Meloxicam tablets instructions for use. Non-steroid Meloxicam tablets: instructions for use, price, reviews, drug analogues for the development of destructive processes in the spine, muscles and joints. Instructions for use and dosage

Meloxicam tablets are prescribed for the development of destructive processes in the spine, muscles, joints. The 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 specific age and type of disease. Violation of the requirements leads to negative reactions to NSAIDs.

Composition and form of release

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

Among the auxiliary ingredients:

• milk sugar,
• microcrystalline cellulose,
• crospovidone,
• anhydrous colloidal silicon oxide,
• povidone.

Pharmacy chains receive packages Nos. 10 and 20.

Action on the body

Selective inhibitor of COX-2, oxicam class, 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%;
• the non-steroidal agent exhibits a cumulative effect - after three to five days in the blood plasma, the tests show a stable concentration of meloxicam;
• up to 50% of the active component is in the synovial fluid, which explains the high degree of influence 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 decongestant effect. For this reason, the remedy is prescribed for acute pain syndrome against the background of many diseases of the back, joints, and the 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 tablets after a short course of injections of the drug of the same name. Solution for injection relieves even the most severe manifestations of sciatica, exacerbation of arthritis and osteoarthritis, lumbodynia, but Meloxicam injections cannot be given for more than three to five days in order to avoid serious complications. To maintain the effect after injections, it is imperative to switch to a "milder" form of the drug - tablets or gel with meloxicam.

Contraindications

Meloxicam is a potent drug with a high risk of adverse effects. Taking pills without taking into account the 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, polyps in the nose, bronchial asthma;
• under the age of 15;
• against the background of a decrease in creatinine clearance to 30 ml / minute and below in kidney disease;
• with liver failure;
• in case of allergic reactions to components of NSAIDs;
• with high levels of potassium in blood plasma;
• during lactation;
• with a history of Quincke's edema;
• 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 meals, water - up to 150 ml, you do not need to chew the tablet;
• with rheumatoid arthritis, the initial daily rate is 15 mg of meloxicam in two doses. Maintenance dosage - half a tablet;
• for osteoarthritis, 7.5 mg of meloxicam is sufficient for 24 hours. If the pain does not subside, then after consulting your doctor, you can increase the daily rate by 2 times;
• with lumbodynia, sciatica, the doctor specifies the dosage depending on the severity of the clinical symptoms. After the pain subsides, the norm is necessarily reduced from 15 to 7.5 mg for one day;
• with severe renal failure, more than 7.5 mg of the active ingredient cannot be obtained within 24 hours;
• with a weak 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, stomach, you need to take drugs with enveloping, protective properties, for example, Omeprazole.

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

Side effects

The frequency of manifestation of adverse reactions largely depends on the individual sensitivity of the patient to the active substance and the general condition of the body. To minimize the risk of negative effects, you must strictly follow the rules for use, a one-time rate, a daily dosage, and 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, pain in the abdomen;
• violation of blood counts: leukopenia, a decrease in the number of red blood cells, thrombocytopenia;
• fainting, unpleasant tinnitus, headaches;
• the development of polymorphic erythema;
• skin rashes, itching, urticaria;
• photosensitivity;
• changes in the level of liver enzymes;
• stomatitis.

With an excessive intake of meloxicam, nausea, abdominal pain, weakness, vomiting, tremor appear, the work of the respiratory center, central nervous system is disrupted, 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 and forced diuresis are practically ineffective due to the rapid and strong binding of meloxicam to proteins in the blood plasma.

Drug interactions

The correct combination of NSAIDs with other names determines not only the degree of effect on the body, but also the likelihood of side effects. When prescribing a non-steroidal composition, the patient must list all the drugs that he takes, especially long courses to stabilize vital signs (heart drugs, diuretics, antihypertensive drugs). When choosing an NSAID, the doctor takes into account the data to reduce the risk of negative manifestations.

Highlights of Meloxicam interaction:

• it is important to be tested regularly 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 when the mucous membranes of the intestines and stomach are affected;
• taking several types of NSAIDs dramatically increases the risk of erosion, ulcers in the digestive tract;
• reduces the effectiveness of oral contraceptives;
• the combination with Methotrexate enhances the negative effect of 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: the inhibition of the functioning of the central nervous system increases, the risk of negative reactions increases, and the effectiveness of therapy decreases.

The cost

Meloxicam is an active effect on the foci of inflammation and pain, positive reviews and a low price 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.

Meloxicam is a non-steroidal anti-inflammatory drug that has a selective effect. The medicine is available in 3 different forms, the choice depends on the severity of the process and the purpose of therapy.

This is one of the first representatives of selective type 2 cyclooxygenase inhibitors, which significantly reduced the manifestation of side symptoms, and has already managed to justify itself. Let us consider in more detail the principle of action of the drug, the composition of the drug and possible side effects.

Release forms

Meloxicam is available in the form of a solution for injection in ampoules, tablets of various dosages and rectal suppositories.

The tablet preparation has 2 dosages:

• Meloxicam 15 mg;
• Meloxicam 7.5 mg.

The tablets have a rounded porous structure, white in color, sometimes a yellowish tint can be seen. Without smell. Depending on the manufacturer, 1 blister usually contains 10 tablets (it can vary from 7 to 15), of which there are from 2 to 5 in a package.

Rectal suppositories are produced in a similar way and have a dosage of 7.5 and 15 mg, respectively.

The candles have a cylindrical torpedo shape, a smooth waxy structure. The color can range from white to straw yellow. On the cut, an air pocket, a porous rod or a funnel-shaped depression is allowed.

The package contains 2 dense blisters that maintain the internal temperature suitable for storage. Each blister contains 5 rectal suppositories.

Solution for injection contains 10 mg of active ingredient in 1 ml. In an ampoule, 1.5 ml of solution, that is, in 1 bottle 15 mg of active ingredient.

A solution for injection is produced in dark brown glass ampoules, which protects it from direct sunlight with subsequent inactivation.

The package contains 1 blister with 5 suspension units.

Liquid of yellowish-green color with a characteristic pungent odor.

Structure

The main active ingredient has the same name - meloxicam.

Pills

Meloxicam - 7.5 and 15 mg, respectively.

Additional funds:

• Lactose monohydrate - used as a stabilizer and linker.
• Pregelatinized starch - powder occupies the main mass fraction. Its properties improve the permeability of the tablet through the esophagus and the swallowing procedure itself.
• Corn starch is a cheaper filler for the tablet form of the drug, which does not have a harmful effect on the body. Its properties allow the medicine to be compressed into any shape, after which the tablet does not change its structure.
• Magnesium stearate - acts as a link between the components, does not dissolve in the blood and improves the bioavailability of meloxicam. The product itself, when it enters the bloodstream, has a calming effect.
• Silicon dioxide is of synthetic origin, used in medicine as an enterosorbent. Likewise, the main active ingredient of the drug is cumulated with the help of adsorbing properties, which allows for a longer effect on inflammatory agents in the blood and tissues.
• Sodium citrate - binds free calcium in the blood, while inhibiting the effect of hemocoagulation, improving the rheological properties of blood.
• Microcrystalline cellulose is a vegetable product. The filler improves the release of the main substance into the blood, reduces the disintegration time of the tablet preparation. Due to the properties of the component, meloxicam accumulates better in tissues, increases bioavailability and slows down the half-life.

Injection

Meloxicam - 10 mg in 1 ml.

Additional funds:

• Meglumin is a conductive substance that maintains the bioavailability of the drug and allows the main active ingredient to be released gradually.
• Glycofurol is a synthetic solvent that is added to injection solutions to improve the solubility of the main component in alcohol compounds.
• Sodium chloride - hypotonic solution corresponds to the structure of plasma. It is added as the main component to dilute the active ingredient.
• Poloxamer 188 is a stabilizer in a solution in the form of a fat emulsion, allows meloxicam to remain unchanged and gradually released from the muscle, an excellent plasma substitute.
• Sodium hydroxide - alkali has disinfecting properties, in blood plasma it is a good solvent and stabilizer of the main active ingredient.
• Water for injection - distilled water is devoid of any ions and is used as a bulk filling of the solution, since the body does not perceive liquid as a foreign agent.
• Glycine - improves the metabolism of brain cells.

Meloxicam - 7.5 mg and 15 mg in 1 suppository.

Auxiliary components: semi-synthetic components.

The main auxiliary substance is glycerin weighing 1 gram. It provides ease of administration, rapid efficiency. Glycerin helps to shape the drug. And also the blister ensures the integrity of the candle until the moment of its introduction.

After the glycerin components are exposed to the temperature of the body, they quickly begin to melt and release the drug.

Pharmacodynamics

Meloxicam belongs to the oxicam groups. Selective inhibitor of cyclooxygenase type 2 has anti-inflammatory and analgesic effects. It has a less pronounced effect on the center of hyperthermia, normalizing body temperature.

The main action of the drug is aimed at inhibiting the synthesis of prostaglandins. They are a metabolite of arachidonic acid. But for conversion, you need a sufficient amount of COX2. It is on this link that the drug has a direct effect.

Meloxicam has a major effect on the exudation phase. The proliferation phase is also affected, but to a lesser extent. Meloxicam slows down the hardening of the affected tissue. The phase of alteration by the action of the drug is not affected in any way.

The anti-inflammatory effect occurs indirectly due to inhibition of lipid peroxidation, stabilization of organelle membranes, especially lysosomes.

There is a decrease in the supply of inflamed tissue with energy material (ATP), a slowdown in the aggregation of blood cells, especially neutrophils (from which inflammatory mediators are released), inhibition of the production of rheumatoid factor in typical diseases.

Analgesic effect

It is effective for mild and moderate pain due to inhibition of inflammatory mediators, relief of edematous syndrome. Symptoms are quite simple to stop when the process is localized in muscles, tendons, joints, nerve endings and trunks. They are effective in treating neurological symptoms, but have the least therapeutic effect in the fight against an anginal clinic of internal organs.

It is effective in renal colic by inhibiting prostaglandin E2, which originates in the kidney tubules. Reflexively reduces renal blood flow and relieves spasm.

Antiplatelet effect

Unfortunately, the useful property of improving blood rheology due to NSAID preparations is possible only with the use of non-selective inhibitors. Since this effect is manifested when stopping the production of COX1. Meloxicam is unable to have an antiplatelet effect.

Immunosuppressive effect

This action is possible only with prolonged use of non-steroidal anti-inflammatory drugs. The drug reduces the effectiveness of the antigen-antibody contact by reducing capillary permeability.

Pharmacokinetics

Absorption and bioavailability of the drug depends entirely on the route of administration. Injection solutions for intramuscular administration are completely absorbed and the bioavailability of the drug is almost 100%. The maximum concentration in the blood after administration is observed after 1-6 hours and is approximately 1.8 μg / ml of blood plasma.

When taken orally, the drug is absorbed almost completely in the gastrointestinal tract. Oral bioavailability is about 89%. The maximum concentration is observed in the blood after 6 hours. With constant oral administration, the concentration remains in equilibrium throughout the day. At an accepted dose of 7.5 mg, the plasma concentration is up to 1 μg / ml. When the dose is 15 mg per tablet, it provides a plasma concentration of up to 2 μg / ml.

The concentration and bioavailability when using rectal suppositories is similar to intramuscular administration. The maximum concentration in the blood is observed after 60 minutes, and has an effect after 15 minutes.

The effectiveness of the drug and the amount of solute in the blood does not depend on the fullness of the stomach and incoming food.

Meloxicam has a high affinity (affinity) for blood proteins - albumin. The concentration is up to 99%. The synovial fluid also contains up to 50% of the main active ingredient.

Metabolism occurs in the liver tissue. Elimination through the kidneys and intestines. These organ systems excrete the drug equally. During laboratory examinations, 5 meloxicam metabolites were isolated in the urine. Of these, 4 representatives are inactive, but 5 are active metabolites - carboxymeloxicam.

It is eliminated by the kidneys at a concentration of 60% of the dose taken. It is formed due to the oxidation reaction of intermediate forms of the active substance. In the urine, about 10% of 5-hydroxymeloxicam is eliminated unchanged.

The total clearance of the active substance in plasma is approximately 8 ml / min. The half-life of the drug is approximately 21 hours.

With mild to moderate renal and hepatic failure, changes in pharmacokinetics are not particularly observed. Plasma clearance of the substance increases slightly. Terminal renal failure reduces the drug's affinity for blood albumin. The amount of free meloxicam as an active metabolite also increases. Therefore, it is not recommended to exceed the minimum dose of 7.5 ml.

Elderly patients do not require a change in the daily dose, since there was no decrease in bioavailability or an extension of the half-life

Indications for use

• Diseases of rheumatic genesis (ankylosing spondylitis, rheumatic fever, rheumatoid arthritis, psoriatic arthritis, Reiter's syndrome);
• Non-rheumatic pathologies of the musculoskeletal system (mechanical injury, myositis, tendovaginitis, osteoarthritis);
• Neurological diseases - degenerative dystrophic changes in the spine (sciatica, lumbago, radiculitis, intercostal neuralgia);
• Renal and hepatic colic;

Contraindications

The main contraindication to the use of the drug is hypersensitivity or individual intolerance to the components.

Although a selective inhibitor of type 2 cyclooxygenase does not affect type 1 COX, which is one of the main protective factors of the gastric mucosa, it is still not recommended for people with:

Relative contraindications:

• Severe renal and hepatic impairment;
• Heart failure;
• Internal bleeding;
• Age up to 15 years;
• Pregnancy and lactation period;
• Blood diseases associated with clotting disorders;
• Treatment of postoperative pain associated with coronary artery bypass grafting.

Instructions for use

Intramuscular injection

People with peculiarities of the body (old age, renal failure) are administered up to 7.5 mg per day, which is equivalent to half an ampoule of Meloxicam.

To avoid side effects in the form of a seal at the injection site, the development of an abscess, it is necessary to observe the correct injection technique.

Pour the solution into a syringe with a thin needle, release all air bubbles from the flask. Pre-treat the injection site with alcohol.

Insert the needle into the lateral upper quadrant, alternating the buttocks every day. Hold the needle at an angle of 90 degrees. Inject with a sharp movement until it penetrates into the gluteus muscle. Pull the plunger towards you slightly to check for blood in the needle. Then slowly inject the drug.

With high pain sensitivity, reduce the injection rate. Then pull the needle out of the injection site and treat with alcohol again. It is advisable to massage the "ball with solution" to prevent abscess and reduce pain sensitivity as a result of muscle fiber stretching.

After emptying, carry out hygiene of the perineum and external genital organs, and then insert the candle. Prepare a suppository: cut 1 piece from the blister, put an open package next to you, but do not touch the drug itself.

For easy correct insertion, you need to lie on your left side, pull your legs to your stomach. Take the suppository from the package in one hand, lift the buttock with the other hand. Relax the external sphincter and insert the suppository into the anus. Then align your legs and squeeze your buttocks. Lie on your side for another 10-15 minutes until the drug is completely absorbed.

The procedure should not be painful due to its structure and base material.

Tablet preparation

Treatment is usually complex. With exacerbations of inflammatory processes, therapy begins with intramuscular injection for several days, after which they switch to oral administration.

The dose is selected in relation to the treatment regimen of the disease, which is prescribed by the doctor and depends on the individual characteristics of the organism and the course of the pathological process.

It is recommended to take 1 tablet a day with a glass of water at room temperature. The procedure should be performed only after a meal, since an empty stomach is a big risk factor for the development of side effects from the gastrointestinal tract.

It is advisable to start taking it with a dose of 7.5 mg per day. If the therapeutic effect is insufficient, increase to 15 mg per day.

The daily dose of Meloxicam should not exceed 15 mg

It is not advisable to take alcohol during the course of treatment, as the toxicity of the drink on the liver may increase. Also, ethyl will enhance the action of the drug with the risk of side effects.

Taking Meloxicam reduces the effectiveness of hormonal contraceptives, therefore it is recommended to use additional methods of protection.

Groups of drugs such as antihypertensives, diuretics, thrombolytics, corticosteroids, anticoagulants, additional NSAIDs in combination with Meloxicam require specialist supervision, as there is an increased risk of side effects.

Side effects

Most of the side effects are associated with a violation of the functionality and integrity of the organs of the gastrointestinal tract.

Depending on the organ systems, side effects from the use of the drug may manifest with the following symptoms.

From the digestive system:

• Often: dyspepsia, abdominal pain, vomiting, nausea, diarrhea;
• Uncommon: constipation, belching, heartburn, flatulence, gastrointestinal bleeding due to relapse, stomatitis, changes in liver function;
• Rarely: development of gastroduodenal ulcers, colitis, esophagitis, hepatitis;
• Very rare: perforation of a stomach or duodenal ulcer, liver failure.

From the blood system:

• Uncommon: anemia;
• Rarely: leukopenia, thrombocytopenia.

Allergic reactions:

• Uncommon: urticaria, itching, rash, Quincke's edema;
• Rarely: anaphylactic shock, Lyell's syndrome, laryngospasm, and subglottic edema.

From the respiratory system:

• Rarely: aspirin asthma, cough.

On the part of the cardiovascular system:

• Rarely: increased blood pressure, palpitations, hot flashes;
• Very rare: development of respiratory failure, cardiogenic shock.

From the organs of the central and peripheral nervous system:

• Often: headache;
• Uncommon: dizziness, drowsiness, sleep inversion;
• Rarely: nightmares, mood changes;
• Very rare: confusion, depersonalization, disorientation.

From the genitourinary system:

• Uncommon: hyperkalemia, increased concentration of urea and creatinine;
• Very rare: acute renal failure, dysuria.

- An effective non-steroidal drug that relieves inflammation and copes with severe pain. This annotation will tell you what diseases this drug can be used for. You will find out what contraindications and side effects Meloxicam has.

Indications for the use of the drug

Doctors often prescribe medication to relieve bouts of pain and inflammation. What else does the drug help from? The medicine does not treat the underlying cause of the disease, but it can help to cope with the unpleasant symptom. Here are the purposes for which Meloxicam can be used:

• To relieve pain during exacerbations of arthrosis;
• For long-term therapy of polyarthritis;
• Suitable for the treatment of rheumatoid arthritis;
• Used for ankylosing spondylitis.

How to take medication correctly

Doctors prescribe taking the drug 1 tablet per day. The medicine must be washed down with at least 250 ml of water. Sometimes the dose can be changed, but only after a doctor's prescription.

The injection solution is used for intramuscular administration. Doctors prohibit meloxicam injections intravenously. Usually, injections are used for the first days of therapy to relieve a severe pain attack quickly and effectively. After that, you can stop the treatment with the solution and switch to Meloxicam tablets.

With an exacerbation of pain in arthrosis, doctors prescribe a dose of 7.5 mg once a day. If the drug has little therapeutic effect on the patient, the doctor may increase the dosage to 15 mg. It is strictly forbidden to prescribe such doses on your own. Also, the doctor may prescribe the applied drug in the form of a gel, ointment

If the patient has ankylosing spondylitis or rheumatoid arthritis, then the doctor will immediately prescribe a dosage of 15 mg of Meloxicam per day. If the drug relieves pain quickly, then doctors may reduce the dose to 7 mg. In no case should the amount of drug administration exceed 15 mg. In any case, the duration of treatment and the dose of the drug is determined by the attending physician.

How to use the drug in special categories of patients

Doctors prescribe a dose of 7.5 mg per day to dialysis patients. If a person has kidney and liver problems, the dosage of 7.5 mg should not be exceeded. If any side effects occur, you must immediately stop the injection with Meloxicam. How long the course of treatment will be is decided by the attending physician - do not self-medicate!

Elderly people should be prescribed no more than 7.5 mg even with ankylosing spondylitis and arthritis. Even if the effect of the drug is small, you still cannot exceed the dosage. Otherwise, severe side effects can occur.

Side effects of the medication

Doctors should warn the patient about the possible side effects of Meloxicam. They can occur due to a high dose or if the body is intolerant to the composition of the drug.

The respiratory system is rarely affected. Sometimes bronchial asthma can occur only if the patient is allergic to nonsteroidal drugs.

Severe gastric side effects occur in elderly patients. They may develop bleeding, peptic ulcers, or perforation. Therefore, Meloxicam should be prescribed to such patients with extreme caution.

Any side effect should be reported to the attending physician. Perhaps he will reduce the dosage of Meloxicam or prescribe another analgesic. Side effects symptoms can be dangerous if not reported to a specialist in time.

Contraindications to medication

Sometimes the drug Meloxicam can greatly harm the body in specific cases. That is why the doctor first examines the patient, and only then prescribes treatment. In no case will the doctor prescribe Meloxicam for you for such diseases:

1. Ulcers in the digestive zone in the acute stage;
2. The patient's sensitivity to the composition of the drug. Allergy to aspirin and acetylsalicylic acid;
3. Bleeding in the stomach;
4. Pregnancy;
5. Breastfeeding period;
6. Insufficiency of the liver and kidneys;
7. The occurrence of bleeding in other organs;
8. Forbidden for children under 15;
9. Heart failure in a patient.

If you are aware of any diseases in the body, be sure to tell your doctor. He will immediately decide whether you can take Meloxicam or whether the therapy will be dangerous to your health.

Medication overdose

If the patient has exceeded the prescribed dose of Meloxicam, side effects will begin to appear in the body. Here are some signs of overdosing:

• Nausea with vomiting
• A sharp feeling of drowsiness;
• Stomach ache;
• Bleeding in the stomach is rare.

If the patient is poisoned with a large dose of Meloxicam, then such dangerous complications will appear:

• Increased pressure;
• Increased breathing;
• Acute renal failure;
• The onset of seizures;
• Collapse;
• Liver dysfunction.

In case of severe drug poisoning, such dangerous consequences can occur:

1. Heart failure;
2. The patient goes into a coma;
3. Anaphylactoid shock.

If the patient has taken too much of the drug, then the doctor prescribes symptomatic therapy. It is necessary to be under the supervision of a specialist until all unpleasant symptoms recede. In extreme cases, 4000 mg of cholestyramine should be administered, then Meloxicam will be excreted from the body faster.

Interaction with other medications

You need to know what effects Meloxicam gives when taking other drugs in parallel. In order to prevent complications in the body, it is imperative that you tell your doctor what drugs you are taking at the moment. They may not be combined with the composition of Meloxicam and cause side effects. Here are some examples of concurrent drug use:

• If you give Meloxicam injections with lithium preparations, then their concentration in the blood will increase to a dangerous, toxic level. In extreme cases, you can prescribe these medications, but only under the close supervision of a doctor. It is imperative to monitor the level of lithium in the blood;
• Taking cholestyramine will reduce the period of elimination of Meloxicam from the body. Doctors categorically forbid taking such funds together;
• The drug Methotrexate will increase all the negative side effects of Meloxicam on the body and on the properties of the blood. There is a threat of anemia or leukopenia;
• Do not drink non-steroidal drugs with Meloxicam;
• If the patient is combining the medicine with diuretics, then a large amount of fluids should be drunk during the day. It is imperative at this moment that the doctor is reported to monitor the condition of the patient's kidneys;
• When taking thrombolytic drugs together with Meloxicam, the risk of bleeding increases;
• If the patient takes salicylic acid in parallel with the drug, then ulcers may begin in the digestive tract;
• When taking ACE together with Meloxicam, acute renal failure may occur;
• Taking oral medications leads to bleeding of any organs and damage to the mucous membrane in the intestine;
• The effect of hormonal contraceptives decreases with the parallel use of Meloxicam;
• The effect of cyclosporine in the body is enhanced.

Drug release form

Now you can buy Meloxicam at the pharmacy in the following forms:

• 15 or 7 mg tablets. Sold in packs of 20;
• Anti-inflammatory solution for injections and suspensions in ampoules. Sold 5 ampoules of 1, 5 ml.
• The drug can also be in the form of an ointment, gel or suppository.

How to store the drug correctly?

Composition of the preparation: description

Meloxicam tablets include the following active substances:

1. The main active ingredient of meloxicam is 15 mg;
2. Starch;
3. Lactose extract;
4. Silicon dioxide;
5. Sodium;
6. Magnesium;
7. Some cellulose.

The composition of the liquid for injection and injections includes:

• Active ingredient meloxicam - 15 mg;
• Meglumin;
• Sodium;
• Glycine;
• Pure water for injection;
• Glycofurol;
• Poloxamer.

Alcohol compatibility

The most commonly prescribed non-steroidal anti-inflammatory drugs (NSAIDs), such as Meloxicam, are prescribed for people with joint inflammation. In addition, due to their medicinal properties, medicines of this group can be used as antipyretic and pain relievers.

NSAIDs work by the principle of blocking the prostaglandin substance, which is responsible for the inflammatory process in the body. Thus, the effect of these medications stops the pain process. However, it is little known that NSAIDs have an extremely negative effect on the mucous membrane of the gastrointestinal tract, and, therefore, it is highly undesirable to combine such drugs with alcohol intake.

Meloxicam is a member of the most popular class of non-steroidal anti-inflammatory drugs. Today NSAIDs have firmly established themselves on the top lines of the pharmacological charts in terms of the frequency of prescriptions by doctors and the volume of sales from pharmacies. And this is absolutely justified: they allow you to achieve the desired therapeutic effect in the shortest possible time - and this is exactly what both patients and doctors themselves expect from a drug. The mechanism of action of NSAIDs is associated with the suppression of the activity of cyclooxygenase, or, as it is abbreviated in the specialized literature, COX. For reference: it is an enzyme that promotes the reproduction of pain mediators and inflammation of prostaglandins. There are (in any case, their presence has been established for certain) two forms of COX. COX-1 saturates most organs and tissues and is in a constantly activated form. It is involved in the synthesis of normal, "non-extreme" prostaglandins that regulate the normal routine functioning of cells, which is expressed in the formation of gastrointestinal mucus, suppression of the secretion of hydrochloric acid in the stomach, the effect on platelet aggregation, blood supply to the kidneys and other completely ordinary, but necessary for the body processes. Another thing is COX-2: this enzyme is activated only in response to any anti-inflammatory stimuli. That is why it is believed that the undesirable side effects of NSAIDs on the digestive tract and kidneys are associated with suppression of COX-1, and the therapeutically significant anti-inflammatory effect is associated with inhibition of COX-2.

The effect of early generations of NSAIDs could be compared to carpet bombing: they indiscriminately "turned off" both COG-1 and COG-2. In contrast, meloxicam is a selective COX-2 inhibitor, which avoids negative reactions with a compatible or higher therapeutic effect in comparison with the same diclofenac or naproxen. The domain of meloxicam is the suppression of pain and inflammatory reactions in osteoarthritis and rheumatoid arthritis, although the drug can be used to relieve pain and other genesis.

Today, in Russian pharmacies, you can find three dosage forms of meloxicam: tablets, solution for intramuscular administration and rectal suppositories. The tablets are taken orally once a day with meals. In osteoarthritis, the recommended (it is also the maximum) daily dose for all forms of drug release is 15 mg, in rheumatoid arthritis - 7.5 mg. Injections are made only intramuscularly in compliance with the required injection depth. Suppositories are inserted as deep as possible into the anus. If the patient has an increased risk of developing negative side effects, then the daily dose should be halved.

Pharmacology

NSAIDs, selective COX-2 inhibitor. Belongs to the class of oxicams, is a derivative of enolic acid. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with a decrease in the biosynthesis of prostaglandins as a result of inhibition of the enzymatic activity of COX. At the same time, meloxicam more actively affects COX-2, which is involved in the synthesis of prostaglandins in the inflammatory focus, which reduces the risk of side effects on the upper gastrointestinal tract and slightly affects COX-1.

At the same time, meloxicam does not affect proteoglycan synthesis by chondrocytes of the articular cartilage, does not affect the development of spontaneous arthrosis in rats and mice, which indicates its chondroneutrality.

Pharmacokinetics

After oral administration or rectal administration, absorption of meloxicam from the gastrointestinal tract is 89%. Food intake does not affect the absorption of meloxicam.

Plasma concentration is dose dependent. Plasma concentration plateau is reached within 3-5 days. With prolonged use (more than 1 year), there is no increase in the concentration in the blood plasma compared to the level reached at the plateau. In plasma, 99% of meloxicam is in a protein-conjugated form. Fluctuations in the concentration of meloxicam when taken 1 time / day are small and are in the range of 0.4-1 μg / ml for a dose of 7.5 mg and 0.8-2 μg / ml for a dose of 15 mg.

The concentration of meloxicam in the synovial fluid is 50% of the plasma concentration.

Meloxicam is almost completely metabolized to inactive metabolites.

T 1/2 of meloxicam is 20 hours. Plasma clearance averages 8 ml / min. Meloxicam is excreted by the kidneys and through the intestines in approximately equal proportions.

Mild to moderate hepatic and renal failure do not significantly affect the pharmacokinetic parameters of meloxicam.

Release form

1.5 ml - dark glass ampoules (3) - contoured cell packs (1) - cardboard packs.
1.5 ml - dark glass ampoules (5) - contoured cell packs (1) - cardboard packs.
1.5 ml - dark glass ampoules (10) - contoured cell packs (1) - cardboard packs.
1.5 ml - dark glass ampoules (10) - contoured cell packs (2) - cardboard packs.
1.5 ml - dark glass ampoules (525) - cardboard boxes - cardboard packs.

Dosage

Inside, 7.5-15 mg 1 time / day.

The maximum daily dose is 15 mg.

Interaction

With simultaneous use, it is possible to reduce the effectiveness of antihypertensive drugs (beta-blockers, ACE inhibitors, vasodilators).

With simultaneous use with anticoagulants, the risk of bleeding increases.

With simultaneous use with diuretics, the risk of developing renal failure in patients with dehydration increases.

With simultaneous use with NSAIDs, the risk of developing ulcerative lesions of the gastrointestinal tract and gastrointestinal bleeding increases.

With simultaneous use with lithium preparations, the concentration of lithium in the blood plasma increases.

With simultaneous use, cholestyramine accelerates the elimination of meloxicam.

With simultaneous use with methotrexate, it is possible to increase the myelodepressant effect; with cyclosporine - it is possible to increase the nephrotoxic effect of cyclosporine.

Side effects

From the digestive system: dyspepsia, nausea, vomiting, abdominal pain, constipation, intestinal colic, diarrhea, esophagitis, stomatitis; rarely - erosive and ulcerative lesions of the gastrointestinal tract.

From the side of the central nervous system: dizziness, headache, tinnitus.

From the side of the cardiovascular system: increased blood pressure, palpitations, edema, hot flashes.

From the urinary system: changes in laboratory parameters of renal function.

From the hematopoietic system: anemia, leukopenia, thrombocytopenia.

Allergic reactions: bronchospasm, photosensitivity, pruritus, rash, urticaria.

Meloxicam

International non-proprietary name

Meloxicam

Dosage form

7.5 mg and 15 mg tablets

Structure

One tablet contains

aactive substance - meloxicam 7.5 mg and 15 mg

inauxiliary substances:lactose monohydrate (milk sugar), potato starch, colloidal silicon dioxide, low molecular weight medical polyvinylpyrrolidone, sodium citrate, crospovidone, calcium stearate, talc - until a tablet weighing 250 mg or 300 mg is obtained.

Description Tablets of light yellow color, flat-cylindrical shape with a score and a chamfer

Pharmacotherapeutic group

Non-steroidal anti-inflammatory drugs. Oxycams. Meloxicam.

ATXM01AC06 code

Pharmacological properties

Pharmacokinetics

Absorption from the gastrointestinal tract after oral administration - 89%. Time to reach maximum concentration (TCmax) - 5 - 6 hours. Equilibrium concentration (Css) is created in 3-5 days. Communication with plasma proteins - 99%. Passes through the histohematogenous barriers, enters the synovial fluid. The concentration in the synovial fluid is 50% of the plasma concentration. About 2/3 of the amount of the drug is metabolized in the liver, destroyed by enzymes of the cytochrome P450- system to inactive metabolites. Half-life (T1 / 2) 15 - 20 hours. Plasma clearance is an average of 8 ml / min (decreases in old age). It is excreted through the intestines and by the kidneys (in approximately equal proportion), unchanged - 5% of the daily dose (through the intestines).

Pharmacodynamics

Non-steroidal anti-inflammatory drug, has anti-inflammatory, antipyretic, analgesic effect. Belongs to the class of oxicams; a derivative of enolic acid. The mechanism of action is the inhibition of the synthesis of prostaglandins (Pg) as a result of the selective suppression of the enzymatic activity of cyclooxygenase (COX2). When administered in high doses, long-term use and individual characteristics of the body, COX2 selectivity decreases. Suppresses the synthesis of Pg in the area of \u200b\u200binflammation to a greater extent than in the mucous membrane of the stomach or kidneys, which is associated with a relatively selective inhibition of COX2. Less commonly, it causes erosive and ulcerative diseases of the gastrointestinal tract (GIT).

Indications for use

Symptomatic treatment

pain syndrome in osteoarthritis, arthrosis, degenerative joint diseases

rheumatoid arthritis

ankylosing spondylitis

Method of administration and dosage

Inside, during meals, in a daily dose of 7.5 mg - 15 mg. Food intake does not affect absorption. The maximum daily dose is 15 mg, in patients with severe renal failure on hemodialysis, 7.5 mg. With a slight or moderate decrease in renal function (CC more than 25 ml / min), as well as with liver cirrhosis in a stable clinical state, dose adjustment is not required. In patients with an increased risk of side effects, the recommended dose is 7.5 mg per day.

Side effects

Often\u003e 1%:

dyspepsia, nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea

• itching, skin rash

  dizziness, headache

  peripheral edema

Rarely 0.1 - 1%:

transient increase in the activity of "hepatic" transaminases, hyperbilirubinemia, belching, esophagitis, gastroduodenal ulcer, latent or overt gastrointestinal bleeding, stomatitis

violation of hematopoiesis, incl. leukopenia, thrombocytopenia

hives

vertigo, tinnitus, drowsiness

increased blood pressure, palpitations, "hot flushes" of blood to the skin of the face

hypercreatininemia and / or increased serum urea.

Very rarely< 0,1 % :

perforation of the gastrointestinal tract, colitis, hepatitis, gastritis

photosensitivity, bullous eruptions, erythema multiforme, incl. Stevens-Johnson syndrome, toxic epidermal necrolysis

bronchospasm

confusion, disorientation, emotional lability

acute renal failure

conjunctivitis, visual impairment, incl. blurred vision

angioneurotic edema, anaphylactoid / anaphylactic reactions

The connection with taking meloxicam has not been established - interstitial nephritis, albuminuria, hematuria.

Contraindications

hypersensitivity to drug components (including NSAIDs of other groups)

a combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, and intolerance to acetylsalicylic acid (ASA) and other non-steroidal anti-inflammatory drugs

peptic ulcer of the stomach and duodenum (in the acute phase)

severe liver failure

chronic renal failure in patients not undergoing dialysis (Creatinine clearance - CC - less than 30 ml / min)

gastrointestinal bleeding

progressive kidney disease

condition after coronary artery bypass grafting

confirmed hyperkalemia

active inflammatory bowel disease (Crohn's disease or ulcerative colitis)

children under 15 years old

pregnancy and lactation

hereditary glucose intolerance or glucose / galactose malabsorption

Drug interactions

When taken simultaneously with salicylates and other non-steroidal anti-inflammatory drugs, the risk of developing erosive and ulcerative lesions of the gastrointestinal tract and gastrointestinal bleeding increases; may reduce renal excretion of lithium, which leads to an increase in its concentration in plasma; reduces the effectiveness of intrauterine contraceptives; antihypertensive drugs (β-blockers, ACE inhibitors); indirect anticoagulants, ticlopidine, heparin, thrombolytics increase the risk of bleeding; methotrexate enhances the myelodepressant effect; diuretics increase the risk of developing renal dysfunction; cyclosporine enhances the nephrotoxic effect; cholestyramine accelerates excretion.

Myelotoxic drugs increase the manifestations of the drug's hematotoxicity.

special instructions

It is prescribed with caution to patients suffering from diseases of the gastrointestinal tract, history of ulcerative lesions of the gastrointestinal tract, the presence of Helicobacter pуlori infection In case of peptic ulcers or gastrointestinal bleeding, the development of side effects from the skin and mucous membranes, the drug should be canceled. To reduce the risk of developing adverse events from the gastrointestinal tract, the minimum effective dose should be used with the minimum possible short course.

Care should be taken when treating patients with coronary artery disease, chronic heart failure, cerebrovascular diseases, dyslipidemia / hyperlipidemia, diabetes mellitus, peripheral arterial disease, severe somatic diseases, CC less than 60 ml / min.

In patients with a reduced volume of circulating blood and decreased glomerular filtration (dehydration, chronic heart failure, cirrhosis of the liver, nephrotic syndrome, clinically pronounced kidney disease, taking diuretics, dehydration after major surgical operations), clinically expressed chronic renal failure (CRF) may appear, which completely reversible after discontinuation of the drug (in such patients, at the beginning of treatment, daily diuresis and renal function should be monitored).

In the terminal stage of chronic renal failure in patients on dialysis, the dose should not exceed 7.5 mg / day.

When using Meloxicam, an episodic increase in the activity of transaminases in the blood serum or other indicators of liver function is possible. In most cases, this increase was small and transient. With a persistent and significant increase in transaminases and changes in other indicators of liver function, the drug should be canceled and control tests should be performed.

Caution should be observed when treating elderly patients who are more likely to have impaired renal, liver, or heart function.

Application in pediatrics

Given that the dose for children has not been established, the use of the drug should be limited only in children over 15 years of age. The maximum recommended daily dose for children over 15 years of age is 0.25 mg / kg body weight.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions (with the appearance of dizziness and drowsiness).

Overdose