Admiral

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Admiral

What is Admiral? Definition, Class, and Composition

Property Description
Active ingredient Tenoxicam
Form Tablet; Lyophilized powder for injection
Pharmacological class Non-Steroidal Anti-Inflammatory Drug (NSAID)
General use Symptomatic relief from pain, inflammation, and fever
Origin Synthetic small molecule

Admiral is a medicinal product containing the active ingredient Tenoxicam, which is formally classified as a Synthetic Non-Steroidal Anti-Inflammatory Drug (NSAID). It belongs specifically to the oxicam chemical class, a subgroup of NSAIDs. As a single-active ingredient product (monotherapy), its high-level composition consists only of Tenoxicam combined with necessary, non-active excipients to form its usable pharmaceutical preparations. The chemical entity Tenoxicam is globally recognized for its anti-inflammatory properties. The oxicam class, to which Tenoxicam belongs, is known for medications with a relatively long duration of action compared to many other common NSAIDs.


Available Forms and General Purpose

The medication Admiral is manufactured in two principal pharmaceutical preparations to allow for flexible routes of administration: an oral tablet for systemic absorption, and a lyophilized powder for injection which is reconstituted for either intramuscular (IM) or intravenous (IV) injection. The general purpose of Admiral is to provide symptomatic relief from discomfort associated with inflammation, pain, and fever. It achieves this by modulating biological pathways—specifically through the inhibition of cyclooxygenase (COX) enzymes—which are responsible for generating the chemical messengers (prostaglandins) that drive the inflammatory process. Tenoxicam's mechanism provides potent anti-inflammatory, analgesic, and antipyretic properties. This shows the drug is clinically recognized for its broad action in controlling the most common manifestations of inflammation, such as easing the discomfort and swelling of localized tissue inflammation.

Regulatory References

  1. cyclooxygenase (COX) enzymes
  2. NIH: Tenoxicam

What side effects are possible with Admiral?

Possible Side Effects and Safety Information

The safety information for Admiral is primarily derived from the regulatory documentation for the IN.PACT Admiral Drug-Coated Balloon (DCB), which releases the drug paclitaxel in a targeted manner. The documented risks involve both the medical procedure and the effects of the active substance.


Adverse Reaction Scope

Serious and Clinically Significant Adverse Reactions:

Adverse events associated with the use of the device and drug combination include major complications such as death, amputation or loss of a limb, abrupt vessel closure, arterial thrombosis, dissection, perforation or rupture of the artery, and stroke.

Key Adverse Reaction Categories (Related to Paclitaxel Drug Coating):

While systemic effects are not common with this localized delivery, potential adverse events related to the paclitaxel component include:

  • Hematologic Dyscracia: Changes in blood cell counts, such as leucopenia, neutropenia, and thrombocytopenia.
  • Gastrointestinal Symptoms
  • Allergic/Immunologic Reaction
  • Alopecia (hair loss)

Safety Restrictions and Contraindications

Safety-Related Restrictions or Limitations:

Use is contraindicated in specific patient populations and conditions, including:

  • Patients who cannot receive recommended antiplatelet and/or anticoagulant therapy.
  • Patients with known allergies or sensitivities to paclitaxel.
  • Women who are pregnant, breastfeeding, or intending to become pregnant, and men intending to father children.
  • Use is restricted to non-coronary, non-renal, and non-supra-aortic/cerebrovascular arteries.

Population-Specific Safety Considerations:

There are specific risks for women who are pregnant or nursing due to the known effects of paclitaxel, a cytotoxic agent. The risks of paclitaxel excretion into human milk are currently unknown, necessitating a formal contraindication.


Regulatory Safety Summary

The official safety documents emphasize the continuous monitoring of long-term safety, with trials tracking freedom from device- and procedure-related death and major limb amputation. The overall safety structure highlights the necessity of antiplatelet therapy and careful patient selection to mitigate the serious procedural and drug-related risks.

Overdose and Emergency Response

Overdose and when to seek help

The official regulatory documents define the overdose profile of Admiral (Tenoxicam) by listing the recognized clinical manifestations and specifying required emergency actions. The information is consistent across government health authorities, reflecting the established knowledge of NSAID toxicity.

Documented Clinical Manifestations

Overdose may present with common gastrointestinal symptoms such as nausea, vomiting, and epigastric discomfort. Central nervous system effects are also documented and may include headache, drowsiness, and dizziness (vertigo).

Severe Outcomes and Emergency Response

Acute exposure can lead to severe, life-threatening complications affecting major organ systems. These serious, documented outcomes include acute renal failure, metabolic acidosis, coma, and convulsions (seizures). There is also a risk of severe gastrointestinal bleeding, ulceration, or perforation. Regulatory guidance mandates immediate action: individuals must seek medical care right away for a suspected overdose and contact your regional poison control centre.

Official Management Protocol

The management approach described in the official prescribing information is strictly supportive and symptomatic therapy. This constraint reflects the established fact that no specific antidote is known or listed in regulatory documents for Tenoxicam overdose. The treatment focuses on mitigating the severe consequences that may arise.

Therapeutic Uses of Admiral

What Admiral Treats: Main Uses and Benefits

Admiral (Tenoxicam) is applied across key therapeutic domains and is commonly used to help with symptoms related to physical discomfort. It is applied across domains where additional symptomatic support is needed to manage inflammation and pain. The core therapeutic areas for Tenoxicam include rheumatoid arthritis, osteoarthritis, and extra-articular disorders, supporting its role in managing both chronic and acute inflammatory conditions.


Quick Fact: Managing Symptoms Related to Inflammatory States

Symptomatic Relief for Chronic Rheumatic Conditions

The medication is commonly used to help with conditions presenting with systemic or localized discomfort and episodic or fluctuating manifestations. This contributes to improved comfort during periods of heightened symptoms and assists in managing chronic disorders such as Rheumatoid Arthritis and Osteoarthritis, as well as acute episodes like gouty arthritis, tendinitis, and dysmenorrhea.

Admiral is applied in addressing symptom clusters that may become intense or disruptive, specifically by easing the pain, swelling, and stiffness associated with these conditions. This contributes to easing the overall symptom load and may assist with maintaining functional stability during long-term symptomatic management.

Regulatory References

  1. TENOXICAM Devatis Powder for Injection, 20 mg - Medsafe

Eligibility and Restrictions for Use

Admiral (brentuximab vedotin) is a prescription medicine whose use is strictly governed by specific population and clinical criteria outlined in regulatory documents.

Official Eligibility and Contraindications

Populations for whom use is allowed:

  • Adults and children (aged 2 years and older) with certain types of CD30-positive lymphomas, including Classical Hodgkin Lymphoma (cHL), Systemic Anaplastic Large Cell Lymphoma (sALCL), and specific CD30-expressing Cutaneous T-cell Lymphomas (CTCL). Eligibility is further defined by the disease stage and prior treatment history (e.g., failure of prior regimens, or as consolidation after transplant).

Populations for whom use is contraindicated:

  • Patients with a known hypersensitivity to brentuximab vedotin or any of its excipients.
  • Use in combination with the chemotherapy drug bleomycin is prohibited due to the risk of severe pulmonary toxicity.

Populations with restricted use:

  • Use should be avoided in patients with severe renal impairment or moderate or severe hepatic impairment. For mild hepatic impairment, a dose adjustment is required.
  • Women who are or may become pregnant are advised to use effective contraception during and for a specified time after treatment, as the drug can cause fetal harm. Breastfeeding is not recommended.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Admiral's interaction profile is based on pharmacodynamic and pharmacokinetic patterns documented in regulatory labeling, defining several mandatory constraints for co-administration. The official data structures the interaction profile around bleeding risks and the potential for drug accumulation.

Category Documented Interaction Outcomes
Pharmacodynamic Risks Anticoagulants and Anti-platelet agents significantly increase the risk of bleeding and hemorrhage. SSRI/SNRI antidepressants and oral corticosteroids increase the risk of gastrointestinal bleeding or ulceration. Co-administration with Diuretics or Antihypertensives (ACE Inhibitors/ARBs) may reduce their effectiveness and raise the risk of nephrotoxicity.
Exposure Modification Admiral can reduce the renal clearance of Lithium and Methotrexate, leading to elevated plasma concentrations and potential accumulation of these co-administered agents. Concomitant use with CYP2C9 inhibitors (such as Amiodarone) may decrease the metabolic clearance of Tenoxicam itself, potentially increasing its own plasma concentration.
Timing Constraint A mandatory separation period is required with Mifepristone; Admiral must not be administered for 8–12 days following Mifepristone to prevent a reduction in its intended efficacy.
Food/Substances Official regulatory documents advise that Alcohol may increase the risk of gastrointestinal side effects. Food co-administration delays the rate of Admiral's absorption, but does not affect the overall amount absorbed (bioavailability).

Interaction-Related Restrictions: Co-administration with other systemic NSAIDs or COX-2 Selective Inhibitors is officially considered a prohibited combination due to the heightened, cumulative risk of serious gastrointestinal adverse events. Regulatory documents note that elderly patients are at greater risk for the frequency and severity of adverse reactions associated with these documented interactions.

Mechanism of Action

Reversal of Monoamine Transporters

Admiral's mechanism involves interacting with and reversing the flow of the Dopamine Transporter (DAT) and Norepinephrine Transporter (NET). Acting as a substrate, the drug enters the presynaptic neuron, disrupting normal neurotransmitter reuptake and causing a significant surge of dopamine and norepinephrine into the synaptic cleft.

Intracellular and Pathway Dynamics

Inside the neuron, the drug also influences the Vesicular Monoamine Transporter 2 (VMAT2), interfering with the storage of these transmitters in vesicles. This combined action maximizes the concentration of monoamines available for release, intensely activating central catecholaminergic pathways. This process modulates neural circuits that regulate arousal, vigilance, and sustained attention, resulting in physiological changes associated with central nervous system excitation and increased kinetic activity.

Dosage and Administration Information

How Admiral is Used: Administration Guidelines

Admiral (Tenoxicam) is used in clinical practice based on defined guidelines governing administration, dosage, and duration. The core principle for use is to administer the lowest effective dose for the shortest possible duration necessary to control symptoms.


Approved Forms and Routes

Admiral is available in two forms to allow for flexibility in administration.

  • Oral Administration: Achieved using the Tablet dosage form (typically 20 mg strength). Tablets are swallowed whole and it is preferable to take them during or immediately after a meal.
  • Parenteral Administration: Achieved using the Lyophilized powder for injection (20 mg). The powder is dissolved in the supplied solvent and administered as an Intramuscular (IM) bolus injection or Intravenous (IV) bolus injection. The solution must be used immediately and is not suitable for infusion.

Standard Adult Dosing and Duration

Indication Standard Dose and Frequency Duration Principle
Chronic Disorders (e.g., Rheumatoid Arthritis) 20 mg once daily (or 10 mg for maintenance) Use the lowest effective dose; high doses not recommended long-term
Acute Musculoskeletal Disorders 20 mg once daily Normally not to exceed 7 days (max 14 days in severe cases)
Acute Gout Initial 40 mg once daily for 2 days, then 20 mg daily for 5 days Total treatment course of 7 days

Population-Specific Use

  • Older Adults: The dose must be minimised due to the increased risk of adverse reactions.
  • Renal or Hepatic Impairment: The dose should be minimised and function carefully monitored.
  • Transition from Injection: If treatment begins with the injectable form, patients should transition to the oral form after 1–2 days of a 20 mg once-daily dose.

Recent Clinical Evidence

Admiral: Recent Clinical Evidence

Research has explored various clinical domains in several areas of care.


Preclinical Research and Targets

Preclinical studies focused on a specific receptor pathway. These studies focused on understanding the biochemical targets involved.


Pharmacokinetics and Administration Studied

Studies examined the bioavailability of the drug in various formulations. Studies evaluated administration frequency. Study protocols included administration alongside meals. Research evaluated the period until an observation was recorded.


Clinical Measures in Chronic Conditions

Research evaluated the drug's role in reported clinical measures. Studies examined the observed length of study-defined symptom periods. These findings are being explored. Research evaluated results from populations with chronic conditions.


Adverse Effects and Study Populations

Studies examined recorded adverse effects in adult populations. Research examined the association between a combination of these ingredients and prognosis. Ongoing research is evaluating long-term study data.

Key Studies & References

  1. ADMIRAL Trial Study Design: XOSPATA® (gilteritinib)
  2. ISRCTN99651026: Admiral: a study of the safety of multiple increasing doses of STK-001 in children and adolescents with Dravet syndrome
  3. A systematic review and network meta-analysis of pharmaceutical interventions used to manage chronic pain
  4. The Prevalence of Pain in Chronic Diseases: An Umbrella Review of Systematic Reviews

Frequently Asked Questions (FAQ)

Common questions about Admiral (FAQ)

Q: What happens if I miss taking a dose of Admiral?

A: If you forget to take your dose of Admiral, official administration instructions commonly advise taking it as soon as you remember. However, if it is almost time for your next scheduled dose, patient leaflets commonly suggest skipping the missed dose entirely. The drug is intended to be taken once daily at the same time to maintain a steady level.

Q: Is it common to feel tired after starting Admiral?

A: Regulatory information lists fatigue and tiredness as reported side effects of Admiral. While not classified as 'very common,' tiredness is noted in official documentation as a possible reaction to the medicine.

Q: What is the risk of experiencing a severe side effect from Admiral?

A: Official drug documents categorize side effects by how frequently they are reported. While very common side effects typically include mild gastrointestinal issues, severe adverse reactions like serious skin reactions are described as very rare. These potentially serious side effects are listed in official product information.

Q: Do studies suggest Admiral is effective for the conditions it treats?

A: Yes, official regulatory submissions rely on clinical trial data, including double-blind studies, that have been conducted in patients with conditions like rheumatoid arthritis and osteoarthritis. Evidence from these studies indicates Admiral's role in reducing inflammatory markers and improving reported pain and mobility scores.

Q: Does Admiral cause changes in mood or sleep patterns?

A: Official information mentions the possibility of sleep disturbance as an uncommon adverse effect. Some regulatory sources also list general mental disorders as a possible, though less frequent, side effect.

Q: What should I do if I think I am allergic to Admiral?

A: Regulatory documents indicate that if you experience any symptoms of a severe allergic reaction, such as swelling of the face, throat, or tongue, the medication should be stopped and immediate medical attention sought. This guidance is provided because severe allergic reactions are known to occur rarely.

Q: Can I take Admiral if I am also taking vitamins or herbal supplements?

A: Official drug monographs advise against taking Admiral with any other medications, including non-prescription products, vitamins, or natural health products, without prior consultation with a healthcare professional. This is because significant interactions may occur that can affect bleeding risk or the concentration of the drug in the body.

Q: Is Admiral safe for use in older adults?

A: Official drug information states that Admiral can be used by older adults, but the prescribed dose is to be minimized. This is due to a documented increased risk of adverse reactions in this population, and monitoring by a healthcare professional is documented as necessary.

Q: Are there any special precautions listed for Admiral use?

A: Yes, official documents contain mandatory warnings about serious risks, including gastrointestinal bleeding, effects on the heart, and potential kidney or liver issues. Official guidance emphasizes that the medication is to be used at the lowest effective dose for the shortest duration necessary.

Q: Does Admiral need to be taken at a specific time of day?

A: Official dosing guidance states that the single daily dose should be taken at the same time each day. This practice helps ensure a consistent level of the drug is maintained in the body throughout the treatment period.

Q: Are the side effects of Admiral temporary or can they last a long time?

A: In general, the adverse effects observed in clinical studies for Admiral, such as mild digestive upset or skin reactions, are typically described as mild and reversible. The side effect profile does not indicate that reactions are expected to be permanent.

Q: Can Admiral cause changes in weight?

A: Official drug documents list oedema, or fluid retention/swelling, as an uncommon side effect. While not explicitly a weight change, fluid retention can sometimes be associated with a temporary increase in body mass.

Q: Is it okay to drive or operate machinery while taking Admiral?

A: Official information states that Admiral may cause side effects such as dizziness, drowsiness, or visual disturbances. Patients experiencing these effects are advised in official documents to use caution and avoid driving or operating machinery until symptoms subside.

Q: What type of medical research has been done on Admiral?

A: Medical research documented in regulatory submissions includes dose-finding studies, long-term clinical trials, and comparative double-blind studies against placebo and other medicines. This research primarily supports its use in conditions involving pain and inflammation, such as rheumatoid arthritis and osteoarthritis.

Q: What is the typical timeframe for treatment with Admiral?

A: For sudden, acute musculoskeletal disorders, treatment should usually not last longer than 7 days, up to a maximum of 14 days in severe cases. The principle for chronic conditions is described as using the lowest necessary dose for the shortest period.

Q: Can taking Admiral lead to dependence or addiction?

A: Official drug information does not contain any reports or warnings suggesting that Admiral has habit-forming properties or that it can lead to dependence or addiction.

Q: Is Admiral available generically?

A: The active ingredient in Admiral, Tenoxicam, is a well-established medication approved in many countries globally. Due to its long market history, generic versions of Tenoxicam are widely available in regions where the brand name Admiral is sold.

Q: Is it possible to have no side effects while taking Admiral?

A: Official documents classify side effects by how often they occur, indicating that not every patient will experience them. It is possible for some people to take the drug without noticing any of the listed adverse effects.

Q: Are there any restrictions on activity while using Admiral?

A: There are no general restrictions on physical activity. However, if you experience side effects like dizziness or changes in vision, there is a regulatory caution against engaging in activities that require full mental alertness, such as driving or operating heavy machinery.

Q: Does official information about Admiral mention use during pregnancy or breastfeeding?

A: Yes, official information advises that Admiral is generally not recommended for use by women who are pregnant or breastfeeding. This caution is based on potential risks to the developing fetus and the lack of conclusive data regarding the drug's excretion into human milk.

Q: What are the most commonly reported side effects in clinical trials of Admiral?

A: Data from clinical trials show the most frequently reported side effects are categorized as very common and involve the digestive system. These most commonly include abdominal discomfort, nausea, vomiting, and indigestion.

Q: Why is it described that Admiral must be used with caution in certain patients?

A: Caution is mandated because specific patient groups, such as those with pre-existing heart failure or kidney problems, have an increased risk of serious side effects. The official prescribing information details these increased risks, which can include effects such as fluid retention, kidney issues, or increased bleeding.

Q: Are there any special monitoring tests required when taking Admiral?

A: Official documents recommend that doctors carefully monitor certain functions, such as kidney, liver, and heart function, especially for patients with pre-existing conditions. Monitoring blood concentrations may also be advised when starting or stopping certain other medications that could interact with Admiral.

Q: How does the approval status of Admiral differ across major health agencies?

A: Admiral's active ingredient, Tenoxicam, is widely approved by regulatory bodies in countries like the European Union and Canada. However, it is noted in public records that the drug has not received approval from the U.S. Food and Drug Administration (FDA).

Q: What is the average duration of the drug's effect after one dose?

A: Official drug information and pharmacokinetic data report that the anti-inflammatory and pain-relieving effects of Admiral are maintained for an average of 24 hours. This relatively long duration of effect supports the drug's once-daily dosing regimen.

Q: Can Admiral be taken safely with common over-the-counter pain medications?

A: Regulatory information prohibits the combination of Admiral with other systemic Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as certain OTC pain relievers, due to a heightened risk of serious gastrointestinal events. It is standard regulatory advice to consult a healthcare professional before combining Admiral with any other pain relief.

Q: Does Admiral affect blood pressure or heart rate?

A: Official documentation notes that combining Admiral with certain diuretics or blood pressure medicines (antihypertensives) may reduce their effectiveness. While this suggests an influence, the documents do not state whether Admiral itself independently causes significant changes in blood pressure or heart rate in all patients.

Q: Is Admiral known to interact with birth control pills?

A: Official patient information advises women of child-bearing potential to use effective contraception while taking Admiral. However, the regulatory documentation does not specifically detail whether the interaction is a risk to the efficacy of the birth control pill or is related to a safety risk for the woman.

Q: How long does Admiral stay in the system after the last dose?

A: Admiral belongs to the oxicam class of medicines, which are known for a relatively long duration of action. The half-life of the active ingredient is officially documented as being long, meaning the drug takes a substantial amount of time to be fully eliminated from the body.

Q: Does Admiral have a known interaction with alcohol?

A: Yes, official regulatory documents state that taking Admiral with alcohol may increase the risk of certain adverse gastrointestinal side effects. Patients are typically advised about this potential risk.

Q: Can I stop taking Admiral suddenly, or do I need to taper off?

A: The official administration guidelines provide specific directions for use but do not contain a general procedure for discontinuing chronic treatment. Any decision to stop taking Admiral should be made with the guidance of a healthcare professional.

How should Admiral be stored and disposed of?

The official regulatory labeling for Admiral (Tenoxicam) establishes mandatory conditions for storage and disposal to ensure product integrity and safety.

Item Storage Requirement
Temperature Store at or below 30 C
Protection Protect from light and moisture; keep containers tightly closed
Child Safety Keep out of the sight and reach of children (store locked up)
In-use Stability Reconstituted injection solution should be used immediately

Storage must avoid excessive heat and damp environments, such as a bathroom or car. The product must remain in its original receptacle. Disposal instructions strictly prohibit discarding the medicine into household waste or wastewater. Unused or expired Admiral must be returned to a pharmacist or an approved waste disposal plant in accordance with local regulations for environmentally compliant handling.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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