Flamax - instructions for use, analogs, reviews and release forms (capsules 50 mg, 100 mg Forte tablets, injections for injections) for the treatment of arthritis, arthrosis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Flamax. Comments of visitors of the site - consumers of this medicine, as well as opinions of specialists on the use of Flamax in their practice are presented. 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. Flamax analogs in the presence of existing structural analogs.Use for the treatment of pain and inflammation in arthritis, arthrosis, lumbago in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Flamax - a non-steroidal anti-inflammatory drug (NSAID), a derivative of propionic acid. It has analgesic, anti-inflammatory and antipyretic effects, suppresses platelet aggregation.

By acting on the cyclooxygenase and lipoxygenase unit of arachidonic acid metabolism, Ketoprofen inhibits the synthesis of prostaglandins, leukotrienes and thromboxanes. The analgesic effect is due to both central and peripheral mechanisms.

Composition

Ketoprofen + auxiliary substances.

Pharmacokinetics

Absorption is fast, bioavailability is 90%. Up to 99% of absorbed ketoprofen binds to plasma proteins, mainly with albumin. Ketoprofen penetrates well into the synovial fluid and connective tissue. Cmax in the synovial fluid is 30% of the serum concentration, and after 4-6 hours after ingestion it exceeds it. Ketoprofen penetrates the blood-brain barrier (GEB). Do not cumulate.Almost completely metabolized in the liver by glucuronation, is subjected to the effect of "first passage" through the liver. It is excreted mostly by the kidneys and through the intestine (1-8%).

Indications

Inflammatory and degenerative diseases of the musculoskeletal system:

• rheumatoid arthritis;
• psoriatic arthritis;
• Bechterew's disease (ankylosing spondylitis);
• gouty arthritis (with an acute attack of gout, quick-acting dosage forms are preferred);
• osteoarthritis.

Pain syndrome:

• myalgia, ossalgia, arthralgia;
• neuralgia;
• tendonitis, bursitis;
• radiculitis;
• adnexitis;
• otitis;
• headache;
• toothache;
• with oncological diseases;
• post-traumatic and postoperative pain syndrome, accompanied by inflammation;
• algodismenorea.

Forms of release

Capsules 50 mg.

Tablets coated with 100 mg (Flamax Forte).

Solution for intravenous and intramuscular injection (injections in ampoules for injection).

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

Instructions for use and dosage

Capsules

The drug is taken orally, during a meal.

When rheumatic diseases - 1 capsule in the morning, 1 capsule - in the afternoon and 2 capsules - in the evening or 1 capsule 4 times a day. A combination of dosage forms is possible.

In the treatment of pain syndrome and algodismenorea, the dose, if necessary, is 50 mg of ketoprofen every 6-8 hours.

For patients with renal insufficiency, the dose is reduced to 33-50%, in elderly patients the dose is adapted to age.

The maximum daily dose is 300 mg.

Flamax Forte Tablets

Assign adults 1 tablet 2-3 times a day (every 8 hours). The maximum daily dose is 300 mg.

Ampoules

The drug is intended for intravenous and intramuscular administration.

Intramuscular injection: 100 mg (1 ampoule) 1-2 times a day.

In / in the infusion of the drug should be carried out only in a hospital. The average infusion time is 0.5-1 h, maximum - no more than 48 h, with the dose of the drug should not exceed 300 mg.

Short-term intravenous infusion: 100-200 mg (1-2 ampoules) of the drug, diluted in 100 ml of 0.9% sodium chloride solution, is injected for 0.5-1 hour. It is possible to re-introduce after 8 hours.

Continuous intravenous infusion: 100-200 mg (1-2 ampoules) of the drug diluted in 500 ml of the infusion solution (0.9% sodium chloride solution, Ringer's solution, 5% Dextrose solution) for 8 hours.Possible repeated administration after 8 hours.

A minimum effective dose should be used with the minimum possible short course.

Side effect

• abdominal pain;
• dyspepsia (nausea, vomiting, heartburn, flatulence, decreased appetite, diarrhea);
• stomatitis;
• abnormal liver function;
• change in taste;
• ulceration of the mucosa of the gastrointestinal tract;
• gingival, gastrointestinal, hemorrhoidal hemorrhage;
• headache;
• dizziness;
• insomnia;
• excitation;
• nervousness;
• drowsiness;
• depression;
• asthenia;
• confusion or loss of consciousness;
• memory impairment;
• migraine;
• peripheral neuropathy;
• noise or ringing in the ears;
• blurred vision;
• conjunctivitis;
• dryness of the mucous membrane of the eye;
• Pain in the eyes;
• hyperemia of the conjunctiva;
• hearing loss;
• vertigo;
• increased blood pressure;
• tachycardia;
• agranulocytosis, anemia, hemolytic anemia, thrombocytopenia, leukopenia;
• edematous syndrome;
• cystitis;
• urethritis;
• impaired renal function;
• interstitial nephritis;
• nephrotic syndrome;
• hematuria (blood in the urine);
• skin rash (including erythematous, urticaria);
• itching of the skin;
• rhinitis;
• angioedema;
• bronchospasm;
• exfoliative dermatitis;
• anaphylactic shock;
• increased sweating;
• hemoptysis;
• nose bleed;
• myalgia;
• muscle twitching;
• dyspnea;
• thirst;
• photosensitization;
• with prolonged use in large doses - vaginal bleeding.

Contraindications

• erosive and ulcerative lesions of the gastrointestinal tract (in the phase of exacerbation);
• bleeding from the gastrointestinal tract, inflammatory bowel disease in the phase of exacerbation (ulcerative colitis, Crohn's disease);
• severe hepatic insufficiency or liver disease in an acute period;
• severe renal failure (CC less than 30 ml / min);
• progressive kidney disease;
• hyperkalemia;
• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses and intolerance to acetylsalicylic acid or other NSAIDs (including in anamnesis);
• violation of hematopoiesis, hemostasis disorders (including hemophilia);
• 3 trimester of pregnancy;
• lactation period;
• children's age till 15 years;
• period after aortocoronary shunting;
• hypersensitivity (including other NSAIDs or ancillary components).

Application in pregnancy and lactation

The use of Flamax in the 3rd trimester of pregnancy and during breastfeeding is contraindicated (breastfeeding should be abandoned for the period of drug use).

Use of the drug in the 1 and 2 trimesters of pregnancy is allowed if the intended benefit to the mother exceeds the potential risk to the fetus.

Use in children

Contraindicated in children under 15 years of age.

Application in elderly patients

With caution should prescribe the drug to elderly patients (over 65 years).

special instructions

When using Flamax and Warfarin or lithium drugs simultaneously, patients should be under strict medical supervision.

Care should be taken when prescribing the drug to patients with peptic ulcer diseases in history, kidney or liver failure, and also receiving coumarin anticoagulants.

Like the rest of the drugs in this group, it can mask the symptoms of infectious diseases.

During treatment, it is necessary to monitor the picture of peripheral blood and the functional state of the liver and kidneys.

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

If there is a violation of the liver, kidneys need to reduce the dose and careful observation.

To reduce the risk of developing adverse events on the part of the gastrointestinal tract, a minimum effective dose should be used with the minimum possible short course.

Impact on the ability to drive vehicles and manage mechanisms

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

Drug Interactions

Flamax can be combined with analgesics of central action; can be mixed with morphine in one bottle. Do not mix in one bottle with Tramadol due to precipitation.

Parenteral administration of Flamax can be combined with the use of oral forms (tablets, capsules) or rectal suppositories, and the total daily dose can be increased to 300 mg or reduced to 100 mg, depending on the nature of the disease and the condition of the patient.

With the simultaneous use of Flamax and "loop" diuretics, the nephrotoxic effect of both drugs is enhanced.

Ketoprofen reduces the effectiveness of uricosuric drugs.

Strengthens the effect of anticoagulants, antiaggregants, fibrinolytics, ethanol, side effects of glucocorticosteroids and mineralocorticosteroids, estrogens; reduces the effectiveness of antihypertensive drugs and diuretics.

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

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

Ketoprofen enhances hypoglycemic action of insulin and oral hypoglycemic drugs (dose recalculation is necessary).

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

Simultaneous use with sodium valproate reduces the aggregation of platelets.

Ketoprofen increases the concentration in the plasma of Verapamil and nifedipine, lithium preparations, methotrexate.

Antacids and colestyramine reduce the absorption of ketoprofen.

Myelotoxic drugs increase manifestations of hematotoxicity of the drug.

Analogs of the drug Flamax

Structural analogs for the active substance:

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

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