Reception of Movalis. Movalis injections: features of the drug use. Treatment should be comprehensive

Instructions for the use of Movalis injections characterizes the drug as one of the most effective remedies for inflammatory pain. The abstract indicates significant differences between this medication and the drugs included with it in the same pharmacological group.

Movalis won an exceptional position due to its high selectivity - the ability to act only on a certain type of prostaglandins. Due to this quality, it quickly reaches the goal and to a lesser extent affects other organs and systems.

Movalis injections is a drug for intramuscular injection. The medicine is a transparent, homogeneous, lemon-colored solution without the presence of solid particles, which is poured into ampoules with a capacity of 2 ml.

Ampoules are made of thin, colorless transparent glass. Each product unit has a break line. A distinctive feature of the packaging is two horizontal markings in yellow and green, located just above the constriction.

The ampoule is not completely filled with the drug solution. It contains only 1.5 ml of liquid. This volume contains 15 mg of the active substance, which bears the non-proprietary international name - meloxicam.

In addition to the main component, meglumine, furfural and poloxamer are added, which contribute to the dissolution of the main active substance in water. Movalis composition is diluted in a special purified injection liquid, into which glycine and sodium salts are introduced to maintain a homogeneous structure.

The ampoules with the medicine are laid out on transparent plastic pallets and packed in cartons of three or five pieces. Each product package is accompanied by a paper annotation. The shelf life of the medicine is limited to five years.

Pharmacological properties and pharmacokinetics

Movalis belongs to the category of non-steroidal, i.e. non-hormonal, anti-inflammatory drugs (NSAIDs). Its action is to suppress the inflammatory process. Hence, it is able to relieve pain and to some extent fever.

The mechanism of action of the substance is based on the suppression of enzymes (cyclooxygenase or COX), which activate the production of prostaglandins.

It is with the release of prostaglandins that inflammation and, accordingly, pain begins.

COX is present in many organs and tissues. But the species of this enzyme behave differently. Cyclooxygenase of the first type is used almost constantly. She not only takes part in inflammatory processes, but also in reactions to the life support of the body. For example, this enzyme is part of the liver's self-regulation mechanism and blood clotting.

Cyclooxygenase of the second type is activated only under certain conditions. Any annoyance contributes to its launch. Pharmacists are faced with the task of learning to “turn off” this particular enzyme, without affecting the first type of COX, thereby not disrupting the course of natural processes.

Most NSAIDs act on both enzymes, which is why there are many side effects. In this light, meloxicam has a significant advantage. He has a selective ability. Acts to some extent on COX-1, but to a greater extent suppresses COX-2. Therefore, during treatment, patients are less likely to experience negative effects in relation to other organs.

The drug is well absorbed and excreted very slowly. With intramuscular administration, adsorption reaches almost one hundred percent. The active substance is 99% combined with blood albumin. Half of the total concentration is then found in the joint fluid.

A twofold decrease in activity is observed only after twenty hours. The breakdown of the compound occurs in the liver. The original substance is practically not detected in the products of elimination. The entire volume of the administered compound is decomposed by the liver into inactive substances. The metabolites are disposed of together with feces and urine.

Why are Movalis injections prescribed?

Movalis in injections is prescribed to obtain a quick analgesic effect in cases where other forms of the drug for some reason are not suitable. Injections relieve joint and periarticular pain of various origins.

They must be caused by inflammation. Concentrating in the joint fluid, meloxicam stops the development of the pathological process, preventing further release of prostaglandins.

Examples of diseases for which Movalis injections are prescribed may be arthrosis, arthritis, osteoarthritis, spondylitis. The medicine is part of symptomatic therapy and is only used to relieve acute pain.

Instructions for using the drug

Empirically, it turned out that the result of the use of the drug will depend on the dose. By the same principle, it was decided that the optimal amount of the compound required for one injection is 7.5 or 15 mg. It is in this dosage that the active substance exhibits the highest activity against COX-2 and affects COX-1 less.

While taking the medication, there is a high probability of side effects, therefore, it is necessary to follow two principles: choose the lowest possible dosage and shorten the course of treatment as actively as possible.

Movalis injections are given intramuscularly only at the acute stage of the process (during the first 2-3 days). In the future, they switch to other forms, for example, tablets.

Single dose - 0.5 or 1 ampoule. A whole ampoule is the maximum daily dosage. Patients with kidney disease are given no more than 7.5 mg per day. 15 mg is the total maximum daily amount of the active substance in all forms of the drug. If Movalis injections and suppositories or tablets are prescribed at the same time, then the total amount of meloxicam should not exceed the given value.

Movalis is not prescribed in conjunction with other NSAIDs and, moreover, is not mixed in the same syringe with other drugs. Injections are injected once a day or every other day deep into the muscle. The medication is not suitable for intravenous infusion.

Injections during pregnancy and lactation

Movalis is contraindicated during pregnancy planning. Its ability to inhibit the synthesis of prostaglandins and cyclooxygenase, which are involved in many vital processes, have a negative effect on the state of the reproductive organs.

In the third trimester, the medicine is prescribed only for health reasons. In the first and second trimester, it should be strictly prohibited, since it can cause malformations of the heart, kidneys and esophagus in an unborn child.

In the last weeks of pregnancy, the non-steroidal anti-inflammatory drug is still potentially harmful to the fetus. In addition, he can make adjustments to labor: weaken contractions, increase bleeding, generally delay labor and cause complications.
The medicine is not suitable for breastfeeding women, as it can be excreted in breast milk.

Alcohol compatibility

Simultaneous intake of the drug with alcohol can result in acute renal failure. This danger lies in wait for patients with impaired renal function. Despite the fact that the instruction does not contain a direct prohibition, it is not worth drinking alcohol during treatment.

Drug interactions

Non-steroidal anti-inflammatory drugs enhance each other's action, as a result of which the synthesis of prostaglandins is disrupted not only in the focus of pathology, but also where they ensure the normal course of physiological processes. The result of this action can be the formation of ulcers in the gastrointestinal tract, the development of pathologies from the kidneys, a decrease in blood viscosity and the opening of bleeding.

From the above, it follows that the drug cannot be combined with other analgesics, including acetylsalicylic acid, paracetamol, ibuprofen, etc.

Similar effects can be observed while taking the drug with hormonal anti-inflammatory drugs, methotrexate, serotonin inhibitors, and lithium preparations.

People who have chronic diseases or are on hormone therapy should know that Movalis suppresses the action of hormones, including those found in medical intrauterine devices, as well as drugs that lower blood pressure.

If during treatment with Movalis the patient takes another drug, it is imperative to check the drugs for compatibility.

Contraindications, side effects and overdose

The medicine is prescribed with caution to the elderly, smokers, people on hormone therapy, people with heart and liver diseases, diabetes mellitus and those who take other pain relievers on a regular basis.

The rest of the groups of people can be prescribed treatment only upon reaching the age of 18. This circle does not include those who have inflammatory or ulcerative diseases of the gastrointestinal tract, signs of dehydration, respiratory tract polyps, asthma, a tendency to allergic edema and rashes, hypersensitivity to the components of the drug, renal and liver failure.

The medicine is undesirable for women undergoing fertility treatment, as it inhibits the activity of the reproductive system. The drug is banned for persons who have recently undergone arterial surgery.

The following are noted as undesirable reactions:

• dizziness, disorientation, headaches, tinnitus, impaired vision, increased blood pressure, flushing of the face, irregular heartbeat;
• abdominal pain, changes in stool, belching, nausea, bloating, colic, opening of gastrointestinal ulcers and intestinal inflammation;
• violations of the hematopoietic organs, changes in the leukocyte formula, thrombocytopenia, a decrease in hemoglobin below threshold levels;
• edema, asthma attacks, pruritus, immediate reactions, urticaria, degenerative skin diseases;
• delay in urine formation, acute renal failure, depression of liver function;
• local reactions in the area of \u200b\u200bdrug administration.

The intensity of manifestations can be different and depends on the sensitivity of a particular patient. So, for example, gastrointestinal bleeding can come off at any stage of treatment. The likelihood of such an outcome increases in the elderly.

The higher the dose of the prescribed drug and the longer the treatment period, the stronger the manifestations of the cardiovascular system can be. Attacks of angina pectoris pass with varying intensity, including those that can be fatal.

Changes in the kidneys and liver are often temporary. With the complete abolition of the drug, organ functions are restored to their original level.

Before prescribing treatment, the patient should be examined for kidney pathology, since against the background of delayed urine formation, negative reactions may worsen. The drug provokes dehydration, due to which salt metabolism is disturbed and blood pressure increases.

Analogs

Often, in search of a better remedy, patients compare drugs with a similar effect, for example, "Movalis" with "Voltaren", "Nise" or "Xefocam". Among the popular drugs, it is "Movalis" that looks preferable.

Nise, in contrast to it, has a high liver toxicity. "Ksefokam" often causes bleeding from the gastrointestinal tract. "Voltaren" (based on diclofenac) does not have a pronounced selectivity and therefore more intensely provokes the appearance of side effects.

In search of a suitable medicine, it is better to pay attention to Movalis analogs with the same active ingredient:

• "Amelotex", available in the form of a gel, tablets and injections;
• Artrozan, injections and tablets;
• "Genitron" at choice or solution for injection, or tablets;
• "LEM" - oral form (tablets);
• "Mataren" in the form of tablets and cream;
• "Melbek" injections and pills;
• "Melocan" - oral form;
• "Melox" tablets;
• "Meloxicam" from various manufacturers in the form of injections and tablets.

A variety of such funds provides an opportunity to choose a drug from the optimal price range. Almost all analogues are cheaper than the original medicine.

It follows from the above that Movalis is a very effective drug. In comparison with similar agents, it causes less side effects. However, it can be very dangerous for people with certain pathologies. To reduce the likelihood of side effects, it should be taken as soon as possible.

Photo of the drug

Description up to date on 11.08.2015

• Latin name:Movalis
• ATX code:M01AC06
• Active substance:Meloxicam
• Manufacturer:Boehringer Ingelheim Pharma GmbH & Co. KG. (Germany), Boehringer Ingelheim Espana, SA (Spain), Istituto De Angeli S.r.l. (Italy)

Composition

The drug contains an active substance meloxicam , as well as the following auxiliary components:

Movalis tablets: sodium citrate, lactose monohydrate, MCC, povidone, anhydrous colloidal silicon dioxide, magnesium stearate, crospovidone.

Composition injections: meglumine, glycofurol, poloxamer 188, glycine, sodium hydroxide, sodium chloride, purified water.

Candles Movalis: base for the manufacture of suppositories suppositories BP, cremophor RH40 (polyethylene glycol glyceryl hydroxystearate).

Movalis suspension: colloidal silicon dioxide, hyetellose, , xylitol; benzoate, saccharinate and sodium dihydrogen phosphate dihydrate; citric acid monohydrate, raspberry flavor, purified water.

Release form

The drug is produced in:

• tablet form (dosage of active substance 7.5 mg (package No. 20) and 15 mg (package No. 10 or No. 20));
• solution for injection 10 mg / ml (ampoules 1.5 ml, package No. 5);
• rectal suppositories 7.5 and 15 mg (pack # 6);
• suspensions 1.5 mg / ml (bottle 100 ml).

The tablets are flat-cylindrical and have beveled edges. One side is marked with the company logo, the other has a fault line. The color of the tablets is from pastel yellow to lemon yellow, roughness is allowed on the surface.

The solution is yellow with a greenish tinge, transparent.

Suppositories are smooth yellowish-green, have a funnel-shaped depression at the base.

The suspension is a viscous substance of yellowish-green color.

The manufacturer does not produce external therapy agents (ointment, gel).

pharmachologic effect

Relieves pain, possesses antipyretic and anti-inflammatory activity .

Pharmacodynamics and pharmacokinetics

Pharmacodynamics: what is Meloxicam and how does it work?

Wikipedia states that the mechanism of action of the drug is based on its ability to suppress the production of Pg. Its pronounced anti-inflammatory activity has been established in all standard models of inflammation.

In vivo, it suppresses Pg synthesis in the pathological focus to a greater extent than in the kidneys or in the gastric mucosa, which is associated with a more selective inhibition of the COX-1 isoenzyme in comparison with COX-2.

It is generally accepted that the therapeutic efficacy of NSAIDs is provided by the suppression of COX-2, while the side effects of these drugs on the part of the kidneys and the digestive tract arise due to the suppression of the constantly present COX-1 isoenzyme.

Selectivity for COX-2 has been confirmed in various tests, both in vitro and ex vivo. In ex vivo models, it more actively suppressed liposaccharide-stimulated production of PgE2, which is controlled by COX-2, than the production of thromboxane, which is involved in hemocoagulation, which is controlled by COX-1. The effects were dose-dependent.

It was also shown in ex vivo models that at recommended doses the drug does not change bleeding time and does not affect aggregation. ... This fundamentally distinguishes from , , and .

Clinical studies have established that NSAID gastropathy when taken Meloxicam develops much less frequently than when taking other NSAIDs. Vomiting, abdominal pain, nausea, dyspepsia in patients taking Meloxicam , were recorded less frequently than in patients taking other NSAIDs.

Application-related frequency Meloxicam bleeding, perforations and upper gastrointestinal ulcers was low and dose-dependent.

Pharmacokinetics:

• absorption from the alimentary canal is good, does not change with the simultaneous intake of food;
• bioavailability - 89% (when taken orally);
• TSmax with a single dose - 5-6 hours, during the period of a steady state of pharmacokinetic parameters (when taking Meloxicam in tablets and in the form of a suspension) - 5-6 hours;
• the time to reach a steady state of pharmacokinetic parameters with repeated use - 3-5 days;
• linking with (plasma proteins) - 99%;
  T1 / 2 (average) - 20 hours

Dosing 1 r. / Day leads to an average plasma concentration with slight fluctuations in peak values: for 7.5 mg in the range of 0.4-1, for 15 mg - in the range of 0.8 2 μg / ml (Cmax and Cmin during a steady state of pharmacokinetic parameters).

Concentration of honey. the drug after systematic administration for more than six months are similar to the concentrations observed after 14 days. oral dose of 15 mg.

Pharmacokinetic parameters (Cmax, Cmin, TCmax) Meloxicam in the form of suppositories are similar to those for tablets.

The drug penetrates well into the synovium.

Movalis and its analogs in ampoules differ mainly in price: a significant disadvantage of Movalis is its high cost. Inexpensive substitutes for drugs - drugs Arthrosan , Meloxicam , Liberum .

Similar drugs in tablet form

You can replace Movalis in this dosage form with drugs: , Mataren , Mixol-Od , , M-Kam , To medics , Oxycamox , Movix ... Also, the drugs listed in the list of analogs for the solution are available in the form of tablets.

The price of Movalis analogues in tablets is from 120 rubles.

Which is better: Movalis or Meloxicam?

Meloxicam is the active ingredient of Movalis, therefore, these drugs do not differ in their action. The main advantage of Meloxicam is its significantly lower cost.

Movalis or Voltaren - which is better?

Is a drug based on diclofenac ... The difference between this substance and meloxicam is that it non-selectively suppresses COX-1 and COX-2. Consequently, the use of Voltaren is often accompanied by the development of adverse reactions that are associated with inhibition of COX-1.

Unlike Voltaren, Movalis also affects the metabolism of cartilage tissue and increases the reparative capacity of chondrocytes.

Thus, for pain relief, both drugs are equally effective, but with osteoarthritis the drug of choice is Movalis.

Ksefokam or Movalis - which is better?

If we compare Movalis with , then the latter is characterized by a more pronounced analgesic activity and a higher incidence of adverse reactions against the background of its use. Movalis relieves inflammation better and is better tolerated by patients.

Thus, we can conclude that Movalis is preferable for patients with stomach ulcer in history, as well as for patients currently suffering from gastritis .

Movalis is more effective at inflammatory-degenerative joint diseases that are accompanied by mild to moderate pain, and Ksefokam recommended for intense pain of various origins, as well as for course use in patients with a healthy gastrointestinal tract.

Nise or Movalis - which is better?

Active substance of the drug — - applies as well meloxicam , to conventionally selective NSAIDs. Both drugs are effective for fever and pain, and are equally good at relieving symptoms of inflammatory reactions.

Nimesulide toxic to the liver, therefore, if present acute and chronic pathologies of the hepatobiliary system meloxicam is more preferable because it does not have such effects.

Patient reviews indicate that for short-term use (for example, in order to relieve acute pain) is more suitable Nise , in case of recurring pain, Movalis is more effective. Meloxicam relieves pain more slowly, but at the same time its effect lasts longer than the effect after application nimesulide .

Movalis and alcohol compatibility

The instructions do not indicate the compatibility of the drug with alcoholic beverages, but this does not mean that the latter are allowed to be consumed during the period of treatment with Movalis.

Alcohol, disrupting the redistribution of fluid in the body, thereby provoking its dehydration. The use of Movalis in dehydrated patients, in turn, can lead to acute renal failure.

During pregnancy

Like other drugs with the ability to suppress the activity of COX-2 and Pg, meloxicam may have a negative effect on reproductive function. When planning a pregnancy, it is recommended to stop treatment with Movalis.

Suppression of Pg synthesis negatively affects the development of pregnancy and / or fetal development. In particular, when taken by the mother meloxicam in the early period of pregnancy, the risk of miscarriages increases, as well as the occurrence gastroschisis and heart defects in a child ... It is believed that the likelihood of such violations increases with increasing duration of treatment and the dose of the drug.

In the 1st and 2nd trimesters, the appointment of Movalis is possible for health reasons, but the dose assigned to a woman should be minimal.

In the 3rd trimester, all Pg inhibitors pose a risk to the fetus:

• cardiorespiratory toxicity ;
• kidney dysfunction which can develop into renal failure with oligohydramnios .

In addition, taking the drug in the last weeks of pregnancy can increase the bleeding time, the development antiaggregatory effect , suppression of uterine contractions and, as a result, delay or delay in labor.

Due to the risk of penetration meloxicam into breast milk, Movalis is not recommended for taking during breastfeeding.

Reviews about Movalis

Reading reviews on the forums, you can see that the majority of patients who took Movalis give this drug a fairly high rating.

The drug rapidly accumulates in the body, is slowly excreted, its bioavailability is higher than that of analogues, and the variety of forms allows you to choose the most convenient one depending on the indications and subjective sensations.

The agent has a relatively small spectrum of undesirable side effects in comparison with other NSAIDs and a proven high clinical efficacy.

This allows it to be included in the complex therapy of many pathological conditions that accompany inflammatory and degenerative rheumatic diseases as well as use to relieve pain when primary and fever .

For joint pain, inflammation, fever, and other types of pain syndrome, doctors prescribe medications that can eliminate such manifestations of the disease. The first in the line of choice of a drug for symptomatic treatment are non-narcotic analgesics with a pronounced anti-inflammatory effect. One of the most effective drugs is Movalis. This non-steroidal anti-inflammatory agent was developed and manufactured by the German company Boehringer Ingelheim, one of the top 20 leading pharmaceutical companies in the world. Movalis is characterized by a powerful anti-inflammatory effect against a background of low toxicity and sufficient safety. It is used in the complex treatment of various joint pathologies and has earned a lot of positive feedback and patient confidence. The medication is presented in several dosage forms. The instructions attached to the drug will tell you about the mechanism of action of Movalis and the rules of admission.

Pharmacological properties of the drug

The main active ingredient of Movalis is. It is an NSAID belonging to the oxycam group - a derivative of enolic acid. It is he who determines the pharmacological properties of Movalis. As indicated in the instructions, when introduced into the patient's body, the medication has a wide range of actions characteristic of non-steroidal drugs:

• Anti-inflammatory effect - quickly eliminates the clinical symptoms of all types of inflammation: pain syndrome, swelling of soft tissues, focal hyperemia (redness of the skin and mucous membranes in the area of \u200b\u200binflammation), local hyperthermia (increased temperature of the affected area of \u200b\u200bthe body), dysfunction of the inflamed organ. The effect is achieved by inhibiting the activity of cyclooxygenases involved in the synthesis of prostaglandins. These lipid physiologically active substances are formed in all tissues, they increase the sensitivity of pain receptors to factors damaging or potentially dangerous to the integrity of the structure (nociceptive stimuli).

• Antipyretic action - fights attacks of heat, rise and maintenance of elevated body temperature. The antipyretic effect is provided by a decrease in the production of protective factors - endogenous prostaglandin E2, which activates the thermoregulation center located in the hypothalamus. It manifests itself only in a febrile state, the drug does not lower the normal temperature, and it also does not affect the total duration of the febrile period.

• Analgesic effect - relieves or reduces the severity of pain, increasing the pain threshold and reducing the excitability of the subcortical center, which interprets the pain signal and forms a holistic pain sensation. The mechanism of action is based on incl. and to suppress the production of highly active regulators of biochemical reactions - prostaglandins, which are involved in the development of the inflammatory process. Acting only on the focus of pain, Movalis, like all non-narcotic painkillers, does not affect other parts of the nervous system.

A distinctive feature of Movalis is the selectivity of action. The text of the instructions says that the therapeutic effect is achieved by inhibiting the activity of the pathological enzyme COX-2 (cyclooxinenase of the second type), which is formed during inflammation. At the same time, its action does not affect the physiological enzyme COX-1 that is constantly present in the body of a healthy person, which, with an equal strength of the anti-inflammatory effect, avoids many side effects that inevitably arise when using non-selective drugs.

Composition, release form

For ease of use and in order to achieve the desired therapeutic effect, the manufacturer prepares Movalis of different dosage and consistency. Each package comes with instructions. The original drug enters the pharmaceutical market in solid, liquid and soft dosage forms, these are:

• Tablets - round, with the company logo on one side and two engravings separated by a groove "77C" on the other, the color ranges from pale to deep yellow. Meloxicam 7.5 or 15 mg tablets are placed in contoured plastic cells. A cardboard box can contain 1 blister (10 pcs.) Or 2 (20 pcs.).

• Injection solution - 15 mg of Meloxicam in 1.5 ml transparent glass ampoules. A homogeneous liquid of greenish-yellow color, injected intramuscularly. The cardboard box contains a contour pallet with 3, 5 or 10 (in hospital packs) ampoules.

• Rectal suppositories 7.5, 15 mg are a solid, smooth or slightly rough to the touch, homogeneous mass in the form of a cylindrical candle with a pointed end and a funnel-shaped depression at the base. The pharmacy package contains 6 yellow-green suppositories enclosed in protective aluminum foil.

• Suspension for internal use 7.5 mg / 5 ml - labeled 100 ml dark vial with a viscous greenish liquid in which the smallest particles of solid are suspended in suspension. The cardboard box also contains instructions and a special measuring spoon.

In addition to the active ingredient - Meloxicam, all forms of the drug contain different auxiliary ingredients:

• Tablets: sodium salt of citric acid - preservative; microcrystalline cellulose - food fiber; povidone K-25, polysorb, crospovidone - sorbents, absorb and remove slags and toxins, have binding and prolonging properties; lactose (milk sugar), magnesium stearate - fillers.

• Solution for injection: meglumine (N-methyl-D-glucamine) - stabilizer; sodium chloride, glycofurol, sterile water for injection - solvents; glycine is a metabolic agent; poloxamer 188 - emulsifier, has antimicrobial activity; sodium hydroxide is an alkaline emulsifying additive.

• Suppositories: suppository BP - semi-synthetic suppository base; Cremophor RH40 is a surfactant that enhances the pharmacological action of Movalis.

• Suspension: polysorb - sorbent; glycerin - emulsifier and stabilizer; sodium dihydrogen phosphate dihydrate - filler, conveyor, water-retaining agent; sodium saccharin - an artificial sweetener; food grade citric acid monohydrate - acidity regulator. Sorbitol, hydroxyethyl cellulose, xylitol, benzoate - food additives, thickeners, preservatives. It also contains a raspberry flavor and purified water.

Since 2016, Boehringer Ingelheim has suspended slurry production.

How Movalis works

All dosage forms of Movalis demonstrate a pronounced anti-inflammatory effect, have analgesic and antipyretic properties. When taken into the body, they are easily absorbed and provide quick results:

• when injected into the thickness of the muscle tissue, Meloxicam begins to act faster - after 30 minutes. after hitting. The maximum concentration in the blood serum is recorded after 1-1.6 hours, the indicator lasts for 5-6 hours. The active component is completely absorbed, its bioavailability with the injection route reaches 100%;

• when ingested, it is absorbed by 89-90%, does not require a separate intake with food, because Digestive processes do not affect the ability of Movalis to be absorbed from the gastrointestinal tract. The peak concentration of the active substance with a single dose of tablets, suspensions or suppositories is noted after 5-6 hours.

In the blood, 99% of Meloxicam binds to serum albumin, which performs a transport function. It enters the focus of inflammation through the histohematogenous barrier located between tissue fluid and blood. The drug freely penetrates into the synovium - the stronger the inflammation, the higher the level of Meloxicam here. As follows from the instructions, the processes of biotransformation occur almost completely in the liver, as a result of chemical conversion, pharmacologically inactive metabolites are formed. They are excreted naturally - together with feces and urine, in equal amounts. No more than 5% of the received Movalis leaves the body unchanged. The half-life ranges from 13 hours for children and 20 for adults. Revealed renal dysfunction or moderate hepatic impairment does not significantly affect the distribution, change and excretion of Meloxicam.

Reception of Movalis

The exact dosage, rules of admission, duration of therapy are set by the doctor. When prescribing the drug and instructing on the method of treatment, the nature of the disease, the age of the patient, and the presence of complications are taken into account. Daily fluctuations in the content of Meloxicam in the blood are small, which allows you to take the medication once - once a day. To reach a plateau of concentration, which remains stable for a year, multiple use of Movalis is required - usually for 2 weeks (in the form of tablets or suppositories), but a stable, stable state occurs as early as 3-5 days of therapy.

The most effective form is injections. With this method of admission, it is a short-term drug. Injections are prescribed when it is impossible or insufficiently effective to take other forms, because they allow you to quickly alleviate the patient's condition. The indication is an acute attack of rheumatoid arthritis, spondylitis, chronic polyarthritis, 1-2 days of another disease, accompanied by severe pain. It is preferable to limit yourself to 1 injection, in severe cases - 2-3. Admission rules:

• the injection site is the upper quarter of the gluteus maximus muscle; when the injection is repeated, use the second side of the body. Intravenous injections are prohibited. Observe the angle of introduction and the correct choice of the site, avoid damage to a large vessel or nerve;

• provide deep and slow introduction in compliance with all stages of disinfection - cleaning, disinfection;

• severe pain at the time of the injection is a signal to terminate the procedure;

• the standard dose is 7.5 mg, the daily dose is limited to 15 mg;

• injections are contraindicated in patients under 18 years of age.

After elimination of severe pain and acute signs of inflammation, an internal or rectal intake is prescribed. The medicine, intended for administration through the mouth or into the rectum, has a softer effect on the body, does not provoke damage to muscle fibers and tissue death. When switching and combining, it is important to observe the total dosage. It is advisable to adhere to a single dose during the day and constantly monitor symptoms. Instructions for use and therapy regimen:

• in case of disorders of the functioning of the liver, kidneys, old age, long-term treatment - it is optimal to limit yourself to 7.5 mg, in other cases it is permissible to take 15 mg;

• the maximum dose for children and adolescents is calculated based on their weight, in the calculation of 0.125 mg per kg, but not more than 0.25 / kg;

• when dosing the suspension, use a measuring spoon;

• tablets and suspension should be taken with food or separately with water, do not chew tablets;

• do not combine with other NSAIDs.

Symptomatic therapy aimed at eliminating adverse symptoms is indicated for patients with the following pathologies:

• degenerative joint lesions - deforming arthrosis, arthritis;

• all forms of rheumatoid arthritis;

• chronic systemic disease of the axial skeleton - ankylosing spondylitis;

• other inflammatory diseases affecting the musculoskeletal system - reactive arthritis, dorsalgia - unspecified back pain.

Contraindications, side effects

All forms of Movalis have the same contraindications, which should be taken into account when prescribing treatment. The absolute prohibition to use are:

• hypersensitivity to Meloxicam, additional ingredients, intolerance to NSAIDs, fructose, lactase deficiency, a history of allergic reactions;

• recently suffered inflammatory diseases, erosion, ulcers of the esophagus and other organs of the gastrointestinal tract, exacerbation stages, complications in the form of bleeding from the gastrointestinal tract;

• severe forms of heart, renal, hepatic, vascular insufficiency;

• blood clotting disorders, cerebrovascular disease, rectal diseases, rectal bleeding;

• the period of therapy for acute thrombosis, rehabilitation treatment after coronary artery bypass grafting;

• use in pediatrics: suppositories and suspensions up to 12 years old, tablets - 16, injections - 18;

• carrying a child, breastfeeding.

To relative contraindications requiring increased caution, the instruction includes:

• total form of heart failure, accompanied by blood stagnation, impaired blood circulation in the arteries, ischemic disease;

• violation of lipid metabolism, insulin deficiency, increased levels of potassium salts;

• planning pregnancy;

• long-term use of NSAIDs;

• elderly, senile age;

• addiction to alcohol, drugs, nicotine addiction.

In such cases, the final decision on the admissibility of the appointment of Movalis is made by a qualified specialist. Possible side effects are warned by the instruction for the drug, it can be observed:

• violation in the blood system, a decrease in the level of leukocytes, hemoglobin, platelets;

• anaphylaxis, angioedema, skin manifestations of allergies, toxic erythema, allergic contact dermatitis;

• malfunctions of the kidneys, liver, disorders of urination, ovulation;

• swelling, soreness, redness at the injection site, post-injection skin necrosis.

Price and analogues

The international name of the drug patented under the Movalis brand is Meloxicam, which corresponds to the name of its main active ingredient. Released strictly according to the recipe. Drug price in pharmacy chains:

• solution for injection (ampoules 1.5 ml), Spain: 3 pcs. - 650 rubles., 5 pcs. - 860 rubles;

• tablets, Greece: dosage of 0.015 10 pcs. - 530 rubles., 20 pcs. - 740 rubles; dosage 0.0075 20 pcs. - 640 rubles;

• suspension (bottle 100 ml), USA: 7.5 / 5 - 580 rubles;

• rectal suppositories made in Austria, Germany: 15 mg, 6 pcs. - from 300 rubles, under the order.

Prices for Movalis are high, but the drug has significant advantages over other selective NSAIDs of a similar effect, is characterized by maximum efficiency and the most gentle effect. There are many inexpensive analogues, the most famous are:

• drugs based on Diclofenac, Ibuprofen;

• injections Mesipol, Liberum;

• tablets Melbek and Molbek Forte, Mirlox.

The risk of adverse effects for a person depends on the correct choice of medicine, dosage, dosage form and duration of treatment. Observing caution, following the doctor's instructions and controlling the slightest changes in your body, you can quickly eliminate severe pain syndrome, lower the temperature, and suppress the inflammatory process.

Before taking medications, be sure to consult with your doctor, undergo the necessary examination

Dosage Form: & nbsptablets Composition:

1 tablet contains:

Active substance: meloxicam - 7.5 mg or 15.0 mg.

Excipients: sodium citrate dihydrate - 15 mg (30 mg), lactose monohydrate - 23.5 mg (20 mg), microcrystalline cellulose - 102 mg (87.3 mg), povidone K25 - 10.5 mg (9 mg), colloidal silicon dioxide - 3.5 mg (3 mg), crospovidone - 16.3 mg (14 mg), magnesium stearate - 1.7 mg.

Description:

7.5 mg tablets

Tablets 15 mg

Round, pale yellow to yellow tablets. One side is convex with a beveled edge. On the convex side - the company logo; on the other side is the code and the concave risk. Roughness of tablets is allowed.

Pharmacotherapeutic group:Non-steroidal anti-inflammatory drug - NSAIDs ATX: & nbsp

M.01.A.C.06 Meloxicam

M.01.A.C Oxycama

Pharmacodynamics:

MOVALIS is a non-steroidal anti-inflammatory drug, belongs to the derivatives of enolic acid and has anti-inflammatory, analgesic and antipyretic effects. The pronounced anti-inflammatory effect of meloxicam has been established in all standard models of inflammation. The mechanism of action of meloxicam is its ability to inhibit the synthesis of prostaglandins - known mediators of inflammation.

Meloxicam in vivo inhibits the synthesis of prostaglandins at the site of inflammation to a greater extent than in the gastric mucosa or kidneys.

These differences are associated with a more selective inhibition of cyclooxygenase-2 (COX-2) compared with cyclooxygenase-1 (COX-1). It is believed that inhibition of COX-2 mediates the therapeutic effects of NSAIDs, whereas inhibition of the persistent isoenzyme COX-1 may be responsible for gastric and renal side effects. The selectivity of meloxicam in relation to COX-2 has been confirmed in various test systems, asin vitro and in vivo. Selective ability of meloxicam to inhibit COX-2 has been demonstrated using human whole blood as a test systemin vitro. It was found that (at doses of 7.5 and 15 mg) inhibited COX-2 more actively, exerting a greater inhibitory effect on prostaglandin productionE 2, stimulated by lipopolysaccharide (reaction controlled by COX-2) than to the production of thromboxane involved in blood coagulation (reaction controlled by COX-1). These effects were dose dependent. In researchex vivo it has been shown that (in doses of 7.5 mg and 15 mg) does not affect platelet aggregation and bleeding time.

In clinical studies, gastrointestinal (GI) side effects generally occurred less frequently with meloxicam 7.5 and 15 mg than with other NSAIDs with which the comparison was made. This difference in the frequency of side effects from the gastrointestinal tract is mainly due to the fact that when taking meloxicam, such phenomena as dyspepsia, vomiting, nausea, and abdominal pain were less often observed. The incidence of upper gastrointestinal perforations, ulcers and bleeding associated with meloxicam was low and dose-dependent.

Pharmacokinetics:

Absorption

Meloxicam is well absorbed from the gastrointestinal tract, as evidenced by the high absolute bioavailability (90%) after oral administration. After a single use of meloxicam, the maximum plasma concentration of the drug is reached within 5-6 hours. The simultaneous intake of food and inorganic antacids does not alter absorption. When using the drug inside (in doses of 7.5 and 15 mg), its concentrations are proportional to the doses. A steady state of pharmacokinetics is achieved within 3-5 days. The range of differences between the maximum and basal concentrations of the drug after taking it

once a day is relatively small and amounts to 0.41.0 μg / ml when using a dose of 7.5 mg, and 0.8-2.0 μg / ml when using a dose of 15 mg (valuesCmin and Cmax in the period of steady state pharmacokinetics), although values \u200b\u200boutside the specified range were also noted.

The maximum plasma concentration of meloxicam in the period of steady state pharmacokinetics is achieved 5-6 hours after oral administration.

Distribution

Meloxicam binds very well to plasma proteins, mainly albumin (99%). Penetrates into synovial fluid, the concentration in the synovial fluid is approximately 50% of the plasma concentration. The volume of distribution after repeated oral administration of meloxicam (in doses from 7.5 mg to 15 mg) is about 16 liters, with a coefficient of variation from 11 to 32%.

Metabolism

Meloxicam is almost completely metabolized in the liver with the formation of 4 pharmacologically inactive derivatives. The main metabolite, 5'-carboxymeloxicam (60% of the dose), is formed by oxidation of the intermediate metabolite, 5'-hydroxymethylmeloxicam, which is also excreted, but to a lesser extent (9% of the dose). Researchin vitro showed that this metabolic transformation plays an important roleCYP 2 C 9, isozyme is of additional importanceCYP 3 A 4. Peroxidase is involved in the formation of two other metabolites (constituting, respectively, 16% and 4% of the drug dose), the activity of which is likely to vary individually.

Withdrawal

It is excreted equally through the intestines and by the kidneys, mainly in the form of metabolites. In unchanged form, less than 5% of the daily dose is excreted in the feces, in urine unchanged the drug is found only in trace amounts. The average elimination half-life of meloxicam varies from 13 to 25 hours.

Plasma clearance averages 7 - 12 ml / min after a single dose of meloxicam.

Lack of liver and / or kidney function

Lack of liver function, as well as mild renal failure, has no significant effect on the pharmacokinetics of meloxicam. The rate of elimination of meloxicam from the body is significantly higher in patients with moderate renal failure. poorly binds to plasma proteins in patients with end-stage renal failure. In end-stage renal disease, an increase in volume distribution can lead to higher concentrations of free meloxicam, therefore, in these patients, the daily dose should not exceed 7.5 mg.

Elderly patients

Elderly patients have similar pharmacokinetic parameters compared to younger patients. In elderly patients, the mean plasma clearance during steady state pharmacokinetics is slightly lower than in younger patients. Older women have higher valuesAUC (area under the concentration-time curve) and a long elimination half-life compared to young patients of both sexes.

Indications:

Symptomatic treatment:

osteoarthritis (arthrosis, degenerative diseases of the joints), including with a pain component;

rheumatoid arthritis;

ankylosing spondylitis;

other inflammatory and degenerative diseases of the musculoskeletal system, such as arthropathies, dorsopathies (for example, sciatica, lower back pain, shoulder periarthritis, and others), accompanied by pain.

Contraindications:

Hypersensitivity to the active ingredient or auxiliary components of the drug;

Complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses, angioedema or urticaria caused by intolerance to acetylsalicylic acid or other nonsteroidal anti-inflammatory drugs due to the existing likelihood of cross-sensitivity (including a history);

Erosive and ulcerative lesions of the stomach and duodenum in the acute stage or recently transferred;

Inflammatory bowel disease - Crohn's disease or ulcerative colitis in the acute stage;

Severe liver failure;

Severe renal failure (if hemodialysis is not performed, creatinine clearance is less than 30 ml / min, as well as with confirmed hyperkalemia), progressive kidney disease;

Active gastrointestinal bleeding, recent cerebrovascular bleeding or an established diagnosis of diseases of the blood coagulation system

Severe uncontrolled heart failure;

Pregnancy;

Breast-feeding;

Therapy of perioperative pain during coronary artery bypass grafting;

Children under 12 years old;

Rare hereditary galactose intolerance (the maximum daily dose of the drug with a dosage of 7.5 mg and 15 mg meloxicam contains 47 mg and 20 mg of lactose, respectively).

Carefully:

Diseases of the gastrointestinal tract in the anamnesis (peptic ulcer and duodenal ulcer, liver disease);

congestive heart failure;

renal failure (creatinine clearance 30 - 60 ml / min);

cardiac ischemia;

cerebrovascular diseases;

dyslipidemia / hyperlipidemia;

diabetes;

concomitant therapy with the following drugs: oral glucocorticosteroids, anticoagulants (including), antiplatelet agents, selective serotonin reuptake inhibitors (including);

peripheral arterial disease;

elderly age;

long-term use of NSAIDs;

smoking;

frequent alcohol consumption.

Pregnancy and lactation:

The use of MOVALIS is contraindicated during pregnancy.

It is known that NSAIDs penetrate into breast milk, therefore, the use of MOVALIS during breastfeeding is contraindicated.

As a drug that inhibits cyclooxygenase / prostaglandin synthesis, MOVALIS can affect fertility and is therefore not recommended for women planning a pregnancy. may delay ovulation. In this regard, for women who have problems with conception and are undergoing examination for such problems, it is recommended to stop taking MOVALIS.

Method of administration and dosage:

Osteoarthritis with pain syndrome: 7.5 mg per day. If necessary, this dose can be increased to 15 mg per day.

Rheumatoid arthritis:

Ankylosing spondylitis: 15 mg per day. Depending on the therapeutic effect, this dose can be reduced to 7.5 mg per day.

In patients with an increased risk of adverse reactions (a history of gastrointestinal tract disease, the presence of risk factors for cardiovascular disease), it is recommended to start treatment with a dose of 7.5 mg per day (see Special Instructions).

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

Since the potential risk of adverse reactions depends on the dose and duration of treatment, the lowest possible dose and duration of use should be used.

Combined use

Do not use the drug concurrently with other NSAIDs.

The total daily dose of MOVALIS used in different dosage forms should not exceed 15 mg.

Teenagers

The maximum dose for adolescents (12 - 18 years old) is 0.25 mg / kg and should not exceed 15 mg.

The use of tablets

The drug is contraindicated in children under 12 years of age due to the impossibility of selecting the appropriate dosage for this age group.

The total daily dose should be taken at one time, with meals, with water or other liquid.

Side effects:

The side effects are described below, the connection of which with the use of the drug MOVALIS was regarded as possible.

Side effects registered with post-marketing use, the connection of which with the drug intake was regarded as possible, are marked with a *.

Within the systemic organ classes, the following categories are used in terms of the incidence of side effects: very often (\u003e 1/10); often (\u003e 1/100,< 1/10); нечасто (> 1/1,000, < 1/100); редко (> 1/10,000, < 1/1,000); очень редко (< 1/10,000); не установлено.

On the part of the blood and lymphatic system

Uncommon - anemia;

Rarely - changes in the number of blood cells, including changes in the leukocyte count, leukopenia, thrombocytopenia.

From the immune system

Uncommon - other immediate hypersensitivity reactions *;

Not established - anaphylactic shock *, anaphylactoid reactions *.

From the nervous system

Often - headache;

Infrequently - dizziness, drowsiness.

Mental disorders

Often - mood changes *;

Not established - confusion *, disorientation *.

From the senses

Infrequently - vertigo;

Rarely - conjunctivitis *, visual impairments, including blurred vision *, tinnitus.

From the gastrointestinal tract

Often - abdominal pain, dyspepsia, diarrhea, nausea, vomiting;

Uncommon - latent or overt gastrointestinal bleeding, gastritis *, stomatitis, constipation, bloating, belching;

Rarely - gastroduodenal ulcers, colitis, esophagitis;

Very rarely - perforation of the gastrointestinal tract.

From the liver

Uncommon - transient changes in liver function indicators (for example, increased activity of transaminases or bilirubin);

Very rare - hepatitis *.

From the skin and subcutaneous tissues

Uncommon - angioedema *, itching, skin rash;

Rarely - toxic epidermal necrolysis *, Stevens-Johnson syndrome *, urticaria;

Very rarely - bullous dermatitis *, erythema multiforme *;

Not established - photosensitivity.

From the respiratory system

Rarely - bronchial asthma in patients with allergy to acetylsalicylic acid or other NSAIDs.

On the part of the cardiovascular system

Infrequently - increased blood pressure, a feeling of "rush" of blood to the face;

Rarely - palpitations.

From the genitourinary system

Uncommon - changes in renal function indicators (increased serum creatinine and / or urea levels), urinary disorders, including acute urinary retention *;

Very rare - acute renal failure *.

On the part of the genitals and mammary gland

Uncommon - late ovulation *;

Not established - infertility in women *.

Combined use with drugs that suppress the bone marrow (for example) can provoke cytopenia.

Gastrointestinal bleeding, ulceration, or perforation can be fatal.

As with other NSAIDs, they do not exclude the possibility of the appearance of interstitial nephritis, glomerulonephritis, renal medullary necrosis, and nephrotic syndrome.

Overdose:

Insufficient data have been accumulated on cases associated with drug overdose. Symptoms of an NSAID overdose are likely to be present in severe cases:

drowsiness, impaired consciousness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, acute renal failure, changes in blood pressure, respiratory arrest, asystole.

Treatment: the antidote is not known, in case of an overdose of the drug, the following should be carried out: evacuation of the stomach contents and general supportive therapy. Cholestyramine accelerates the elimination of meloxicam.

Interaction:

Other inhibitors of prostaglandin synthesis, including glucocorticoids and salicylates - simultaneous administration with meloxicam increases the risk of ulceration in the gastrointestinal tract and gastrointestinal bleeding (due to synergistic action). Concomitant use with other NSAIDs is not recommended.

Anticoagulants for oral administration, heparin for systemic use, thrombolytic agents - simultaneous administration with meloxicam increases the risk of bleeding. In the case of simultaneous use, careful monitoring of the blood coagulation system is necessary.

Antiplatelet drugs, serotonin reuptake inhibitors - simultaneous administration with meloxicam increases the risk of bleeding due to inhibition of platelet function. In the case of simultaneous use, careful monitoring of the blood coagulation system is necessary.

Lithium preparations - NSAIDs increase the level of lithium in plasma by decreasing its excretion by the kidneys. The simultaneous use of meloxicam with lithium preparations is not recommended. If necessary, simultaneous

Methotrexate - NSAIDs reduce renal secretion of methotrexate, thereby increasing its plasma concentration. The simultaneous use of meloxicam and methotrexate (at a dose of more than 15 mg per week) is not recommended. In case of simultaneous use, careful monitoring of renal function and blood count is necessary. may increase the hematological toxicity of methotrexate, especially in patients with impaired renal function. With the combined use of meloxicam and methotrexate for 3 days, the risk of increased toxicity of the latter increases.

Contraception - There is evidence that NSAIDs can reduce the effectiveness of intrauterine contraceptive devices, but this has not been proven.

Diuretics - the use of NSAIDs in case of dehydration of patients is accompanied by the risk of developing acute renal failure.

Antihypertensive drugs (beta-blockers, angiotensin-converting enzyme inhibitors, vasodilators, diuretics). NSAIDs reduce the effect of antihypertensive drugs by inhibiting prostaglandins, which have vasodilating properties.

Angiotensin antagonists- II receptors, as well as angiotensin-converting enzyme inhibitors, when used together with NSAIDs, increase the decrease in glomerular filtration, which, thereby, can lead to the development of acute renal failure, especially in patients with impaired renal function.

Colestyramine, binding in the gastrointestinal tract, leads to its faster elimination.

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

Pemetrexed - with the simultaneous use of meloxicam and pemetrexed in patients with creatinine clearance from 45 to 79 ml / min, meloxicam should be discontinued five days before starting pemetrexed and may be resumed 2 days after the end of the drug. If there is a need for the combined use of meloxicam and pemetrexed, then patients should be carefully monitored, especially with regard to myelosuppression and the occurrence of side effects from the gastrointestinal tract. In patients with creatinine clearance less than 45 ml / min, it is not recommended to take meloxicam together with pemetrexed.

When used in conjunction with meloxicam, drugs that have a known ability to inhibitCYP 2 C 9 and / or CYP 3A4 (or metabolized with the participation of these enzymes), such as derivatives

sulfonylureas or probenecid, the potential for pharmacokinetic interactions should be taken into account.

When used together with antidiabetic agents for oral administration (for example, sulfonylurea derivatives, nateglinide), mediated interactions are possibleCYP 2 C 9, which can lead to an increase in the concentration of both these drugs and meloxicam in the blood. Patients concurrently taking sulfonylureas or nateglinide with drugs should carefully monitor blood sugar levels due to the possibility of hypoglycemia.

With the simultaneous use of antacids, cimetidine, digoxin and furosemide, significant pharmacokinetic interactions were not identified.

Special instructions:

Patients suffering from diseases of the gastrointestinal tract should be monitored regularly. If ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding occur, MOVALIS should be canceled.

Gastrointestinal ulcers, perforation, or bleeding can occur during the use of NSAIDs at any time, with or without a history of alarming symptoms or a history of serious gastrointestinal complications. The consequences of these complications are generally more serious in the elderly.

When using MOVALIS, such serious skin reactions as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis can develop. Therefore, special attention should be paid to patients reporting the development of adverse events from the skin and mucous membranes, as well as hypersensitivity reactions to the drug, especially if such 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 case of the first signs of a skin rash, changes in mucous membranes or other signs of hypersensitivity, the question of discontinuing the use of MOVALIS should be considered.

There are cases when taking NSAIDs to increase the risk of developing serious cardiovascular thrombosis, myocardial infarction, angina pectoris, possibly fatal. Such the risk increases with prolonged use of the drug, as well as in patients with a history of the above-mentioned diseases and predisposed to such diseases.

NSAIDs inhibit the synthesis of prostaglandins in the kidney, which are involved in maintaining renal perfusion. The use of NSAIDs in patients with reducedrenal blood flow or reduced volume of circulating blood can lead to decompensation of latent renal failure. After the withdrawal of NSAIDs, renal function is usually restored to its original level. Elderly patients are most at risk of developing this reaction; the use of NSAIDs in conjunction with diuretics can lead to sodium, potassium and water retention, as well as to a decrease in the natriuretic effect of diuretics.

As a result, predisposed patients may experience increased signs of heart failure or hypertension. Therefore, careful monitoring of the condition of such patients is necessary, and adequate hydration should also be maintained. Before starting treatment, a study of renal function is necessary. In the case of combination therapy, renal function should also be monitored.

When using the drug MOVALIS (as well as most other NSAIDs), an episodic increase in the activity of transaminases in the blood serum or other indicators of liver function is possible. In most cases, this increase was small and transient. If the identified changes are significant or do not decrease over time, MOVALIS should be canceled, and the identified laboratory changes should be monitored.

Weakened or emaciated patients may be less tolerant of adverse events, and therefore, such patients should be carefully monitored.

Like other NSAIDs, MOVALIS can mask the symptoms of an underlying infectious disease.

As a drug that inhibits the synthesis of cyclooxygenase / prostaglandin, MOVALIS can affect fertility and is therefore not recommended for women who have difficulty conceiving. In this regard, in women undergoing examination for this reason, it is recommended to cancel the drug MOVALIS.

In patients with mild or moderate renal impairment (creatinine clearance more than 25 ml / min), dose adjustment is not required.

No dose adjustment is required in patients with (compensated) cirrhosis of the liver.

Impact on the ability to drive vehicles. Wed and fur .:

Special clinical studies of the effect of the drug on the ability to drive a car and mechanisms have not been conducted. However, when driving and working with mechanisms, one should take into account the possibility of developmentdizziness, drowsiness, blurred vision, or other disturbances from the central nervous system. Patients should be careful when driving and operating machinery.

Release form / dosage:Tablets 7.5 mg or 15.0 mg. Packaging:

10 tablets in a blister made of PVC / A1-foil or PVC / PVDC / A1-foil. 1 or 2 blisters together with instructions for use in a cardboard box.

Storage conditions:Tablets at a temperature not exceeding 25 ° C. Keep out of the reach of children. Shelf life: 3 years. Do not use after the expiration date printed on the package. Pharmacy dispensing conditions:On prescription Registration number:P N012978 / 01 Registration date:05.07.2011 Expiration date:Indefinite Marketing Authorization Holder:Boehringer Ingelheim International GmbH Germany Manufacturer: & nbsp Representative office: & nbspBoehringer Ingelheim, OOO Date of information update: & nbsp14.07.2017 Illustrated instructions

Movalis belongs to the group of non-steroidal anti-inflammatory medicinal products that have analgesic, antipyretic, anti-inflammatory effects. The tool is released in the form of tablets, injections, the following material is devoted to the first form of release.

The medication is used to treat joint pathologies (osteoporosis, arthritis, arthrosis and many others). Tablets are used in the early stages of disease development, with moderate pain syndrome. Before using the medication, be sure to consult a doctor, read the instructions attached to the drug.

Pharmacological properties

Movalis belongs to the group of enolic acid derivatives, therefore, the desired effect is achieved in a fairly short period of time. A pronounced anti-inflammatory, analgesic effect is observed in all models of inflammatory processes. The mechanism of action of the drug: effectiveness is achieved by its ability to inhibit the synthesis of prostaglandins (substances that are mediators of inflammation).

Clinical studies confirm that the appearance of side effects after taking Movalis is much less than the effects from drugs of the same group. This is due to the fact that after taking the drug, the appearance of vomiting, dyspepsia, nausea is much less than after using other drugs of the group of non-steroidal anti-inflammatory products.

The active components of the drug are quickly absorbed from the stomach, providing quick results. With a single dose of the medication, the maximum concentration is achieved six hours after use, with constant use - the effect lasts for four days. After using the product, the concentration of active ingredients remains at the level of a single dose of the drug. Food intake does not affect the effectiveness of the drug.

Release form and composition

A medicinal product is produced in several forms (suppositories, tablets, ampoules for injection). Let's explore the pills in more detail. Movalis tablets is a pill with a beveled edge, convex on one side, pale yellow in color. The logo of the company is written on the convex side, on the other - "59D" (for tablets with a dosage of 7.5 mg of active substance), "77C" - pills with 15 mg of the main active ingredient.

All pills are packed in blisters of ten pieces, cardboard packs of 1/2 blister each. Mandatory instructions for use are attached to the medication. The main active ingredient is meloxicam. Additionally, the tablets include the following auxiliary components: sodium citrate dihydrate, microcrystalline cellulose, lactose monohydrate, silicon dioxide and others. Additional components provide the necessary structure to the pill, its color.

Indications for use

Movalis is used for the symptomatic treatment of such ailments:

• , other diseases associated with degenerative changes in the joints, accompanied by moderate pain;

Contraindications

The medication in any form is prohibited to use in such cases:

• a history of bronchial asthma, nasal sinus diseases, individual intolerance to acetylsalicylic acid, similar drugs, NSAIDs group;
• with inflammation of the gastrointestinal tract, such as Crohn's disease, which is in the acute stage;
• erosive lesions of the stomach or intestines (in the acute stage);
• severe cases of renal and hepatic failure, progressive kidney ailments;
• diseases associated with poor blood clotting, open bleeding in the stomach, intestines;
• uncontrolled heart failure;
• children under 12 years old;
• period of childbearing, breastfeeding;
• hereditary intolerance to galactose (extremely rare);
• individual hypersensitivity to certain components of the drug.

Use the drug with extreme caution in such cases:

• in the presence of ailments of the gastrointestinal tract in humans;
• renal failure;
• heart failure;
• diabetes mellitus, hepatitis;
• preliminary use of drugs from the group of anti-inflammatory nonsteroidal drugs;
• the presence of bad habits, the patient's advanced age;
• concomitant therapy with other potent medicinal products (anticoagulants, selective inhibitors, and others).

Before you start taking Movalis, read the instructions, especially the section on contraindications. Violation of certain rules leads to dramatically negative consequences.

Side effects and overdose

In most cases, the drug is well tolerated, cases of overdose and side effects are noted against the background of prolonged or improper use. There are also groups of people who are hypersensitive to the individual components of the drug, which can provoke a negative reaction from various organs and systems of the patient:

• anemia, changes in the indicators of the general blood test;
• dizziness, disorientation, sudden mood swings, drowsiness, fatigue;
• bleeding in the stomach or intestines (sometimes fatal), stomatitis, severe abdominal pain, stool disturbances, bloating, changes in liver parameters (increased bilirubin, which may indicate the course of hepatitis);
• allergic reactions (anaphylactic shock, urticaria, rashes on the skin, itching, erythema);
• there is a high probability of developing bronchial asthma;
• swelling of the face, increased blood pressure, heart palpitations;
• the occurrence of serious kidney pathologies, serious abnormalities in renal function indicators, urinary retention, painful urination;
• blurred vision, conjunctivitis.

Important! If you find any unpleasant symptoms, immediately call the ambulance at your home. There is no specific antidote to Movalis. Doctors can flush the stomach, begin to cope with the symptoms of a medication overdose. It is difficult to cope with serious side effects on your own at home.

Pregnancy and breastfeeding

When carrying a baby, Movalis is categorically contraindicated. The active components of the drug negatively affect the course of pregnancy, fetal development. Studies have shown that taking a medicinal product several times increases the risk of spontaneous abortion, the occurrence of heart defects in an unborn baby. The risk of pathology increased from 1% to 5%, a similar picture was observed with an increase in the dose taken, a long course of treatment.

The use of inhibitors of prostaglandin synthesis during the period of bearing a child leads to the following disorders in fetal development:

• dysfunction of the kidneys, in the future is fraught with the occurrence of renal failure;
• toxic effects on the heart leads to the closure of the ductus arteriosus, sometimes - pulmonary hypertension.

Doctors recommend to stop taking Movalis during pregnancy planning. Due to the use of Movalis, the mother's blood clotting worsens, an increased risk of bleeding (accordingly, the duration of labor increases). The active components of the drug penetrate into breast milk; it is prohibited to take it during lactation.

Instructions for use and dosage

The specific dosage and duration of taking the medicine is determined by the doctor, it all depends on the specific case, the individual characteristics of the patient, the type of joint disease. Tablets are recommended to be taken in honey breaks with meals or during a meal, washed down with a small amount of liquid (still water, natural juice). The maximum allowable rate for a teenager is 0.25 mg per kilogram of the child's weight.

Go to the address and learn about the nuances of treating arthrosis of the joints with folk remedies.

The instruction offers an approximate treatment regimen for certain ailments with Movalis:

• rheumatoid arthritis. The patient is prescribed a single dose of fifteen mg, in the initial stages of the development of the disease, doctors prefer a dosage of 7.5 mg;
• osteoarthritis. In most cases, 7.5 mg is used once a day, neglected cases require an increase in the used tablet form twice (fifteen mg);
• ankylosing spondylitis. A single dose of 15 mg (per day) is shown, after a month of use, the dose is most often reduced to 7.5 mg per day.

In people at risk (kidney, liver, gastrointestinal tract problems), the daily rate should not exceed 7.5 mg. Failure to comply with this rule is fraught with disastrous consequences. Listen to the doctor's recommendations, read the instructions, if any discomfort occurs, immediately stop taking Movalis, seek medical help.

Drug analogs

The modern pharmacological industry produces a lot of medicinal products that can replace Movalis. Before using an analogue of a medication, be sure to consult a doctor, carefully read the instructions for the product.

Movalis analogs in tablets:

• Amelotex;
• Melox;
• Movasin;
• Movix;
• Meloflam and others.

Cost and patient opinions

The price of Movalis in tablets (10 pcs. With an active substance concentration of 15 mg) is 500 rubles, a similar drug (20 pcs. In a package) costs 697 rubles. Movalis with a concentration of the main component of 7.5 mg costs about 718 rubles for 20 pieces per package. The exact amount depends on the city of purchase, pharmacy chain.

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