How long can you take movalis tablets. Features of the appointment of Movalis injections: instructions for use for the treatment of articular pathologies, price, reviews, analogues of the drug

This drug does not cure your disease - it only acts as an analgesic drug (relieves severe pain) and therefore should not be taken for more than a week.

Ideally, Movalis is taken like this: to remove severe spasm(pain) give 1 injection of Movalis (the effect will be in an hour).

So next day start taking pills, if after two or three days the pain is not as strong as in the first days, then stop taking the pills. If the pain is strong, then a maximum of a week to drink them.

If after a week the pain has not subsided, then replace the tablets with suppositories (candles) - they give less side effects on the stomach, liver and kidneys.

But remember that Movalis is only an anesthetic and it will not cure your disease.

Movalis refers to non-steroidal anti-inflammatory drugs. The course of treatment and duration should be determined by the doctor. Several years ago, I had an exacerbation of osteochondrosis and the doctor prescribed a three-day course of injections of Movalis + Mydocalm + Milgama to relieve pain. And then he transferred to the tablet form of Movalis within one month. I took 1 tablet 7.5 mg twice a day in the morning and evening. But it was assigned to me. The course can be 5, and 10, and 15 days. It all depends on the severity of the disease.

Since I accepted this medicine more than 5 days, in addition to protect against harmful effects Omeprazole was prescribed for my stomach.

Usually Movalis in the form of tablets is not taken for more than 10 days. If the pain syndrome is strong, then a course of injections is first prescribed, and then the person switches to pills.

Usually such a period of treatment is enough for the pain to decrease and the inflammation to subside. Most often, a lower dosage is prescribed - tablets that contain 7.5 mg of meloxicam. Less often - a large one, which is 15 mg of the active substance.

The exception is patients with joint diseases that require long-term treatment. But then the doctor selects the most appropriate therapy, since the drug, like most NSAIDs, has a lot side effects.

My diagnosis is lumbar osteochondrosis (lumbago). The lower back started to hurt and later the pain went away in the leg. The doctor prescribed movalis and mydocalm for 10 days. The pain in the lower back went away on the 3rd day, but the leg does not go away. After 7 days of taking drugs in tablets, the same thing was prescribed, only in injections and physiotherapy with the addition of combilipen in injections for 5 days.

With an extensive inflammatory process and with severe pain, Movalis" should be taken in injections for 5 days, and then you can switch to tablets.

The maximum dose per day is 15 mg, but it all depends on the severity of the disease, if the course of injections is completed, then the doctor reduces the dose in tablets.

Movalis tablets should be drunk for at least 10 days.

The daily norm per day is not more than 15 mg. Movalis excellent drug, but more effective in injections. Movalis tablets are drunk as prescribed by a doctor for no more than 20 days after Movalis injections in the continuation of therapy. Movalis can cause damage to the digestive tract, therefore uncontrolled reception Movalis tablets can harm.

0t 3 to 6 days with the obligatory intake of omeprazole - reduces the risk of damage to the gastrointestinal tract

Movalis

Movalis is a drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs), a selective COX-2 inhibitor (cyclooxygenase-2 enzyme). It contains the substance meloxicam. Release form this tool some:

• Tablets for oral administration - 7.5 and 15 mg each active substance in each
• Suspension for oral administration - 500 ml, 7.5 mg of the active substance in 5 ml of liquid
• Solution for injection - 15 mg of the active substance in a 1.5 ml ampoule
• Candles for rectal application- 15 mg of the active substance in each candle

Indications for use in diseases of the spine

Movalis is most often used for diseases musculoskeletal system especially in diseases of the spine. The main ones are:

Contraindications

Movalis is contraindicated for use under the following conditions:

• Allergy to the drug and its components
• Peptic ulcer of the stomach or duodenum
• kidney failure
• Liver failure
• Pregnancy
• lactation period
• Age after 80 years (relative contraindication)
• Combination bronchial asthma allergic to aspirin
• Taking blood thinners (for injection form release)
• Inflammation anus and rectum (for suppositories)
• Children under 14
• Heart failure, decompensation

Operating principle

Getting into the systemic circulation, Movalis penetrates into the affected cells and tissues of the spine and its structures. There, it inhibits the enzyme cyclooxygenase-2, which is directly involved in the production of inflammatory mediators (prostaglandins). At the same time, the patient feels an anti-inflammatory, antipyretic and analgesic effect.

Instructions for use

Movalis in the form of tablets

Movalis tablets should be taken orally, during a meal or within minutes after a meal, with a glass of water. enough liquids. Depending on the severity of the disease and its symptoms, the dosage is 7.5-15 mg per day at a time. The duration of the course of treatment depends on the severity of the symptoms. However, days are usually sufficient to relieve pain and inflammation. If necessary, the course of treatment can be extended or repeated.

Movalis in the form of a suspension

The liquid form of Movalis is used if it is impossible to take pills for one reason or another. 1 time per day, during or immediately after a meal, you should drink 5-10 ml of the suspension. If necessary, you can drink water. The course of treatment is calculated in the same way as when taking pills - days. Extended or repeated as needed.

Movalis in the form of a solution for injection

Injections are administered intramuscularly, 7.5-15 mg of the drug 1 time per day for 3-5 days. After that, it is necessary to switch to the tablet form of release until the symptoms completely stop. Maximum daily dosage Movalis in any form of release is 15 mg. You can also combine injections and tablets of the drug, 7.5 mg of each release form.

Movalis in the form of candles

Movalis suppositories are used if taking tablet forms is not possible for one reason or another. The candle should be injected deep into the rectum, 1 per day. The course of treatment ranges from 2 weeks to 1 month and is selected individually, depending on the severity of the symptoms of the disease.

Side effects

The list of side effects from taking Movalis is quite large, but all these symptoms are extremely rare and with individual intolerance to the remedy. The main ones include the following:

• Dizziness
• Headache
• Rapid heart rate (tachycardia)
• Rash and itching on the skin
• Pain in the abdomen
• Vomit
• Nausea
• Constipation or diarrhea, or alternation
• Noise in ears
• Bloating
• Gastrointestinal bleeding
• Exacerbation of peptic ulcer
• Attacks of bronchial obstruction and bronchial asthma
• Increased sleepiness
• Jumps in blood pressure
• Swelling of the legs

If these symptoms occur, you should stop taking the drug and consult your doctor. If the recommended dosage of Movalis is exceeded several times, the following symptoms may develop:

• Drowsiness
• Vomit
• Nausea
• Pain in the abdomen
• Bleeding from the stomach or intestines
• Respiratory failure
• convulsions
• Interruptions in the work of the heart
• Cardiac and respiratory arrest
• Acute renal failure

If the dosage of the drug is exceeded, it is urgent to call a doctor, rinse the stomach and start taking symptomatic drugs.

special instructions

During pregnancy, it is not advisable to take Movalis, especially the first 2 trimesters, when the laying and development of organs occurs. The lactation period is a contraindication to taking Movalis. If necessary, therapy with this drug breast-feeding should be stopped.

For children under 14 years of age, taking Movalis is contraindicated, because there is no reliable data on its effect on the child.

Alcoholic drinks do not affect the effect of the drug.

Movalis's analogs

Artrozan, Melox, Meloxicam, Movasin, Amelotex, etc.

Movalis - instructions for use, reviews, analogs and formulations (tablets 7.5 mg and 15 mg, suppositories, injections in ampoules for injection) of a drug for the treatment of arthrosis and arthritis in adults, children and pregnancy

In this article, you can read the instructions for use medicinal product Movalis. Reviews of site visitors - consumers are presented this medicine, as well as the opinions of doctors of specialists on the use of Movalis in their practice. A big request to actively add your reviews about the drug: did the medicine help or not help get rid of the disease, what complications and side effects were observed, perhaps not declared by the manufacturer in the annotation. Movalis analogues in the presence of existing structural analogues. Use for the treatment of arthrosis, arthritis and spondylitis in adults, children, as well as during pregnancy and lactation.

Movalis is a non-steroidal anti-inflammatory drug (NSAID), belongs to enolic acid derivatives 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 (the active substance of Movalis) 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 gastric mucosa or kidneys. These differences are associated with more selective inhibition of COX-2 compared to COX-1. It is believed that inhibition of COX-2 provides therapeutic effect NSAIDs, while inhibition of the ubiquitous COX-1 isoenzyme may be the cause side effects from 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.

AT clinical research Gastrointestinal side effects were generally less common with meloxicam 7.5 mg and 15 mg than with other NSAIDs compared. 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 common. The frequency of perforations in upper divisions The gastrointestinal tract, ulcers and bleeding that were associated with the use of meloxicam was low and depended on the dose of the drug.

Meloxicam is well absorbed from the gastrointestinal tract, as evidenced by the high absolute oral bioavailability (89%). Simultaneous reception food does not affect the absorption of the drug. Meloxicam 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. Less than 5% of the daily dose is excreted unchanged in the feces; in the urine, unchanged, the drug is found only in trace amounts.

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

Tablets 7.5 mg and 15 mg.

Candles rectal 7.5 mg and 15 mg.

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

Suspension for oral administration.

Instructions for use and dosing regimen

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

At rheumatoid arthritis and ankylosing spondylitis, the drug is prescribed at 15 mg per day, when a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg per day.

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

In patients with severe renal insufficiency on hemodialysis, the dose of Movalis 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, with water or other liquid.

Since the risk of adverse reactions depends on the dose and duration of use, the drug should be used for as long as possible. short term at the lowest possible effective dose.

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

• change in the leukocyte formula;
• leukopenia, thrombocytopenia, anemia;
• headache;
• dizziness;
• noise in ears;
• drowsiness;
• mood changes;
• perforation of the gastrointestinal tract;
• occult or overt gastrointestinal bleeding, possibly with fatal;
• gastroduodenal ulcers;
• colitis;
• gastritis;
• esophagitis;
• stomatitis;
• abdominal pain;
• diarrhea;
• nausea, vomiting;
• constipation;
• bloating;
• angioedema;
• skin rash;
• hives;
• photosensitivity;
• bronchial asthma;
• increase in blood pressure;
• heartbeat;
• acute renal failure;
• glomerulonephritis;
• conjunctivitis;
• visual impairment.

• symptoms of bronchial asthma, nasal polyposis, angioedema or urticaria after ingestion acetylsalicylic acid or other NSAIDs in history;
• peptic ulcer/gastric perforation and duodenum in the acute stage or recently transferred;
• Crohn's disease or ulcerative colitis in the acute phase;
• severe liver failure;
• severe renal failure (if hemodialysis is not performed);
• acute gastrointestinal bleeding, recent cerebrovascular bleeding or established diagnosis of diseases of the blood coagulation system;
• severe uncontrolled heart failure;
• therapy of perioperative pain during coronary artery bypass surgery;
• pregnancy;
• lactation (breastfeeding);
• children's age up to 12 years (with the exception of the use of established diagnosis- juvenile rheumatoid arthritis);
• hypersensitivity to the active ingredient or auxiliary components of the drug (there is a possibility of cross-sensitivity to acetylsalicylic acid and other NSAIDs).

• diseases of the gastrointestinal tract in history;
• congestive heart failure;
• kidney failure;
• cerebrovascular diseases;
• dyslipidemia/hyperlipidemia;
• diabetes;
• peripheral arterial disease;
• elderly age;
• prolonged use of NSAIDs;
• smoking;
• frequent alcohol use.

Use during pregnancy and lactation

Movalis is contraindicated during pregnancy and during breastfeeding.

As a drug that inhibits cyclooxygenase and prostaglandin synthesis, Movalis may affect fertility and is therefore not recommended for women planning pregnancy. In this regard, in women undergoing examination for similar problems, it is recommended to cancel Movalis.

Patients with gastrointestinal diseases should be monitored regularly. When ulcerative lesion Gastrointestinal or gastrointestinal bleeding Movalis must be discontinued.

Gastrointestinal bleeding, ulcers, and perforations may occur during treatment at any time, either in the presence of warning signs or a history of serious gastrointestinal complications, or in the absence of these signs. The consequences of these complications are generally more severe in the elderly.

Particular attention should be paid to patients reporting the development of adverse events from the skin and mucous membranes, as well as reactions 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 stopping the use of Movalis should be considered.

Like other NSAIDs, Movalis may increase the risk of serious cardiovascular thrombosis, myocardial infarction, angina attack, possibly fatal. This risk increases with long-term use drug, as well as in patients with the above diseases in 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 may lead to decompensation of latent kidney failure. After discontinuation of NSAIDs, kidney function usually returns to baseline. Elderly patients, patients with dehydration, congestive heart failure, cirrhosis of the liver, nephrotic syndrome, or acute disorders kidney function, patients taking diuretics at the same time, as well as patients who have had serious surgical interventions leading to hypovolemia. In such patients, diuresis and renal function should be carefully monitored at the beginning of therapy.

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, in predisposed patients, signs of heart failure or hypertension may be exacerbated. Therefore, careful monitoring of the condition of such patients is necessary, and they must be maintained adequate hydration. Before starting treatment, a study of kidney function is necessary.

In the case of combination therapy, renal function should also be monitored.

When using the drug Movalis, an occasional 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 monitoring of the identified laboratory changes should be carried out.

Debilitated or debilitated patients may be less able to tolerate adverse events, so these patients require careful monitoring.

Meloxicam, like other NSAIDs, may mask the symptoms of an infectious disease.

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

When simultaneous application anticoagulants for oral administration, ticlopidine, heparin for systemic use, thrombolytic agents, careful monitoring of the effect of anticoagulants is necessary.

Influence on the ability to drive vehicles and control mechanisms

Special studies on the effect of the drug on the ability to drive vehicles and mechanisms have not been conducted. This activity should be avoided in patients with visual impairments, patients who report drowsiness or other disorders of the central nervous system.

With the simultaneous use of other prostaglandin synthesis inhibitors with meloxicam, incl. glucocorticosteroids and salicylates (acetylsalicylic acid), increases the risk of gastrointestinal ulcers and gastrointestinal bleeding due to synergy of action. The combined use of meloxicam and other NSAIDs is not recommended.

With the simultaneous use of meloxicam with selective serotonin reuptake inhibitors, the risk of gastrointestinal bleeding may increase.

Due to the presence of sorbitol in the composition of Movalis, co-administration with sodium polystyrene sulfonate may cause the risk of colon necrosis with a possible fatal outcome.

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

NSAIDs increase plasma lithium concentration by decreasing renal excretion of lithium. It is recommended to monitor the level of lithium during the period of prescribing Movalis when changing the dose of lithium preparations and canceling them.

NSAIDs can reduce the tubular secretion of methotrexate, thereby increasing its plasma concentration and hematological toxicity, while the pharmacokinetics of methotrexate does not change. In this regard, the simultaneous administration of Movalis and methotrexate at a dosage of more than 15 mg / week is not recommended.

The risk of interaction between NSAIDs and methotrexate may also occur in patients using low doses of methotrexate, especially in patients with impaired renal function. Therefore, constant monitoring of the number of blood cells and kidney function is necessary. At joint application meloxicam and methotrexate for 3 days increases the risk of increasing the toxicity of the latter.

NSAIDs reduce the effectiveness of intrauterine contraceptive devices.

The use of NSAIDs while taking diuretics in case of dehydration of patients is accompanied by a risk of developing acute renal failure.

Antihypertensive agents (beta-blockers, ACE inhibitors, vasodilators, diuretics), NSAIDs reduce the effect of antihypertensive agents due to inhibition of prostaglandins that have vasodilatory properties.

A joint 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.

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

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

The possibility of interaction with hypoglycemic drugs for oral administration cannot be ruled out.

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

Analogues of the drug Movalis

Structural analogues for the active substance:

Detailed instructions for the use of Movalis tablets

Movalis is a drug that relieves inflammation and pain in diseases of the joints. Movalis release forms: ampoules, tablets, suspension, suppositories. Thanks to various forms release, it is easy for doctors to choose the dosage and method of application for almost any pathology. What can they be cured of? The tool is used for spondylitis, arthritis, osteoarthritis. Not recommended for people with stomach ulcers, kidney and liver problems.

More about the drug

This non-steroidal drug relieves inflammation in the affected joints and relieves pain. Mechanism of action: active ingredient meloxicam prevents the synthesis of prostaglandins, which provoke the development of the inflammatory process. This process occurs not in the mucous membranes of the internal organs, but in the place where the inflammation began.

According to studies contained in tablets, meloxicam does not interfere with blood clotting and does less harm to the gastrointestinal tract than many NSAIDs. It causes fewer side effects (vomiting, nausea, bloating).

Manufacturer

The rights to release the drug belong to a large German concern with a worldwide reputation "Boehringer Ingelheim GmbH". It has an extensive network of branches around the world. The geography of its presence covers about 45 countries. The company is engaged scientific research and the production of medicines. It is among the top twenty large companies peace.

Watch a video about the drug

Forms of release and composition

The drug is produced in four forms.

Description: The color of the tablets varies from pale yellow to deep yellow. Logo printed on one side pharmaceutical company. Rough to the touch. The concentration of the active substance (meloxicam) can be 7.5 mg or 15 mg. Additional components: lactose monohydrate, crospovidone, magnesium stearate, etc.

Packed in cardboard boxes with one or two blisters. The blister contains 10 tablets. Depending on the number of tablets, the price varies from 571 to 736 rubles.

Active substance: meloxicam - 7.5 mg or 15.0 mg

Excipient: sodium citrate, lactose, microcrystalline cellulose, povidone, magnesium stearate, colloidal silicon dioxide, crospovidone.

Which is better: pills or injections?

For severe pain with temporary disability, it is better to use injections. They are immediately absorbed into the blood, thanks to the intramuscular method of administration. With prolonged use of tablets, they negatively affect the gastric mucosa.

The drug, which enters the bloodstream with the help of injections, is quickly absorbed and reaches its maximum concentration within an hour. It is enough to inject it once every 24 hours so that the required therapeutic concentration in the blood is reached in a short period of time (3-5 days). In this form, the drug quickly penetrates into the articular tissue. And within a week pain symptoms disappear and inflammatory process decreases.

But intramuscular injections there is another disadvantage. They cause necrosis muscle tissue at constant use. Solution for intramuscular injection gives fewer complications than other NSAIDs, which is confirmed medical research. But it is treated in the long term, it is not recommended, for this it is better to use tablets or suppositories.

For each stage of the disease, its own form of release of the drug is preferable. For example, injections quickly relieve acute pain syndromes, which is important when the patient needs urgent help. And other forms are better used for a long course of treatment.

Application scheme

Movalis in tablets, according to the instructions for use, is taken every 24 hours during a meal, drinking plenty of water or juice.

Patients diagnosed with osteoarthritis are recommended to drink 7.5 mg. The dose for severe pain is increased by a doctor 2 times. The dosage for rheumatoid arthritis and spondylitis is 15 mg every 24 hours, with relief of symptoms, the dosage is halved. Maximum dose Movalis medicines: 15 mg.

If the patient is at risk (diseases of the gastrointestinal tract, cardiovascular diseases, renal insufficiency), the dose of the drug begins with 7.5 mg.

For children over 12 years old, the dose is calculated based on the norm of 0.25 mg per 1 kg of weight. For children under 12 years of age, the drug is not prescribed, because it is impossible to calculate required amount means for treatment.

How many days to take?

How long can this remedy be taken? If the patient has a strong inflammatory process and increasing pain, then the doctor begins treatment with 3-5 days of injections. With them, he quickly relieves pain and continues therapy with other forms of medicine. The course of treatment with a suspension, suppositories or tablets averages 14–21 days, depending on the stage of the disease, its course, diagnosis and individual features patient.

Indications for use

Contraindications

Contraindicated in case of individual intolerance to the components of the drug. Not recommended for asthmatics; patients suffering from polyps in the nasopharynx or urticaria after taking acetylsalicylic acid. The drug is contraindicated in people with peptic ulcer and perforations of the stomach and intestines. It should not be used for acute ulcerative colitis and Crohn's disease. You can not use it for liver and kidney failure in a severe stage. The drug is contraindicated for internal bleeding in the intestines and stomach, for violations of blood clotting. The drug is prohibited for children under 12 years of age, except in cases of diagnosing juvenile rheumatoid arthritis.

special instructions

With caution and under the supervision of a physician, it is prescribed to patients with gastrointestinal diseases, heart and kidney failure. And also at coronary disease heart disease, diabetes, elderly patients. Under the supervision of a doctor, the drug is taken with long-term use of other NSAIDs, with smoking and frequent use alcoholic drinks.

Pregnancy and lactation

The drug is prohibited for pregnant and lactating mothers.

Reception by children

Reception by the elderly

The use of the drug by the elderly is carried out under the strict supervision of a physician, and the drug is prescribed with caution.

Overdose and side effects

Side effects can occur in the form of a change in the number of leukocytes in the blood, anemia, thrombocytopenia. In rare cases it is possible anaphylactic reactions, migraine. The patient complains of dizziness, confusion, disorientation in space, frequent shifts moods, etc.

In rare cases, perforation of the gastrointestinal tract occurs, begins internal bleeding ulcers appear. The drug can provoke exacerbations of gastritis or colitis. In addition, from the gastrointestinal tract, the patient may feel bloating, bouts of nausea and vomiting. Belching begins, bilirubin rises. Possibly hepatitis.

In some cases, there are allergic reactions(itching, rash, tissue swelling, dermatitis, etc.). Rarely, asthma attacks, increased heart rate, a feeling of heat, increased pressure are noted.

The patient may complain of acute renal failure, problems with urination, changes in kidney function. With prolonged use of the drug, conjunctivitis and visual impairment may occur.

Toxicity

Meloxicam contained in this remedy has a toxic effect on the patient's body. Thanks to the developments of pharmacists, created last generation non-steroids (this includes Movalis), which have less effect on internal organs patient. A number of studies have found that this drug causes fewer negative effects for the patient. But still, it must be taken with caution by people with kidney and liver diseases, and doctors do not prescribe it to pregnant women and nursing mothers.

Interaction with other drugs

May increase bleeding and ulceration when combined with prostaglandin inhibitors. It is not prescribed together with other non-steroids.

Promotes an increase in the concentration of lithium drugs in plasma while taking them.

If taken together with methotrexate, then methotrexate does not increase hematological activity.

The drug reduces the effectiveness intrauterine contraception, so you need to use additional methods protection from unwanted pregnancy.

Interaction with alcohol

You can not combine it with alcohol intake. This threatens with poisoning and problems with the kidneys and liver in the future.

Storage, dispensing from pharmacies

The drug is easy to purchase in pharmacies, but only with a prescription from your doctor. Store it in a place inaccessible to children at a temperature not exceeding 25 degrees.

Analogues

Like many medicines containing meloxicam, this drug has a number of analogues that can be bought at pharmacies or used as a substitute for it.

• Artrozan. Domestic drug of JSC "Pharmstandard-UfaVITA". Release form: solution for intramuscular injection and tablets. Indications: arthritis, Bechterew's disease, etc. The price, depending on the form of the drug, varies from 145 to 509 rubles.

• Movasin. Producer: "Synthesis" (Russia). Available in ampoules and tablets. It has an antipyretic effect, eliminates pain, relieves inflammation. It is used for arthritis, spondylitis, osteoarthritis. Cost: 60-96 rubles.

• Amelotex. Produced by CJSC PharmFirma Sotex. Available in the form of ampoules, tablets, suppositories, gel for external use. Eliminates inflammation and pain. Price: 107–523 rubles, depending on the form of release.

• Meloxicam Pfizer. This analogue of Movalis was produced in India under license from the American company Pfizer. Release form: tablets. Cost: 300-412 rubles.

• Matarin. The domestic drug is available in the form of tablets, has an anti-inflammatory effect. It is used for arthritis, osteoarthritis. Cost: 136 to 184 rubles.

Reviews

Patients taking the drug leave numerous positive reviews, because it is not for nothing that this medicine is called a breakthrough among nonsteroidal drugs. People write about how quickly they managed to relieve pain in inflamed joints. Despite the fact that they read the instructions for use and see many contraindications, side effects, Negative consequences are very rare. Patients note a pronounced analgesic effect, thanks to which many of them were able to refuse analgesics, and after an X-ray or MRI they learn from doctors that the condition of the joint has improved significantly.

But some of them note that they do not see much difference between it and generics. And injections that can be done in a short course of 3-5 days do not always have a sufficient effect in the fight against inflammation. All of them note its good tolerability by patients. Experts talk about the effect of the drug on the gastrointestinal tract and advise to combine it with taking Omeprazole. Omeprazole relieves the already rare exacerbations of pathologies of the upper sections gastrointestinal tract. The drug cannot be taken frequently, it is fully comparable in terms of "price - quality", but for each patient, when prescribing it, it is necessary individual approach. Moreover, doctors do not prescribe it to patients with acute and chronic diseases gastrointestinal tract.

Editor and expert of the site zdorovya-spine.ru. Specialization: general practitioner. More than 10 years experience. City polyclinic, Smolensk. Graduated from the Smolensk State medical academy specialty: medicine. I love my profession very much.

The Chinese have opened to the whole world a method of how to treat joints in 2 days! Write the recipe before it's deleted.

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The joints will stop breaking the next day, if you spread a penny in the evening.

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Movalis is the original German non-steroidal anti-inflammatory drug, the main driving force which is the substance meloxicam. In addition to anti-inflammatory, the drug also has analgesic and antipyretic effects (antipyretic). Movalis is mainly used to relieve pain and inflammation in degenerative-dystrophic diseases of the musculoskeletal system, such as osteoarthritis (an outdated name, which, however, is actively used in the medical environment - osteoarthritis), rheumatoid arthritis and ankylosing spondylitis. Movalis is effective in inflammation of a wide variety of etiologies, which has been confirmed for certain in clinical studies. Based on the mechanism of action this drug lie it in the highest degree hostile relationship with prostaglandins, mediators of pain and inflammation: movalis inactivates the enzyme cyclooxygenase-2 (COX-2), which is involved in the synthesis of the latter. The advantage of movalis over other NSAIDs is that it is a selective inhibitor of COX-2, and has practically no effect on COX-1. This is very important, because all the therapeutic properties of NSAIDs are provided by the inhibition of COX-2, similar actions against COX-1 provoke side effects from the gastrointestinal tract and kidneys. The selectivity of movalis, in turn, is beyond doubt, since confirmed both in a laboratory test tube and in a living organism: meloxicam suppresses the synthesis of prostaglandin in the focus of inflammation to a much greater extent compared to the gastric mucosa and kidneys.

Another advantage of movalis over its "brothers" in the line of NSAIDs, diclofenac, indomethacin, ibuprofen and naproxen, and others like them, is that it does not suppress platelet aggregation (in other words, gluing) and, therefore, does not increase bleeding time. Side effects from the gastrointestinal tract - nausea, vomiting, dyspepsia, abdominal pain, and, most unpleasantly, ulceration of the mucous membrane - when taking movalis occur less frequently than when taking non-selective NSAIDs

Movalis is quite widely represented on Russian pharmacy shelves: it is both a tablet form and rectal suppositories, and a suspension for preparing a solution for oral administration, and a solution for intramuscular administration. The last dosage form is intended for use only during the first 2-3 days, after which the transition to a tablet or any other form is carried out. The recommended daily dose varies depending on the specific disease and its severity in the range of 7.5-15 mg per day, the last mark being critical, which is not recommended to be exceeded. Children's dosages for Movalis have not been determined, therefore, only adults can take the drug (injection solution can be used from 18 years old, tablets and suspension from 15 years old, and suppositories from 12 years old).

Pharmacology

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 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 inflammatory mediators.

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 more selective inhibition of COX-2 compared to COX-1. It is believed that inhibition of COX-2 provides the therapeutic effect of NSAIDs, while inhibition of the constantly present COX-1 isoenzyme can cause side effects from the stomach and kidneys.

The selectivity of meloxicam for COX-2 has been confirmed in various test systems, both in vitro and in vivo. The selective ability of meloxicam to inhibit COX-2 has been shown when used as a test system in human whole blood in vitro. It was found that meloxicam (in doses of 7.5 mg and 15 mg) inhibited COX-2 more actively, having a greater inhibitory effect on the production of prostaglandin E 2 stimulated by lipopolysaccharide (a reaction controlled by COX-2) than on the production of thromboxane involved in the blood coagulation process. (reaction controlled by COX-1). These effects were dose dependent. Ex vivo studies have shown that meloxicam (at doses of 7.5 mg and 15 mg) had no effect on platelet aggregation and bleeding time.

In clinical studies, gastrointestinal side effects were generally less common with meloxicam 7.5 mg and 15 mg than with other NSAIDs compared with. 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 common. The frequency of perforations in the upper gastrointestinal tract, ulcers and bleeding, which were associated with the use of meloxicam, was low and depended on the dose of the drug.

Pharmacokinetics

Suction

Meloxicam is well absorbed from the gastrointestinal tract, as evidenced by the high absolute bioavailability (90%) after oral administration. After a single application of meloxicam, Cmax in plasma is reached within 5-6 hours. Simultaneous ingestion of food and inorganic antacids does not change absorption. When using the drug inside (in doses of 7.5 and 15 mg), its concentrations are proportional to doses. Steady state pharmacokinetics is achieved within 3-5 days. The range of differences between C max and C min of the drug after taking it 1 time / day is relatively small and amounts to 0.4-1.0 μg / ml when using a dose of 7.5 mg, and when using a dose of 15 mg - 0.8-2.0 μg / ml (given, respectively, values ​​of C min and C max during the steady state of pharmacokinetics), although values ​​outside the specified range were also noted. Cmax in plasma during the steady state of pharmacokinetics is achieved within 5-6 hours after ingestion.

Distribution

Meloxicam binds very well to plasma proteins, especially to albumin (99%). Penetrates into synovial fluid, concentration in synovial fluid is approximately 50% of the plasma concentration. V d 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). In vitro studies have shown that in this metabolic transformation important role CYP2C9 isoenzyme plays, CYP3A4 isoenzyme has additional significance. In the formation of two other metabolites (constituting 16% and 4% of the dose of the drug, respectively), peroxidase takes part, the activity of which, probably, varies individually.

breeding

Excreted equally through the intestines and kidneys, mainly in the form of metabolites. Less than 5% of the daily dose is excreted unchanged in the feces; in the urine, unchanged, the drug is found only in trace amounts. The average T 1/2 of meloxicam varies from 13 to 25 hours. Plasma clearance averages 7-12 ml / min after a single dose of meloxicam.

Pharmacokinetics in special clinical situations

Lack of liver function, as well as mild renal failure, does not significantly affect the pharmacokinetics of meloxicam. The rate of elimination of meloxicam from the body is significantly higher in patients with moderately severe renal insufficiency. Meloxicam binds worse to plasma proteins in patients with end-stage renal disease. In end-stage renal failure, an increase in V d can lead to higher concentrations of free meloxicam, so in these patients the daily dose should not exceed 7.5 mg.

Elderly patients compared with young patients have similar pharmacokinetic parameters. In elderly patients, the average plasma clearance during the equilibrium state of pharmacokinetics is slightly lower than in young patients. In older women, more high values AUC and longer T 1/2 compared with young patients of both sexes.

Release form

Tablets from pale yellow to yellow color, round, one side is convex with a bevelled edge, on the convex side - the logo of the company, on the other side - a code and a concave risk; roughness of tablets is allowed.

Excipients: sodium citrate dihydrate - 15 mg, lactose monohydrate - 23.5 mg, microcrystalline cellulose - 102 mg, povidone K25 - 10.5 mg, colloidal silicon dioxide - 3.5 mg, crospovidone - 16.3 mg, magnesium stearate - 1.7 mg.

10 pieces. - blisters (1) - packs of cardboard.
10 pieces. - blisters (2) - packs of cardboard.

Dosage

The drug is taken orally 1 time / day, during meals, washed down with water or other liquid.

For osteoarthritis with pain syndrome the daily dose is 7.5 mg, if necessary, the dose can be increased to 15 mg / day.

In rheumatoid arthritis, the drug is prescribed at a dose of 15 mg / day, depending on therapeutic effect the dose may be reduced to 7.5 mg/day.

In ankylosing spondylitis, the drug is prescribed at a dose of 15 mg / day, depending on the therapeutic effect, the dose can be reduced to 7.5 mg / day.

In patients with an increased risk of adverse reactions (diseases of the gastrointestinal tract in history, the presence of risk factors cardiovascular diseases) it is recommended to start treatment with a dose of 7.5 mg.

Because the potential risk of adverse reactions depends on the dose and duration of treatment, the minimum effective dose should be prescribed for the shortest possible course.

In patients with severe renal insufficiency who are on hemodialysis, the dose of Movalis ® should not exceed 7.5 mg / day.

The maximum dose in adolescents aged 12-18 years is 0.25 mg/kg and should not exceed 15 mg.

The use of the drug is contraindicated in childhood up to 12 years, due to the impossibility of selecting the appropriate dose for this age group.

Combined application

Do not use the drug simultaneously with other NSAIDs.

The total dose of the drug Movalis ® used in the form of different dosage forms, should not exceed 15 mg / day.

Overdose

Data on cases associated with an overdose of the drug has not been accumulated enough. It is likely that there will be symptoms characteristic of an overdose of NSAIDs 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, evacuation of the contents of the stomach and general supportive therapy should be carried out. Colestyramine accelerates the elimination of meloxicam.

Interaction

With the simultaneous use of other prostaglandin synthesis inhibitors with meloxicam, incl. GCS and salicylates, increases the risk of gastrointestinal ulcers and gastrointestinal bleeding (due to synergism of action). The simultaneous use of meloxicam and other NSAIDs is not recommended.

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

Antiplatelet drugs, serotonin reuptake inhibitors, when used simultaneously with meloxicam, increase 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.

NSAIDs increase plasma lithium concentration by reducing its excretion by the kidneys. The simultaneous use of meloxicam with lithium preparations is not recommended. In case of need for simultaneous use, careful monitoring of the concentration of lithium in plasma is recommended during the entire course of the use of lithium preparations.

NSAIDs can reduce tubular 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 the case of simultaneous use, careful monitoring of kidney function and blood counts is necessary. Meloxicam may increase the haematological toxicity of methotrexate, especially in patients with impaired renal function. With the combined use of meloxicam and methotrexate for 3 days, the risk of increasing the toxicity of the latter increases.

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

The use of NSAIDs while taking diuretics in case of dehydration of patients is accompanied by a risk of developing acute renal failure.

NSAIDs reduce the effect of antihypertensive drugs (beta-blockers, ACE inhibitors, vasodilators, diuretics) due to inhibition of prostaglandins that have vasodilatory properties.

The combined use of NSAIDs and angiotensin II receptor antagonists, as well as ACE inhibitors, enhances the effect of reducing glomerular filtration, thereby may lead to the development of acute renal failure, especially in patients with impaired renal function.

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

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

In patients with CC from 45 to 79 ml / min, meloxicam should be discontinued 5 days before the start of pemetrexed and may be resumed 2 days after the end of pemetrexed. If there is a need for the combined use of meloxicam and pemetrexed, then patients should be carefully monitored, especially in relation to myelosuppression and the occurrence of side effects from the gastrointestinal tract. In patients with CC<45 мл/мин применение мелоксикама совместно с пеметрекседом не рекомендуется.

With simultaneous use with meloxicam of drugs that have a known ability to inhibit CYP2C9 and / or CYP3A4 (or are metabolized with the participation of these enzymes), such as sulfonylurea derivatives or probenecid, the possibility of pharmacokinetic interaction should be taken into account.

When co-administered with oral hypoglycemic agents (eg, sulfonylurea derivatives, nateglinide), a CYP2C9-mediated interaction is possible, which can lead to an increase in the concentration of both hypoglycemic agents and meloxicam in the blood. Patients concomitantly taking meloxicam with sulfonylurea drugs or nateglinide should carefully monitor the concentration of glucose in the blood because of the possibility of hypoglycemia.

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

Side effects

The following side effects are described, the relationship of which with the use of the drug Movalis ® was regarded as possible.

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

Within the system-organ classes, the following categories are used in terms of the incidence of side effects: very often (≥1 / 10); often (≥1/100,<1/10); нечасто (≥1/1000, <1/100); редко (≥1/10 000, <1/1000); очень редко (<1/10 000); не установлено.

From the hemopoietic system: infrequently - anemia; rarely - a change in the number of blood cells, including changes in the leukocyte formula, leukopenia, thrombocytopenia.

From the immune system: infrequently - other immediate hypersensitivity reactions *; frequency not established - anaphylactic shock *, anaphylactoid reactions *.

From the nervous system: often - headache; infrequently - dizziness, drowsiness.

On the part of the psyche: often - mood changes *; frequency not established - confusion*, disorientation*.

From the senses: infrequently - vertigo; rarely - conjunctivitis *, visual disturbances, including blurred vision *, tinnitus.

From the gastrointestinal tract: often - abdominal pain, dyspepsia, diarrhea, nausea, vomiting; infrequently - hidden or obvious gastrointestinal bleeding, gastritis *, stomatitis, constipation, bloating, belching; rarely - gastroduodenal ulcers, colitis, esophagitis; very rarely - perforation of the gastrointestinal tract.

From the side of the liver and biliary tract: infrequently - transient changes in liver function parameters (for example, increased transaminase activity or bilirubin concentration); very rarely - hepatitis *.

From the skin and subcutaneous tissues: infrequently - angioedema *, itching, skin rash; rarely - toxic epidermal necrolysis *, Stevens-Johnson syndrome *, urticaria; very rarely - bullous dermatitis *, erythema multiforme *; frequency not established - photosensitivity.

From the respiratory system: rarely - bronchial asthma in patients with allergies to acetylsalicylic acid or other NSAIDs.

From the side of the cardiovascular system: infrequently - increased blood pressure, a feeling of "rush" of blood to the face; rarely - a feeling of palpitations.

From the urinary system: infrequently - changes in indicators of kidney function (increased concentration of creatinine and / or urea in the blood serum), urination disorders, including acute urinary retention *; very rarely - acute renal failure *.

From the reproductive system and mammary gland: infrequently - late ovulation *; frequency not established - infertility in women *.

Co-administration with drugs that depress the bone marrow (eg, methotrexate) may cause cytopenia.

Gastrointestinal bleeding, ulceration, or perforation can be fatal.

As with other NSAIDs, the possibility of interstitial nephritis, glomerulonephritis, renal medullary necrosis, and nephrotic syndrome cannot be ruled out.

Indications

Symptomatic treatment:

• osteoarthritis (arthrosis, degenerative joint diseases), incl. with a painful component;
• rheumatoid arthritis;
• ankylosing spondylitis;
• other inflammatory and degenerative diseases of the musculoskeletal system, such as arthropathy, dorsopathy (eg, sciatica, lower back pain, shoulder periarthritis), accompanied by pain.

Contraindications

• 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 NSAIDs (including history) due to the existing likelihood of cross-sensitivity;
• erosive and ulcerative lesions of the stomach and duodenum in the acute phase or recently transferred;
• inflammatory bowel disease (Crohn's disease or ulcerative colitis in the acute phase);
• severe liver failure;
• severe renal failure (if hemodialysis is not performed, QC<30 мл/мин, а также при подтвержденной гиперкалиемии);
• progressive kidney disease;
• active gastrointestinal bleeding, recent cerebrovascular bleeding or established diagnosis of diseases of the blood coagulation system;
• severe uncontrolled heart failure;
• therapy of perioperative pain during coronary artery bypass surgery;
• pregnancy;
• lactation period (breastfeeding);
• children's age up to 12 years;
• rare hereditary galactose intolerance (the maximum daily dose of the drug with a dose of meloxicam 7.5 mg and 15 mg contains 47 mg and 20 mg of lactose, respectively);
• hypersensitivity to the active substance or auxiliary components of the drug.

Carefully:

• diseases of the gastrointestinal tract in history (peptic ulcer of the stomach and duodenum, liver disease);
• congestive heart failure;
• renal failure (CC 30-60 ml / min);
• cerebrovascular diseases;
• dyslipidemia/hyperlipidemia;
• diabetes;
• concomitant therapy with the following drugs: oral corticosteroids, anticoagulants (including warfarin), antiplatelet agents, selective serotonin reuptake inhibitors (including citalopram,
  fluoxetine, paroxetine, sertraline);
• peripheral arterial disease;
• elderly age;
• prolonged use of NSAIDs;
• smoking;
• frequent alcohol use.

Application features

Use during pregnancy and lactation

The use of Movalis ® is contraindicated during pregnancy.

It is known that NSAIDs are excreted in breast milk, so the use of Movalis ® during breastfeeding is contraindicated.

As a drug that inhibits the synthesis of COX / prostaglandin, Movalis ® may affect fertility, and therefore is not recommended for women planning pregnancy. Meloxicam may delay ovulation. In this regard, in women who have problems conceiving and are being examined for such problems, it is recommended to stop taking the drug Movalis ® .

Application for violations of liver function

The drug is contraindicated in severe liver failure.

Application for violations of kidney function

The drug is contraindicated in severe renal failure (if hemodialysis is not performed, QC<30 мл/мин, а также при подтвержденной гиперкалиемии), прогрессирующем заболевании почек.

With caution, the drug should be prescribed for renal failure (CC 30-60 ml / min).

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

In patients with mild to moderate renal insufficiency (CC>

Use in children

special instructions

Patients with gastrointestinal diseases should be monitored regularly. If an ulcerative lesion of the gastrointestinal tract or gastrointestinal bleeding occurs, Movalis ® must be discontinued.

Gastrointestinal bleeding, ulcers and perforations may occur during the use of NSAIDs at any time, either in the presence of warning symptoms or a history of serious gastrointestinal complications, or in the absence of these signs. The consequences of these complications are generally more severe in the elderly.

When using Movalis ®, serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis may 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 the event of the first signs of a skin rash, changes in the mucous membranes or other signs of hypersensitivity, the question of discontinuing the use of the drug Movalis ® should be considered.

Cases of an increased risk of developing serious cardiovascular thrombosis, myocardial infarction, an attack of angina pectoris, possibly fatal, are described when taking NSAIDs. This risk increases with prolonged use of the drug, as well as in patients with a history of the above diseases 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 latent renal failure. After discontinuation of NSAIDs, kidney function usually returns to baseline. Elderly patients, patients with dehydration, congestive heart failure, liver cirrhosis, nephrotic syndrome or acute renal dysfunction, patients concomitantly taking diuretics, ACE inhibitors, angiotensin II receptor antagonists, and also patients who have undergone major surgical interventions that lead to hypovolemia. In such patients, diuresis and renal function should be carefully monitored at the beginning of therapy.

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, as well as maintaining adequate hydration. Before starting treatment, a study of kidney 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 occasional increase in the activity 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 monitoring of the identified laboratory changes should be carried out.

Debilitated or debilitated patients may be less able to tolerate adverse events, so these patients require careful monitoring.

Like other NSAIDs, Movalis ® may mask the symptoms of an infectious disease.

As a drug that inhibits the synthesis of COX / prostaglandin, Movalis ® can affect fertility, and therefore is not recommended for women who have difficulty conceiving. In women undergoing examination for this reason, it is recommended that Movalis be discontinued.

In patients with mild to moderate renal insufficiency (CC> 25 ml / min), dose adjustment is not required.

In patients with cirrhosis of the liver (compensated), dose adjustment is not required.

Influence on the ability to drive vehicles and control mechanisms

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, the possibility of dizziness, drowsiness, visual impairment or other disorders of the central nervous system should be taken into account. Patients should be careful when driving and operating machinery.

Trade name: Movalis ®

International non-proprietary name:

Dosage form:

Compound
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
Tablets 7.5 mg
Round, pale yellow to yellow tablets. One side is convex with a beveled edge. On the convex side - the logo of the company; on the other side is a code and a concave risk. Roughness of tablets is allowed.
Tablets 15 mg
Round, pale yellow to yellow tablets. One side is convex with a bevelled edge. On the convex side is the company logo; on the other side - a code and a concave risk. Roughness of tablets is allowed.

Pharmacotherapeutic group
Non-steroidal anti-inflammatory drug - NSAIDs.
ATX code: M01AC06.

Pharmacological properties
Pharmacodynamics
Movalis is a non-steroidal anti-inflammatory drug, belongs to enolic acid derivatives 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 inflammatory mediators.
In vivo, meloxicam 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 more selective inhibition of cyclooxygenase-2 (COX-2) compared to cyclooxygenase-1 (COX-1). It is believed that inhibition of COX-2 provides the therapeutic effect of NSAIDs, while inhibition of the constantly present COX-1 isoenzyme can cause side effects from the stomach and kidneys.
The selectivity of meloxicam for COX-2 has been confirmed in various test systems, both in vitro and ex vivo. The selective ability of meloxicam to inhibit COX-2 has been shown when used as a test system in human whole blood in vitro. It was found ex vivo that meloxicam (at doses of 7.5 and 15 mg) inhibited COX-2 more actively, having a greater inhibitory effect on the production of prostaglandin E 2 stimulated by lipopolysaccharide (a reaction controlled by COX-2) than on the production of thromboxane involved in the process of blood coagulation (a reaction controlled by COX-1). These effects were dose dependent. Ex vivo showed that meloxicam at the recommended doses did not affect platelet aggregation and bleeding time, unlike indomethacin. diclofenac. ibuprofen and naproxen. which significantly inhibited platelet aggregation and increased bleeding time.
In clinical studies, gastrointestinal (GI) side effects were generally less common with meloxicam 7.5 and 15 mg than with the other NSAIDs compared. 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 common. The frequency of perforations in the upper gastrointestinal tract, ulcers and bleeding, which were associated with the use of meloxicam, was low and depended on the dose of the drug.
Pharmacokinetics
Meloxicam is well absorbed from the gastrointestinal tract, as evidenced by the high absolute oral bioavailability (89%).
With a single dose of the drug in the form of tablets, the average maximum plasma concentration is reached within 5-6 hours. With repeated use, a steady state of pharmacokinetics is achieved in a period of 3 to 5 days.
The range of differences between the maximum (C max) and basal concentrations (C min) of the drug during the steady state of pharmacokinetics after taking it once a day is relatively small and amounts to 0.4-1.0 μg / ml - for a dose of 7.5 mg, and 0.8-2.0 µg/ml for the 15 mg dose. The maximum plasma concentration during the steady state of pharmacokinetics is reached within 5-6 hours when taking tablets.
The concentrations of the drug after continuous use of the drug for more than 6 months are similar to the concentrations that are observed after 2 weeks of oral administration of 15 mg per day. When taken for more than 6 months, such differences are unlikely.
Simultaneous food intake does not affect the absorption of the drug.
Distribution
Meloxicam binds well to plasma proteins (albumin - 99%). Meloxicam penetrates the synovial fluid: local concentrations are approximately 50% of plasma concentrations.
The volume of distribution is low, averaging 11 liters. Individual fluctuations - 30-40%.
Metabolism
Meloxicam is almost completely metabolized in the liver with the formation of 4 pharmacologically inactive derivatives, which are determined in the urine. 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). In vitro studies have shown that CYP 2C9 plays an important role in this metabolic transformation, and the CYP 3A4 isoenzyme is of additional importance. Peroxidase is involved in the formation of two other metabolites (constituting, respectively, 16% and 4% of the dose of the drug). the activity of which is likely to vary individually.
It is excreted equally with feces and urine, mainly in the form of metabolites. Less than 5% of the daily dose is excreted unchanged in the feces; in the urine, unchanged, the drug is found only in trace amounts. The mean elimination half-life of meloxicam is 20 hours.
Plasma clearance averages 8 ml/min. Meloxicam shows linear pharmacokinetics at doses of 7.5-15 mg when administered orally.
Lack of liver and/or kidney function
Insufficiency of liver function, as well as mild or moderate renal failure, does not significantly affect the pharmacokinetics of meloxicam.
In end-stage renal disease, an increase in the volume of distribution may lead to higher concentrations of free meloxicam, so in these patients the daily dose should not exceed 7.5 mg.
Elderly patients
In elderly patients, the mean plasma clearance during steady state pharmacokinetics is slightly lower than in younger patients.
During the study of meloxicam in children, the pharmacokinetics of the drug was studied at doses used at the rate of 0.25 mg / kg. When comparing indicators in children of different ages (2-6 years old, n = 7 and 7-14 years old, n = 11), a tendency to lower maximum plasma concentration (C max , -34%) and AUC 0-∞ (- 28%) in young children, and the clearance of the drug (adjusted for body weight) in this group of children was higher. Plasma concentrations of meloxicam in older children and adults are similar. In children of both age groups, plasma half-lives of meloxicam were similar (13 hours) and somewhat shorter than in adults (15-20 hours).

Indications
Symptomatic treatment:
- osteoarthritis (arthrosis, degenerative joint diseases),
- rheumatoid arthritis,
- ankylosing spondylitis.

Contraindications
- Hypersensitivity to the active ingredient or auxiliary components of the drug. There is a possibility of cross-sensitivity to acetylsalicylic acid and other NSAIDs;
- Symptoms of bronchial asthma, nasal polyps, angioedema or urticaria after taking acetylsalicylic acid or other NSAIDs in history;
- Peptic ulcer / perforation of the stomach and duodenum in the acute stage or recently transferred;
- Crohn's disease or ulcerative colitis in the acute stage;
- Severe liver failure;
- Severe renal failure (if hemodialysis is not performed);
- Acute gastrointestinal bleeding, recent cerebrovascular bleeding or established diagnosis of diseases of the blood coagulation system;
- Severe uncontrolled heart failure;
- Children's age up to 12 years, except for the use in juvenile rheumatoid arthritis (if this indication is registered);
- Pregnancy;
- Breast-feeding;
- Therapy of perioperative pain during coronary artery bypass surgery (CABG);
Carefully:
- diseases of the gastrointestinal tract in history;
- congestive heart failure;
- renal failure;
- coronary artery disease;
- cerebrovascular diseases;
- dyslipidemia / hyperlipidemia;
- diabetes;
- diseases of peripheral arteries;
- elderly age;
- long-term use of NSAIDs;
- smoking;
- Frequent use of alcohol.

Dosage and administration

Since the risk of adverse reactions depends on the dose and duration of use, the drug should be used for the shortest possible time with the lowest possible effective dose.
Combined application. The total daily dose of Movalis ® used in the form of tablets, suppositories, suspensions for oral administration and injections should not exceed 15 mg.

Side effects
The following side effects are described, the relationship of which with the use of the drug Movalis ® was regarded as possible.
Side effects, the relationship of which with the use of the drug was regarded as possible, and which were registered with the widespread use of the drug, are marked with *.
From the side of the hematopoietic organs:
Changes in the number of blood cells, including changes in the leukocyte formula, leukopenia, thrombocytopenia, anemia.
From the immune system:
anaphylactoid/anaphylactic reactions*, other immediate hypersensitivity reactions*.
From the side of the central nervous system:
headache, dizziness, tinnitus, drowsiness, confusion*, disorientation*, mood changes*.
From the gastrointestinal tract:
perforation of the gastrointestinal tract, hidden or obvious gastrointestinal bleeding, possibly fatal, gastroduodenal ulcers, colitis, gastritis*, esophagitis, stomatitis, abdominal pain, dyspepsia, diarrhea, nausea, vomiting, constipation, bloating, belching, transient changes in liver function tests (for example, increased activity of transaminases or bilirubin), hepatitis *.
From the skin and skin appendages:
toxic epidermal necrolysis*, Stevens-Johnson syndrome*, angioedema*, bullous dermatitis*, erythema multiforme*, pruritus, skin rash, urticaria, photosensitivity.
From the side of the respiratory system:
bronchial asthma.
From the side of the cardiovascular system:
Increased blood pressure, palpitations, a feeling of a rush of blood to the face.
From the genitourinary system:
acute renal failure*, changes in renal function (increased levels of creatinine and / or urea in the blood serum), urinary disorders, including acute urinary retention*, interstitial nephritis, glomerulonephritis, renal medullary necrosis, nephrotic syndrome*.
From the side of the organs of vision:
conjunctivitis*, visual disturbances, including blurred vision*.
Common diseases:
Edema.

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

Interactions with other drugs
- 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) and is therefore not recommended. Simultaneous reception with other NSAIDs is not recommended.
- Selective serotonin reuptake inhibitors - increased risk of gastrointestinal bleeding.
- Sodium polystyrene sulfonate - due to the presence of sorbitol in the composition of Movalis ®, co-administration may cause the risk of developing necrosis of the large intestine, with a possible fatal outcome.
- Anticoagulants for oral administration, antiplatelet drugs, heparin for systemic use, thrombolytic agents, serotonin reuptake inhibitors - simultaneous use with meloxicam increases the risk of bleeding due to inhibition of platelet function.
- Lithium preparations - NSAIDs increase the level of lithium in plasma by reducing its excretion by the kidneys. It is recommended to monitor the level of lithium during the appointment of Movalis ® when changing the dose of lithium preparations and canceling them.
- Methotrexate - NSAIDs reduce tubular secretion of methotrexate, thereby increasing its plasma concentration and hematological toxicity, while the pharmacokinetics of methotrexate does not change. In this regard, the simultaneous administration of Movalis ® and methotrexate at a dosage of more than 15 mg / week is not recommended.
The risk of interaction between NSAIDs and methotrexate may also occur in patients using low-dose methotrexate, especially in patients with impaired renal function. Therefore, constant monitoring of the number of blood cells and kidney function is necessary.
With the combined use of meloxicam and methotrexate for 3 days, the risk of increasing the toxicity of the latter increases.
- Contraception - NSAIDs reduce the effectiveness of intrauterine contraceptive devices.
- Diuretics - The use of NSAIDs in the case of dehydration of patients is accompanied by a risk of developing acute renal failure.
- Antihypertensive agents (beta-blockers, angiotensin converting enzyme inhibitors, vasodilators, diuretics). NSAIDs reduce the effect of antihypertensive drugs due to inhibition of prostaglandins, which have vasodilating properties.
- Angiotensin-II receptor antagonists, when co-administered 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.
- Cholestyramine, binding meloxicam in the gastrointestinal tract, leads to its faster elimination.
- NSAIDs, by acting on renal prostaglandins, may increase the nephrotoxicity of cyclosporine.
When using together with meloxicam drugs that have a known ability to inhibit CYP 2C9 and / or CYP 3A4 (or are metabolized with the participation of these enzymes), the possibility of pharmacokinetic interaction should be taken into account.
The possibility of interaction with oral antidiabetic drugs cannot be ruled out. With the simultaneous use of antacids, cimetidine, digoxin and furosemide, no significant pharmacokinetic interactions were identified.

special instructions
Patients suffering from diseases of the gastrointestinal tract should be monitored regularly. If an ulcerative lesion of the gastrointestinal tract or gastrointestinal bleeding occurs, Movalis ® must be discontinued.
Gastrointestinal ulcers, perforation, or bleeding may occur at any time during treatment, whether or not there are warning signs or a history of serious gastrointestinal complications. The consequences of these complications are generally more severe in the elderly.
Particular 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 such cases, the question of stopping the use of Movalis ® should be considered.
Like other NSAIDs, Movalis ® may increase the risk of serious cardiovascular thrombosis, myocardial infarction, angina attack, possibly fatal. This risk increases with prolonged use of the drug, as well as in patients with a history of the above diseases 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 a reduced volume of circulating blood can lead to decompensation of latent renal failure. After discontinuation of NSAIDs, kidney function usually returns to baseline. Elderly patients, patients with dehydration, congestive heart failure, cirrhosis of the liver, nephrotic syndrome or acute renal impairment, patients taking concomitant diuretics, and patients who have undergone major surgery who lead to hypovolemia. In such patients, diuresis and renal function should be carefully monitored at the beginning of therapy.
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, in predisposed patients, signs of heart failure or hypertension may be exacerbated. Therefore, careful monitoring of the condition of such patients is necessary, and they must be maintained adequate hydration.
Before starting treatment, a study of kidney function is necessary.
In the case of combination therapy, renal function should also be monitored.
When using Movalis ® (as well as most other NSAIDs), an episodic increase in the level 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 discontinued and monitoring of the identified laboratory changes should be carried out.
Debilitated or malnourished patients may be less able to tolerate adverse events, and therefore, such patients should be closely monitored.
Like other NSAIDs, Movalis ® may mask the symptoms of an underlying infectious disease.
As a drug that inhibits the synthesis of cyclooxygenase / prostaglandin, Movalis ® may affect fertility, and therefore is not recommended for women planning pregnancy. In this regard, in women undergoing examination for such problems, it is recommended to stop taking Movalis ® .
The maximum recommended daily dose of 7.5 and 15 mg tablets contains 47 and 20 mg of lactose, respectively. Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose/galactose malabsorption should not take this medicine.
In the case of simultaneous use of oral anticoagulants, ticlopidine, heparin for systemic use, thrombolytic agents, careful monitoring of the effect of anticoagulants is necessary.
Influence on the ability to drive vehicles and mechanisms
Special studies on the effect of the drug on the ability to drive vehicles and mechanisms have not been conducted. However, this activity should be refrained from in patients with visual impairments, patients who report drowsiness or other disorders of the central nervous system.

Release form
Tablets 7.5 mg or 15.0 mg. 10 tablets in a PVC/A1-foil or PVC/PVDC/A1-foil blister. 1 or 2 blisters with instructions for use in a cardboard box.

Shelf life
3 years. Do not use after the expiry date stated on the package.

Storage conditions
Tablets at a temperature not exceeding 25 o C. Keep out of the reach of children. Vacation from pharmacies By prescription.

Manufacturer
Boehringer Ingelheim International GmbH
Produced
"Boehringer Ingelheim Ellas A.E."
5th km Paiania-Markopoulo, 194 00 Koropi. Greece
or
Boehringer Ingelheim Pharma GmbH & Co.KG
Binger Strasse 173, 55216 Ingelheim am Rhein, Germany
Claims of consumers by sending to the address of the Representative Office in Moscow:
117049. Moscow, Donskaya st. d.29/9. building 1.

The main component of the drug Movalis is the substance meloxicam. It not only has an anti-inflammatory effect, but is also able to have a selective effect on certain microelements (mostly negative ones). This drug relieves pain, works as an antipyretic, blocks the activity of a special enzyme responsible for the development and activation of inflammatory processes.

The drug has an active effect on proteins and is able to easily penetrate into diseased organs through histohematic barriers.

Most popular with patients Movalis injections- their action starts immediately. Movalis tablets do not begin to act so quickly, but their effectiveness does not decrease from this. Today, there are many analogues of the drug, but their choice should be approached with extreme caution.

Patients who have been treated with Movalis speak very positively about it. But at the same time, do not forget to point out that when using the drug, you need to pay attention to the features of its administration.

In pharmacies, Movalis is sold only by prescription.

Indications for use and features of the drug

Movalis is excreted from the body within 20 hours after ingestion. 5 percent of the substance taken throughout the day passes through the gastrointestinal tract. The range of indications for taking Movalis is quite wide - the medicine effectively fights a large number of diseases. Movalis is prescribed for:

• Rheumatoid arthritis.
• The presence of pain in arthrosis, osteoarthritis, cervical osteochondrosis.
• Osteoarthritis.
• Vertebral hernia.
• Pain in the back, including the lower back.

Movalis injections and tablets will cope with all these diseases more than confidently. Analogues will not be so successful in the fight against such diseases - despite their composition, identical to the original, they are not so effective and efficient.

The instructions for use of Movalis (injections) indicate that one ampoule of the drug contains 15 ml of the active substance and additional components - glycine, sodium chloride, poloxamer, glycofurol. Movalis has no color and is sold in ampoules of 2 ml. Analogue drugs are not so effective - using them, it is much more difficult to cope with the disease.

Movalis tablets have a convex shape. On one side of each is printed the logo of the manufacturer, on the other - the code. This labeling is designed to minimize the risk of drug counterfeiting. The color of the tablets is yellow, the edges are painted on one side. What exactly - injections or tablets - only a doctor can decide to treat a particular disease. First of all, it will depend on the severity of the disease and the characteristics of the patient's body.

Contraindications for use

Movalis is an excellent remedy for the treatment of many diseases. But, like all drugs, it has many contraindications. The drug is not prescribed for:

• The presence of a patient hypersensitivity to any of the components that make up the composition.
• Violation of hemostasis.
• Taking anticoagulants (to avoid the risk of intramuscular hematomas).
• Taking acetylsalicylic acid and other NSAIDs (to reduce the possibility of negative reactions of the body).
• Bronchial asthma.
• Urticaria.
• Exacerbation of peptic ulcer.
• Malfunctions in the work of the cardiovascular system.
• Inflammatory bowel diseases.
• Liver diseases.
• Stomach bleeding.

Movalis is contraindicated in children and adolescents under 18 years of age, as well as pregnant and lactating women.

Use in pregnancy

Movalis helps to suppress the synthesis of prostaglandins, which has a negative effect on the unborn child. That is why doctors categorically forbid pregnant women give injections and suppositories and take pills. In addition, studies show that the use of Movalis in any form increases the risk of spontaneous abortion. In the third trimester of pregnancy when taking Movalis:

• The ductus arteriosus to the fetus is closed.
• Renal failure develops.

Taking even a small dose of the drug has a negative effect on the body of a pregnant woman - during labor pains, prolonged bleeding may begin. In the instructions for using the drug, all the complications are written in more than detail.

The choice between Movalis and Diclofenac

Patients often ask themselves the question: which drug is better to buy - Movalis or Diclofenac? After visiting the attending physician, the decision becomes obvious - of course, Movalis. Reviews of Movalis injections and suspensions are only positive - the medicine has a longer analgesic effect on the body and fights the disease more effectively. And, importantly, if the drug is not available in the pharmacy, you can purchase its analogues. Just do not forget to consult a doctor before taking them.

Instructions for use

The instructions of Movalis contain complete information about the drug - after its careful study, problems with the use of the drug, in principle, cannot arise.

For each form of Movalis, there are dosages. For intramuscular injections, the recommended daily dose is 15 mg. Or half of this volume - it all depends on the characteristics of the disease and the intensity of its development. However, if the patient has problems with the functioning of the kidneys, injections are not prescribed for him - treatment with Movalis in the presence of renal failure threatens with serious complications.

The course of treatment and its duration are individual for each patient. Tablets are taken 1 time per day with meals. And drink plenty of plain water or other liquid. However, in the treatment of certain diseases, there are some features of their use:

• Osteoarthritis with pain- the dose is 7.5 mg during the day. If the pain syndrome is not removed, the doctor can increase it.
• Rheumatoid arthritis- the dose is 15 mg during the day. Moreover, the doctor must keep the patient's well-being under control and, if problems arise, reduce the dose.
• Osteochondrosis- the dose is 15 mg during the day and is the maximum.

Consequences of an overdose

Exceeding the dose of medicine prescribed by the doctor inevitably threatens with an overdose. Its symptoms are similar to those that appear with an overdose of NSAIDs, but there are some features. In especially severe situations, the appearance of:

• Nausea and vomiting.
• Drowsiness.
• Stomach bleeding.
• Stops of breathing.
• Jumps in blood pressure.

There is only one way to eliminate these symptoms - the complete elimination of the drug from the patient's body. In the future, the doctor prescribes general therapy aimed at maintaining the patient in a normal state.

drug interaction

Simultaneous reception of Movalis and other medicines (as well as some vitamins) threatens with the appearance of gastric bleeding and ulcers. The reason for this is synergy. That is why the combined use of meloxicam and drugs containing NSAIDs is strictly prohibited.

If, nevertheless, it is impossible to do without the simultaneous use of these drugs, this should be done under the strict supervision of a doctor. Even if we are talking about drug substitutes.

Movalis and alcoholic drinks

Ethanol is incompatible with any drugs - this is a well-known fact. The negative reaction of the body to such an interaction will be immediate, the consequences can be completely unpredictable. This also applies to Movalis.

The use of alcohol while taking it is strictly prohibited.

Side effect

Adverse reactions of the body to taking Movalis can be completely different - it all depends on the individual characteristics of the patient. Each system of the body on tablets and injections of the drug can give its own failure:

• Hematopoietic - anemia and leukopenia.
• Immune - anaphylactic shock.
• Nervous - drowsiness and pain in the head.
• Respiratory - bronchial asthma.
• Urinary - problems with urination.
• The liver is a dysfunction of the organ.
• Psyche - uncontrolled mood swings.

There may be changes in the genital area and late ovulation.

special instructions

Reception of Movalis by patients with disorders of the gastrointestinal tract should be carried out under the strict supervision of a physician. If they have stomach bleeding and ulcers, the use of the drug should be immediately canceled.

In the risk group in this case are the elderly - the reaction of their organisms to the reception of Movalis can be expressed by special symptoms.

It is not uncommon for the skin to react sharply to taking Movalis tablets (less often suppositories). Patients diagnosed with skin problems should be especially careful when using the drug and inform their doctor at the first appearance of rashes.

Also, when taking Movalis, a heart attack and an attack of angina pectoris may occur. Moreover, in such situations, a lethal outcome is not excluded at all. Patients with a history of a certain kind of disease and those who take Movalis for a long time are susceptible to the appearance of just such side effects.

If any complications occur, the dose of the drug should be adjusted. And in especially difficult situations, its reception must be canceled - if, despite the negative reaction of the body, the use of Movalis is continued, the consequences can be unpredictable.

Studies on the effect of the drug on the reaction of drivers while driving vehicles have not been conducted. However, given that when taking Movalis, dizziness and vision problems may occur, you need to drive a car with extreme caution and be extremely careful while driving.

In any case, taking the drug requires an individual approach, patient self-control and advice from a competent doctor - how much and how to drink pills, put candles or inject injections, only he can decide.

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

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

Pharmacological properties

Movalis belongs to the group of enolic acid derivatives, so 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. Mechanism of action of the drug: effectiveness is achieved through its ability to inhibit the synthesis of prostaglandins (substances that are mediators of inflammation).

Clinical studies confirm that the occurrence of side effects after taking Movalis is much less than the effects of 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 from the group of non-steroidal anti-inflammatory products.

The active components of the drug are quickly absorbed from the stomach, providing a quick result. With a single dose of the drug, the maximum concentration is reached six hours after use, with a constant intake - the effect persists for four days. After using the product, the concentration of active components is maintained at the level of a single dose of the drug. Eating does not affect the effectiveness of the drug.

Release form and composition

The medicinal product is produced in several forms (candles, tablets, injection ampoules). Learn more about pills. Movalis in tablets is a pill convex on one side with a bevelled edge, pale yellow in color. The company logo is written on the convex side, on the other - "59D" (for tablets with a dosage of 7.5 mg of the active substance), "77C" - pills with 15 mg of the main active substance.

All pills are packed in blisters of ten pieces, carton packs of 1/2 blisters each. Without fail, 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 drug in any form is prohibited to use in such cases:

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

Use the drug with extreme caution in such cases:

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

Without fail, before you start taking Movalis, read the instructions, especially the contraindications section. Violation of certain rules leads to sharply 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 individual components of the drug, which can provoke a negative reaction from various organs, systems of the patient:

• anemia, changes in the parameters 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 disorders, bloating, changes in liver parameters (elevated bilirubin, which may indicate the course of hepatitis);
• allergic reactions (anaphylactic shock, urticaria, rashes on the skin, itching, erythema);
• the likelihood of developing bronchial asthma is high;
• swelling of the face, increased blood pressure, palpitations;
• the occurrence of serious pathologies of the kidneys, serious deviations in the indicators of kidney function, urinary retention, painful urination;
• blurred vision, conjunctivitis.

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

Pregnancy and lactation

During the bearing of the baby, Movalis is categorically contraindicated. The active components of the drug negatively affect the course of pregnancy, the development of the fetus. 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 prostaglandin synthesis inhibitors during the period of gestation leads to such disturbances in the development of the fetus:

• kidney dysfunction, further fraught with the occurrence of renal failure;
• toxic effects on the heart lead to closure of the ductus arteriosus, sometimes to pulmonary hypertension.

Doctors recommend stopping Movalis during pregnancy planning. Due to the intake 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 forbidden to take it during lactation.

Instructions for use and dosage

The specific dosage and duration of the medication 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 between 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 the treatment of 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, advanced cases require an increase in the tablet form used twice (fifteen mg);
• ankylosing spondylitis. A single dose of 15 mg (per day) is indicated, after a month of use, the dose is most often reduced to 7.5 mg per day.

In people at risk (problems with the kidneys, liver, gastrointestinal tract), the daily allowance 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 you experience any discomfort, immediately stop taking Movalis, seek medical help.

Medication analogues

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

Analogues of Movalis 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 approximately 718 rubles for 20 pieces per pack. The specific amount depends on the city of purchase, the pharmacy chain.

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