculoskeletal radiologists on a 4-point ordinal scale. Clinical usability was retrospectively assessed in 130 examinations at 1.5 and 3 T. One fat-sensitive image set (conventional T1-weighted or Dixon fat-only) and one fluid-sensitive set were scored independently by two readers. Scores of 2 or higher defined usability. Inter-reader agreement was assessed with Cohen kappa. Experimentally, the glycerin suppository showed the most consistent multi-sequence visibility among the tested markers. Unlike vitamin E markers, it remained highly conspicuous on fat-suppressed T1-weighted, fat-suppressed T2-weighted, and Dixon water-only images; it remained visible on STIR but showed lower conspicuity on Dixon fat-only images. Packaging did not affect visibility. Clinically, the marker was usable on both image sets in 123/130 examinations (94.6%) for reader 1 and 120/130 (92.3%) for reader 2. Usability on conventional T1-weighted images was 100% for both readers but decreased on Dixon fat-only reconstructions to 80.0% and 66.7%, respectively. Weighted kappa was 0.90 for fat-sensitive and 0.88 for fluid-sensitive scores. No marker-related image-quality degradation occurred. Glycerin suppositories are inexpensive, disposable MRI skin markers with broad sequence visibility. Their limitation is reduced conspicuity on Dixon fat-only reconstructions.

PMID 43002240
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PubMedAmerican journal of obstetrics and gynecology2026-11-05

Baclofen Vaginal Suppositories in Chronic Pelvic Pain: a Randomized, Double-Blind, Placebo Controlled Trial.

Rothenberger Rodger W RW, Abraham Alyce A, Gaskins Jeremy T JT, Carbone Laurel L et al.

Pelvic floor muscle dysfunction is a common contributor to chronic pelvic pain (CPP), yet targeted treatment options remain limited. To determine whether baclofen vaginal suppositories in CPP is safe and effective when compared with placebo. This randomized, double-blind, placebo-controlled trial compared 20mg baclofen vaginal suppositories to placebo suppositories nightly in women with CPP. Women older than18 years without allergy to baclofen or the suppository base were included if they had ≥40/100 mm pain on a visual analogue scale (VAS) with palpation of the obturator internus or levator ani on standardized pelvic exam. Improvement in this standardized pelvic exam 100mm VAS pain score represented the primary outcome. Participants completed Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference, PROMIS global health, PROMIS sexual function at baseline, 4, and 8 weeks, with repeat pelvic examination at 8 weeks. The study was powered to detect the minimum clinically important difference (MCID) of 20mm on a 100mm VAS pain scale on a standardized pelvic floor muscle examination with a total sample size of 34, 17 in each group. Adverse events, pill count, and other treatments for CPP during the study period were collected. Differences between treatment groups were assessed using the Mann-Whitney test, and multiple imputation was used to account for missing data. A total of 39 women were enrolled in the study with 37 randomized.19 patients received baclofen vaginal suppositories and 18 received placebo suppositories. Demographic data was similar between groups, with similar mean age (42.5 ± 12.5 baclofen vs 46.3 ± 12.2 placebo) and body mass index (29.4 ± 6.7 vs 29.8 ± 7.6). There was a statistically and clinically significant improvement in the primary outcome of change in the 100mm VAS pain score on pelvic floor muscle examination at 8 weeks relative to baseline in the baclofen group as compared to placebo (median improvement of 33.5 mm [IQR: 30 to 46.230.0] baclofen vs 7.2 mm [0.0 to 10.0] placebo, p=<0.001). Further, patient-reported overall 100mm VAS pain was also significantly improved with baclofen when compared to placebo (median improvement 32.0 mm [14.0 to 43.0] baclofen vs 0.0 mm [-6.5 to 11.8] placebo, p=0.001) (Figure 2). Other validated questionnaires demonstrated no significant differences between baclofen and placebo. Medication compliance, assessed using Spearman correlation between the number of missed doses and the survey score at 8 weeks, did not impact the outcomes among those in the baclofen arm. There were no adverse events in the baclofen group. In the placebo group one participant had intermittent headaches and one participant had irritated vaginal skin. In this appropriately powered, randomized trial, patients experienced statistically and clinically significantly less pain with 8 weeks of nightly baclofen vaginal suppositories when compared to placebo. Baclofen suppositories were shown to be well tolerated with no adverse events.

PMID 42988098
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PubMedEuropean journal of pharmaceutics and biopharmaceutics : official journal of Arbeitsgemeinschaft fur Pharmazeutische Verfahrenstechnik e.V2026-10-29

Impact of phosphate buffer strength and unbuffered water on ionizable drug powder dissolution.

Patel Roshni P RP, Polli James E JE

We are unaware of prior reports of the dependence of drug powder dissolution on buffer strength. The objective was to assess the effect of 5, 10, 50, and 100 mM sodium phosphate concentration on in vitro particle dissolution of ionizable drugs. Three weakly acidic drugs (naproxen, piroxicam, and phenytoin) and one weakly basic drug (dipyridamole) were studied at different pH conditions. Dissolution was conducted using USP Apparatus II with a mini-paddle at 37 °C in 100 mL media. Overall, the effect on dissolution profile was modest, with the largest effect generally being between 5 mM phosphate and zero phosphate (i.e., unbuffered water). Hence, a secondary objective was to predict the dissolution of the four ionizable drugs into unbuffered water, as well as for ibuprofen, ketoprofen, indomethacin, haloperidol, and meloxicam. Predictions anticipated slower ionizable drug dissolution into unbuffered water. Overall, dissolution predictions into buffer were better using the transient pH film model that accounts for the changing solid-liquid interfacial pH during dissolution, than for the conventional z-factor film model.

PMID 42957101
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PubMedPLoS pathogens2026-10-23

Oral uracil treatment increases susceptibility to rectal SIV infection.

Bodykevich Elizabeth G EG, Castello Casta Fabiola F, Flynn Jacob K JK, Nichols Charlotte A CA et al.

The intestinal microbiomes of men who have sex with men (MSM) are distinct as compared to non-MSM and may increase susceptibility to rectal HIV infection. We recently demonstrated that dysbiosis-associated disruptions to host antimicrobial immunity increase macaque susceptibility to rectal SIVmac239X acquisition. The described susceptibility-associated network identified Dual Oxidase 2 (DUOX2) - an epithelial sensor that catalyzes reactive oxygen species (ROS) production upon sensing pathobiont-derived uracil - as a likely contributor to increased SIV susceptibility. We hypothesized that intestinal, uracil bioavailability increases susceptibility to rectal HIV acquisition. Here, we treated rhesus macaques with oral uracil or uracil suppositories, prior to low-dose intra-rectal challenge with SIVmac239X. Oral treatment reduced pro-inflammatory cytokine production from peripheral T-cells but did not perturb rectal immunologic transcripts or epithelial ROS production and did not alter biomarkers of intestinal damage. Although treatment with uracil suppositories led to increased concentrations of fecal uracil and indices of intestinal damage, there were fewer immunological perturbations relative to oral treatment. Despite limited evidence of intestinal damage, oral uracil treatment increased susceptibility to intra-rectal SIV acquisition whereas uracil suppositories did not. These data provide mechanistic insights into intra-rectal SIV acquisition and may lead to novel therapeutic interventions that reduce incidence of HIV acquisition.

PMID 42911942
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PubMedJournal of ethnopharmacology2026-10-13

Artemisia vulgaris and sabinene ameliorate gastric ulceration and its recurrence through modulation of acid secretion, oxidative stress, and inflammatory cytokines: an in vivo and in silico study.

Borba Ana Laura Tomaselli ALT, Freschi Khetlyn K, Miorando Daniela D, Maccagnan Juliana Cristina JC et al.

Artemisia vulgaris L., popularly known as mugwort, is traditionally used to treat gastric disturbances, yet the mechanistic basis of its antiulcer effects is largely unexplored. The study evaluated the gastroprotective, healing, and anti-recurrence effects of the hydroalcoholic extract of A. vulgaris (HEAv) and its constituent sabinene, and their underlying pharmacological mechanisms. Phytochemical analysis of HEAv used LC-MS, LC-MS/MS, and LC-ESI-IT-MSn. Gastroprotective activity of HEAv (3, 10, or 30 mg/kg) and sabinene (3 mg/kg) was assessed in ethanol- and piroxicam-induced ulcers, beyond pyloric ligation. Healing and recurrence were assessed via acetic acid-induced and IL-1β-triggered ulcers, the latter monitored by ultrasonography. Oxidative stress, inflammatory markers, histology, network pharmacology, and molecular docking/dynamics were evaluated, along with acute toxicity in mice. Chemical analysis identified 36 compounds in HEAv, predominantly phenolics and flavonoids. HEAv and sabinene showed gastroprotective effects, corroborated by mucosal protection and modulation of oxidative stress and inflammatory parameters. In addition, HEAv increased gastric pH, compared to omeprazole. Moreover, HEAv and sabinene reduced ulceration in both the healing and recurrence models, accompanied by increased GSH and CAT activity, and reduced LPO, MPO, and pro-inflammatory cytokines (IL-6 and IL-17A). No acute toxicity was observed. Network pharmacology identified inflammatory signaling as a key target of HEAv constituents, and docking and dynamic molecular assays confirmed favorable, stable interactions between phenolic compounds and sabinene with H+/K+-ATPase and IKKβ, supported by favorable MM-PBSA/MM-GBSA binding energies. HEAv and sabinene exert gastroprotective and healing effects by modulating acid secretion, oxidative stress, and inflammatory cytokines, as suggested by in silico analyses. Nonetheless, further studies are warranted to validate the predicted molecular targets and to elucidate additional pharmacological pathways.

PMID 42869396
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