Movalis - instructions for use, reviews, analogs and forms of release (tablets 7.5 mg and 15 mg, suppositories, injections for injections) for the treatment of arthritis and arthritis in adults, children and pregnancy

In this article, you can read the instructions for using the drug Movalis. Comments of visitors of the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Movalis 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. Analogues of Movalis in the presence of existing structural analogs. Use for the treatment of arthrosis, arthritis and spondylitis in adults, children, as well as during pregnancy and lactation.

Movalis - non-steroidal anti-inflammatory drug (NSAID), refers to the derivatives of enolic acid and has anti-inflammatory, analgesic and antipyretic effects. The pronounced anti-inflammatory effect of meloxicam is established on all standard models of inflammation.

The mechanism of action of meloxicam (the substance of the drug Mowalis) is its ability to inhibit the synthesis of prostaglandins - known inflammatory mediators. In vivo meloxicam inhibits the synthesis of prostaglandins at the site of inflammation to a greater extent than in the mucous membrane of the stomach or kidneys. These differences are associated with a more selective inhibition of COX-2 compared to COX-1. It is believed that inhibition of COX-2 provides a therapeutic effect of NSAIDs, whereas inhibition of the constantly present isoenzyme COX-1 can cause side effects on the part of the stomach and kidneys.

Ex vivo showed that meloxicam at recommended doses did not affect platelet aggregation and bleeding time, in contrast to indomethacin, diclofenac, Ibuprofen and naproxen, which significantly inhibited platelet aggregation and increased bleeding time.

In clinical trials, side effects from the gastrointestinal tract as a whole occurred less frequently with the use of meloxicam 7.5 mg and 15 mg than with other NSAIDs that were compared. This difference in the frequency of side effects from the gastrointestinal tract is mainly due to the fact that when taking meloxicam, there were less frequent phenomena such as dyspepsia, vomiting, nausea, abdominal pain. The frequency of perforations in the upper gastrointestinal tract, ulcers and bleeding that were associated with the use of meloxicam, was low and depended on the magnitude of the dose of the drug.

Pharmacokinetics

Meloksikam is well absorbed from the digestive tract, as evidenced by the high absolute bioavailability when ingestion (89%). Simultaneous food intake does not affect the absorption of the drug. Meloksikam is almost completely metabolized in the liver with the formation of 4 pharmacologically inactive derivatives. It is excreted equally with feces and urine, mainly in the form of metabolites. In unchanged form with feces less than 5% of the daily dose is excreted, in the urine in unchanged form the drug is found only in trace amounts.

Indications

Symptomatic treatment:

• osteoarthritis (arthrosis, degenerative joint diseases);
• rheumatoid arthritis;
• ankylosing spondylitis.

Forms of release

Tablets 7.5 mg and 15 mg.

Candles rectal 7.5 mg and 15 mg.

Solution for intramuscular injection (injections for injections) in ampoules of 1.5 ml.

Suspension for oral administration.

Instructions for use and dosing regimen

In osteoarthritis (arthrosis) the daily dose is 7.5, if necessary, increase the dose to 15 mg per day.

In rheumatoid arthritis and ankylosing spondylitis drug prescribed to 15 mg a day, while achieving a positive therapeutic effect, the dose may be reduced to 7.5 mg per day.

In patients with an increased risk of adverse reactions, it is recommended to start treatment with a dose of 7.5 mg.

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

For adolescents, the maximum dose is 0.25 mg / kg body weight.

The maximum daily dose is 15 mg.

Tablets should be taken with food, washed down with water or other liquid.

Since the risk of adverse reactions depends on the size of the dose and duration of use, the drug should be used within the shortest possible time in the lowest possible effective dose.

The total daily dose of the drug Movalis in the form of tablets, suppositories and injections should not exceed 15 mg.

Side effect

• change in the leukocyte formula;
• leukopenia, thrombocytopenia, anemia;
• headache;
• dizziness;
• noise in ears;
• drowsiness;
• mood changes;
• perforation of the gastrointestinal tract;
• latent or obvious gastrointestinal bleeding, possibly fatal;
• gastroduodenal ulcers;
• colitis;
• gastritis;
• esophagitis;
• stomatitis;
• abdominal pain;
• diarrhea;
• nausea, vomiting;
• constipation;
• bloating;
• angioedema;
• skin rash;
• hives;
• itching;
• photosensitization;
• bronchial asthma;
• increased blood pressure;
• palpitation;
• acute renal insufficiency;
• glomerulonephritis;
• conjunctivitis;
• visual impairment.

Contraindications

• symptoms of bronchial asthma, polyposis of the nose, angioedema or urticaria after taking acetylsalicylic acid or other NSAIDs in anamnesis;
• peptic ulcer / perforation of the stomach and duodenum in the acute stage or recently transferred;
• Crohn's disease or ulcerative colitis in the phase of exacerbation;
• severe hepatic impairment;
• severe renal failure (if hemodialysis is not performed);
• acute gastrointestinal bleeding, recent cerebrovascular bleeding, or an established diagnosis of coagulation system diseases;
• severe uncontrolled heart failure;
• therapy of perioperative pain during coronary artery bypass grafting;
• pregnancy;
• lactation (breastfeeding);
• Children under 12 years of age (with the exception of juvenile rheumatoid arthritis when diagnosed);
• increased sensitivity to the active ingredient or auxiliary components of the drug (there is a possibility of cross-sensitivity to acetylsalicylic acid and other NSAIDs).

Carefully:

• Gastrointestinal disease in history;
• congestive heart failure;
• kidney failure;
• IHD;
• cerebrovascular diseases;
• dyslipidemia / hyperlipidemia;
• diabetes;
• diseases of peripheral arteries;
• elderly age;
• long-term use of NSAIDs;
• smoking;
• frequent use of alcohol.

Application in pregnancy and lactation

Movalis is contraindicated in pregnancy and during breastfeeding.

As a preparation that inhibits cyclooxygenase and the synthesis of prostaglandins, Movalis can affect fertility, and therefore is not recommended for women planning a pregnancy. In this regard, women who are being examined for such problems are recommended to cancel Movalis.

special instructions

Patients with gastrointestinal diseases should be observed regularly. If there is a gastrointestinal lesion of the gastrointestinal tract or gastrointestinal bleeding, Mawalis should be canceled.

Gastrointestinal bleeding, ulcers and perforations can occur during treatment at any time, as in the presence of alarming symptoms or information about serious gastrointestinal complications in the history, and in the absence of these symptoms. The consequences of these complications are generally more serious in the elderly.

Particular attention should be given to patients reporting the development of adverse skin and mucous membrane effects, as well as reactions of hypersensitivity to the drug, especially if similar reactions were observed during previous courses of treatment. The development of such reactions is observed, as a rule, during the first month of treatment.In such cases, the issue of termination of the application of Movalis should be considered.

Like other NSAIDs, Movalis can increase the risk of developing serious cardiovascular thrombosis, myocardial infarction, angina attack, possibly fatal. This risk increases with prolonged use of the drug, as well as in patients with the above mentioned diseases in the history and predisposed to such diseases.

NSAIDs inhibit the synthesis of prostaglandins in the kidneys, which are involved in maintaining renal perfusion. The use of NSAIDs in patients with reduced renal blood flow or reduced BCC can lead to decompensation of the secretive renal failure. After the abolition of NSAIDs, the kidney function is usually restored to its original level. The elderly patients, patients with dehydration, congestive heart failure, liver cirrhosis, nephrotic syndrome or acute renal dysfunction, patients taking diuretics at the same time, as well as patients undergoing serious surgical interventions that lead to hypovolemia.In such patients at the beginning of therapy, diuresis and renal function should be carefully monitored.

The use of NSAIDs in conjunction with diuretics can lead to a delay in sodium, potassium and water, as well as a decrease in natriuretic action of diuretics. As a result, predisposing patients may have signs of heart failure or hypertension. Therefore, careful monitoring of the condition of such patients is needed, and adequate hydration should be maintained. Before the beginning of treatment it is necessary to study the function of the kidneys.

In the case of combined therapy, kidney function should also be monitored.

When using the drug Movalis, an episodic increase in the level of transaminases or other indicators of liver function in the blood serum was reported. In most cases, this increase was small and transient. If the identified changes are significant or do not decrease over time, Movalis should be discontinued and observed for identified laboratory changes.

Weakened or depleted patients can tolerate undesirable events worse, therefore, such patients need careful monitoring.

Meloksikam, as well as other NSAIDs, can mask the symptoms of an infectious disease.

The maximum recommended daily dose of tablets 7.5 mg and 15 mg contains 47 mg and 20 mg of lactose, respectively. Patients with rare hereditary intolerance to galactose, lactase deficiency lapp, or impaired glucose / galactose absorption should not take this drug.

In the case of simultaneous use of anticoagulants for oral administration, ticlopidine, Heparin for systemic use, thrombolytic agents, careful monitoring of the effect of anticoagulants is necessary.

Impact on the ability to drive vehicles and manage mechanisms

Special studies on the effect of the drug on the ability to drive vehicles and mechanisms were not carried out. This activity should be refrained to patients with visual impairment, to patients who report drowsiness or other abnormalities from the CNS.

Drug Interactions

At simultaneous application with meloxicam of other inhibitors of synthesis of prostaglandins, incl. glucocorticosteroids and salicylates (acetylsalicylic acid), the risk of ulceration of the gastrointestinal tract and gastrointestinal bleeding increases due to synergism of action.The combined use of meloxicam and other NSAIDs is not recommended.

With the simultaneous use of meloxicam with selective serotonin reuptake inhibitors, an increased risk of gastrointestinal bleeding is possible.

Due to the presence of sorbitol in the composition of Mawalis, the simultaneous administration of sodium polystyrene sulfonate may cause the risk of developing colon necrosis with possible fatal outcome.

Anticoagulants for oral administration, antiplatelet agents, heparin for systemic use, thrombolytic agents, serotonin reuptake inhibitors and simultaneous use with Movalis increase the risk of bleeding due to inhibition of platelet function.

NSAIDs increase the concentration of lithium in the plasma by decreasing the renal excretion of lithium. It is recommended to monitor the level of lithium during the period of administration of the drug Movalis with a change in the dose of lithium preparations and their cancellation.

NSAIDs can reduce the tubular secretion of methotrexate, thereby increasing its plasma concentration and hematological toxicity, the pharmacokinetics of Methotrexate remain unchanged.In this regard, the simultaneous administration of Mawalis and methotrexate in a dosage more than 15 mg / week is not recommended.

The risk of developing an interaction between NSAIDs and methotrexate may also occur in patients using methotrexate in low doses, especially in patients with impaired renal function. Therefore, constant monitoring of the number of blood cells and the function of the kidneys is necessary. With the combined use of meloxicam and methotrexate for 3 days, the risk increases the toxicity of the latter.

NSAIDs decrease the effectiveness of intrauterine contraceptive devices.

The use of NSAIDs with diuretics in the case of dehydration of patients is accompanied by a risk of acute renal failure.

Antihypertensives (beta-blockers, ACE inhibitors, vasodilators, diuretics), NSAIDs reduce the effect of antihypertensive drugs, due to the inhibition of prostaglandins with vasodilating properties.

The combined use of NSAIDs and angiotensin 2 receptor antagonists enhances the effect of reducing glomerular filtration. In patients with impaired renal function, this can lead to the development of acute renal failure.

Kolestyramin, binding meloxicam in the digestive tract, leads to its faster excretion.

NSAIDs, acting on renal prostaglandins, can enhance the nephrotoxicity of cyclosporine.

It is impossible to exclude the possibility of interaction with hypoglycemic drugs for oral administration.

With the simultaneous use of antacids, cimetidine, Digoxin and furosemide, no significant pharmacokinetic interaction was identified.

Analogues of the drug Movalis

Structural analogs for the active substance:

• Amelotex;
• Arthrosan;
• Bee-ksikam;
• Lem;
• M-Kam;
• Matarin;
• Medsikam;
• MELBEK;
• Melbek forte;
• Meloks;
• Meloksam;
• Meloksikam;
• Meloksikam DS;
• Meloksikam Pfizer;
• Meloxicam Sandoz;
• Meloksikam SHTADA;
• Meloksikam-Prana;
• Meloksikam-Teva;
• Meloflam;
• Meloflex Rompharm;
• Mesipol;
• Mixol-Od;
• Mirlocks;
• Movasin;
• Movix;
• Exen-Sanovel.

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