# Lornoxicam
**Lornoxicam** (also known as chlorotenoxicam) is a nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class, sold under trade names including Xefo, Xafon, Lorcam, and Acabel, and used for moderate to severe pain, osteoarthritis, rheumatoid arthritis, acute lumbar-sciatica conditions, and postoperative pain management.[1](https://www.cochrane.org/evidence/CD007441_single-dose-lornoxicam-trade-names-xefo-xafon-lorcam-acabel-acute-postoperative-pain-adults) • [2](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf) It produces analgesic and antipyretic effects in part through non-selective inhibition of cyclo-oxygenase-1 and cyclo-oxygenase-2 (COX-1 and COX-2), the enzymes that generate prostaglandins involved in pain and inflammation.[1](https://www.cochrane.org/evidence/CD007441_single-dose-lornoxicam-trade-names-xefo-xafon-lorcam-acabel-acute-postoperative-pain-adults)
| Key fact | Detail |
|---|---|
| Drug class | Oxicam-class NSAID; non-selective inhibitor of COX-1 and COX-2[1](https://www.cochrane.org/evidence/CD007441_single-dose-lornoxicam-trade-names-xefo-xafon-lorcam-acabel-acute-postoperative-pain-adults) |
| Distinguishing property | Plasma half-life of 3 to 5 hours, short compared with other oxicams such as piroxicam and tenoxicam[3](https://pubmed.ncbi.nlm.nih.gov/9646006/) |
| Usual dose | 8 to 16 mg daily, divided into 2 or 3 doses; available as 4 mg and 8 mg tablets and as a 4 mg/ml solution for intramuscular or intravenous injection[2](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf) |
| Single-dose efficacy | NNT of 2.9 (95% CI 2.3 to 4.0) for at least 50% pain relief over 6 hours at 8 mg in postoperative dental pain[4](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007441.pub2/pdf/full) |
| Metabolism | Converted mainly to 5'-hydroxy-lornoxicam, which is pharmacologically inactive; cytochrome P450 2C9 is the primary enzyme involved[5](https://pubmed.ncbi.nlm.nih.gov/2284216/) • [6](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/lornoxicam) |
| Age restriction | Not recommended for children and adolescents below age 18 because of a lack of safety and efficacy data[2](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf) |
## Pharmacology
Lornoxicam is a highly potent cyclo-oxygenase inhibitor among the oxicam derivatives. It does not inhibit 5-lipoxygenase and does not appear to shunt arachidonic acid through that cascade. In animal studies this potent COX inhibition produced strong analgesic and anti-inflammatory effects, and additional actions have been described: inhibition of polymorphonuclear leukocyte migration, inhibition of superoxide release from human polymorphonuclear leukocytes, inhibition of platelet-derived growth factor release from human platelets, and stimulation of proteoglycan synthesis in cartilage in tissue culture.[5](https://pubmed.ncbi.nlm.nih.gov/2284216/)
## Pharmacokinetics
**Short half-life.** Unlike other oxicams, which typically have elimination half-lives measured in tens of hours (tenoxicam, for example, averages 60 to 75 hours), lornoxicam has a relatively short plasma half-life of 3 to 5 hours.[3](https://pubmed.ncbi.nlm.nih.gov/9646006/) • [7](https://pubmed.ncbi.nlm.nih.gov/8162655/) Phase I studies with the 4 mg dose found a terminal half-life in the range of 4 to 5 hours after both oral and intravenous administration, with rapid and almost complete absorption when given orally as a solution.[8](https://pubmed.ncbi.nlm.nih.gov/2284217/)
The drug is eliminated by biotransformation to 5'-hydroxy-lornoxicam, which does not undergo enterohepatic recirculation; glucuronidated metabolites are excreted in urine and feces with a half-life of about 11 hours.[3](https://pubmed.ncbi.nlm.nih.gov/9646006/) Only minimal amounts of the parent compound are excreted in urine; degradation products appear in urine (42%) and feces (51%).[9](https://pmc.ncbi.nlm.nih.gov/articles/PMC3966166/) 5-[Hydroxylation](https://www.edgepedia.org/hydroxylation) accounts for up to 95% of total intrinsic clearance, and cytochrome P450 2C9 is the primary enzyme forming the 5-hydroxy metabolite in vitro.[6](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/lornoxicam) On the basis of limited data, some individuals eliminate lornoxicam very slowly, suggesting polymorphic metabolism.[7](https://pubmed.ncbi.nlm.nih.gov/8162655/)
Lornoxicam and its metabolites bind extensively to plasma albumin, and substantial concentrations are attained in synovial fluid, the proposed site of action in chronic inflammatory arthropathies.[3](https://pubmed.ncbi.nlm.nih.gov/9646006/) In elderly subjects, clearance is reduced by 30 to 40%, so the half-life is somewhat longer.[6](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/lornoxicam) Like other NSAIDs, lornoxicam appears to interact with warfarin, sulphonylureas, digoxin, and furosemide.[3](https://pubmed.ncbi.nlm.nih.gov/9646006/)
## Clinical evidence
**Acute postoperative pain.** A Cochrane review of single-dose oral lornoxicam identified three studies with 628 participants, all in pain after third molar extraction. About 45% of participants with moderate to severe postoperative dental pain experienced a high level of pain relief after a single 8 mg dose, compared with about 10% with placebo. The number needed to treat (NNT, the average number of patients who must be treated for one to achieve at least 50% pain relief over 6 hours) was 2.9 (95% CI 2.3 to 4.0). Adverse events were generally mild and did not differ from placebo, and no serious adverse events or withdrawals were reported in the included studies.[1](https://www.cochrane.org/evidence/CD007441_single-dose-lornoxicam-trade-names-xefo-xafon-lorcam-acabel-acute-postoperative-pain-adults) • [4](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007441.pub2/pdf/full) Limited results indicate a duration of action of about 4 hours for the standard-release 8 mg dose.[4](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007441.pub2/pdf/full)
Indirect comparisons using identical trial methods place lornoxicam 8 mg at roughly equivalent efficacy to ibuprofen 200 mg, more effective than paracetamol 1000 mg (NNT 3.6, 95% CI 3.4 to 4.0), and less effective than celecoxib 400 mg (NNT 2.1, 95% CI 1.8 to 2.5) and etoricoxib (NNT 1.6, 95% CI 1.5 to 1.8).[4](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007441.pub2/pdf/full)
**Osteoarthritis.** In a 12-week double-blind trial of 135 patients with hip or knee osteoarthritis, lornoxicam 4 mg three times daily and 8 mg twice daily were as effective as diclofenac 50 mg three times daily, with no significant difference in tolerability; 85 patients continued lornoxicam for up to 40 weeks with continued benefit.[10](https://pubmed.ncbi.nlm.nih.gov/8877932/) The multicenter COLOR study compared lornoxicam with the selective COX-2 inhibitor rofecoxib in 2520 patients treated for about 25 days; improvements in pain on movement, at rest, and at night were significantly greater in the lornoxicam group.[11](https://pubmed.ncbi.nlm.nih.gov/17516707/) A 12-week randomized study of 90 patients with knee osteoarthritis found significantly better pain and function scores with lornoxicam 8 mg twice daily than with etodolac 400 mg twice daily or diclofenac 50 mg three times daily, along with a lower rate of adverse effects.[12](https://pubmed.ncbi.nlm.nih.gov/29515279/)
**Renal colic.** A 2025 Cochrane review of NSAIDs for acute renal colic compared lornoxicam with other NSAIDs ([dexketoprofen](https://www.edgepedia.org/dexketoprofen), tenoxicam, and diclofenac) in two studies with 170 participants. Lornoxicam likely results in little to no difference in pain at 30 minutes (mean difference −0.22 cm on a 10 cm visual analog scale, 95% CI −0.69 to 0.24; moderate-certainty evidence). The evidence was judged very uncertain about the need for rescue medication within 30 minutes (RR 0.85, 95% CI 0.51 to 1.40), and one study of 90 participants reported no serious adverse events in any group up to 120 minutes.[13](https://pubmed.ncbi.nlm.nih.gov/40084512/) • [14](https://doi.org/10.1002/14651858.cd006027.pub3)
## Regulatory status and formulations
In the European Union, lornoxicam (Xefo and associated names) is approved for the treatment of moderate to severe pain and is available as 4 mg and 8 mg film-coated tablets, 8 mg rapid-release tablets, and a powder and solvent for solution for injection at 4 mg/ml for intramuscular and intravenous use, marketed under a range of national names including Artok, Lornox, Telos, Taigalor, Bosporon, and Acabel.[2](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf) The recommended dose is 8 to 16 mg daily divided into 2 or 3 doses, and use is not recommended below age 18.[2](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf)
## References
1. [Single dose lornoxicam (trade names Xefo, Xafon, Lorcam, Acabel) for acute postoperative pain in adults, Cochrane](https://www.cochrane.org/evidence/CD007441_single-dose-lornoxicam-trade-names-xefo-xafon-lorcam-acabel-acute-postoperative-pain-adults)
2. [XEFO, INN: lornoxicam, Article 30 referral Annex I–III, European Medicines Agency](https://www.ema.europa.eu/en/documents/referral/xefo-article-30-referral-annex-i-ii-iii_en.pdf)
3. [Skjodt NM, Davies NM (1998). Clinical pharmacokinetics of lornoxicam. A short half-life oxicam. Clin Pharmacokinet.](https://pubmed.ncbi.nlm.nih.gov/9646006/)
4. [Hall PE, Derry S, Moore RA, McQuay HJ (2009). Single dose oral lornoxicam for acute postoperative pain in adults. Cochrane Database Syst Rev, CD007441.](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007441.pub2/pdf/full)
5. [Overview of the pharmacological properties, pharmacokinetics and animal safety assessment of lornoxicam, PubMed](https://pubmed.ncbi.nlm.nih.gov/2284216/)
6. [Lornoxicam – an overview, ScienceDirect Topics](https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/lornoxicam)
7. [Pharmacokinetics of oxicam nonsteroidal anti-inflammatory agents, PubMed](https://pubmed.ncbi.nlm.nih.gov/8162655/)
8. [Hitzenberger G et al. (1990). Pharmacokinetics of lornoxicam in man. Postgrad Med J.](https://pubmed.ncbi.nlm.nih.gov/2284217/)
9. [Tsakiridis K et al. (2014). Lung inflammatory response syndrome after cardiac-operations and treatment of lornoxicam. J Thorac Dis.](https://pmc.ncbi.nlm.nih.gov/articles/PMC3966166/)
10. [A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis, PubMed](https://pubmed.ncbi.nlm.nih.gov/8877932/)
11. [Comparison of Lornoxicam and Rofecoxib in Patients with Activated Osteoarthritis (COLOR Study), PubMed](https://pubmed.ncbi.nlm.nih.gov/17516707/)
12. [Comparison of Clinical Effectiveness and Safety of Newer NSAIDs in Osteoarthritis of Knee Joint, PubMed](https://pubmed.ncbi.nlm.nih.gov/29515279/)
13. [Nonsteroidal anti-inflammatory drugs (NSAIDs) for acute renal colic, PubMed](https://pubmed.ncbi.nlm.nih.gov/40084512/)
14. [Nonsteroidal anti-inflammatory drugs (NSAIDs) for acute renal colic, Cochrane Library](https://doi.org/10.1002/14651858.cd006027.pub3)
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*Topic: Encyclopedia › Life and health › Human health and medicine › Medicines and therapeutics › Analgesics, antihistamines, and anti-inflammatory drugs › Traditional medicine pain and fever remedies*
*Initially written Oct 20, 2026*
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