Flexen - instructions for use, analogs, reviews and release forms (capsules or tablets 50 mg, gel or ointment 2.5%, suppositories rectal 100 mg, injections in ampoules) for the treatment of inflammatory pain in adults, children and of pregnancy

In this article, you can read the instructions for using the drug Fleksen. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Flexan in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogs of Flexan in the presence of existing structural analogs.Use for the treatment of pain with inflammation in the joints, muscles (arthrosis, arthritis, sciatica and other inflammatory diseases) in adults, children, as well as during pregnancy and lactation.

Fleksen - a non-steroidal anti-inflammatory drug (NSAID), a derivative of propionic acid. Has analgesic, anti-inflammatory and antipyretic effect. The mechanism of action is associated with oppression of the activity of COX, the main enzyme of arachidonic acid metabolism, which is the precursor of prostaglandins, which play a major role in the pathogenesis of inflammation, pain and fever.

The pronounced analgesic effect of Ketoprofen (the active substance of the Flexen preparation) is due to two mechanisms: peripheral (mediated, through suppression of prostaglandin synthesis) and central (due to inhibition of prostaglandin synthesis in the central and peripheral nervous system, and the effect on biological activity of other neurotropic substances playing a key role in the release of mediators of pain in the spinal cord). In addition, ketoprofen has anti-bradykinin activity, stabilizes lysosomal membranes,causes significant inhibition of neutrophil activity in patients with rheumatoid arthritis. Suppresses the aggregation of platelets.

Composition

Ketoprofen + auxiliary substances.

Ketoprofen sodium salt + excipients (injections in ampoules for injections Flexen).

Pharmacokinetics

When intramuscular injection of Tmax in blood plasma is 15-30 minutes. Bioavailability more than 90%. Binding to blood plasma proteins - 99%. The therapeutic concentration in the synovial fluid persists for 6-8 hours. It is metabolized in the liver by glucuronation. Do not cumulate. It is excreted mainly in urine and 1-8% with feces.

Indications

Symptomatic treatment of pain syndrome of various genesis, rheumatic and inflammatory diseases, including:

• osteoarthrosis of different localization;
• ankylosing spondylitis;
• a gout attack;
• rheumatoid arthritis and periarthritis;
• Bursitis, tendonitis, tenosynovitis, synovitis;
• sciatica, sciatica;
• myalgia;
• bruises, dislocations and sprains of muscles;
• phlebitis, superficial thrombophlebitis, lymphangitis;
• headache and toothache;
• otitis;
• adnexitis;
• algodismenorea;
• pain syndrome in cancer;
• post-traumatic and postoperative pain syndrome.

Forms of release

Capsules 50 mg (sometimes mistakenly called pills).

Gel for external use 2.5% (sometimes mistakenly called ointment).

Candles rectal 100 mg.

Lyophilizate for the preparation of solution for intramuscular injection (injections in ampoules for injection).

Instructions for use and dosage

Capsules

Inside Flexin appoint 1-2 capsules 2-3 times a day. Capsules are taken after eating, squeezed with enough water.

Rectal Candles

Rectal - 1 suppository every 1-2 times a day.

Ampoules

For relief of acute pain syndrome, the drug is administered intramuscularly at a dose of 100 mg 1-2 times a day. The maximum daily dose of the drug should not exceed 300 mg.

The duration of parenteral therapy is usually several days. After achieving the desired effect, the patient is prescribed capsules or suppositories.

To obtain a solution for parenteral administration, the lyophilizate is dissolved with the applied solvent.

The maximum daily dose of the drug should not exceed 300 mg.

Gel

Gel in a small amount is applied a thin layer over the inflammation focus and lightly rubs 2-3times a day. Duration of external application should not exceed 14 days.

Side effect

• NSAID-gastropathy;
• pain in the stomach;
• nausea, vomiting;
• diarrhea;
• flatulence;
• tenesmus;
• decreased appetite;
• stomatitis;
• change in taste;
• ulceration and perforation of the gastrointestinal mucosa;
• bleeding (including gingival, gastrointestinal, hemorrhoidal);
• increased hepatic transaminase activity in blood serum;
• hepatitis;
• headache;
• dizziness;
• insomnia;
• excitation;
• nervousness;
• drowsiness;
• depression;
• asthenia;
• confusion or loss of consciousness;
• forgetfulness;
• migraine;
• peripheral neuropathy;
• dyspnea;
• bronchospasm;
• rhinitis;
• laryngeal edema;
• nose bleed;
• hemoptysis;
• dyspnea;
• increased blood pressure;
• tachycardia;
• edematous syndrome;
• cystitis;
• urethritis;
• impaired renal function;
• transient dysuria;
• interstitial nephritis;
• nephrotic syndrome;
• hematuria (blood in the urine);
• noise or ringing in the ears;
• blurred vision;
• conjunctivitis;
• hearing loss;
• vertigo;
• agranulocytosis, anemia, hemolytic anemia, thrombocytopenia, leukopenia;
• multi-form exudative erythema (including Lyell's syndrome, Stevens-Johnson syndrome);
• photodermatitis;
• skin rash (including erythematous, urticaria);
• itching of the skin;
• angioedema;
• exfoliative dermatitis;
• anaphylactic shock;
• alopecia (baldness);
• eczema;
• increased sweating;
• myalgia;
• muscle twitching;
• thirst;
• vaginal bleeding;
• pain, burning and redness at the injection site.

Contraindications

• Gastrointestinal disease in the exacerbation phase;
• gastrointestinal hemorrhages and perforations in the anamnesis;
• severe renal dysfunction;
• severe liver dysfunction;
• violations of the hematopoiesis system (including leukopenia, thrombocytopenia, hemocoagulation disorders, hemophilia and other disorders of blood coagulation);
• pregnancy;
• lactation (breastfeeding);
• severe heart failure;
• pain relief immediately before or immediately after surgery on the cardiovascular system;
• children and adolescents under 15 years (capsules and suppositories), up to 18 years (injections in ampoules);
• increased sensitivity to ketoprofen, acetylsalicylic acid (including indications in the anamnesis for bronchospasm, urticaria or rhinitis caused by taking acetylsalicylic acid) or to other NSAIDs
• hemorrhoids, proctitis (for rectal administration).

Application in pregnancy and lactation

Despite the fact that ketoprofen in therapeutic doses does not have embryo and fetotoxic effect, Flexen is contraindicated in pregnancy and lactation (breastfeeding).

Use in children

Contraindicated in children and adolescents under the age of 18 (injections in ampoules) and up to 15 years (capsules and rectal suppositories).

Application in elderly patients

With caution should be used in elderly patients.

special instructions

With simultaneous use of ketoprofen and warfarin, as well as coumarin anticoagulants or lithium salts, patients should be under strict medical supervision.

Care should be taken when using the drug in patients with peptic ulcer diseases in history, renal and hepatic insufficiency. During the treatment, it is necessary to monitor the picture of peripheral blood and the functional state of the liver / kidneys. If the renal and / or liver function is impaired (increased ALT activity is an indicator of NSAID-induced liver dysfunction), a dose reduction and careful follow-up of the doctor are necessary.

If it is necessary to determine 17-ketosteroids, the drug should be discontinued 48 hours before the test.

With Flexien therapy, alcohol intake should be avoided (ulcers and gastrointestinal bleeding may occur).

With the development of violations from the organs of vision, one should consult an ophthalmologist.

Impact on the ability to drive vehicles and manage mechanisms

During the treatment with Flexen, caution should be exercised when driving vehicles and engaging in other potentially hazardous activities requiring increased attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous application with Flexen, the effectiveness of uricosuric medicines decreases, the effect of anticoagulants, antiplatelet agents, fibrinolytic agents, ethanol is increased, side effects of glucocorticosteroids (SCS) and mineralocorticoids, estrogens are intensified; reduces the effectiveness of antihypertensive drugs and diuretics.

Combined use of Flexan with other NSAIDs, GCS, ethanol (alcohol), and corticotropin can lead to the formation of ulcers and the development of gastrointestinal bleeding, an increased risk of kidney dysfunction.

The simultaneous use of Flexan with oral anticoagulants, heparin, thrombolytic agents, antiaggregants, cefoperazone, cefamandole and cefotetan increases the risk of bleeding.

With the simultaneous use of Flexen with insulin and oral hypoglycemic drugs, the action of the latter increases - dose adjustment is necessary.

Inductors of microsomal oxidation in the liver (including phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites.

The combined use of Flexen with sodium valproate causes disruption of platelet aggregation.

Simultaneous application with Flexen raises the concentration in the plasma of verapamil, nifedipine, lithium preparations, methotrexate.

Antacids and colestyramine reduce the absorption of Flexan.

Myelotoxic drugs intensify manifestations of Fleksen's hematotoxicity with simultaneous application.

Flexene is pharmaceutically incompatible with Tramadol solution.

Analogues of the drug Flexen

Structural analogs for the active substance:

• Arketal Rompharm;
• Arthrosylen;
• Artrum;
• Bystrumgel;
• Bystrumcaps;
• Valusal;
• Ketonal;
• Ketonal Duo;
• Ketonal uno;
• Ketoprofen;
• Ketosphere;
• OCI;
• Oruvel;
• Profenide;
• Fastum gel;
• Febrofide;
• Flamax;
• Flamax forte.

Analogues on the curative effect (means for treating sciatica):

• Alvipsal;
• Anopyrine;
• Apizarthron;
• Bralangin;
• Brufen;
• Brufen retard;
• Voltaren Emulgel;
• Dexalgin;
• Diklobene;
• Dicluberl;
• Diqlovit;
• Dicloran;
• Diclofenac;
• Diprospan;
• Dolgit;
• Adhesive plaster medical Nanoplast forte;
• Maxigan;
• Nyz;
• Neurodiclavitis;
• Neuromultivitis;
• Nikofleks;
• Nimulid;
• Nimesulide;
• Niflugel;
• Nifluryl;
• Novigan;
• Oruvel;
• Panadol;
• Piroxicam;
• Pliwalgin;
• Radiculosan;
• Rapten Duo;
• Revalgine;
• Sanaprox;
• Solpadein;
• Spasgan;
• Spazmalgon;
• The Texman;
• Tilcotyl;
• Finalgon;
• Flamadex;
• Forapine E;
• Cefecon H;
• Espol;
• Efkamon;
• Yunispaz.

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