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What is meloxicam for? What can replace the drug Meloxicam? Release form, composition and packaging

The drug Meloxicam ( Latin name Meloxikam is a broad-spectrum anti-inflammatory drug. It does not contain steroids and can be suitable for patients with almost any problem - relieve pain and swelling, reduce inflammation and reduce elevated temperature up to normal. But it should be used, strictly coordinating the reception with the attending physician and carefully reading the instructions.

Composition and form of release

The drug contains the active substance meloxicam, which is a derivative of enolic acid and belongs to the category of oxycams. Depending on the form of release of the drug, its composition is slightly different.

Meloxicam is produced and sold in the following forms:

tablets;
rectal suppositories (candles);
sterile liquid in ampoules for injections.

As additional substances, colloidal silicon dioxide (Aerosil 380), gelatinized starch 1500, as well as magnesium stearate, sodium citrate dihydrate and MCC can be used.

Most Popular Meloxicam tablet form. Each pale yellow tablet is round in shape with a separating notch on one side. They are packed in special blisters of 10 pcs. The cardboard pack contains instructions for use and 2 blisters. Sometimes there is packaging in plastic jars of 20 pieces. The content of the drug in each tablet depends on the variety - 7.5 or 15 mg.

injection solution transparent yellow-green color is available in ampoules of 1.5 ml. The special packaging contains 3 or 5 units. The fluid is administered intramuscularly.

Rectal suppositories contain 15 mg of meloxicam and are packaged in 6 or 12 white or yellowish suppositories in one package.

The release of the drug is made by the following countries:

Russia;
Greece;
China;
Israel;
India;
Vietnam.

To purchase a medicinal product, you will need a prescription from the attending physician: without it, the drug is not dispensed at points of sale.

Pharmacological properties

Meloxicam has pronounced analgesic properties, prevents the onset of inflammation and relieves pain. Due to the rapid dissolution in digestive acids and enzymes in the stomach, it penetrates into the blood and binds to its proteins within 15 minutes after taking the pill inside.

Rectal suppositories act just as quickly. Injection administration can significantly reduce the period until a tangible effect appears, since the drug penetrates even faster through muscle tissue into circulatory system and starts its action.

The drug slows down the process of synthesizing prostaglandins in the focus of inflammation, without damaging the mucous surface of the walls gastrointestinal tract. Such therapy does not threaten the patient with the appearance of ulcers. Meloxicam inhibits the enzymatic activity of cyclooxygenase, the selectivity of which is significantly reduced with prolonged use of the maximum permissible doses of the drug.

5-6 hours after a single dose of the drug, its concentration in the body is maximum, then it decreases and the drug is gradually excreted, but it does not cease to act.

In the process of metabolism, Meloxicam enters the liver and is destroyed there almost completely - by 96%. The decay products are easily excreted with the help of the urinary system in just two days, therefore, the body does not accumulate either the substance itself or its constituent components, regardless of the dosage regimen and dosage.

Indications

The list of diseases from which Meloxicam helps is extensive. More often than other drugs, it is prescribed for various painful pathologies of the joints.

The use of this drug is very effective in relieving pain and the state of edema in the following diseases:

rheumatism;
rheumatoid arthritis;
osteoarthritis and osteochondrosis;
Bechterew's disease - ankylosing spondylitis;
various bruises and sprains of the articular ligaments;
chronic polyarthritis.

It is also indicated for any other inflammation of the joints and periarticular tissues, accompanied by severe pain and degenerative processes. Due to its antipyretic effect, Meloxicam is successfully used in acute respiratory infections, fevers of various etiologies and local fevers. The analgesic properties of the active substance are actively used in the fight against pain of any origin, including toothache.

Indications for the use of tablets are similar for the solution in ampoules. Suppositories can be prescribed for local relief of pain near the anus caused by flowing there inflammatory processes.

Instructions for use, dosage

The amount of the drug for single use and the frequency of its use per day is prescribed by the doctor based on the diagnosis of the patient, his age category and individual characteristics.

The general reception schemes are as follows:

Reception tablet form recommended with meals, dosage from 7.5 to 15 mg per day. If the patient has kidney disease or pathology of their development, then the maximum allowable amount for consumption per day should not exceed 7.5 mg.
deep intramuscular injections can be prescribed to both adults and children over 15 years of age. The first injections should contain no more than 7.5 mg of the active substance per day, then it can be increased to 15 mg, and after 3-4 days of therapy, switch to tablets with the same content of meloxicam.
Reception suppositories let's say at a dosage of 7.5 mg 1 time per day. As an exception, you can increase the dose to 15 mg, but in no case higher.

For various diseases, the daily dose can be varied depending on the achieved result of treatment and the recommendations of the treating specialist.

Contraindications

Despite the high quality of treatment with Meloxicam, there are much more contraindications to its use than the scope of permissible use. In view of this, before using the drug, a doctor's appointment and strict adherence to the instructions are required.

For the cases when medicine strictly prohibited for admission, include the following diseases and conditions:

acute course peptic ulcer gastrointestinal tract;
the risk of opening internal bleeding in the gastrointestinal tract;
individual intolerance to the components of the drug or special sensitivity to this and other anti-inflammatory nonsteroidal drugs;
liver failure in severe form, as well as active on this moment liver disease;
severe active kidney disease;
During pregnancy and breastfeeding;
postoperative phase after coronary artery bypass grafting;
inflammatory processes in the gastrointestinal tract;
age up to 15 years;
hyperkalemia - excess of the norm of potassium in the blood, confirmed by an electrocardiogram.

There are also cases when the use of Meloxicam is possible, however, the dosage must be calculated very carefully, and when taking, carefully monitor the patient's well-being. In such situations, it is necessary to weigh all the pros and cons of using this medication, and if the positive effect greatly covers the degree of risk, then this drug is prescribed.

cardiac ischemia;
cerebrovascular disorders;
heart failure in a chronic form;
diabetes mellitus of all types;
peripheral arterial disease;
severe somatic diseases;
ulcer of the stomach and intestines in the history of the patient;
dyslipidemia;
infectious lesions of the body by the bacterium H. Pylori;
alcoholism and heavy dependence on smoking or other drugs.

In addition, the risk category also includes the elderly, as well as patients taking similar nonsteroidal drugs for a long time. Do not prescribe a reception in cases of simultaneous use of antiplatelet agents, anticoagulants, selective serotonin reuptake inhibitors and glucocorticosteroids.

Rectal suppositories, in addition, have specific contraindications associated with the risk of bleeding and inflammatory diseases in the rectum, both at the time of administration and in history.

Side effects and overdose

With an increase in the dose or manifestation of the body's sensitivity to the drug, side effects of a different nature may occur. As a rule, their manifestation is characterized by instability and short duration - after stopping the intake or reducing the dose, everything returns to normal.

The following body reactions to intramuscular injections of Meloxicam may occur:

From the respiratory system an acute asthmatic attack may develop.
urinary system may result in impaired renal function.
Ability may be temporarily lost perceive clearly the world in addition, the development of corneal conjunctivitis is possible.
Reaction skin most often manifested in the appearance of a rash, accompanied by itching and redness, as well as increased skin sensitivity to ultraviolet radiation.
maybe promotion blood pressure and increased heart rate, less often - the appearance of edema.
Appears often headache and dizziness, as well as tinnitus, disorientation in space and drowsiness. Occasionally confusion may occur.
From the gastrointestinal tract inflammation of the oral cavity, stomach pain, diarrhea or constipation, nausea, vomiting, development of gastritis and peptic ulcer of the stomach and intestines, as well as flatulence are possible.
Hematopoietic organs may respond to Meloxicam with manifestations of thrombocytopenia, anemia or leukopenia.

Tablet form The drug threatens with a total of the same side effects, although there are still some differences:

From the digestive tract may occur: gastroduodenal ulcer, fetid eructation, increased activity of hepatic transaminases, latent internal bleeding, hyperbilirubinemia, hepatitis, colitis, sometimes gastrointestinal perforation and stomatitis.
On the skin sometimes reactions such as erythema multiforme, Stevens-Johnson syndrome, toxic necrolysis of the epidermis, and bullous rash may occur.
From the side nervous system possible confusion, vertigo and instability of the emotional state, manifested in sharp unpredictable mood swings, often without objective reasons.
When exposed to respiratory system the drug can provoke bronchospasm.
urinary system may respond to taking pills with an increase in the level of urea in the blood and hypercreatininemia, and sometimes with the manifestation of albuminuria, hematuria and interstitial nephritis. In addition, while taking Meloxicam, acute renal failure may develop. Urination will be difficult and painful.
The medication may cause allergic reactions such as anaphylactic shock or angioedema.
maybe feverish state- fever and associated syndromes.

If any of these symptoms appear, caused by the use of Meloxicam, it is necessary to stop taking the drug. An overdose of the drug causes the same manifestations, only to a greater extent.

To get rid of unpleasant consequences, it is necessary to wash the stomach as soon as possible, since the absorption of the drug occurs very quickly, and also take absorbent medications, such as regular Activated carbon, which will reduce the concentration of the active substance in the body and reduce the severity of side effects.

special instructions

Before using the product, there are some important instructions to be taken into account. First of all, Meloxicam should never be taken with alcohol: this can lead to the development of irreversible processes in the liver, kidneys and gastrointestinal tract.

The use of the drug and similar medicines can affect fertility, this must be taken into account by women when planning conception. Meloxicam can hide the symptoms of infectious and viral diseases.

Taking the drug can adversely affect the ability to concentrate, so it should be taken with caution in people whose work requires concentration.

Interaction with other drugs

With the simultaneous use of other medicines, compatibility with Meloxicam must be taken into account. In particular, the use together with diuretics, as well as Cyclosporine, can cause kidney failure, and the joint intake of lithium preparations will cause its accumulation in the body, and consequently, poisoning.

There are other dangerous drug combinations with Meloxicam and its analogues:

The effect of antihypertensive drugs on the body will be significantly reduced when taking this medication.
There is an increased risk of bleeding when taking blood-thinning medications.
Myelotoxic drugs can increase the severity of Meloxicam hepatotoxicity.
Methotrexate in this combination will cause the development of leukopenia.
The drug Meloxicam is not advised to be taken with other drugs of the same group, since the risk of developing peptic ulcer of the entire gastrointestinal tract increases significantly, starting from the oral cavity and ending with the rectum. The same goes for receiving acetylsalicylic acid.
When taking medication with diuretics, it is necessary to significantly increase the amount of fluid consumed.

In addition to the already studied risky combinations of medicines, there are still unknown ones, therefore, it is possible to combine the drug with any other types of medicines only under the supervision of the attending physician.

Analogues of the drug and prices

There are quite a lot of drugs similar in content of the active substance. In composition, they differ slightly, the main differences in price and manufacturer.

The main analogues of Meloxicam are the following:

- the average cost ranges from 150 to 170 rubles.
Amelotex- the price of the drug in tablets is from 135 rubles, in ampoules - 400 rubles.
Bi-xicam- from 140 rubles.
Melbeck- cost from 230 rubles.
Matarin will cost the buyer an average of 285 rubles.
Meloflam- price from 300 rubles. Contains dimexide as an excipient.
Meloflex Rompharm- costs from 210 to 325 rubles in various pharmacies.
Melox- 450 r.
Meloxicam Prana, Pfizer, Sandoz, Tev, Avexim, RLS, Ksefok- from 170 to 500 rubles.
Movalis- from 200 r.
Movasin- 315 rubles
Mesipol- 180 rubles.
Mixol Aude- 265 rubles
Mirloks- the cost does not exceed 200 rubles.
Moviks- the price of the drug is approximately 340 rubles.
Exen Sanovel- 500 r.

Thus, the price of Meloxicam and its analogues ranges from 130 to 500 rubles. In addition, when buying, you need to pay attention to the dosage - it also greatly affects the cost, as well as auxiliary components, in order to take into account the body's reaction to them.

Meloxicam is sometimes substituted Nimesulide. This is due to the lack of the necessary medicine in the pharmacy at the moment, a similar effect on the body and a relatively low cost. Which of the drugs is better, the patient decides. The difference between these medicines is small, but in case of individual intolerance to Meloxicam, you have to look for a replacement, and Nimesulide is perfect for this role.

Analogues of Meloxicam are also used in veterinary medicine. For example, there is a popular drug Meloxivet in suspension for cats and dogs. Its principle of action is the same - it is an analgesic, antipyretic and anti-inflammatory agent.

Anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drug (NSAID).

Release form

1.5 ml - ampoules (3) - contour plastic packaging (1) - cardboard packs. 1.5 ml - dark glass ampoules (3) - blister packs (1) - cardboard packs. 1.5 ml - dark glass ampoules (5) - blister packs (1) - cardboard packs. 10 - blister packs (2) - cardboard packs. 10 - cellular contour packs (1) - packs of cardboard. 10 - cellular contour packs (2) - packs of cardboard. 10 - cellular contour packs (2) - packs of cardboard. 10 - cellular contour packs (1) - packs of cardboard. 10 - cellular contour packs (3) - packs of cardboard. 10 - cellular contour packs (2) - packs of cardboard. 10 - cellular contour packs (1) - packs of cardboard. 10 - cellular contour packs (3) - packs of cardboard. 10 - cellular contour packs (2) - packs of cardboard. 10 - cellular contour packs (3) - packs of cardboard. 10 - cellular contour packs (2) - packs of cardboard. 20 - cellular contour packs (1) - packs of cardboard 10 tabs in a pack of 10 pcs. - blister packs (2) - packs of cardboard 20 tabs per pack 3 plastic ampoules of 1.5 ml in a box 5 plastic ampoules of 1.5 ml in a box 6 suppositories are placed in a blister pack of PVC film. 1, 2 blister packs together with instructions for use are placed in a pack of cardboard. Solution for intramuscular injection 10 mg / ml - 1.5 ml each in ampoules made of low-density polyethylene or polypropylene - 5 pcs per pack. Tablets 15 mg - 20 tablets per pack. Tablets of 15 mg - 20 pcs per pack. Tablets of 7.5 mg - 20 pieces per pack. pack of 10 tablets pack of 20 tablets pack of 20 tablets

Description of the dosage form

Tablets are light yellow in color, flat-cylindrical, with a risk and a chamfer. Round ploskotsilindrichesky tablets from light yellow to yellow color with a facet and risk. The presence of marbling and small inclusions is allowed. round flat-cylindrical tablets of light yellow color with a chamfer Transparent yellow or greenish-yellow liquid. clear solution from yellow to yellow with a greenish tint Solution for intramuscular administration Suppositories of yellow color, torpedo-shaped, without inclusions on the longitudinal section. An air rod or a funnel-shaped recess is allowed on the cut. Tablets Tablets from light yellow to yellow with a greenish tinge of flat-cylindrical shape. Light marbling is allowed. Tablets from light yellow to yellow with a greenish tinge of flat-cylindrical color. Light marbling is allowed. Tablets with a dosage of 15 mg have a dividing line on one side. Tablets from light yellow to yellow with a greenish tint, flat-cylindrical, with a chamfer and risk; the presence of "marbling" is allowed. Tablets from light yellow to yellow, flat-cylindrical shape with a chamfer. The presence of marbling and minor inclusions is allowed. Tablets from light yellow to yellow, flat-cylindrical shape with a chamfer. Tablets with a dosage of 15 mg are at risk on one side. The presence of marbling and minor inclusions is allowed. Tablets of light yellow color with a greenish tinge, flat-cylindrical, with a chamfer. Tablets are light yellow in color, flat-cylindrical, with a risk and a chamfer. tablets

pharmachologic effect

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID), belongs to enolic acid derivatives and has anti-inflammatory, analgesic and antipyretic effects. The pronounced anti-inflammatory effect of meloxicam has been established in all standard models of inflammation. The mechanism of action of meloxicam is its ability to inhibit the synthesis of prostaglandins (PGs), known inflammatory mediators. Meloxicam in vivo inhibits PG synthesis at the site of inflammation to a greater extent than in the gastric mucosa or kidneys. These differences are associated with more selective inhibition of cyclooxygenase-2 (COX-2) compared to cyclooxygenase-1 (COX-1). It is believed that inhibition of COX-2 provides the therapeutic effects of NSAIDs, while inhibition of the constantly present COX-1 isoenzyme may be responsible for side effects from the side of the stomach and kidneys. The selectivity of meloxicam for COX-2 has been confirmed in various test systems, both in vitro and in vivo. The selective ability of meloxicam to inhibit COX-2 has been shown when used as a test system in human whole blood in vitro. It was found that meloxicam (at doses of 7.5 and 15 mg) inhibited COX-2 more actively, exerting a greater inhibitory effect on the production of PG E2 stimulated by lipopolysaccharide (a reaction controlled by COX-2) than on the production of thromboxane involved in the blood coagulation process. (reaction controlled by COX-1). These effects were dose dependent. Ex vivo studies have shown that meloxicam at the recommended doses did not affect platelet aggregation and bleeding time. In clinical studies, gastrointestinal (GI) side effects were generally less common with meloxicam 7.5 and 15 mg than with the other NSAIDs compared. This difference in frequency side effects on the part of the gastrointestinal tract is mainly due to the fact that when taking meloxicam, such phenomena as dyspepsia, vomiting, nausea, and abdominal pain were less common. The frequency of perforations in the upper gastrointestinal tract, ulcers and bleeding, which were associated with the use of meloxicam, was low and depended on the dose of the drug.

Pharmacokinetics

Absorption Meloxicam is well absorbed from the gastrointestinal tract (GIT), as evidenced by its high absolute bioavailability (89%) after oral administration. Simultaneous intake of food and antacids does not change absorption. After a single dose of the drug in tablets, the average maximum plasma concentration is reached within 5-6 hours. When taking the drug Meloxicam inside (in doses of 7.5 mg and 15 mg), its concentrations are proportional to the doses. With repeated use, a steady state of pharmacokinetics is achieved in a period of 3 to 5 days. The range of differences between the maximum and minimum concentrations of the drug after taking it once a day is relatively small and amounts to 0.4-1.0 μg / ml when using a dose of 7.5 mg, and 0.8-2 when using a dose of 15 mg. 0 μg / ml (minimum and maximum values are given during the equilibrium concentration of pharmacokinetics, respectively), although values \u200b\u200bthat go beyond the specified range were also noted. Distribution Meloxicam binds very well to plasma proteins, especially albumin (99%). Penetrates into the synovial fluid, the concentration in the synovial fluid is approximately 50% of the concentration in the blood plasma. The volume of distribution after repeated oral administration of meloxicam (in doses from 7.5 mg to 15 mg) is about 16 liters, with a coefficient of variation from 11% to 32%. Metabolism Meloxicam is almost completely metabolized in the liver to four pharmacologically inactive derivatives. The main metabolite 5'-carboxymeloxicam (60% of the dose) is formed by oxidation of the intermediate metabolite 5'-hydroxymethylmeloxicam, which is also excreted, but to a lesser extent (9% of the dose). In vitro studies have shown that the CYP2C9 isoenzyme plays an important role in this metabolic transformation, and the CYP3A4 isoenzyme plays an additional role. In the formation of two other metabolites (constituting 16% and 4% of the dose of the drug, respectively), peroxidase takes part, the activity of which, probably, varies individually. Withdrawal Meloxicam is excreted equally through the intestines and kidneys, mainly in the form of metabolites. In unchanged form, less than 5% of the daily dose is excreted through the intestines, in the urine in unchanged form, the drug is found only in trace amounts. The mean half-life of meloxicam varies from 13 to 25 hours. Plasma clearance averages 7-12 ml / min after a single dose of meloxicam. Pharmacokinetics in special groups of patients Patients with impaired renal and / or liver function Impaired liver function, as well as mild renal failure, do not significantly affect the pharmacokinetics of meloxicam. The rate of elimination of meloxicam from the body is significantly higher in patients with moderate renal insufficiency. Meloxicam binds worse to plasma proteins in patients with end-stage renal disease. In end-stage renal disease, an increase in the volume of distribution may lead to higher concentrations of free meloxicam, so in these patients the daily dose should not exceed 7.5 mg. Elderly patients Elderly patients have pharmacokinetic parameters similar to those of younger patients. In elderly patients, the average plasma clearance during the equilibrium state of pharmacokinetics is slightly lower than in young patients. Elderly women have higher values of the area under the concentration-time curve and a longer half-life, compared with young patients of both sexes.

Special conditions

The potential risk of side effects depends on the dose and duration of treatment, so the lowest effective dose of Meloxicam should be used with the lowest possible course. The duration of the course of treatment is set individually depending on the course of the disease and the effectiveness of the therapy. Patients with a history of gastric or duodenal ulcers, as well as patients on anticoagulant therapy, should undergo regular medical examinations, since such patients have an increased risk of erosive and ulcerative diseases of the gastrointestinal tract. In the event of peptic ulcers or gastrointestinal bleeding, as well as the development of side effects from the skin and mucous membranes, the drug should be discontinued. In patients with cardiovascular disease or with risk factors for the development of such diseases, NSAIDs may increase the risk of serious cardiovascular thrombosis, myocardial infarction, angina attack, which can be fatal. With increasing duration of treatment, this risk may increase. NSAIDs inhibit the synthesis of prostaglandins in the kidneys, which are involved in maintaining renal perfusion. The use of NSAIDs in patients with reduced renal blood flow or a reduced volume of circulating blood can lead to decompensation of latent renal failure. After discontinuation of NSAIDs, kidney function usually returns to baseline. Elderly patients, patients with dehydration, congestive heart failure, liver cirrhosis, nephrotic syndrome or acute renal dysfunction, patients concomitantly taking diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and also patients who have undergone major surgical interventions that lead to hypovolemia. In such patients, diuresis and renal function should be carefully monitored at the beginning of therapy. The use of NSAIDs in conjunction with diuretics can lead to sodium, potassium and water retention, as well as to a decrease in the natriuretic effect of diuretics. As a result, in predisposed patients, signs of heart failure or hypertension may be exacerbated. Therefore, careful monitoring of the condition of such patients is necessary, and they must be maintained adequate hydration. Before starting treatment, a study of kidney function is necessary. In patients with mild or moderate renal insufficiency (CC more than 30 ml / min), dose adjustment is not required. In patients with end-stage renal disease who are on hemodialysis, the dose of Meloxicam should not exceed 7.5 mg per day. When using the drug Meloxicam (as well as most other NSAIDs), an episodic increase in serum transaminase activity or other indicators of liver function may have been noted. In most cases, this increase was small and transient. If the identified changes are significant or do not decrease over time, Meloxicam should be discontinued and monitoring of the identified laboratory changes should be carried out. In patients with cirrhosis of the liver (compensated), dose adjustment is not required. Debilitated or debilitated patients may be less able to tolerate adverse events, and therefore such patients should be carefully monitored. Like other NSAIDs, meloxicam may mask the symptoms of an underlying infectious disease. The drug Meloxicam, which inhibits the synthesis of cyclooxygenase / prostaglandin, can affect fertility, and therefore is not recommended for women who have difficulty conceiving. In this regard, in women undergoing examination for this reason, it is recommended that Meloxicam be discontinued. In very rare cases, serious skin reactions have been observed with the use of NSAIDs, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. A high risk of such reactions is observed at the beginning of treatment, while in most cases such reactions appeared during the first month of treatment. At the first appearance of skin rashes, mucosal lesions or other signs of hypersensitivity, Meloxicam should be discontinued. Influence on the ability to drive vehicles and mechanisms The use of the drug Meloxicam can cause unwanted reactions in the form of headache, dizziness and drowsiness. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Compound

1 ml 1 amp. meloxicam 10 mg 15 mg 1 tab. meloxicam 15 mg Excipients: lactose monohydrate 144 mg, potato starch 82.5 mg, colloidal silicon dioxide (aerosil) 6 mg, low molecular weight povidone 6 mg, sodium citrate 27 mg, povidone K25 10.5 mg, calcium stearate 3 mg, talc 6 mg. 1 tab. meloxicam 7.5 mg Excipients: lactose monohydrate 115.5 mg, potato starch 81.9 mg, colloidal silicon dioxide 5.4 mg, low molecular weight povidone 4.5 mg, sodium citrate 22.5 mg, povidone K25 7.5 mg, calcium stearate 2.5 mg, talc 2.7 mg. active substance: meloxicam - 15.0 mg; excipients: lactose monohydrate - 176.0 mg; microcrystalline cellulose - 124.8 mg; sodium citrate dihydrate - 15.0 mg; sodium carboxymethyl starch - 14.4 mg; povidone K-30 - 7.2 mg; colloidal silicon dioxide - 4.0 mg; calcium stearate - 3.6 mg. active substance: meloxicam 15.0 mg; excipients: lactose monohydrate (milk sugar) 161 mg; povidone (polyvinylpyrrolidone) 8.0 mg; potato starch 14.0 mg; magnesium stearate 2.0 mg. active substance: meloxicam 7.5 mg; excipients: lactose monohydrate (milk sugar) 80.5 mg; povidone (polyvinylpyrrolidone) 4.0 mg; potato starch 7.0 mg; magnesium stearate 1.0 mg each tablet contains: as an active ingredient: meloxicam 15 mg; excipients: lactose monohydrate, microcrystalline cellulose, magnesium stearate, corn starch, colloidal silicon dioxide croscarmellose sodium. each tablet contains: as an active ingredient: meloxicam 7.5 mg; excipients: lactose monohydrate, microcrystalline cellulose, magnesium stearate, corn starch, colloidal silicon dioxide meloxicam - 15 mg fatty acids glycerides (Witepsol H 15) - 985 mg. Meloxicam - 15 mg Excipients: lactose monohydrate 69.7 mg, microcrystalline cellulose 56.0 mg, sodium citrate dihydrate 18.0 mg, povidone-KZO 6.0 mg, crospovidone 12.0 mg, colloidal silicon dioxide 1.5 mg , magnesium stearate 1.8 mg. Meloxicam - 7.5 mg 6.0 mg, crospovidone 12.0/12.0 mg, colloidal silicon dioxide 1.5/1.5 mg, magnesium stearate 1.8/1.8 mg. meloxicam 15 mg excipients: pregelatinized starch (starch 1500), microcrystalline cellulose, sodium citrate dihydrate, colloidal silicon dioxide (aerosil 380), magnesium stearate meloxicam 15 mg; Auxiliary substances: colloidal silicon dioxide, crospovidone, magnesium stearate, sodium citrate, povidone, MCC Meloxicam 15mg; excipients: microcrystalline cellulose, lactose, colloidal silicon dioxide, croscarmellose sodium, talc, meloxicam magnesium stearate 15 mg; Auxiliary substances: ethanol, poloxamer, sodium chloride, glycine, meglumine, sodium hydroxide Meloxicam 15 mg; excipients: microcrystalline cellulose, lactose, colloidal silicon dioxide, croscarmellose sodium, talc, meloxicam magnesium stearate 15 mg; Excipients: lactose monohydrate 113mg, corn starch 130mg, povidone 8mg, croscarmellose sodium 8mg, crospovidone 20mg, magnesium stearate 6mg Meloxicam 7.5mg; Excipients: milk sugar, polyvinylpyrrolidone, magnesium stearate, microcrystalline cellulose, aerosil, potato starch, croscamelose sodium. meloxicam 7.5 mg; Auxiliary substances: colloidal silicon dioxide, crospovidone, magnesium stearate, sodium citrate, povidone, MCC Meloxicam 7.5 mg; excipients: microcrystalline cellulose, lactose, colloidal silicon dioxide, croscarmellose sodium, talc, magnesium stearate meloxicam 7.5 mg; Excipients: lactose monohydrate 105.5 mg, corn starch 67 mg, povidone 7 mg, croscarmellose sodium 8 mg, crospovidone 20 mg, magnesium stearate 5 mg meloxicam 15 mg Excipients: microcrystalline cellulose, lactose, colloidal silicon dioxide (aerosil), croscarmellose sodium, talc, meloxicam magnesium stearate 15 mg Excipients: potato starch 33.4 mg, colloidal silicon dioxide (aerosil) 4.4 mg, lactose monohydrate 165 mg, magnesium stearate 2.2 mg. meloxicam 7.5 mg Excipients: microcrystalline cellulose, lactose, colloidal silicon dioxide (aerosil), croscarmellose sodium, talc, magnesium stearate.

Meloxicam indications for use

Sympathomatic treatment of pain in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis (Bekhterev's disease) and other inflammatory and degenerative diseases joints, accompanied by pain when it is impossible to use oral or rectal dosage forms of meloxicam. Meloxicam helps to reduce pain at the time of use (does not affect the progression of the disease).

Meloxicam contraindications

- hypersensitivity to meloxicam or an auxiliary component of the drug; - condition after coronary artery bypass grafting; - decompensated heart failure; - anamnestic data on an attack of bronchial obstruction, rhinitis; - urticaria after taking acetylsalicylic acid or other NSAIDs (complete or incomplete combination bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (including history)); - erosive and ulcerative changes in the mucous membrane of the stomach or duodenum, active gastrointestinal bleeding; - inflammatory bowel disease (ulcerative colitis, Crohn's disease); - cerebrovascular bleeding or other bleeding; - Severe liver failure or active liver disease; - chronic renal failure (CRF) in patients not undergoing dialysis (creatinine clearance less than 30 ml / min), progress

Meloxicam dosage

10 mg/ml 10 mg/ml 15 mg 15 mg 7.5 mg 7.5 mg

Meloxicam side effects

The following describes the side effects, the relationship of which with the use of the drug was regarded as possible. Side effects registered during post-marketing use, the relationship of which with the use of the drug was regarded as possible, are marked with *. Within the system-organ classes, the following categories are used according to the frequency of side effects: very often (? 1/10), often (? 1/100,

drug interaction

- Other inhibitors of prostaglandin synthesis, including glucocorticoids and salicylates - simultaneous use with meloxicam increases the risk of ulceration in the gastrointestinal tract and gastrointestinal bleeding (due to synergistic action). Co-administration with other NHTVPs is not recommended. - Anticoagulants for oral administration, heparin for systemic use, thrombolytic agents - simultaneous use with meloxicam increases the risk of bleeding. In the case of simultaneous use, careful monitoring of the blood coagulation system is necessary. - Antiplatelet drugs, serotonin reuptake inhibitors - simultaneous use with meloxicam increases the risk of bleeding due to inhibition of platelet function. In the case of simultaneous use, careful monitoring of the blood coagulation system is necessary. - Lithium preparations - NSAIDs increase the level of lithium in plasma by reducing its excretion by the kidneys. The simultaneous use of meloxicam with lithium preparations is not recommended. In case of need for simultaneous use, careful monitoring of the concentration of lithium in plasma is recommended during the entire course of the use of lithium preparations. - Methotrexate - NSAIDs reduce the secretion of methotrexate by the kidneys, thereby increasing its plasma concentration. The simultaneous use of meloxicam and methotrexate (at a dose of more than 15 mg per week) is not recommended. In the case of simultaneous use, careful monitoring of kidney function and blood count is necessary. Meloxicam may increase the haematological toxicity of methotrexate, especially in patients with impaired renal function. - Contraception - there is evidence that NSAIDs can reduce the effectiveness of intrauterine contraceptive devices, but this has not been proven. - Diuretics - the use of NSAIDs in case of dehydration of patients is accompanied by a risk of developing acute renal failure. - Antihypertensive agents (beta-blockers, angiotensin-converting enzyme inhibitors, vasodilators, diuretics). NSAIDs reduce the effect of antihypertensive drugs due to inhibition of prostaglandins, which have vasodilating properties. - Angiotensin-II receptor antagonists, as well as angiotensin-converting enzyme inhibitors, when used together with NSAIDs, increase the decrease in glomerular filtration, which thereby can lead to the development of acute renal failure, especially in patients with impaired renal function. - Colestyramine, by binding meloxicam in the gastrointestinal tract, leads to its faster elimination. - Pemetrexed - with the simultaneous use of meloxicam and pemetrexed in patients with creatinine clearance from 45 to 79 ml / min, meloxicam should be discontinued 5 days before the start of pemetrexed and may be resumed 2 days after the end of the dose. If there is a need for the combined use of meloxicam and pemetrexed, then such patients should be carefully monitored, especially with regard to myelosuppression and the occurrence of side effects from the gastrointestinal tract. In patients with creatinine clearance less than 45 ml/min, the use of meloxicam with pemetrexed is not recommended. NSAIDs, by acting on renal prostaglandins, may increase the nephrotoxicity of cyclosporine. When used in conjunction with meloxicam drugs that have a known ability to inhibit CYP2C9 and / or CYP3A4 (or are metabolized with the participation of these enzymes), such as sulfonylurea derivatives or probenecid, the possibility of pharmacokinetic interaction should be taken into account. When co-administered with oral antidiabetic agents (eg, sulfonylurea derivatives, nateglinide), CYP2C9-mediated interactions are possible, which can lead to an increase in the concentration of both these drugs and meloxicam in the blood. Patients taking meloxicam concomitantly with a sulfonylurea or nateglinide should carefully monitor their blood sugar levels due to the possibility of hypoglycemia. With the simultaneous use of antacids, cimetidine, digoxin and furosemide, no significant pharmacokinetic interactions were identified.

Overdose

Symptoms: nausea, vomiting, epigastric pain, gastrointestinal bleeding, acute renal failure, liver failure, respiratory arrest, asystole, lethargy, drowsiness, increased blood pressure, coma, convulsions, cardiovascular collapse, cardiac arrest, anaphylactoid reactions . Treatment: There is no specific antidote. In case of an overdose of the drug, symptomatic therapy should be carried out. Forced diuresis, alkalization of urine, hemodialysis are ineffective due to the high connection of the drug with blood proteins.

Storage conditions

store in a dry place
keep away from children
store in a place protected from light

Information provided by the State Register of Medicines.

Synonyms

Amelotex, Meloxicam, Meloxicam DS, Meloxicam-Teva, Movalis, Movasin

Meloxicam tablets are prescribed for the development of destructive processes in the spine, muscles, and joints. A non-steroidal agent suppresses inflammation, reduces pain, reduces swelling and local temperature in the lesion.

The drug Meloxicam is used in accordance with the instructions, taking into account the dosage for a certain age and type of disease. Violation of the requirements leads to negative reactions to NSAIDs.

Composition and form of release

The drug contains meloxicam (each tablet contains 7.5 or 15 mg).

Among the auxiliary ingredients:

milk sugar,
microcrystalline cellulose,
crospovidone,
silica anhydrous colloidal,
povidone.

Pharmacy chains receive packages Nos. 10 and 20.

Action on the body

Selective inhibitor of COX - 2, class of oxycams, enolic acid group. A drug with an active antirheumatic, anti-inflammatory effect. Meloxicam interferes with the synthesis of prostaglandins. The effect on the production of COX-2 explains the active suppression of inflammation in muscle and joint tissue. Good analgesic effect, pronounced antipyretic effect.

Important nuances:

food intake has little effect on the rate of absorption of the active substance, bioavailability - up to 90%;
a non-steroidal agent exhibits a cumulative effect - after three to five days, blood plasma tests show a stable concentration of meloxicam;
in the synovial fluid is up to 50% of the active component, which explains the high degree of impact on the foci of pain and inflammation in the musculoskeletal structures.

Indications for use

The drug Meloxicam actively suppresses the inflammatory process, exhibits a strong analgesic and anti-edematous effect. For this reason, the remedy is prescribed for acute pain syndrome against the background of many diseases of the back, joints, spinal column.

The positive effect of the drug in the treatment of:

arthropathy;
rheumatoid arthritis;
exacerbation of osteoarthritis;

On a note! The patient often takes meloxicam in tablets after a short course of injections of the drug of the same name. The injection solution relieves even the most severe manifestations of sciatica, exacerbation of arthritis and osteoarthritis, lumbalgia, but Meloxicam injections cannot be given for more than three to five days in order to avoid serious complications. To maintain the effect after injection, it is imperative to switch to a “softer” form of the drug - tablets or gel with meloxicam.

Contraindications

Meloxicam is a potent drug with a high risk of negative effects. Taking pills without taking into account restrictions can cause dangerous complications, up to the development of internal bleeding, coma and respiratory arrest.

The drug Meloxicam is not prescribed:

with the progression of severe renal pathologies;
with peptic ulcer, especially in the acute stage;
patients with poor blood clotting;
if a complex of negative manifestations is detected: aspirin intolerance, nasal polyps, bronchial asthma;
under the age of 15;
against the background of a decrease in creatinine clearance to 30 ml / minute and lower in kidney diseases;
with liver failure;
with allergic reactions to the components of NSAIDs;
with high levels of potassium in the blood plasma;
during lactation;
with angioedema in history;
during pregnancy;
after coronary artery bypass grafting;
with ulcerative colitis.

Instructions for use and daily dosage

take a non-steroidal anti-inflammatory drug during or after a meal, water - up to 150 ml, you do not need to chew the tablet;
with and rheumatoid arthritis, the initial norm per day is 15 mg of meloxicam in two doses. Maintenance dosage - half a tablet;
with osteoarthritis, 7.5 mg of meloxicam for 24 hours is sufficient. If the pain does not subside, then after consultation with the attending physician, you can increase daily allowance 2 times;
with lumbodynia, sciatica, the doctor specifies the dosage depending on the severity of clinical symptoms. After the pain subsides, the norm is necessarily reduced from 15 to 7.5 mg for one day;
in severe renal failure, you can not receive more than 7.5 mg of the active ingredient for 24 hours;
with a mild degree of hepatic insufficiency, correction of the daily dose is not needed;
the course of treatment with the use of Meloxicam tablets is determined by the doctor;
to protect the mucous membranes of the intestines, the stomach, you need to take drugs with enveloping, protective properties, for example, omeprazole.

On a note! It must be remembered that without an integrated approach to the treatment of rheumatoid arthritis, sciatica, osteoarthritis, sciatica, it is difficult to reduce pain and eliminate inflammation. In addition to tablets, it is useful to apply external agents, diet correction, physiotherapy (after the inflammation subsides). Positive effect physiotherapy, normalization metabolic processes, dosing physical activity.

Side effects

The frequency of manifestation of adverse reactions largely depends on the individual sensitivity of the patient to the active substance and general condition organism. To minimize the risk of negative effects, you must strictly follow the rules of use, a single dose, daily dosage, do not exceed the duration of the course.

Possible reactions to NSAIDs:

bronchial asthma in combination with an allergy to acetylsalicylic acid;
anaphylactic shock;
nausea, intestinal bleeding, perforation and ulcers of the gastrointestinal tract, vomiting, constipation, flatulence, abdominal pain;
violation of blood parameters: leukopenia, a decrease in the number of red blood cells, thrombocytopenia;
fainting, unpleasant tinnitus, headaches;
development of polymorphic erythema;
skin rashes, itching, urticaria;
photosensitivity;
changes in the level of liver enzymes;
stomatitis.

With excessive intake of meloxicam, nausea, abdominal pain, weakness, vomiting, tremor appear, the work of the respiratory center, the central nervous system is disturbed, bleeding in the stomach and intestines is possible. The risk of such dangerous manifestations as convulsions, coma, collapse increases, with a significant excess of the norm, acute renal failure and cardiac arrest are possible. Need symptomatic therapy under the guidance of a doctor. Hemodialysis, forced diuresis are practically ineffective due to the rapid and strong binding of meloxicam to plasma proteins.

drug interaction

Not only the degree of impact on the body, but also the likelihood of side effects depends on the correct combination of NSAIDs with other names. When prescribing a non-steroidal formulation, the patient must list all drugs that he takes, especially long-term courses to stabilize vital signs (heart drugs, diuretics, antihypertensive drugs). When selecting NSAIDs, the doctor takes into account the data to reduce the risk of negative manifestations.

The main points of the interaction of Meloxicam:

it is important to regularly take an analysis to clarify the level of lithium in the blood;
the combination with antithrombotic compounds and anticoagulants increases the likelihood of internal bleeding in different parts of the body, especially with damage to the mucous membranes of the intestines and stomach;
taking several types of NSAIDs dramatically increases the risk of erosions, ulcers in the digestive tract;
reduces the effectiveness of oral contraceptives;
combination with methotrexate enhances Negative influence meloxicam on blood quality: a decrease in the level of leukocytes and hemoglobin is possible.

You can not combine alcohol and a drug of the NSAID group: increased depression of the central nervous system, increased risk negative reactions, reduces the effectiveness of therapy.

Price

Meloxicam is an active effect on the foci of inflammation and pain, positive reviews and low cost of the drug. The price of Meloxicam tablets depends on the content of the active substance (15 or 7.5 mg) and the number of units in the package. The average cost of a medicine is from 75 to 190 rubles (10 and 20 tablets, respectively). If the pain syndrome is so painful that injections are needed, then the cost of the drug in injections (5 ampoules) is also acceptable - 260 rubles.

Movexicam.

Piroxicam.

Revmoxicam.

Fedin.

Texamen.

Name:

Meloxicam (Meloxicam)

Pharmachologic effect:

Meloxicam belongs to the group of oxicams. Non-steroidal anti-inflammatory agent. Selective suppression of the cyclooxygenase-2 isoenzyme provides analgesic and anti-inflammatory effects of the drug. For Meloxicam, the IC50 selectivity coefficient is 2. It is absorbed almost entirely in the alimentary canal. With internal use, the percentage of absolute bioavailability is approximately 89. 5-6 hours after oral administration (once), the maximum concentration of the active substance in blood plasma is reached. After 3-5 days of regular repeated administration of the drug, an equilibrium state is reached.

The equilibrium concentration of Meloxicam (Cmin–Cmax) is 0.4–1.0 mg/l when taking 7.5 mg of the drug orally and 0.8–2.0 mg/l when taking 15 mg orally. The maximum concentration figures do not change when used for a long time. Simultaneous reception food products does not affect the degree of absorption of Meloxicam from the digestive system. After intramuscular injection, the bioavailability parameter is 89%, and after 60 minutes the maximum concentration of the active substance is observed in the blood plasma. The linear characteristic of pharmacokinetics is characterized when taking Meloxicam in medium therapeutic dosages - 7.5 mg and 15 mg.

The affinity of Meloxicam with plasma proteins is high, especially with albumin - up to 99%. 50% of the plasma concentration of Meloxicam is observed in the synovial fluid. The volume of distribution averages up to 11 liters with the boundaries of individual fluctuations from 30 to 40%. Metabolized by liver enzymes. It is eliminated by the kidneys and intestines equally, and 4 pharmacologically inactive metabolites of the drug are determined in the urine. 5'-carboxymeloxicam is the main metabolite. It is up to 60% of the administered or accepted dose and is formed due to the oxidation of intermediate metabolic forms (for example, 5'-hydroxymethylmeloxicam). 9% 5'-hydroxymethylmeloxicam is excreted unchanged.

In vitro studies have shown that the first stage of metabolic transformations is carried out mainly by the CYP 2C9 isoenzyme. However, CYP 3A4 also participates to a small extent in this process. Other metabolites make up from 4 to 16% of the taken or administered Meloxicam and are formed due to the action of peroxidase. Unchanged Meloxicam is found in urine in trace concentrations. The half-life is on average determined within 20 hours. The total plasma clearance of the active substance is approximately 8 ml / min.

Indications for use:

It is used as a symptomatic agent in the treatment of:

Exacerbations of arthrosis (short-term),

Chronic polyarthritis (long time),

Rheumatoid arthritis (long term)

Bechterew's disease (ankylosing spondylitis).

Application method:

Tablets should be taken 1 time per day, with meals. Meloxicam tablet should be taken with 250 ml of liquid. Solution for injection Meloxicam is intended exclusively for injection into the muscle. Contraindicated intravenous use of the solution. Intramuscular administration is used in the first days of therapy. In the future, they switch to the internal use of the drug in the form of tablets.

With exacerbation of arthrosis, 7.5 mg is prescribed 1 time per day. You can increase the dosage to 15 mg if the therapeutic effect is insufficient.

With Bechterew's disease and rheumatoid arthritis - 15 mg 1 time per day. If a sufficient therapeutic effect is observed, then the daily dosage is reduced to 7.5 mg once a day. It is not recommended to exceed the dosage of Meloxicam 15 mg per day.

Treatment in special categories of patients

For dialysis patients, the daily dose is not higher than 7.5 mg. In case of insufficiency of renal functions, the daily dose of Meloxicam is 7.5 mg. You can not reduce the dosage of the drug if the clearance of creatinine is 25 ml / min and above (with moderate or mild impairment of renal function).

For elderly patients with Bechterew's disease or rheumatoid arthritis, if long-term treatment is necessary, the recommended daily dosage is 7.5 mg. If there is a need to prescribe a higher dose, but there is a threat of developing unwanted side effects, they are limited to a daily dose of 7.5 mg.

Dosage reduction is not required if the patient is diagnosed with moderate or mild hepatic impairment.

Undesirable phenomena:

The following side effects were evaluated on the following scale: frequency ≥1/10 - very often, ≤1/10, but ≥1/100 patients - often, with a frequency ≤1/100, but ≥1/1000 patients - sometimes, ≤1/100 1000, but ≥1/10,000 - rare. If the frequency was ≤1/10,000, then the side effect was regarded as very rare.

Blood system:

sometimes there were changes in the clinical analysis of blood: leukopenia, thrombocytopenia, agranulocytosis. Anemia was common.

Reactions of the organ of vision:

change in visual acuity (rarely).

The immune system:

reactions of individual hypersensitivity (rarely).

From the side of the central nervous system:

often there was a headache and loss of consciousness, sometimes - tinnitus and dizziness. Rare side effects were nightmares, drowsiness, mood changes and confusion.

From the digestive tract:

stomach discomfort or pain, epigastric pain, flatulence, nausea and vomiting, diarrhea or constipation (common), gastric ulcer, stomatitis, gastrointestinal bleeding, esophagitis (occasionally), perforation of the alimentary canal wall, gastritis, colitis (rare) . Particularly severe side effects from the digestive system can be in the elderly, which is reflected in the more frequent development of perforation, peptic ulcer or gastrointestinal bleeding.

From the side of the cardiovascular system:

side effects were sometimes recorded - increased blood pressure, tachycardia, dilation of subcutaneous vessels with a feeling of heat.

From the urinary system:

sometimes there were impaired renal function, which were accompanied by an increase in the concentration of creatinine and urea in the blood serum. In rare cases, the development of renal failure has been recorded.

From the external respiratory system:

in patients with a history of allergic reactions to non-steroidal anti-inflammatory drugs (especially aspirin or acetylsalicylic acid), asthma attacks were rarely observed.

From the side of the skin:

allergic itching and skin rash (often), urticaria, toxic epidermal necrolysis, or Lyell's syndrome, Stevens-Johnson syndrome, angioedema of the mucous membrane and / or skin, photosensitivity and erythema multiforme were rare.

From the hepatobiliary system:

liver dysfunction (sometimes), hepatitis (rarely).

Other:

edema often appeared.

Contraindications:

Ulcers in the digestive system (taking into account the history of life or current exacerbations),

Hypersensitivity to the active substance or other ingredients of Meloxicam, as well as to other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid, or aspirin. It is strictly contraindicated in patients who, after taking any non-steroidal anti-inflammatory drug, had angioedema, polyps in the nasal cavity, signs of bronchial asthma or urticaria,

gastrointestinal bleeding,

During pregnancy and breastfeeding,

cerebrovascular bleeding,

Severe renal or hepatic failure,

Bleeding from other organs

Age up to 15 years,

Uncorrected severe heart failure.

During pregnancy:

Interaction with other drugs:

Interactions due to pharmacokinetics

Non-steroidal anti-inflammatory drugs, including Meloxicam, can, when combined with lithium, increase its serum concentration to toxic levels by reducing the excretion of lithium by the kidneys. The simultaneous use of Meloxicam with lithium preparations is not recommended. If such a combination is justified, the level of lithium electrolyte in the blood serum should be carefully monitored both before the start, during the intake, and some time after the end of the course of treatment with the drug.

It accelerates the elimination of Meloxicam cholestyramine, while there is an increase in the clearance of meloxicam by 2 times and a decrease in its half-life by about 13 (± 3) hours. This pharmacokinetic interaction is of significant clinical significance.

Methotrexate increases the negative impact of Meloxicam on the blood system (high risk of leukopenia and anemia). With this combination, hemogram parameters should be periodically monitored.

Non-steroidal anti-inflammatory drugs reduce the effectiveness of intrauterine contraception. When taken simultaneously with cimetidine, digoxin and antacids, there is no clinically significant drug interaction.

Interactions due to pharmacodynamics

When combining meloxicam with diuretics, the patient should take enough liquids. In this case, careful regular monitoring is necessary. medical personnel for kidney function both before and during the administration of Meloxicam.

Antithrombotic and thrombolytic agents: when combined with Meloxicam, the risk of bleeding increases significantly. In such cases, periodic monitoring of blood coagulation potential is necessary.

The risk of ulcerative erosive diseases of the digestive system increases dramatically if non-steroidal anti-inflammatory drugs of other groups (including salicylic acid derivatives) are taken in parallel. This combination is not recommended.

Angiotensin-converting factor (ACE) inhibitors and other antihypertensive drugs: concomitant use with Meloxicam in dehydrated elderly people may cause acute renal failure. Also, the combined use of these drugs with Meloxicam can neutralize their hypotensive effect.

The combined use of Meloxicam and oral anticoagulants significantly increases the risk of bleeding from any organs due to damage to the intestinal and gastric mucosa and suppression of platelet function. Therefore, concomitant use with oral anticoagulants is not recommended.

When combined with Meloxicam, the effectiveness of hormonal contraceptives may decrease.

Against the background of Meloxicam, the nephrotoxic effect of cyclosporine is enhanced.

Overdose:

Acute overdose of non-steroidal anti-inflammatory drugs is characterized by nausea and vomiting, drowsiness, and abdominal pain. These symptoms are usually treated with symptomatic remedies. Rarely, bleeding of their gastrointestinal tract can develop. Poisoning with large doses of the drug is characterized by an increase in blood pressure, impaired liver function, respiratory depression, the development of acute renal failure, convulsions, and collapse. A coma or cardiac arrest may occur.

There are reports in the literature of anaphylactoid-type reactions both during overdose and during the use of therapeutic doses of Meloxicam.

After an overdose of the drug, patients need symptomatic and supportive therapy. Treatment is carried out according to the symptoms of intoxication and the severity of the overdose. Clinical studies have shown that oral administration of 4000 mg of cholestyramine triples the rate of elimination of meloxicam.

Release form of the drug:

Meloxicam tablets

Tablets of 15 and 7.5 mg in a blister pack. There are 20 tablets in a blister.

Ampoules 1.5 ml containing 15 mg of active ingredient. There are 5 ampoules in a box.

Storage conditions:

Released by prescription. During storage, observe a temperature of approx. 25 °C.

Synonyms:

Lem, Melbek, Artrozan, Meloxicam-Ratiopharm, Melbek forte, Mirloks, Melox, Movasin, Movalis.

Compound:

Meloxicam 15 (tablets)

Active ingredient: meloxicam 15 mg.

Excipients: pregelatinized starch, lactose monohydrate, corn starch, anhydrous colloidal silicon dioxide, microcrystalline cellulose, sodium citrate, magnesium stearate. Meloxicam 7.5 (tablets)

Active ingredient: meloxicam 7.5 mg.

Excipients: pregelatinized starch, lactose monohydrate, corn starch, anhydrous colloidal silicon dioxide, microcrystalline cellulose, sodium citrate, magnesium stearate. Meloxicam solution for intramuscular injection

glycofurol, meglumine, sodium chloride, poloxamer 188, sodium hydroxide, glycine, water for injection. Additionally: Before prescribing the drug, it is recommended to treat concomitant diseases such as gastritis, esophagitis, peptic ulcers of the stomach and duodenum. Patients with these diseases may experience relapses during treatment with Meloxicam.

Similar drugs:

Meloxicam 7.5 (tablets)

Active ingredient (in 1.5 - 1 ampoule): meloxicam 15 mg.

glycofurol, meglumine, sodium chloride, poloxamer 188, sodium hydroxide, glycine, water for injection.

Meloxicam solution for intramuscular injection

Before prescribing the drug, it is recommended to conduct a course of treatment for such concomitant diseases as gastritis, esophagitis, peptic ulcers of the stomach and duodenum. Patients with these diseases may experience relapses during treatment with Meloxicam.

It is necessary to take into account the risks of side effects of Meloxicam, and therefore the duration of its administration should be as short as possible with the minimum effective daily dosage.

In patients with anamnestic indications of diseases of the digestive tract, a thorough assessment of the condition of the intestines and stomach in order to detect gastrointestinal bleeding should be carried out.

Against the background of treatment with Meloxicam, as with the use of other non-steroidal anti-inflammatory drugs, it was reported about the occurrence of perforation or gastrointestinal bleeding, which proceeded without severe symptoms. In these cases, there may be deaths. In elderly patients, perforation or gastrointestinal bleeding of the alimentary canal occurs in more severe forms. In such cases, Meloxicam should be discontinued.

Meloxicam interacts with diuretics (like other non-steroidal anti-inflammatory drugs), causing sodium, potassium and water retention in the body. This can aggravate the condition of patients with arterial hypertension or heart failure.

In isolated cases, non-steroidal anti-inflammatory drugs can initiate the development of glomerulonephritis, interstitial nephritis, nephrotic syndrome and necrosis of the renal papillae.

Reception of Meloxicam, as well as other non-steroidal anti-inflammatory drugs, may be accompanied by the appearance of pronounced life-threatening allergic reactions. In such cases, you should immediately stop taking or administering Meloxicam and prescribe all necessary treatment.

The effectiveness of Meloxicam therapy should be monitored regularly, carefully assessing the need to continue its use. With caution appoint elderly patients, as well as those suffering from cirrhosis of the liver, renal or heart failure. Be wary appoint patients on the background of taking diuretic drugs. In such patients, when treated with Meloxicam, it is necessary to carefully monitor renal function and diuresis.

In latent renal failure, the use of non-steroidal anti-inflammatory drugs (including Meloxicam) can cause decompensation. Usually, after discontinuation of therapy, kidney function is restored to the original. While taking Meloxicam, transient increases in the parameters of liver function tests may occur. These disturbances are temporary in most cases. With a persistent violation of liver function tests, Meloxicam is discontinued.

Meloxicam, like other non-steroidal anti-inflammatory drugs, which, according to the mechanism of action, belong to inhibitors of cyclooxygenase or prostaglandin formation, can neutralize the symptoms of infectious diseases (for example, fever and fever). In some cases, the drug adversely affects fertility, so Meloxicam is not recommended for women who are planning a pregnancy.

There is no data on the negative impact of Meloxicam on the ability to work with various mechanisms or drive vehicles. If, while taking Meloxicam, side effects from the organ of vision and the central nervous system develop (for example, increased fatigue, decreased visual acuity, dizziness or other disorders), these activities are contraindicated. Tablets contain lactose, therefore, patients suffering from galactosemia, hereditary lactose deficiency or glucose / galactose absorption disorder syndrome Meloxicam in the form of tablets for oral administration is contraindicated.

Additionally:

Diclo-F (Diclo-F) Remisid (Remisid) Rapten gel (Rapten gel) Rapten (Rapten) Dolgit (Dolgit)

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Efficiency

Easy to find in pharmacies

Side effects

average rating

Based on 2 reviews

A serious achievement of pharmacology was the drug Meloxicam, having appeared on the market. The tool allows you to quickly and effectively deal with diseases of the joints, varicose veins, osteochondrosis.

Medicines developed on the basis of the Meloxicam component, belong to the non-steroidal anti-inflammatory group medical preparations , have a rapid analgesic, antipyretic effect.

The pain reliever is not only more effective than its counterparts, but also has a lower cost.

Now it’s worth figuring out in what form Meloxicam is offered to the buyer and what helps.

Ask your question to a neurologist for free

Irina Martynova. Graduated from the Voronezh State Medical University. N.N. Burdenko. Clinical intern and neurologist of BUZ VO \"Moscow Polyclinic\".

Forms of release and composition

Standard medicine is sold in several forms:

Oral tablets containing 7.5 or 15 mg.
Solution for intramuscular injections– 10mg/ml.
Rectal suppositories (candles) - 7.5 and 15 mg.

In pharmacies, you may encounter the fact that many products with a similar composition are offered. This is due to the fact that subspecies of the drug are produced in the same form by different manufacturers with exactly the same dosage of active substances. That is, for example, Meloxicam - PRANA.

Meloxicam is the name of the drug itself, and the subsequent abbreviation PRANA is the abbreviation of the manufacturer's company.

The following types of the drug are considered the most common:

Meloxicam;
Meloxicam-STADA;
Meloxicam-Pharmaplant.
Meloxicam-SZ;
Meloxicam-PRANA;
Meloxicam-TEVA;
Meloxicam Pfizer;
Meloxicam DS;
Meloxicam-OBL;

Prices for various forms, depending on the manufacturer, fluctuate in the range 70 - 550 rubles.

Manufacturers

Many foreign manufacturers in the field of pharmacology produce Meloxicam. The composition of the drugs is identical to domestic options. These include:

Israeli firm TEVA;
Vietnamese pharmaceutical companies DANH, Mekophar chemical-pharmaceutical;
Help in Greece;
Pfizer - USA;
Indian firm Aurobindo pharma.

Naturally, this drug is produced in Russia. Among the manufacturing companies, the most famous are:

Nizhpharm;
Pranapharm;
Meloxicam Avexima;
Vertex ZAO.

Indications for use

A drug designed to relieve pain. All forms have absolutely identical indications for the use of meloxicam.

It is prescribed to stop inflammatory processes, relieve pain in osteochondrosis, degenerative diseases, Bechterew's disease, osteoarthritis, arthritis.

Contraindications

Meloxicam Prana, as well as other varieties of the drug, has a number of contraindications for use that must be taken into account before treatment. It is not recommended to start treatment with intolerance to one of the components of the drug, acetylsalicylic acid. Problems with the digestive system such as stomach ulcers, inflammation of the intestines, gastrointestinal bleeding are a contraindication to the use of meloxicam prana. Also, this list includes kidney disease (including renal failure), hyperkalemia.

It is forbidden to use the drug for children under 12 years old, pregnant and lactating women.

special instructions

There are a number of diseases in which Mexico is used with extreme caution. These include:

peptic ulcers;
gastrointestinal bleeding;
decrease in the volume of circulating blood;
heart failure;
cirrhosis of the liver;
kidney disease.

If the patient belongs to a group of people with an increased risk of side effects, then start the drug at the lowest dose.

Dosage and duration of the drug

Before starting treatment, you should read the instructions for use of Meloxicam.

Tablets, as a rule, are drunk with meals, the daily dose is 7.5-15 mg and is prescribed by the attending physician.

Meloxicam injections are prescribed depending on the severity of the disease. As a rule, with osteoarthritis, 7.5 mg is administered once a day, which is half the ampoule. If after the first two injections the condition does not improve, then the dose is increased to 15 mg. The duration of treatment is no more than 5 days. After that, a course of treatment with tablets is prescribed.

For people over 60 years of age, for any disease, a dosage is prescribed no more than 7.5 mg / day.

Meloxicam suppositories are administered rectally at a daily dosage of 15 mg. You can either drive suppositories containing 15 mg of the active ingredient once a day, or 7.5 mg twice a day.

Drug overdose and side effects

When using any form of the drug, always there is a risk of overdose and manifestations of side effects. This fact can be determined if the patient has increased drowsiness, abdominal pain, nausea, vomiting.

More complex forms are characterized by gastrointestinal bleeding, renal failure (passes after discontinuation of the drug), increased blood pressure, coma, convulsions.

Interaction with other drugs

When using meloxicam with other drugs, you should be careful, as this can lead to unpleasant consequences:

The simultaneous use of meloxicam and drugs of the NSAID group often leads to the development of ulcerative bleeding of the gastrointestinal tract.
When interacting with, a decrease in the number of blood cells is possible - erythrocytes, platelets and leukocytes.
Diuretics and meloxicam together lead to the development of renal failure.
Blood pressure medications reduce the effectiveness of meloxicam.

Storage, dispensing from pharmacies

Meloxicam is released from the pharmacy only on prescription, use is allowed only on the recommendation of a specialist.

When storing the drug, it is necessary to observe a temperature of about 20-26 degrees Celsius.

Drug analogues

Pharmacists can offer two types of drugs as a replacement for meloxicam - synonyms and, of course, Meloxicam analogues. The so-called synonyms include drugs that also contain meloxicam. Analogues are medications from the group of non-steroidal anti-inflammatory drugs, having a therapeutic effect similar to Meloxicam.

Synonyms of Meloxicam are the following drugs:

- the medicine is offered in the form of tablets and solution for injection;
Means and is available in the form of tablets, suppositories and injections, and Movalis can also be bought in the form of a suspension;
Preparations Mirloks, Oxycamox, Exen-Sanovel, M-Kam, Moviks, Medsicam, Melbek forte, Meloflam, Mixol-Od are distributed exclusively in the form of tablets, which is a significant drawback;
In the form of tablets and solutions for injection, you can buy Artrozan, Bi-xicam, Liberum,.

Analogues of Meloxicam are drugs with the most similar spectrum and severity of therapeutic action.

The price of a medicine can depend on many indicators: the manufacturer, the pharmacy that sells the goods.

Meloxicam-Teva:

15 mg 10 tablets - 125-150 rubles.
15 mg 20 tablets - 190-230 rubles.
7.5 mg 20 tablets - 145-170 rubles.

Meloxicam-Teva solution for injection:

15 mg / 1.5 ml 5 ampoules - 250-290 rubles.

Meloxicam-OBL:

7.5 mg 20 tablets - 15-25 rubles.

Meloxicam DS:

10mg / ml, 1.5 ml 3 ampoules - 190-250 rubles.

The advantage of many analogues is that they are available in the form of a gel. The gel does not have a negative effect on the digestive system, and the gel can also be applied directly to a non-sore spot on the body.

Influence on the ability to control mechanisms

Meloxicam significantly impairs a person's ability to control various mechanisms, since its use often causes dizziness, increased drowsiness, and headache. It is because of this that when treating with Meloxicam, experts advise to abandon any activities associated with the need to have a high reaction rate and concentration of attention, in particular from driving.

Use during pregnancy and lactation

Meloxicam in any dosage is prohibited for use by pregnant women, as well as during lactation.

Frequently asked Questions

Is meloxicam used for gout??

Meloxicam Teva is one of the most popular treatments for inflammation and rheumatic symptoms and is often recommended for the short-term treatment of acute gout. A dose of 15 mg is prescribed once a day, in the form of intramuscular injections.

Is meloxicam related to?

Meloxicam Teva does not belong to the groups of antibiotics, but has a good anti-inflammatory and antipyretic effect.

The active substance of the drug Nise is nimesulide, which, like meloxicam, belongs to NSAIDs. This means that both drugs are excellent pain relievers and are antipyretic.

or Meloxicam?

Both drugs contain the same amount of the active substance meloxicam. The only question is the addition of excipients.

Meloxicam and nimesulide: which is better?

And Meloxicam belong to. Accordingly, both drugs effectively anesthetize and reduce elevated body temperature.

Comparison and meloxicam

Meloxicam and Ametoleks have an almost identical composition based on the same main component. It follows that Ametoleks has exactly the same properties as meloxicam.

Does meloxicam help with osteochondrosis?

Specialists often prescribe this drug to get rid of pain in osteochondrosis. Depending on the severity of the disease, meloxicam solution or meloxicam tablets may be prescribed.

or Meloxicam

Both drugs have approximately the same purpose, although there are a number of differences. The main advantage of Diclofenac is that it is available as a gel or ointment. That is, you can apply the gel directly to the affected area of the body. And the tablets of the same drug can be taken even in the presence of stomach ulcers and other diseases of the digestive system. But at the same time, Meloxicam has a higher therapeutic effect.

Injections or pills?

Often people are faced with the problem: what is more effective, meloxicam injections or meloxicam tablets? In many ways, the choice depends on the degree and duration of pain.

Meloxicam tablets are prescribed for the treatment of short-term manifestations of symptoms of exacerbation of osteoarthritis, for a long course of treatment of rheumatoid arthritis, as well as spondylitis.

Meloxicam injection solution is most often used to get rid of short-term pronounced symptoms of rheumatoid arthritis and spondylitis.

Can it be mixed with alcohol?

Often the question arises whether it is possible to use Meloxicam if there is alcohol in the blood. Drinking alcohol-based drinks during treatment with meloxicam is strictly prohibited. Alcohol will quickly provoke an exacerbation of many side effects, eliminate the therapeutic effect of the drug.

Reviews

People who have been treated with meloxicam note that improvement in well-being occurs after several doses of the drug.

Any form of medicine quickly and effectively eliminates pain, relieves swelling, acts as an antipyretic.