Arthrosan - instructions for use, analogs, reviews and release forms (tablets 7.5 mg and 15 mg, injections in ampoules for injection 2.5 ml) of the drug for the treatment of pain in arthrosis, arthritis, osteochondrosis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Arthrosan. Presented are the opinions of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Arthrosan 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. Analogues of Arthrosan in the presence of existing structural analogues. Use for the treatment of pain and inflammation with arthrosis, arthritis, osteochondrosis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Arthrosan - a non-steroidal anti-inflammatory drug (NSAID), which has anti-inflammatory, antipyretic and analgesic effects.

It belongs to the class of oxyocams, it is a derivative of enolic acid.

The mechanism of action is associated with inhibition of the synthesis of prostaglandins as a result of selective inhibition of the enzymatic activity of cyclooxygenase of the second type (COX-2) involved in the biosynthesis of prostaglandins in the inflammatory region. When administered in high doses, prolonged use and individual characteristics of the organism, the selectivity for COX-2 decreases. It acts less on the first type of cyclooxygenase (COX-1) involved in the synthesis of prostaglandins protecting the gastrointestinal mucosa and taking part in the regulation of blood flow in the kidneys. Due to this selectivity of inhibition of COX-2 activity, the drug less often causes erosive and ulcerative lesions of the gastrointestinal tract.

Composition

Meloksikam + auxiliary substances.

Pharmacokinetics

Well absorbed from the digestive tract. Simultaneous food intake does not change the absorption of the drug. When using the drug inside at doses of 7.5 and 15 mg, its concentrations are proportional to the doses.Equilibrium concentrations are achieved within 3-5 days of treatment. With prolonged use of the drug (more than 1 year), the concentrations are similar to those observed after the first achievement of a steady state of pharmacokinetics. Binding to plasma proteins is 99%. Almost completely metabolized in the liver with the formation of four pharmacologically inactive derivatives. The drug penetrates through the histohematological barriers, the concentration in the synovial fluid is 50% of the maximum concentration in the plasma. Hepatic or renal insufficiency of moderate severity has no significant effect on the pharmacokinetics of meloxicam. It is excreted in equal proportion with feces and urine, mainly in the form of metabolites. Through the intestine, less than 5% of the daily dose is excreted unchanged, in urine, in unchanged form, the drug is found only in trace amounts.

Indications

Symptomatic treatment of inflammatory and degenerative diseases of the musculo-articular system, accompanied by pain syndrome, including:

• osteoarthritis;
• rheumatoid arthritis;
• ankylosing spondylitis (Bekhterev's disease);
• osteochondrosis.

Forms of release

Tablets 7.5 mg and 15 mg.

Solution for intramuscular injection (injections in ampoules for injection 2.5 ml).

Other dosage forms, whether ointment or gel, at the time of publication of the drug in the Directory did not exist.

Instructions for use and dosage

Pills

The drug is taken orally during meals at a daily dose of 7.5-15 mg.

Recommended dosing regimen:

Rheumatoid arthritis: 15 mg per day. If necessary, the dose can be reduced to 7.5 mg per day.

Osteoarthritis, osteochondrosis and other inflammatory and degenerative diseases of the musculo-articular system, accompanied by a pain syndrome: 7.5 mg per day. If the dose is ineffective, it can be increased to 15 mg per day.

Ankylosing spondylitis: 15 mg per day. The maximum daily dose should not exceed 15 mg.

In patients with an increased risk of side effects, as well as in patients with severe renal failure who are on hemodialysis, the dose should not exceed 7.5 mg per day.

Ampoules

Intramuscular injection of the drug is indicated in the first 2-3 days of treatment. Further treatment is continued with the use of oral forms (tablets). The recommended dose is 7.5 or 15 mg once a day, depending on the intensity of pain and the severity of the inflammatory process.Since the potential risk of adverse reactions depends on the dose and duration of treatment, the lowest effective doses and the lowest possible short course should be used.

In patients with severe renal failure who are on hemodialysis, the dose should not exceed 7.5 mg per day.

The drug is administered via a deep intramuscular injection. The contents of the ampoules should not be mixed in the same syringe with other medicines. The drug can not be administered intravenously.

Side effect

• dyspepsia, incl. nausea, vomiting, abdominal pain, diarrhea, constipation, flatulence;
• transient increase in hepatic transaminase activity;
• hyperbilirubinemia;
• eructation;
• esophagitis;
• a stomach ulcer or duodenal ulcer;
• gastrointestinal bleeding (latent or obvious);
• stomatitis;
• perforation of the gastrointestinal tract;
• colitis;
• hepatitis;
• gastritis;
• anemia, leukopenia, thrombocytopenia;
• itching;
• skin rash;
• hives;
• photosensitization;
• bullous eruptions;
• multiform erythema, incl. Stevens-Johnson syndrome;
• toxic epidermal necrolysis;
• bronchospasm;
• dizziness;
• headache;
• noise in ears;
• drowsiness;
• emotional lability;
• confusion of consciousness;
• disorientation;
• peripheral edema;
• increased blood pressure;
• palpitation;
• hyperemia of the face;
• increased serum urea concentration;
• acute renal insufficiency;
• albuminuria (protein in the urine);
• hematuria (blood in the urine);
• conjunctivitis;
• blurred vision;
• angioedema;
• anaphylactic, anaphylactoid reactions.

Contraindications

• hypersensitivity to meloxicam or auxiliary components of the drug;
• Decompensated heart failure;
• early postoperative period after aortocoronary shunting;
• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs; exacerbation of peptic ulcer of the stomach and duodenum; active gastrointestinal bleeding;
• inflammatory bowel disease (ulcerative colitis, Crohn's disease in the acute stage);
• cerebrovascular bleeding or other bleeding;
• hemophilia and other bleeding disorders;
• severe hepatic impairment or active liver disease;
• chronic renal failure (in patients not undergoing hemodialysis (creatinine clearance less than 30 ml / min)); progressive kidney disease, incl. confirmed hyperkalemia;
• children under 15 years (tablets) and up to 18 years (injections);
• pregnancy; the period of breastfeeding.

Application in pregnancy and lactation

Arthrosan is contraindicated in pregnancy and lactation.

Use in children

Contraindicated in children and adolescents under the age of 15 years for the tablet form and up to 18 years for the injectable form of the drug.

Application in elderly patients

Take with caution elderly patients.

special instructions

The drug can change the properties of platelets, but does not replace the preventive effect of Acetylsalicylic acid in cardiovascular diseases.

Caution should be exercised when using the drug in patients who have a history of gastric ulcer and duodenal ulcer and patients on anticoagulant therapy. In such patients, the risk of erosive and ulcerative gastrointestinal diseases is increased.

Caution should be exercised and daily diuresis and renal function should be monitored when using Arthrosan in elderly and patients with reduced BCC and reduced glomerular filtration (dehydration, chronic heart failure, liver cirrhosis, nephrotic syndrome, clinically expressed kidney disease, diuretics, dehydration after large surgical operations).

With caution: in elderly patients and in the presence of the following conditions in the history: coronary heart disease, congestive heart failure, cerebrovascular disease, peripheral arterial disease, dyslipidemia / hyperlipidemia, diabetes mellitus, chronic renal failure (creatinine clearance 30-60 ml / min) ; the presence of Helicobacter pylori (Helicobacter) infection, smoking, severe physical illnesses.

With prolonged use of NSAIDs, alcohol abuse, concomitant anticoagulant therapy (eg, warfarin), antiplatelet agents (eg acetylsalicylic acid, clopidogrel), oral glucocorticosteroids (eg, prednisolone), selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, sertraline, Paroxetine ) the drug should be taken with caution.

To reduce the risk of developing adverse events from the gastrointestinal tract, the minimum effective dose should be used in a short course.

If there are signs of liver damage (pruritus, yellowing of the skin, nausea, vomiting, abdominal pain, darkening of the urine, persistent and significant increase in the level of transaminases and changes in other indicators of liver function), stop taking the medication and contact your doctor.

After two weeks of using the drug, it is necessary to monitor the activity of liver enzymes.

In patients with a slight or moderate decrease in renal function (QC more than 30 ml / min), dose adjustment is not required.

Patients taking both diuretics and meloxicam should take a sufficient amount of fluid.

In case of allergic reactions (itching, skin rash, urticaria, photosensitization), it is necessary to consult a doctor in order to resolve the issue of stopping the drug.

Arthrosan, like other NSAIDs, can mask the symptoms of infectious diseases.

The use of meloxicam, as well as other drugs that block the synthesis of prostaglandins, can affect fertility,therefore it is not recommended for admission to women planning a pregnancy.

Do not use the drug simultaneously with other NSAIDs.

Impact on the ability to drive vehicles and manage mechanisms

The use of the drug may cause the onset of headache, dizziness and drowsiness. In the event of these phenomena, it is necessary to abandon the management of vehicles and perform other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

Drug Interactions

With the simultaneous use of arthrosan with other NSAIDs (including acetylsalicylic acid), the risk of erosive and ulcerative lesions and gastrointestinal bleeding increases.

When used simultaneously with antihypertensive drugs, the effectiveness of the latter may be reduced.

With simultaneous use with lithium preparations, lithium cumulation and its toxic effect can be developed (control of lithium concentration in the blood is recommended).

With simultaneous use with methotrexate, the side effect of the latter on the hematopoietic system is increased (the risk of anemia and leukopenia,the periodic conduct of a general blood test is shown).

With simultaneous use with diuretics and cyclosporine, the risk of developing kidney failure increases.

With simultaneous use with intrauterine contraceptives, the effectiveness of the latter may be reduced.

With the simultaneous use of arthrosan with anticoagulants (heparin, warfarin), thrombolytic drugs (streptokinase, fibrinolysin), and antiaggregants (ticlopidine, clopidogrel, acetylsalicylic acid) increases the risk of bleeding (periodic monitoring of blood coagulability).

With simultaneous application with colestyramin, the excretion of meloxicam through the gastrointestinal tract is accelerated.

When used simultaneously with selective serotonin reuptake inhibitors, the risk of developing gastrointestinal bleeding increases.

Analogues of the drug Arthrosan

Structural analogs for the active substance:

• Amelotex;
• BiKsikam;
• Lem;
• Liberalum;
• Matarin;
• Medsikam;
• Melbeck;
• Melbek forte;
• Melokvitis;
• Meloks;
• Meloksam;
• Meloksikam;
• Meloflam;
• Meloflex;
• Mesipol;
• Mixol;
• Mirlocks;
• Movalis;
• Movasin;
• Movix;
• Oxycamox;
• Exen Sanovel.

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