Movasin - instructions for use, analogs, reviews and release forms (tablets 7.5 mg and 15 mg, injections in injections) of a drug for the treatment of pain and inflammation in arthrosis, arthritis in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Movasin. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Movasin 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 Movsisin in the presence of existing structural analogs.Use to treat pain and inflammation with arthrosis, arthritis, spondylitis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Movasin non-steroidal anti-inflammatory drug (NSAID). Has analgesic, anti-inflammatory and antipyretic effect. The mechanism of action is associated with the inhibition of the synthesis of prostaglandins as a result of selective suppression of the enzymatic activity of cyclooxygenase-2 (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. Suppresses the synthesis of prostaglandins in the inflammation region to a greater extent than in the gastric mucosa or kidneys, which is associated with a relatively selective inhibition of COX-2. Less often causes erosive and ulcerative diseases of the digestive tract. To a lesser extent, meloxicam (the active substance of the drug Movasin) acts on cyclooxygenase-1 (COX-1), involved in the synthesis of prostaglandins, protecting the mucous membrane of the gastrointestinal tract and taking part in the regulation of blood flow in the kidneys.

Composition

Meloksikam + auxiliary substances.

Pharmacokinetics

After taking the drug inside, Movasin is well absorbed from the digestive tract, the absolute bioavailability is 89%. Simultaneous reception with food does not change the intake. The concentration of meloxicam when taking the drug inside at doses of 7.5 and 15 mg is proportional to the dose. After intramuscular injection, the relative bioavailability is almost 100%. 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 (especially albumin) is more than 99%. Meloksikam penetrates through the histohematological barriers, the concentration in the synovial fluid reaches 50% of the maximum concentration of the drug in the plasma. Almost completely metabolized in the liver with the formation of four pharmacologically inactive metabolites. The main metabolite of 5-carboxymeloxicam (60% of the dose value) is formed by oxidation of the intermediate metabolite of 5-hydroxymethylmeloxicam, which is also excreted, but to a lesser degree (9% of the dose value).Studies have shown that this metabolic transformation plays an important role isoenzyme CYP2C9, the added value is the CYP3A4 isoenzyme. In the formation of the other two metabolites (which constitute, respectively, 16% and 4% of the dose), peroxidase takes part, the activity of which probably varies individually. It is excreted equally through the intestines and kidneys, mainly in the form of metabolites. Through the intestine unchanged output of less than 5% of the daily dose in the urine as unchanged drug is detected only in trace amounts.

Pharmacokinetics in special clinical cases

In elderly people, the clearance of the drug is reduced.

Hepatic or renal failure of moderate severity does not have a significant effect on the pharmacokinetics of meloxicam.

Indications

Symptomatic therapy (pain relief and inflammation in the joints):

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

Forms of release

Tablets 7.5 mg and 15 mg.

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

Instructions for use and dosage

Pills

The drug is taken orally, during a meal, at a daily dose of 7.5-15 mg once a day.

With rheumatoid arthritis, the recommended dose is 15 mg per day; depending on the therapeutic effect, the dose can be reduced to 7.5 mg per day.

With arthrosis, the drug is prescribed at a dose of 7.5 mg per day, in the absence of effect, the dose can be increased to 15 mg per day.

With ankylosing spondylitis, the daily dose is 15 mg.

The maximum daily dose of the drug 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 only during the first 2-3 days. Further treatment is continued with the use of oral forms (tablets).

The recommended dose is 7.5 mg or 15 mg once a day, depending on the intensity of pain and the severity of the inflammatory process.

The drug is administered intramuscularly. Intravenous injection of the drug is prohibited!

In patients with an increased risk of adverse reactions, the daily dose should not exceed 7.5 mg.

With the / m introduction in patients with terminal stage of renal failure who are on hemodialysis, and in patients with small or moderate renal dysfunction (QC more than 30 ml / min), the dose of the drug should not exceed 7.5 mg.

Dosage regimen for the IM injection in children and adolescents is not defined, this dosage form can be used only in adult patients. The maximum recommended daily dose is 15 mg.

With the combined use of various dosage forms of the drug, its maximum daily dose in tablets, suppositories and as a solution for injection is 15 mg.

Side effect

• dyspepsia, incl. nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea;
• transient increase in hepatic transaminase activity;
• hyperbilirubinemia;
• eructation;
• esophagitis;
• gastroduodenal ulcer;
• bleeding from the digestive tract (including latent);
• stomatitis;
• perforation of the gastrointestinal tract;
• colitis;
• hepatitis;
• gastritis;
• anemia;
• change in the blood formula, incl. leukopenia, thrombocytopenia;
• itching;
• skin rash;
• hives;
• photosensitization;
• bullous eruptions;
• multiform erythema, incl. Stevens-Johnson syndrome;
• toxic epidermal necrolysis;
• bronchospasm;
• dizziness;
• headache;
• vertigo;
• noise in ears;
• drowsiness;
• confusion of consciousness;
• disorientation;
• emotional lability;
• peripheral edema;
• increased blood pressure;
• palpitation;
• flushes of blood to the skin of the face;
• hypercreatininaemia and / or elevated urea in the blood serum;
• acute renal insufficiency;
• interstitial nephritis;
• albuminuria (protein in the urine);
• hematuria (blood in the urine);
• conjunctivitis;
• impaired vision, incl. blurred vision;
• angioedema;
• anaphylactoid / anaphylactic reactions;
• swelling at the injection site;
• painful sensations at the injection site.

Contraindications

• condition after aortocoronary bypass surgery;
• Decompensated heart failure;
• complete or incomplete combination of bronchial asthma, recurrent polyposis of the nasal mucosa and paranasal sinuses and intolerance of acetylsalicylic acid and other NSAIDs (including in the anamnesis);
• 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 hepatic impairment or active liver disease;
• chronic renal failure in patients not undergoing dialysis (QC less than 30 ml / min), progressive kidney disease (including confirmed hyperkalemia);
• children under 12 years (for tablets);
• Children under 18 years of age (for solution for intramuscular injection);
• pregnancy;
• lactation (breastfeeding);
• hypersensitivity to meloxicam and other components of the drug.

The formulation in the form of tablets includes lactose, so patients with rare hereditary diseases, such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption, should not take the drug.

Carefully

• IHD;
• cerebrovascular diseases;
• compensated heart failure;
• dyslipidemia / hyperlipidemia;
• diabetes;
• diseases of peripheral arteries;
• smoking;
• CK 30-60 ml / min;
• anamnestic data on the development of gastrointestinal ulcer;
• presence of infection Neliсobacter pуlori;
• elderly age;
• long-term use of NSAIDs;
• frequent use of alcohol;
• severe physical illness;
• concomitant therapy with the following drugs: anticoagulants (eg, warfarin); antiaggregants (eg, acetylsalicylic acid, clopidogrel); oral glucocorticosteroids or GCS (eg, prednisolone); selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, paroxetine, sertraline).

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.

Application in pregnancy and lactation

The drug is contraindicated in pregnancy and lactation (breastfeeding).

The use of Movasin, as well as other drugs blocking the synthesis of prostaglandins, can affect fertility, so it is not recommended to appoint women who want to become pregnant.

Use in children

The drug is contraindicated for use: in children under 12 years (for tablets); in children under 18 years (for a solution for the / m introduction).

Application in elderly patients

Caution should be used in elderly people.

special instructions

Care should be taken when using the drug in patients with a history of peptic ulcer and duodenal ulcer, and in patients receiving anticoagulant therapy, in this category of patients the risk of development of erosive and ulcerative gastrointestinal lesions is increased.

Caution should be exercised and the indicators of renal function should be monitored when the drug is used in elderly patients, patients with chronic heart failure with circulatory insufficiency, in patients with cirrhosis, as well as in patients with hypovolemia as a result of surgical interventions.

In patients with mild to moderate renal impairment (QC greater than 30 mL / min), dosage adjustment is not required.

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

When allergic reactions (itching, skin rash, urticaria, photosensitivity) occur, stop taking the drug.

Meloksikam, as well as other NSAIDs, can mask symptoms of infectious diseases.

Impact on the ability to drive vehicles and manage mechanisms

The use of the drug can cause the emergence of undesirable effects in the form of headaches and dizziness, drowsiness, so during the period of taking the drug should abandon the management of vehicles and maintenance of machines and mechanisms that require concentration.

Drug Interactions

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

It is not recommended to share the use of Movasin with ethanol (alcohol).

With simultaneous use with antihypertensive drugs, the effectiveness of the latter may be reduced.

With simultaneous use with lithium preparations, development of cumulation of lithium and increase of its toxic effect (it is recommended to control the concentration of lithium in the blood).

With simultaneous use with methotrexate, the likelihood of developing toxic effects on hematopoiesis and the occurrence of anemia and leukopenia (a periodic general blood test is shown).

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

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

With simultaneous use with anticoagulants (including heparin, ticlopidine, warfarin), as well as with thrombolytic drugs (including streptokinase, fibrinolysin), the risk of bleeding increases (periodic monitoring of blood clotting parameters is necessary).

With simultaneous application with colestyramin, the excretion of meloxicam through the digestive tract increases (due to binding).

With simultaneous use with selective serotonin reuptake inhibitors, the risk of bleeding from the digestive tract increases.

Analogues of the drug Movasin

Structural analogs for the active substance:

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

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