Xefokam - instructions for use, reviews, analogs and forms of release (tablets 4 mg and 8 mg Rapid, injections in ampoules) for the treatment of pain in adults, children and pregnancy. Composition and interaction with alcohol

In this article, you can read the instructions for using the drug Xsefokam. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Xefokama 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 Xefokam in the presence of existing structural analogues.Use to treat pain of a different nature in adults, children, as well as during pregnancy and lactation. Composition and interaction of the drug with alcohol.

Xsefokam non-steroidal anti-inflammatory drug (NSAID). Has a pronounced analgesic and anti-inflammatory effect.

Lornoxicam (the active substance of the drug Xefokam) has a complex mechanism of action, which is based on suppression of the synthesis of prostaglandins, due to inhibition of the activity of COX isoenzymes. Inhibition of COX leads to desensitization of peripheral pain receptors and, accordingly, to inhibition of inflammation. In addition, lornoxicam is inhibited by the release of free oxygen radicals from activated leukocytes. The analgesic effect of lornoxicam is not associated with an opiate-like effect on the central nervous system and, unlike narcotic analgesics, lornoxicam does not inhibit respiration, it does not cause drug dependence.

Xefokam does not affect vital signs: body temperature, respiratory rate, heart rate, blood pressure, ECG parameters, spirometry.

Composition

Lornoxicam + auxiliary substances.

Pharmacokinetics

Absolute bioavailability after intramuscular injection is 97%.The binding with plasma proteins is 99% and does not depend on concentration. Lornoxicam is present in plasma unchanged, as well as in the form of hydroxylated metabolite, which does not possess pharmacological activity. Lornoxicam is completely metabolized, about 1/3 of the metabolites are excreted by the kidneys and 2/3 by metabolism in the liver.

Pharmacokinetics in special clinical cases

Simultaneous reception with antacids has no effect on the pharmacokinetics of lornoxicam. In the elderly, systemic clearance is reduced by 30-40%. In patients with impaired liver or kidney function, there is no significant change in the pharmacokinetics of lornoxicam.

Indications

• short-term treatment of pain syndrome in trauma and after surgical interventions;
• algodismenorea;
• sciatica;
• symptomatic therapy of rheumatoid arthritis and osteoarthritis.

Forms of release

Tablets coated with a coating of 4 mg and 8 mg (Xefokam Rapid).

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

There are no other forms of the drug, be it cream ointment or gel.

Instructions for use and dosing regimen

Pills

Tablets drug Xefokam taken inside, washed down with a sufficient amount of liquid.

Special dose selection for elderly patients is not required in the absence of impaired renal or hepatic function; in the presence of renal or hepatic insufficiency, the daily dose of the drug should be reduced.

For all patients, the dosing regimen should be based on an individual response to treatment.

Xefokam Rapid should be given in a dose of 8 mg, the maximum daily dose - 16 mg.

Ampoules

The drug is used parenterally.

With postoperative pain, the drug is administered intramuscularly or intravenously, with an acute attack of lumbago / isalgia - intramuscularly.

The initial dose may be 8 mg or 16 mg. With an insufficient analgesic effect of the drug at a dose of 8 mg, you can also add the same dose.

Maintenance therapy: 8 mg twice a day.

The maximum daily dose is 16 mg.

The drug should be applied at the lowest effective dose with the minimum possible short course.

The injection solution is prepared immediately before use by dissolving the contents of one vial (8 mg Xefokam powder) with water for injection (2 ml).After the solution is prepared, the needle is replaced.

In / m injections make a long needle.

The solution thus prepared is administered iv or I / m. The duration of IV administration of the solution should be at least 15 seconds, v / m - not less than 5 seconds.

Side effect

• pharyngitis;
• anemia, thrombocytopenia, leukopenia;
• increased bleeding time;
• hemorrhagic rash;
• hypersensitivity;
• anorexia;
• change in body weight;
• insomnia;
• depression;
• confusion of consciousness;
• nervousness;
• excitation;
• light and transient headaches;
• dizziness;
• drowsiness;
• paresthesia;
• a taste disorder;
• distortion of taste perception;
• tremor;
• migraine;
• conjunctivitis;
• visual impairment;
• dizziness;
• noise in ears;
• cardiopalmus;
• tachycardia;
• edema;
• heart failure;
• tides;
• edema;
• arterial hypertension;
• bleeding;
• hematomas;
• rhinitis;
• dyspnea;
• cough;
• bronchospasm;
• abdominal pain;
• diarrhea;
• nausea, vomiting;
• dyspepsia;
• constipation;
• flatulence;
• eructation;
• dry mouth;
• gastritis;
• stomach ulcer;
• pain in the epigastric region;
• duodenal ulcer;
• ulceration of the oral cavity;
• dysphagia;
• esophagitis;
• stomatitis;
• tarry stools;
• bloody vomiting;
• reflux;
• aphthous stomatitis;
• glossitis;
• peptic ulcer with perforation;
• skin rash;
• itching;
• hyperhidrosis;
• erythematous rash;
• hives;
• alopecia;
• dermatitis;
• hemorrhagic rash;
• Stevens-Johnson syndrome;
• toxic epidermal necrolysis;
• pain in the bones;
• muscle spasms;
• myalgia;
• violation of urination;
• hyperemia, tenderness at the injection site.

Contraindications

• complete or incomplete combination of bronchial asthma, recurrent nasal polyposis or paranasal sinuses and intolerance to acetylsalicylic acid and other NSAIDs (including in the anamnesis);
• thrombocytopenia;
• hemorrhagic diathesis or bleeding disorders, as well as after operations involving a risk of bleeding or incomplete hemostasis;
• period after aortocoronary shunting;
• erosive and ulcerative changes in the mucosa of the stomach or duodenum, active gastrointestinal bleeding; cerebrovascular or other bleeding;
• recurrent gastric ulcer or repeated bleeding from the gastrointestinal tract;
• data on previous bleeding from the gastrointestinal tract associated with the intake of NSAIDs;
• inflammatory bowel disease (Crohn's disease, NJC) in the phase of exacerbation;
• heart failure in the stage of decompensation;
• hepatic insufficiency or active liver disease;
• severe renal failure (serum creatinine content more than 300 μmol / L), progressive kidney disease, confirmed hyperkalemia, hypovolemia or dehydration;
• pregnancy;
• the period of breastfeeding;
• children and adolescents under 18 years of age (due to the lack of clinical data on the use of the drug in this age group);
• hypersensitivity / allergy to drug components.

Application in pregnancy and lactation

Xefokam is contraindicated for use in pregnancy and lactation (breastfeeding).

The use of the drug may adversely affect female fertility and is not recommended for women planning pregnancy.

special instructions

The risk of ulcerogenic action of the drug can be reduced by simultaneous administration of proton pump inhibitors and synthetic analogues of prostaglandins.In case of bleeding from the gastrointestinal tract, the drug should be stopped immediately and appropriate emergency measures taken. Especially it is necessary to observe the condition of those patients with gastrointestinal pathology, who for the first time receive a course of treatment with Xefokam.

Like other oxicams, the drug Xefokam inhibits the aggregation of platelets, so it is possible to increase the time of bleeding. When using the drug, it is necessary to strictly monitor the condition of patients who need absolutely normal functioning of the blood coagulation system (for example, patients who are undergoing surgery) who have disorders of the blood coagulation system or who receive drugs depressing coagulation (including Heparin at low doses), for in time to detect signs of bleeding.

If there are signs of liver damage (itchy skin, icterus of skin, nausea, vomiting, abdominal pain, darkening of urine, increased level of liver transaminases), stop taking the drug and consult a doctor.

Do not use the drug simultaneously with other non-steroidal anti-inflammatory drugs (NSAIDs).

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

Patients with impaired renal function caused by large blood loss or severe dehydration, Xefokam, as an inhibitor of the synthesis of prostaglandins, can be prescribed only after the elimination of hypovolemia and the associated danger of reducing renal perfusion.

Xephoxam (as well as other NSAIDs) can cause an increase in the concentration of urea and creatinine in the blood, as well as water retention, sodium, peripheral edema, arterial hypertension and other early signs of nephropathy. Long-term treatment of such patients with the drug Xefokam can lead to the following consequences: glomerulonephritis, papillary necrosis and nephrotic syndrome with transition to acute renal failure.

In elderly patients, as well as in patients suffering from hypertension and / or obesity, it is necessary to monitor blood pressure.

It is especially important to monitor kidney function in elderly patients, as well as in patients receiving diuretics simultaneously; simultaneously receiving medicines that can cause kidney damage.

With prolonged use of the drug, Xefokam should periodically monitor hematological parameters, as well as kidney and liver function.

Impact on the ability to drive vehicles and manage mechanisms

Patients receiving the drug should refrain from types of action that require increased attention, rapid mental and motor reactions, alcohol consumption.

Drug Interactions

With the simultaneous use of the drug Xefokam with cimetidine, the concentration of lornoxicam in plasma increases. Interaction with Ranitidine and antacids was not revealed.

With the simultaneous use of Xsefokam with anticoagulants or platelet aggregation inhibitors, bleeding time and an increased risk of bleeding may be increased (MHO control is necessary).

Simultaneous use with fenprokumonom reduces its effectiveness.

With the simultaneous use of non-steroidal anti-inflammatory drugs (NSAIDs) and heparin in combination with spinal / epidural anesthesia, the risk of spinal or epidural hematomas increases.

With the simultaneous use of Xefokam, the hypotensive effect of beta-adrenoblockers and ACE inhibitors decreases.

Xefokam reduces the diuretic effect and the hypotensive effect of diuretics.

Xefokam reduces renal clearance of digoxin.

At simultaneous application with antibiotics of group of quinolones the risk of development of a convulsive syndrome increases.

When used simultaneously with other NSAIDs or glucocorticosteroids (GCS), the risk of bleeding from the gastrointestinal tract increases.

Xefokam increases the concentration of Methotrexate in the serum.

When used simultaneously with selective serotonin reuptake inhibitors (eg, citalopram, fluoxetine, paroxetine, sertraline), the risk of bleeding from the gastrointestinal tract increases.

Xefokam increases the nephrotoxicity of cyclosporine.

Xefokam is able to enhance the hypoglycemic effect of sulfonylurea derivatives.

With the simultaneous use of Xephocam with corticotropin, potassium preparations, alcohol, the risk of GIT side effects increases.

With the simultaneous use of Xephocam with cefamandole, cefoperazone, cefotetan, valproic acid, the risk of bleeding increases.

With simultaneous application with tacrolimus, the risk of nephrotoxicity increases.

Analogues of the drug Xefokam

Structural analogs for the active substance:

• Xsefokam Rapid.

Analogues for the pharmacological group (Oksikamy):

• Aktameloks;
• Amelotex;
• Arthrosan;
• Bee-ksikam;
• Vero Piroxicam;
• Kalmopyrene;
• Lem;
• Matarin plus;
• Matarin;
• Medsikam;
• Melbeck;
• Melbek forte;
• Meloks;
• Meloksam;
• Meloksikam;
• Meloflam;
• Meloflex;
• Mesipol;
• Mixol Aud;
• Mirlocks;
• Movalis;
• Movasin;
• Movix;
• Pirokam;
• Piroxicam;
• Piroximeter;
• Revmadore;
• Remoxicam;
• Sanik;
• The Texman;
• Tenikam;
• Tenoktil;
• Tilcotyl;
• Tobitil;
• Feldoral;
• Velden;
• Finalal;
• Forte chondroxide;
• Hotemin;
• Exen Sanovel.

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