Compound
The composition of Revmoxicam 7.5 tablets includes 7.5 mg of the active component meloxicam , as well as additional components: MCC, lactose monohydrate, sodium citrate, crospovidone, povidone, anhydrous colloidal silicon dioxide, magnesium stearate.
The composition of Revmoxicam 15 tablets includes 15 mg of the active component meloxicam , as well as additional components: MCC, lactose monohydrate, sodium citrate, crospovidone, povidone, anhydrous colloidal silicon dioxide, magnesium stearate.
The drug in the form of suppositories contains the active component meloxicam , as well as solid fat as an additional component.
Revmoxicam in ampoules contains the active substance meloxicam , as well as additional components: glycine, meglumine, glycofurol, poloxamer 188, sodium chloride, sodium hydroxide, water for injection.
Release form
The drug is produced in the form of tablets that contain 7.5 or 15 mg of the active ingredient, in the form of suppositories and a solution for injection.
- The tablets are flat, yellow, scored and chamfered. Marbling on the surface of the tablet is allowed. Packed in blisters of 10 pcs. 1 or 2 blisters are placed in a pack.
- Revmoxicam suppositories for rectal use are contained in a contour package of 5 pieces, the packaging is placed in a cardboard pack.
- The solution for injection is contained in ampoules of 1.5 mg, in a cardboard pack - 5 ampoules.
pharmachologic effect
The medicine belongs to the group of selective non-steroidal anti-inflammatory drugs. It contains the active component meloxicam.
There is a pronounced analgesic, anti-inflammatory, antipyretic activity of the drug. Its mechanism of influence is associated with the ability of the active component to inhibit the activity of cyclooxygenase-2 . As a consequence, there is a decrease in the synthesis of pro-inflammatory cytokines, which are mediators of inflammatory processes. The drug has virtually no effect on the activity of cyclooxygenase-1
After taking the drug, pain is eliminated, the severity of inflammatory processes in the body in diseases of the musculoskeletal system decreases. At the same time, the drug does not affect the activity of chondrocytes, in particular, the synthesis of proteoglycan .
Pharmacological properties
Pharmacodynamics.
rheumoxicam is an anti-inflammatory, analgesic, antipyretic agent. the mechanism of action is due primarily to selective inhibition of cog-2, which leads to inhibition of the biosynthesis of proinflammatory prostaglandins at the site of inflammation. Due to its low affinity for tsog-1, the drug in therapeutic doses does not have a negative effect on the biosynthesis of cytoprotective prostaglandins in the gastrointestinal tract and kidneys, and does not suppress the functional activity of platelets. is a chondroneutral drug, does not affect the synthesis of proteoglycan by chondrocytes of articular cartilage. Pharmacokinetics
When administered rectally, meloxicam is well absorbed into the systemic circulation, bioavailability is 89%. A stable therapeutic concentration in the blood is achieved 3–5 days after the start of treatment. Plasma protein binding is more than 99%. It undergoes biotransformation in the liver, mainly through oxidation with the formation of 4 inactive metabolites. The main role in the metabolism of meloxicam is played by the enzymes CYP 2CP and CYP 3A4, as well as peroxidase. The volume of distribution of the drug is low - on average 11 l, plasma clearance - 8 ml/min. T½ is about 20 hours, which allows you to take the drug once a day. Excretion from the body occurs through urine and feces in equal proportions; 5% of the daily dose is excreted unchanged in feces. The drug passes through histohematic barriers and penetrates well into the synovial fluid, where its concentration is 50% of the level in the blood plasma.
In elderly people, there is only a slight increase in T½ of the drug, as well as a decrease in plasma clearance (especially in women).
There were no significant changes in the pharmacokinetics of meloxicam and no increase in the risk of side effects when using the drug in patients with hepatic or moderate hepatic impairment.
Pharmacokinetics and pharmacodynamics
After oral administration, meloxicam is well absorbed from the gastrointestinal tract, its bioavailability level is 89%. Eating does not affect the absorption of the substance. On days 3-5 after the start of treatment, a stable concentration of the substance in the body is observed, regardless of what form of medication is being treated. 99% of meloxicam is bound to proteins in plasma; the concentration of meloxicam in synovial fluid is equal to 50% of its concentration in plasma.
In the liver, the substance is completely metabolized to inactive metabolites. The half-life is 20 hours. It is excreted approximately equally through the kidneys and intestines. Meloxicam is able to penetrate the hematoplacental and blood-brain barriers. There are no changes in the pharmacokinetics of the active component of Revmoxicam in people suffering from moderate or mild renal and liver dysfunction.
REUMOXICAM 7.5MG TAB No. 20
Instructions
Trade name of the drug: Revmoxicam Active ingredients: Meloxicam Pharmacotherapeutic group: Non-steroidal anti-inflammatory drugs., Non-steroidal anti-inflammatory drugs. Release form: tablets of 7.5 mg or 15 mg. 10 tablets in a blister, 1 or 2 blisters in a pack. Dosage form: Tablets 7.5 mg, 15 mg N10 (1×10), N20 (2×10) (blisters) Composition: 1 tablet contains: active substance: meloxicam 7.5 mg or 15 mg; excipients: lactose, monohydrate; microcrystalline cellulose; sodium citrate; povidone; crospovidone; colloidal anhydrous silicon dioxide (Aerosil), magnesium stearate. Pharmacological properties: The drug belongs to non-steroidal anti-inflammatory drugs of the oxicam class, is a selective inhibitor of COX-2. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the synthesis of prostaglandins (known mediators of inflammation) due to inhibition of the enzymatic activity of COX-2 at the site of inflammation; has a slight effect on COX-1, which reduces the risk of side effects. Pharmacokinetics: Meloxicam after oral administration is well absorbed from the digestive tract. Bioavailability is 89%. A stable concentration is achieved on the 3-5th day. Eating food does not affect the absorption of meloxicam. In plasma, 99% of meloxicam is bound to proteins. The concentration of meloxicam in synovial fluid is 50% of the concentration in blood plasma. Meloxicam is almost completely metabolized to inactive metabolites in the liver. The half-life of meloxicam is 20 hours. Plasma clearance averages 8 ml/min. Meloxicam is excreted by the kidneys and through the intestines in approximately equal proportions. Mild to moderate hepatic and renal impairment do not significantly affect the pharmacokinetic parameters of meloxicam. Indications for use: Symptomatic treatment of: - pain syndrome due to osteoarthritis, arthrosis, degenerative joint diseases; - rheumatoid arthritis; - ankylosing spondylitis. Directions for use: Adults. Osteoarthritis: the daily dose is 7.5 mg, if necessary it is increased to 15 mg/day. Rheumatoid arthritis: the drug is prescribed at 15 mg/day; if a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day. Ankylosing spondylitis: the drug is prescribed at 15 mg/day; if a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day. In patients with an increased risk of adverse reactions, the initial therapeutic dose is 7.5 mg/day. In patients with severe renal failure on hemodialysis, the dose should not exceed 7.5 mg/day. It is necessary to use the lowest effective daily dose and the shortest duration of treatment, since the risk of adverse reactions increases with increasing dose and duration of treatment. The maximum recommended daily dose for children over 15 years of age is 0.25 mg/kg body weight. The maximum recommended daily dose of Revmoxicam is 15 mg. Combined use: the total daily dose of Revmoxicam when used in the form of tablets and suppositories should not exceed 15 mg. Considering that the dose for children under 15 years of age has not been established, it is necessary to limit the use of the drug only to children over 15 years of age and adults. The tablet should be taken with food, not chewed, or washed down with water or other liquid. The duration of treatment is determined individually depending on the course of the disease and the effectiveness of the therapy. Side effects: Adverse effects that were considered possible to be associated with the use of the drug Revmoxicam are described below. The incidence of these events is estimated to be 0.1%. From the respiratory system: less than 0.1% - the occurrence of asthma attacks in persons with hypersensitivity to acetylsalicylic acid or other NSAIDs. From the digestive system: >1% - dyspepsia, nausea, vomiting, flatulence, diarrhea, constipation, intestinal colic; 0.1-1% - esophagitis, stomatitis, hidden or macroscopically visible gastrointestinal bleeding, rarely - erosive and ulcerative lesions of the digestive tract, transient liver dysfunction (increased activity of liver transaminases or bilirubin); <0.1% - gastrointestinal perforation, colitis, gastritis, hepatitis. From the central nervous system: >1% - headache; 0.1-1% - dizziness, tinnitus, drowsiness; <0.1% - mood lability, irritability, disorientation, confusion. From the organ of vision: <0.1% – visual impairment (blurred vision), conjunctivitis. From the cardiovascular system: >1% - edema; 0.1-1% - increased blood pressure, palpitations, hot flashes. From the urinary system: 0.1-1% - changes in kidney function indicators (increased creatinine and/or serum urea); <0.1% - acute renal failure, urinary disorders, including acute urinary retention. From the hematopoietic system: >1% - anemia; 0.1-1% - leukopenia, thrombocytopenia, changes in the leukocyte formula. Concomitant administration of a potentially myelotoxic drug, especially methotrexate, may lead to the development of pancytopenia. Dermatological reactions: >1% - itching, skin rash; 0.1-1% - urticaria; <0.1% - photosensitivity. In rare cases, the development of Stevens-Johnson syndrome, toxic epidermal necrolysis, bullous reactions, erythema multiforme is possible; Allergic reactions: <0.1% - angioedema, anaphylactic and/or anaphylactoid reactions. Contraindications: - Hypersensitivity to meloxicam and other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid; - presence of symptoms (associated with the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs)): bronchial asthma, nasal polyps, angioedema or urticaria in the anamnesis, since cross-hypersensitivity reactions are possible; - gastrointestinal ulcers/perforations (active form or recent appearance); - active form of inflammatory diseases of the large intestine (Crohn's disease or ulcerative colitis); - severe liver failure; - renal failure not subject to hemodialysis; - any bleeding disorders, manifest gastrointestinal bleeding, recent cerebrovascular bleeding; - severe uncontrolled heart failure; - children under 15 years of age; - period of pregnancy and breastfeeding; — treatment to eliminate postoperative pain during coronary artery bypass grafting. — congenital disorders in which the inactive components of the drug may be harmful (see section “Peculiarities of use”). Drug interactions: Revmoxicam together with other NSAIDs may increase the risk of ulcers of the gastrointestinal mucosa and gastrointestinal bleeding due to their synergy. Co-administration of Revmoxicam and other NSAIDs is not recommended. Together with anticoagulants, antiplatelet agents, thrombolytic agents, heparin and selective serotonin reuptake inhibitors, Revmoxicam increases the risk of bleeding due to inhibition of platelet function. If their simultaneous use cannot be avoided, the patient's condition must be monitored. Revmoxicam can reduce the renal excretion of lithium, which leads to an increase in its concentration in the blood plasma to a toxic level. When used simultaneously with methotrexate, the negative effect on the hematopoietic system increases (the risk of developing anemia and leukopenia), so periodic monitoring of blood counts is necessary. There is evidence that the drug may reduce the effectiveness of intrauterine contraceptives, but this statement requires further research and confirmation. When used simultaneously with Revmoxicam, cholestyramine accelerates the elimination of meloxicam. Revmoxicam may reduce the effectiveness of antihypertensive drugs (β-blockers, ACE inhibitors), which is associated with an inhibitory effect on vasodilatory prostaglandins. The risk of acute renal failure may occur with diuretics, so renal function should be monitored and adequate hydration should be maintained. NSAIDs and angiotensin II-converting receptor antagonists, as well as ACE inhibitors, have a synergistic effect on reducing glomerular filtration. In patients with existing renal impairment, this may lead to acute renal failure. NSAIDs, affecting renal prostaglandins, increase the nephrotoxicity of cyclosporine, which requires enhanced monitoring of renal function during simultaneous use of drugs. Meloxicam is almost completely destroyed by hepatic metabolism, approximately two-thirds of which occurs with the participation of cytochrome (CYP) P450 and one-third by peroxidase oxidation. There may be a pharmacokinetic interaction between Revmoxicam and other drugs at the metabolic stage due to their influence on SUR 2C9 and/or SUR 3A4. When taking Revmoxicam simultaneously with antacids, cimetidine, digoxin and furosemide, no interaction was detected at the pharmacokinetic level. Interactions between the drug and oral antidiabetic agents cannot be excluded. Special instructions: It is necessary to carefully monitor the condition of patients when using the drug (as well as other NSAIDs) in patients: - with gastrointestinal diseases and in case of simultaneous use of anticoagulants. It is forbidden to prescribe Revmoxicam to patients with peptic ulcers or gastrointestinal bleeding. At any time during treatment, with or without previous symptoms or a history of serious gastrointestinal disease, potentially fatal gastrointestinal bleeding, ulceration, or perforation may occur
Indications for use
The product in the form of a solution, tablets and suppositories is used to eliminate pain in people who suffer from diseases of the musculoskeletal system of a degenerative-inflammatory nature.
Indicated for use with arthrosis , osteoarthritis . The drug is also prescribed as part of complex treatment for ankylosing spondylitis and rheumatoid arthritis .
Contraindications
The drug Revmoxicam is contraindicated for patients in the following cases:
- high sensitivity to drug components;
- impaired absorption of glucose-galactose, galactose intolerance, lactase deficiency (Revmoxicam tablets);
- stomach and duodenal ulcers;
- severe heart failure;
- severe kidney and liver diseases;
- rehabilitation period after undergoing coronary artery bypass surgery;
- the patient's tendency to bleed , recent cerebrovascular bleeding;
- diseases of the rectum (suppositories);
- pregnancy and breastfeeding;
- The patient's age is up to 15 years.
Revmoxicam injections cannot be administered intravenously.
The drug is prescribed with caution to people who suffer from liver cirrhosis , bronchial asthma , as well as people with dehydration , exhaustion, and elderly patients.
Care is taken to treat those who suffer from diseases of the digestive tract and patients receiving anticoagulants.
Special instructions for the use of the drug Revmoxicam
The drug is prescribed with caution to patients with a history of diseases of the digestive tract, asthma, dehydration, liver cirrhosis, congestive heart failure, the elderly, as well as patients receiving anticoagulants and antiplatelet agents. In patients with kidney disease, at the beginning of therapy with Revmoxicam, it is necessary to monitor the functional state of the kidneys. The solution for injection is not intended for intravenous administration. Meloxicam can cause sodium, potassium, and fluid retention, which increases the risk of progression of heart failure and hypertension (arterial hypertension). If undesirable effects from the central nervous system (drowsiness, dizziness) and visual organs occur during treatment, patients should stop driving vehicles and operating machinery.
Side effects
During treatment, patients may experience the following side effects:
- Digestive tract, liver: disturbances in the digestive process and stool, nausea, vomiting, bloating and abdominal pain, belching, increased activity of liver enzymes; isolated cases - erosive and ulcerative lesions of the gastrointestinal mucosa, bleeding, stomatitis , gastritis .
- Hematopoiesis, blood vessels and heart: swelling of the limbs and face, cardiac arrhythmias, hyperemia , hypertension , leukopenia , anemia , thrombocytopenia ; Heart failure may progress and hypertension may appear in people suffering from heart and vascular diseases.
- Nervous system: dizziness , headache, disturbed rhythm of wakefulness and sleep, emotional lability.
- Urinary system: acute renal failure, glomerulonephritis , interstitial nephritis , changes in creatinine and blood urea levels, nephrotic syndrome ; The manifestation of renal medullary necrosis was noted in isolated cases.
- Sense organs: blurred vision, tinnitus, conjunctivitis .
- Allergies: itching, rash, Stevens-Johnson syndrome , urticaria , bronchospasm , sensitivity to light; Anaphylactic shock may develop .
- Other manifestations: irritation, itching and burning in the anus (suppositories).
If during the use of any form of the drug any negative manifestations are noted, therapy is stopped and consultation with a specialist is sought.
Side effects of the drug Revmoxicam
From the digestive system: dyspepsia, nausea, vomiting, abdominal pain, constipation, intestinal colic, diarrhea, esophagitis, stomatitis, rarely - erosive and ulcerative lesions of the gastrointestinal tract. From the side of the central nervous system: dizziness, headache, tinnitus, sleep disturbance, mood lability, irritability. From the cardiovascular system: increased blood pressure, palpitations, swelling, hot flashes. From the urinary system: changes in laboratory parameters of renal function (increased creatinine and/or serum urea). Blood disorders: anemia, leukopenia, thrombocytopenia, decreased hematocrit and hemoglobin level in the blood. Allergic reactions: bronchospasm, photosensitivity, itching, rash (urticaria) on the skin. Angioedema, immediate hypersensitivity reactions (injection solution). From the organs of vision: rarely - conjunctivitis, blurred vision (blurredness).
Instructions for use of Revmoxicam (Method and dosage)
Revmoxicam tablets, instructions for use
According to the instructions, the tablets should be swallowed whole, without crushing, with plenty of liquid. It is recommended to take the tablets during meals to reduce the likelihood of developing negative effects from the gastrointestinal tract. The doctor determines the dosage individually. As a rule, patients with osteoarthritis are prescribed 7.5 mg of the drug per day. If necessary, the dose is increased to 15 mg.
Patients with ankylosing spondylitis and rheumatoid arthritis are prescribed 15 mg of Rheumoxicam per day. After the effect of treatment has been achieved, the patient is advised to take a maintenance dose of 7.5 mg of the drug per day.
People who are at increased risk of experiencing negative effects are prescribed a dose of no more than 7.5 mg.
Revmoxicam injections, instructions for use
The solution is administered parenterally, intramuscularly. The solution should be injected deeply into the buttocks. The doctor determines how long the treatment lasts individually. As a rule, the use of 0.75-1.5 ml of the solution contained in ampoules is indicated per day. The injection is carried out once a day, it is recommended to do them no more than five days in a row. If necessary, other forms of medication are then used. The permissible dose per day is 15 mg of the drug.
Revmoxicam suppositories, instructions for use
The drug is used rectally in the form of suppositories. Before its introduction, all hygiene procedures must be carried out. The dosage and duration of treatment is determined by the doctor. As a rule, the use of 1 suppository once a day is indicated. The product should not be used for more than 7 days in a row. Suppositories in gynecology are used only as prescribed by a doctor and according to the scheme prescribed by the gynecologist.
Application
Prescribed to adults and children over 16 years of age.
Exacerbation of osteoarthritis (in case of insufficient clinical effect of using meloxicam at a dose of 7.5 mg/day: 15 mg/day (1 suppository).
Rheumatoid arthritis: 15 mg/day (1 suppository).
Ankylosing spondylitis: 15 mg/day (1 suppository).
The maximum recommended daily dose of meloxicam for adults is 15 mg.
Since the risk of adverse reactions increases with increasing dose and duration of treatment, the lowest effective dose should be used for the shortest treatment period.
When combined with various forms of meloxicam preparations (capsules, tablets, suppositories, solution), the total daily dose should not exceed 15 mg.
Overdose
If high doses of medication have been taken, a person may develop nausea, vomiting, abdominal pain, drowsiness , and lethargy . Also, when taking high doses of Revmoxicam, the likelihood of developing side effects increases and their intensity increases.
with meloxicam may occur , in which the patient's kidney and liver functions are impaired and arterial hypertension . Coma and cardiac arrest are possible .
There is no specific antidote. If an overdose occurs, lavage the stomach (in case of an overdose of tablets) or the rectum (in case of an overdose of suppositories). Symptomatic treatment is also carried out. In case of severe intoxication, the patient is hospitalized.
Interaction
When other drugs belonging to the group of non-narcotic analgesics are used simultaneously with Revmoxicam, the likelihood of developing gastrointestinal bleeding and ulcerative lesions increases.
Do not combine the medication with antiplatelet agents serotonin reuptake inhibitors , anticoagulants , thrombolytic drugs, heparin .
When taken concomitantly with diuretics in people with dehydration, the risk of acute renal failure increases. If this combination must be practiced, careful monitoring of renal function is necessary.
Revmoxicam reduces the effect of vasodilators, beta-blockers, diuretics, drugs that inhibit angiotensin-converting enzyme, and intrauterine contraceptives.
The medicine increases the hematotoxic effect of Methotrexate and the negative effect on the kidneys of Cyclosporine . With this combination, monitoring renal function and peripheral blood patterns is important.
The drug increases plasma lithium concentrations.
With the simultaneous use of Revmoxicam and Cholestyramine, the half-life of meloxicam is reduced.
The effectiveness of insulin and oral hypoglycemic drugs may be altered when taken concomitantly. When prescribing this medicine to patients with diabetes mellitus, glucose levels need to be monitored and, if necessary, dose adjustment of hypoglycemic drugs.
Do not mix the injection solution in the same syringe with other medications.
Revmoxicam solution for intramuscular administration 15 mg/1.5 ml in ampoules 1.5 ml No. 5x1
Name
Revmoxicam solution for intramuscular injection. 15mg/1.5ml per amp. 1.5 ml in bl. in pack №5x1
Description
clear yellow or greenish-yellow liquid
Main active ingredient
meloxicam
Release form
Solution for intramuscular administration
Dosage
15mg/1.5ml
Pharmacological properties
Pharmacodynamics
Revmoxicam is a non-steroidal anti-inflammatory drug (NSAID) of the enolic acid class, which has anti-inflammatory, analgesic and antipyretic effects. Meloxicam showed high anti-inflammatory activity in all standard models of inflammation. As with other NSAIDs, its exact mechanism of action remains unknown. However, there is a common mechanism of action for all NSAIDs (including meloxicam): inhibition of the biosynthesis of prostaglandins, which are mediators of inflammation.
Pharmacokinetics
Absorption. Meloxicam is completely absorbed after intramuscular injection. The relative bioavailability compared to that of oral administration is almost 100%. Therefore, there is no need to adjust the dose when switching from intramuscular to oral administration. After an intramuscular injection of 15 mg, the maximum plasma concentration is about 1.6-1.8 mcg/ml and is achieved in 1-6 hours. Distribution. Meloxicam is very strongly bound to plasma proteins, mainly albumin (99%). Meloxicam penetrates into the synovial fluid, where its concentration is half that in the blood plasma. The volume of distribution is low, averaging 11 L after intramuscular or intravenous administration, and shows individual variations of 7-20%. The volume of distribution after multiple oral doses of meloxicam (7.5 to 15 mg) is 16 L, with a variation coefficient ranging from 11% to 32%. Biotransformation. Meloxicam undergoes extensive biotransformation in the liver. Four different metabolites of meloxicam have been identified in urine and are pharmacodynamically inactive. The main metabolite, 5′-carboxymeloxicam (60% of the dose), is formed by oxidation of the intermediate metabolite 5′-hydroxymethylmeloxicam, which is also released, but to a lesser extent (9% of the dose). In vitro studies suggest that CYP 2C9 plays an important role in metabolism, while CYP 3A4 isoenzymes play a lesser role. Peroxidase activity in patients may be responsible for two other metabolites, which account for 16% and 4% of the prescribed dose, respectively. Elimination. Excretion of meloxicam occurs mainly in the form of metabolites in equal parts with urine and feces. Less than 5% of the daily dose is excreted unchanged in the feces, a small amount is excreted in the urine. The half-life ranges from 13 to 25 hours depending on the route of administration (oral, intramuscular or intravenous). Plasma clearance is approximately 7-12 ml/min after a single oral dose, intravenous or rectal administration. Dose linearity. Meloxicam exhibits linear pharmacokinetics within the therapeutic dose range of 7.5 mg to 15 mg after oral and intramuscular administration. Special groups of patients. Patients with liver/renal failure. Mild to moderate hepatic and renal impairment do not significantly affect the pharmacokinetics of meloxicam. Patients with moderate renal impairment had a significantly higher total clearance. Reduced binding to plasma proteins was observed in patients with end-stage renal failure. In end-stage renal failure, an increase in the volume of distribution may lead to an increase in the concentration of free meloxicam. The daily dose should not exceed 7.5 mg (see section "Method of administration and dosage"). Elderly patients. In elderly male patients, mean pharmacokinetic parameters are similar to those in young male volunteers. In elderly female patients, the AUC value is higher and the half-life is longer compared to the corresponding values in young volunteers of both sexes. The average plasma clearance at steady state in elderly patients was slightly lower than in young volunteers.
Indications for use
Short-term symptomatic treatment of exacerbation of rheumatoid arthritis or ankylosing spondylitis if it is impossible to use drugs orally or rectally.
Directions for use and doses
Intramuscular use. One injection of 15 mg 1 time per day. DO NOT EXCEED 15 mg/day. Treatment should be limited to one injection at the beginning of therapy, the maximum duration of therapy is up to 2-3 days in justified exceptional cases (for example, when oral and rectal routes of administration are not possible). Adverse reactions can be minimized by using the lowest effective dose for the shortest treatment duration necessary to control symptoms (see Precautions). The patient's need for symptomatic relief and response to treatment should be periodically assessed. Special categories of patients. Elderly patients and patients at increased risk of adverse reactions. The recommended dose for elderly patients is 7.5 mg per day. Patients with an increased risk of adverse reactions should begin treatment with 7.5 mg per day (half a 1.5 ml ampoule) (see section "Precautions"). Kidney failure. For patients with severe renal failure on dialysis, the dose should not exceed 7.5 mg per day (half a 1.5 ml ampoule). Patients with moderate to moderate renal failure (namely, patients with creatinine clearance above 25 ml/min) do not require a dose reduction. For patients with severe renal impairment without dialysis, see section "Contraindications". Liver failure. Patients with mild to moderate hepatic impairment do not require a dose reduction. For patients with severe hepatic impairment, see section "Contraindications". Mode of application. The drug should be administered slowly, by deep intramuscular injection into the upper outer quadrant of the buttock, using strict aseptic technique. In case of repeated administration, it is recommended to alternate between the left and right buttocks. Before injection, it is important to check that the needle tip is not in the vessel. The injection should be stopped immediately if there is severe pain during the injection. If the patient has a hip replacement, the injection should be given in the other buttock. You can only use a clear solution that does not contain any inclusions.
Precautionary measures
Adverse reactions can be minimized by using the lowest effective dose for the shortest treatment duration necessary to control symptoms (see Dosage and Administration section and information on gastrointestinal and cardiovascular risks below). The recommended maximum daily dose should not be exceeded in case of insufficient therapeutic effect, and additional NSAIDs should not be used, as this may increase toxicity, while therapeutic benefits have not been proven. Concomitant use of meloxicam with NSAIDs, including selective cyclooxygenase-2 inhibitors, should be avoided. Meloxicam should not be used to treat patients requiring relief of acute pain. If there is no improvement after several days, the clinical benefits of treatment should be re-evaluated. A history of esophagitis, gastritis and/or peptic ulcers should be noted to ensure complete resolution before initiating meloxicam therapy. Regular attention should be paid to the possibility of relapse in patients treated with meloxicam and in patients with a history of such cases. Gastrointestinal disorders. As with other NSAIDs, potentially fatal gastrointestinal bleeding, ulceration, or perforation may occur at any time during treatment, regardless of preexisting symptoms or a history of serious gastrointestinal disease. The risk of gastrointestinal bleeding, ulceration or perforation is higher with increasing doses of NSAIDs in patients with a history of ulcers, especially those complicated by bleeding or perforation (see section "Contraindications"), and in elderly patients. Such patients should begin treatment with the lowest effective dose. For such patients, combination therapy with protective drugs (such as misoprostol or proton pump inhibitors) may be appropriate. This also applies to patients who require concomitant use of low-dose aspirin or other drugs that increase gastrointestinal risks (see information below and the section "Interactions with other drugs"). Patients with a history of gastrointestinal disease, especially elderly patients, should be informed of any unusual abdominal symptoms (especially gastrointestinal bleeding), especially during the initial stages of treatment. Patients who are simultaneously using drugs that increase the risk of ulceration or bleeding, such as heparin, as radical therapy or in geriatric practice, anticoagulants such as warfarin or other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid in anti-inflammatory doses (≥ 500 mg at one time intake or ≥ 3 g total daily dose), the use of meloxicam is not recommended (see section “Interaction with other drugs”). If gastrointestinal bleeding or ulceration occurs in patients taking meloxicam, treatment should be discontinued. NSAIDs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since these conditions may be exacerbated (see section "Side effects"). Liver disorders. Up to 15% of patients taking NSAIDs (including Revmoxicam) may have an increase in one or more liver tests. Such laboratory abnormalities may progress, may remain unchanged, or may be temporary with continued treatment. Significant increases in ALT or AST (approximately 3 or more times normal) were observed in 1% of patients during clinical trials with NSAIDs. In addition, rare cases of severe hepatic reactions, including jaundice and fulminant hepatitis, liver necrosis and liver failure, some of them fatal, have been reported during clinical trials with NSAIDs. Patients with symptoms of hepatic dysfunction or abnormal liver tests should be assessed for the development of symptoms of more severe liver failure during therapy with Revmoxicam. If clinical symptoms indicate the development of liver diseases or if systemic manifestations of the disease are observed (for example, eosinophilia, rash), then the use of Revmoxicam should be discontinued. Cardiovascular disorders. For patients with hypertension and/or a history of mild to moderate congestive heart failure, close monitoring is recommended as fluid retention and edema have been observed with NSAID therapy. For patients with risk factors, clinical monitoring of blood pressure is recommended at the beginning of therapy, especially at the beginning of treatment with meloxicam. Research and epidemiological data suggest that the use of some NSAIDs (especially at high doses and during long-term treatment) is associated with a small increased risk of vascular thrombotic events (such as myocardial infarction or stroke). There is insufficient data to exclude such a risk with meloxicam. Patients with uncontrolled hypertension, congestive heart failure, established coronary artery disease, peripheral arterial disease and/or cerebrovascular disease should receive meloxicam therapy only after careful evaluation. Such an examination is necessary before starting long-term treatment of patients with risk factors for cardiovascular diseases (for example, hypertension, hyperlipidemia, diabetes mellitus, smokers). NSAIDs increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. Increased risk is associated with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease have an increased risk of thrombotic complications. Skin disorders. Life-threatening, severe skin lesions such as Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported with the use of meloxicam. Patients should be informed of the symptoms of severe lesions and closely monitored for skin reactions. The greatest risk of Stevens-Johnson syndrome or toxic epidermal necrolysis occurs during the first weeks of treatment. If the patient has symptoms of Stevens-Johnson syndrome or toxic epidermal necrolysis (eg, progressive skin rash, often with blisters or mucosal lesions), treatment with meloxicam should be discontinued. It is important to diagnose and stop using any drugs that may cause severe Stevens-Johnson syndrome or toxic epidermal necrolysis as quickly as possible. This is associated with a better prognosis for severe skin lesions. If a patient is diagnosed with Stevens-Johnson syndrome or toxic epidermal necrolysis while using meloxicam, the use of the drug should not be reinstated in the future. Anaphylactic reactions. As with other NSAIDs, anaphylactic reactions may occur in patients without a known reaction to Revmoxicam. Rheumoxicam should not be used in patients with the aspirin triad. This symptom complex occurs in patients with asthma who have had rhinitis, with or without nasal polyps, or who have experienced severe, potentially fatal bronchospasm after use of aspirin or other NSAIDs. Emergency measures should be taken if an anaphylactic reaction is detected. Liver parameters and kidney function. As with the treatment of most NSAIDs, isolated cases of increased levels of serum transaminases, serum bilirubin or other parameters of liver function, increased serum creatinine and blood urea nitrogen, as well as other laboratory abnormalities have been described. In most cases, these deviations were minor and temporary. If significant or persistent confirmation of such deviations occurs, the use of meloxicam should be discontinued and control tests should be performed. Functional renal failure. NSAIDs, due to inhibition of the vasodilatory effect of renal prostaglandins, can induce functional renal failure by reducing glomerular filtration. This side effect is dose dependent. At the beginning of treatment or after increasing the dose, careful monitoring of diuresis and renal function is recommended in patients with the following risk factors: - advanced age; - simultaneous use with ACE inhibitors, angiotensin II antagonists, sartans, diuretics (see section “Interaction with other drugs”); — hypovolemia (of any origin); - congestive heart failure; - renal failure; - nephrotic syndrome; - lupus nephropathy; - severe liver dysfunction (serum albumin
Interaction with other drugs
Interaction studies were conducted with adults only. Risks associated with hyperkalemia. Certain drugs may promote hyperkalemia: potassium salts, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor antagonists, nonsteroidal anti-inflammatory drugs, (low molecular weight or unfractionated) heparins, cyclosporine, tacrolimus, and trimethoprim. The onset of hyperkalemia may depend on whether there are factors associated with it. The risk of hyperkalemia increases if the above drugs are used concomitantly with meloxicam. Pharmacodynamic interactions. Other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid ≥ 3 g/day. Combination with other NSAIDs is not recommended (see section "Precautions"), including acetylsalicylic acid in doses ≥ 500 mg at a time or ≥ 3 g total daily dose. Corticosteroids (eg glucocorticoids). Concomitant use with corticosteroids requires caution due to an increased risk of bleeding or ulceration in the gastrointestinal tract. Anticoagulants or heparin. The risk of bleeding increases significantly due to inhibition of platelet function and damage to the gastroduodenal mucosa. NSAIDs may potentiate the effects of anticoagulants such as warfarin (see Precautions section). The simultaneous use of NSAIDs and anticoagulants or heparin in geriatric practice or in therapeutic doses is not recommended. Due to intramuscular administration, meloxicam intramuscular solution is contraindicated in patients undergoing anticoagulant treatment (see sections "Contraindications" and "Precautions"). In other cases (eg, prophylactic doses) of heparin use, caution is necessary due to the increased risk of bleeding. Thrombolytic and antiaggregation drugs. Increased risk of bleeding due to inhibition of platelet function and damage to the gastroduodenal mucosa. Selective serotonin reuptake inhibitors (SSRIs). Increased risk of gastrointestinal bleeding. Diuretics, ACE inhibitors and angiotensin II antagonists. NSAIDs may reduce the effect of diuretics and other antihypertensive drugs. In some patients with impaired renal function (eg, dehydrated patients or elderly patients with impaired renal function), concomitant use of ACE inhibitors or angiotensin II antagonists and drugs that inhibit cyclooxygenase may lead to a further deterioration of renal function, including possible acute renal disease. failure, which is usually reversible. Therefore, the combination should be used with caution, especially in elderly patients. Patients should receive adequate fluids and their renal function should be monitored after initiation of concomitant therapy and periodically thereafter (see section "Precautions"). Other antihypertensive drugs (eg beta blockers). As with the use of the above drugs, a decrease in the antihypertensive effect of beta blockers may develop (due to inhibition of prostaglandins with a vasodilatory effect). Calcineurin inhibitors (eg cyclosporine, tacrolimus). The nephrotoxicity of calcineurin inhibitors may be enhanced by NSAIDs by mediating the effects of renal prostaglandins. Renal function should be monitored during treatment. Careful monitoring of renal function is recommended, especially in elderly patients. Deferasirox. Concomitant use of meloxicam and deferasirox may increase the risk of gastrointestinal adverse reactions. Caution should be exercised when combining these drugs. Pharmacokinetic interaction: the effect of meloxicam on the pharmacokinetics of other drugs. Lithium. There is evidence of NSAIDs that increase plasma lithium concentrations (by decreasing renal excretion of lithium), which may reach toxic levels. Concomitant use of lithium and NSAIDs is not recommended (see section "Precautions"). If combination therapy is necessary, plasma lithium levels should be carefully monitored during treatment initiation, dose adjustment, and discontinuation of meloxicam treatment. Methotrexate. NSAIDs can reduce the tubular secretion of methotrexate, thereby increasing its concentration in the blood plasma. For this reason, co-administration of NSAIDs is not recommended in patients taking high-dose methotrexate (more than 15 mg/week) (see Precautions section). The risk of interaction between NSAIDs and methotrexate should also be taken into account in patients taking a low dose of methotrexate, incl. patients with impaired renal function. If combined treatment is required, it is necessary to monitor blood counts and kidney function. Caution should be exercised when taking NSAIDs and methotrexate for 3 consecutive days, as plasma levels of methotrexate may increase and increase toxicity. Although the pharmacokinetics of methotrexate (15 mg/week) was not affected by concomitant treatment with meloxicam, it should be considered that the hematological toxicity of methotrexate may increase during treatment with NSAIDs (see above, as well as the section “Side effects”). Pemetrexed. When meloxicam is used concomitantly with pemetrexed in patients with mild to moderate renal impairment (creatinine clearance 45 to 79 ml/min), meloxicam should be suspended for 5 days before pemetrexed administration, on the day of administration, and for 2 days after administration. If the combination of meloxicam with pemetrexed is necessary, patients should be closely monitored, especially for the occurrence of myelosuppression and gastrointestinal adverse reactions. In patients with severe renal impairment (creatinine clearance below 45 ml/min), concomitant use of meloxicam with pemetrexed is not recommended. In patients with normal renal function (creatinine clearance ≥ 80 mL/min), doses of 15 mg meloxicam may reduce the elimination of pemetrexed and therefore increase the incidence of pemetrexed-related adverse reactions. Therefore, caution should be exercised when prescribing meloxicam 15 mg concomitantly with pemetrexed in patients with normal renal function (creatinine clearance ≥ 80 mL/min). Pharmacokinetic interaction: the influence of other drugs on the pharmacokinetics of meloxicam. Cholestyramine accelerates the elimination of meloxicam by disrupting the intrahepatic circulation, so the clearance of meloxicam increases by 50%, and the half-life decreases to 13 ± 3 hours. This interaction is clinically significant. No clinically significant pharmacokinetic interaction was detected when taken simultaneously with antacids, cimetidine and digoxin.
Contraindications
– Hypersensitivity to meloxicam or to other components of the drug, or to active substances with similar effects, such as NSAIDs, aspirin. Meloxicam should not be administered to patients who have experienced asthma symptoms, nasal polyps, angioedema, or urticaria after taking aspirin or other NSAIDs; – gastrointestinal bleeding or perforation associated with a history of previous NSAID therapy; – active or recurrent peptic ulcer/bleeding history (two or more separate confirmed cases of ulcer or bleeding); – severe liver failure; – severe renal failure without dialysis; – gastrointestinal bleeding, history of cerebrovascular bleeding or other blood clotting disorders; – hemostatic disorders or simultaneous use of anticoagulants (contraindications related to the route of administration); – severe heart failure; – treatment of perioperative pain during coronary artery bypass grafting (CABG); – III trimester of pregnancy (see “Use during pregnancy and breastfeeding”); – the patient’s age is under 18 years.
Compound
active ingredient: meloxicam; 1.5 ml of the drug contains meloxicam 15 mg; excipients: meglumine (N-methylglucamine), glycine, poloxamer 188, glycofurol, sodium chloride, 0.1 M sodium hydroxide solution, water for injection.
Overdose
Symptoms of acute NSAID overdose are usually limited to lethargy, somnolence, nausea, vomiting and epigastric pain, which are generally reversible with maintenance therapy. Gastrointestinal bleeding may occur. Severe poisoning can lead to hypertension, acute renal failure, liver dysfunction, respiratory depression, coma, seizures, cardiovascular failure and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic use of NSAIDs, which can also occur in overdose. In case of NSAID overdose, symptomatic and supportive measures are recommended for patients. Studies have shown accelerated elimination of meloxicam with 4 oral doses of cholestyramine 3 times daily.
Side effect
Research and epidemiological data suggest that the use of some NSAIDs (especially at high doses and in long-term treatment) may be associated with a small increased risk of vascular thrombotic events (such as myocardial infarction or stroke) (see Precautions section). . Edema, hypertension, and heart failure have been observed with NSAID treatment. Most of the observed side effects are of gastrointestinal origin. Peptic ulcer, perforation or gastrointestinal bleeding may occur, sometimes fatal, especially in elderly patients (see section "Precautions"). After use, nausea, vomiting, diarrhea, flatulence, constipation, dyspepsia, abdominal pain, melena, hematemesis, ulcerative stomatitis, exacerbation of colitis and Crohn's disease were observed (see section "Precautions"). Gastritis was observed with less frequency. Severe skin lesions have been reported: Stevens-Johnson syndrome and toxic epidermal necrolysis (see section "Precautions"). Adverse reactions are presented according to the classification of organ systems and frequency of occurrence: very often (≥ 1/10), often (≥1/100 to
Manufacturer
Farmak PJSC, Ukraine
Instructions
Instructions for the drug 1.06MB
special instructions
It should be taken into account that when using the product by patients with gastrointestinal diseases, there is an increased risk of bleeding and ulcerative lesions. Careful monitoring is especially important when treating older people. The risk increases with prolonged treatment.
It should be noted that meloxicam can mask the signs of the underlying disease.
Treatment with meloxicam, as with other drugs that inhibit cyclooxygenase / prostaglandin , may affect fertility. Therefore, women planning pregnancy are not recommended to take this remedy.
There have been very rare cases where serious skin reactions were observed during treatment with non-steroidal anti-inflammatory drugs. If side effects related to the skin develop, you should stop taking the product.
Please note that the product in tablet form contains lactose .
Revmoxicam suppositories in gynecology are used only on the recommendation of a gynecologist and under his supervision.
There was no effect on a person's ability to concentrate when taking the medication. However, for those patients who experience blurred vision or a feeling of drowsiness, it is better to avoid potentially hazardous activities for the period of treatment.
Revmoxicam rectal suppositories 15 mg, 5 pcs.
Adverse reactions can be minimized by using the lowest effective dose for the shortest treatment period necessary to control symptoms.
The recommended maximum daily dose should not be exceeded in case of insufficient therapeutic effect, and additional NSAIDs should not be used, as this may increase toxicity, while therapeutic benefits have not been proven. The simultaneous use of meloxicam with NSAIDs, including selective cyclooxygenase-2 inhibitors, should be avoided.
Meloxicam is not suitable for the treatment of patients requiring relief of acute pain.
If there is no improvement after several days, the clinical benefits of treatment should be re-evaluated.
A history of esophagitis, gastritis and/or peptic ulcers should be noted to ensure complete resolution before initiating meloxicam therapy. The possibility of relapse should be considered in patients taking meloxicam and in patients with a history of such cases.
Gastrointestinal disorders.
As with other NSAIDs, patients with gastrointestinal diseases and those taking anticoagulants should be closely monitored when using the drug. Meloxicam should not be used in the presence of peptic ulcers or gastrointestinal bleeding.
As with other NSAIDs, potentially fatal gastrointestinal bleeding, ulceration, or perforation may occur at any time during treatment, with or without prior symptoms or a history of serious gastrointestinal disease. The most serious effects were observed in older people.
The risk of bleeding, ulceration or gastric perforation is higher with increasing doses of NSAIDs in patients with a history of ulcers, especially if there are complications of bleeding or perforation and in the elderly. These patients should begin treatment with the lowest dose available. In such patients, as well as in patients requiring concomitant use of low-dose acetylsalicylic acid or other drugs that may increase the risk of gastrointestinal complications, combination therapy with protective drugs (misoprostol or proton pump inhibitors) should be considered. ), as well as for patients requiring concomitant use of low doses of acetylsalicylic acid or other drugs that increase gastrointestinal risks.
In patients with a history of gastrointestinal toxicity, especially elderly patients, any unusual abdominal symptoms (especially gastrointestinal bleeding) should be reported, especially during the initial stages of treatment.
Caution should be exercised when concomitantly using medicinal products that may increase the risk of ulceration or bleeding, in particular heparin as definitive therapy or in geriatric practice, anticoagulants such as warfarin, or other NSAIDs, including acetylsalicylic acid in anti-inflammatory doses (≥ 1 g - single dose or ≥ 3 g - total daily dose) (see section “Interaction with other medicinal products and other types of interactions”).
If gastrointestinal bleeding or ulceration occurs in patients using meloxicam, treatment should be discontinued.
NSAIDs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), as these conditions may be exacerbated (see section "Adverse Reactions").
Cardiovascular disorders.
In patients with hypertension and/or a history of mild to moderate congestive heart failure, close monitoring is recommended as fluid retention and edema have been observed with NSAID therapy.
In patients with risk factors, clinical monitoring of blood pressure is recommended at the beginning of therapy, especially at the beginning of treatment with meloxicam.
Patients with uncontrolled hypertension, congestive heart failure, established coronary artery disease, peripheral arterial disease and/or cerebrovascular disease should be treated with meloxicam only after careful evaluation. Such an analysis is necessary to begin long-term treatment of patients with risk factors for cardiovascular diseases, such as arterial hypertension, hyperlipidemia, diabetes mellitus, and smoking.
NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with increasing duration of treatment. This risk may be increased in patients with cardiovascular disease or risk factors for developing such disease.
Skin disorders.
Serious skin reactions, some of them fatal, have been observed in very rare cases with the use of NSAIDs, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. The highest risk of such reactions was observed at the beginning of treatment, with the majority of such reactions occurring within the first month of treatment. At the first appearance of skin rashes, lesions of the mucous membranes or other signs of hypersensitivity, you should stop using meloxicam.
Due to the possibility of side effects on the skin and mucous membranes, special attention should be paid to the appearance of such symptoms. If side effects occur, treatment with meloxicam should be discontinued.
Anaphylactic reactions.
As with other NSAIDs, anaphylactic reactions may occur in patients without a known reaction to meloxicam. Meloxicam should not be used in patients with the aspirin triad. This symptom complex occurs in patients with asthma who have reported rhinitis with or without nasal polyps or who have experienced severe, potentially fatal bronchospasm after use of acetylsalicylic acid or other NSAIDs. Emergency measures should be taken if an anaphylactoid reaction is detected.
Kidney function.
NSAIDs inhibit the synthesis of renal prostaglandins, which play an important role in maintaining renal blood flow. This side effect (inhibition of the vasodilatory effects of renal prostaglandins) is dose-dependent. In patients with reduced blood volume and reduced renal blood flow, the use of NSAIDs may cause renal failure, which is reversible after discontinuation of NSAID treatment.
The greatest risk of such a reaction was recorded in elderly patients, in patients with dehydration, with congestive heart failure, in patients with liver cirrhosis, nephrotic syndrome and chronic renal disorders, as well as in patients receiving concomitant therapy with diuretics, ACE inhibitors or angiotensin receptor blockers II, or after major surgical interventions that led to hypovolemia, patients with lupus nephropathy, severe liver dysfunction (serum albumin - ˂ 25 g / l or ≥ 10 according to the Child-Pugh classification). Such patients require monitoring of diuresis and monitoring of renal function at the beginning of therapy.
In rare cases, NSAIDs may lead to interstitial nephritis, glomerulonephritis, renal medullary necrosis, or the development of nephrotic syndrome.
The dose of meloxicam for patients with end-stage renal failure on dialysis should not exceed 7.5 mg (in tablet form). For patients with minor or moderate renal impairment, the dose may not be reduced (creatinine clearance level ˃ 25 ml/min).
Liver disorders.
As with the treatment of most NSAIDs, isolated cases of increased levels of transaminases or other indicators of liver function have been described. In most cases, these deviations were minor and temporary. If there is a persistent and significant deviation from the norm in liver function tests, the use of meloxicam should be discontinued and control tests should be performed. For patients with clinically stable liver cirrhosis, there is no need to reduce the dose of meloxicam. Weakened patients need more careful monitoring. As with other NSAIDs, caution should be exercised in elderly patients, who are more likely to have decreased renal, hepatic and cardiac function.
Retention of sodium, potassium and water.
NSAIDs may increase sodium, potassium, and water retention and interfere with the natriuretic effect of diuretics, which may lead to cardiac problems or hypertension. Clinical monitoring is recommended for such patients.
In addition, the effect of antihypertensive drugs may be reduced. As a result, susceptible patients may experience edema, heart failure, or hypertension. Thus, clinical monitoring of patients at risk is necessary.
Other warnings and safety precautions.
Adverse reactions are often less well tolerated by elderly, frail or debilitated patients who require careful monitoring.
Meloxicam, like any other NSAID, can mask the symptoms of infectious diseases.
Masking inflammation and fever.
The pharmacologic effects of meloxicam in reducing fever and inflammation may complicate the diagnosis of suspected noninfectious pain conditions.
The use of meloxicam, like other drugs that inhibit the synthesis of cyclooxygenase/prostaglandins, can negatively affect reproductive function and is therefore not recommended for women who are trying to become pregnant. For women who are planning to become pregnant or are being evaluated for infertility, discontinuation of meloxicam should be considered.
Analogs
Level 4 ATX code matches:
Mirlox
Xefocam Rapid
Xefocam
Movalis
Mesipol
Lem
Melbek
Movasin
Piroxicam
Lornoxicam
Arthrozan
Texamen
Amelotex
Meloxicam
Analogues of Revmoxicam are drugs with the same active ingredient: Meloxicam , Movalgin , Movalis , Meloxicam-KV , Melox .
It is important to consult with your doctor before replacing the drug with an analogue.
Note!
Description of the drug Revmoxicam supp. rectal 15mg No. 5 on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.
Reviews about Revmoxicam
Those users who write reviews on any thematic forum note that tablets, injections, and suppositories are effective means for relieving pain in osteoarthritis and other diseases of the musculoskeletal system. Some patients write about side effects - high blood pressure, drowsiness, abdominal pain.
There are also negative opinions from those for whom the drug did not help reduce negative manifestations. Reviews of Revmoxicam suppositories in gynecology indicate that the medicine is effective in inflammatory processes of the female genitourinary organs, but it can only be used after being prescribed by a specialist.
Revmoxicam price, where to buy
You can buy the drug in tablets in Ukraine (Kyiv, Kharkov, etc.) for an average price of 50 UAH. per pack 10 pcs. The price of Revmoxicam injections is on average 100 UAH. for 5 ampoules. The price of candles is 46 UAH. for 5 pcs.
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
Pharmacy24
- Revmoxicam 1% 1.5 ml No. 5 solution for injection
111 UAH. order - Revmoxicam 15 mg No. 10 tablets PAT "Farmak", Ukraine
65 UAH order
- Revmoxicam 7.5 mg No. 20 tablets PAT "Farmak", Ukraine
76 UAH order
- Revmoxicam 1% 1.5 ml No. 3 injection solution PAT "Farmak", Ukraine
71 UAH order
- Revmoxicam 15 mg N20 tablets PAT "Farmak", Ukraine
112 UAH order
PaniPharmacy
- Revmoxicam tablets Revmoxicam tablets. 7.5 mg No. 20 Ukraine, Farmak OJSC
90 UAH order
- Revmoxicam ampoule Revmoxicam injection solution 1% No. 3 Ukraine, Farmak OJSC
88 UAH order
- Revmoxicam ampoule Revmoxicam injection solution 1% ampoule 1.5 ml No. 5 Ukraine, Farmak OJSC
122 UAH order
- Revmoxicam suppository Revmoxicam rectal suppositories 0.015g No. 5 Ukraine, Lekhim-Kharkov JSC
70 UAH order
- Revmoxicam tablets Revmoxicam tablets. 15 mg No. 10 Ukraine, Farmak OJSC
81 UAH order
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