Instructions for use MELBEK®
Adverse reactions can be reduced by administering the lowest effective dose for the shortest possible time necessary to control symptoms.
In case of insufficient therapeutic effect, the maximum recommended daily dose (15 mg) should not be exceeded. Concomitant use of other NSAIDs should be avoided as there may be an increased risk of toxicity without increasing treatment efficacy. The use of meloxicam in combination with other NSAIDs, including selective COX-2 inhibitors, is not recommended.
Meloxicam is not recommended for patients who require relief of acute pain.
If there is no improvement after several days of taking meloxicam, treatment should be reconsidered.
Before starting treatment with meloxicam, it is necessary to clarify the medical history to determine whether the patient previously had esophagitis, gastritis, gastric or duodenal ulcers, and whether these conditions were completely cured. Due to the possible occurrence of relapse, patients with previous diseases should be under constant supervision while taking meloxicam.
Gastrointestinal tract:
As with the use of other NSAIDs, potentially life-threatening gastrointestinal bleeding, ulceration or perforation may occur during treatment at any time with or without warning symptoms, regardless of the patient's history of serious gastrointestinal diseases. The above complications are usually more severe in older patients.
The risk of gastrointestinal bleeding, ulceration or perforation is higher with increasing doses of NSAIDs, in patients with a history of ulcers or bleeding, and in elderly patients. These patients should begin treatment at the lowest effective dose.
As with the use of other NSAIDs, special precautions should be taken when treating patients who have had or are having gastrointestinal diseases.
Patients who experience gastrointestinal symptoms should be under constant monitoring. If ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding occur, Melbek® should be discontinued.
For elderly patients, as well as for patients receiving low doses of aspirin or other drugs that may increase the risk of gastrointestinal disorders, combination therapy (eg, misoprostol or proton pump inhibitors) should be considered.
Patients with gastrointestinal toxicity, especially the elderly, should report the development of any unusual abdominal symptoms, especially early in treatment.
Use with caution in patients receiving drugs that may increase the risk of ulceration or bleeding (elderly patients, patients receiving therapeutic doses of heparin, anticoagulants (eg, warfarin) or other NSAIDs, including acetylsalicylic acid prescribed in anti-inflammatory doses (≥ 500 g per single dose or ≥3 g per daily dose).
Cardiovascular and cerebrovascular effects:
Patients with hypertension and/or mild to moderate heart failure should be monitored during treatment with NSAIDs due to possible fluid retention and increased edema. Clinical monitoring of blood pressure is recommended in patients at risk of elevated blood pressure before and during treatment with meloxicam.
Clinical studies and epidemiological data indicate that the use of some NSAIDs (especially in high doses and during long-term treatment) leads to a small increase in the risk of arterial thrombosis (for example, myocardial infarction or stroke, including death). This risk cannot be excluded for meloxicam.
Patients with cardiovascular disease or who have factors predisposing them to developing cardiovascular disease are at higher risk.
In patients with uncontrolled hypertension, congestive heart failure, coronary artery disease, peripheral arterial disease and/or cerebrovascular disease, meloxicam should only be prescribed after a benefit/risk assessment. The same analysis should be performed before starting long-term therapy in patients with risk factors for cardiovascular disease (for example, hypertension, hyperlipidemia, diabetes mellitus, smoking).
Liver dysfunction:
When using the drug Melbek® (like most other NSAIDs), episodic increases in serum transaminase levels or other indicators of liver function have been reported. In most cases, this increase was small and transitory.
If the identified changes are significant or do not decrease over time, Melbek® should be discontinued and the identified laboratory changes should be monitored.
Renal dysfunction:
When using the drug Melbek® (like most other NSAIDs), episodic increases in serum creatinine or urea levels or other indicators of liver function have been reported. In most cases, this increase was small and transitory. If the identified changes are significant or do not decrease over time, Melbek® should be discontinued and the identified laboratory changes should be monitored.
In rare cases, NSAIDs may cause interstitial nephritis, glomerulonephritis, medullary renal necrosis, or nephrotic syndrome.
In patients with end-stage renal failure on hemodialysis, the dose of Melbek® should not exceed 7.5 mg. Dose reduction is not required for patients with minimal or moderate renal impairment (i.e., CC>25 ml/min).
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 volume may lead to decompensation of renal failure. After discontinuation of NSAIDs, renal function usually returns to baseline levels. Those most at risk for developing this reaction are elderly patients, patients with dehydration, congestive heart failure, severe liver failure, cirrhosis, nephrotic syndrome, lupus nephropathy, or other severe kidney disease; patients simultaneously taking diuretics, ACE inhibitors, angiotensin II receptor antagonists, as well as patients who have undergone major surgical interventions leading to hypovolemia. In such patients, diuresis and renal function should be carefully monitored when initiating therapy.
The use of NSAIDs can lead to sodium, potassium and water retention and affect the natriuretic effect of diuretics. As a result, predisposed patients may experience increased signs of heart failure or hypertension. Clinical monitoring is recommended for these patients. Potassium levels should be monitored in patients with diabetes mellitus and in patients taking medications that may affect blood potassium levels.
Weakened or malnourished patients may be less able to tolerate adverse reactions and such patients should be monitored carefully. As with other NSAIDs, caution should be exercised in the treatment of elderly patients who are more likely to have impaired renal, hepatic and cardiac function.
Meloxicam, like other NSAIDs, can mask the symptoms of an infectious disease.
There have been reports of life-threatening skin reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis) with the use of meloxicam. Patients should be informed of the signs and symptoms of skin reactions and monitored closely. The highest risk of developing Stevens-Johnson syndrome and toxic epidermal necrolysis is during the first weeks of treatment.
If signs or symptoms of Stevens-Johnson syndrome or toxic epidermal necrolysis occur (eg, progressive skin rash, often with blisters, or mucosal lesions), meloxicam should be discontinued immediately.
The best results in the treatment of Stevens-Johnson syndrome or toxic epidermal necrolysis have been obtained with early diagnosis and immediate discontinuation of the suspected drug. Early discontinuation of the suspected drug is associated with a better prognosis.
If a patient develops Stevens-Johnson syndrome or toxic epidermal necrolysis while taking meloxicam, meloxicam should not be restarted.
The use of meloxicam may reduce fertility in women and is therefore not recommended for women planning pregnancy. If the ability to conceive in women is impaired or research is being conducted for infertility, it is necessary to consider discontinuing meloxicam.
Melbek® tablets contain lactose, therefore patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take these tablets.
Concomitant use with pemetrexed
Patients with mild to moderate renal impairment who are being administered pemetrexed should not take meloxicam for at least 5 days before pemetrexed administration, on the day of administration, and for 2 days after pemetrexed administration.
Impact on the ability to drive vehicles and machinery
Studies of the effect of the drug on the ability to drive a car and operate machinery have not been conducted. However, patients should be warned about the possible occurrence of side effects such as visual disturbances, including blurred vision, dizziness, drowsiness and other central nervous system disorders. Patients with such symptoms should avoid performing potentially dangerous activities, such as driving or operating machinery.
Compound
1 Melbek tablet contains 7.5 mg of meloxicam , the active ingredient.
Minor Ingredients: Lactose anhydrous, microcrystalline cellulose, povidone, magnesium stearate, crospovidone, sodium citrate, colloidal anhydrous silica. 1 tablet of Melbek Forte contains 15 mg of meloxicam - the active ingredient. Minor Ingredients: Lactose anhydrous, crospovidone, microcrystalline cellulose, povidone, sodium citrate, magnesium stearate, colloidal silicon dioxide.
1 ampoule of Melbek contains 15 mg of meloxicam , the active ingredient. Minor ingredients: glycofurol, meglumine, poloxamer 188, glycine, sodium chloride, sodium hydroxide, water for injection.
Interaction
Combined use with salicylates and other NSAIDs increases the possibility of bleeding and erosive and ulcerative complications of the gastrointestinal tract .
Concurrent administration of anticoagulants , Heparin , Ticlopidine , and thrombolytics increases the risk of bleeding .
Use with lithium-containing drugs may lead to an increase in lithium .
Combined use with Methotrexate increases the risk of pancytopenia .
In patients with symptoms of dehydration , with the parallel administration of diuretics renal failure may develop , and therefore their function should be monitored and dehydration .
Meloxicam reduces the antihypertensive effectiveness of ACE inhibitors , β-blockers , diuretics and vasodilators .
Cholestyramine in the gastrointestinal tract can bind meloxicam , thereby preventing its absorption.
Combined use with Cyclosporine leads to increased nephrotoxicity .
There is a potential for drug interactions with oral antidiabetic drugs .
Co-administration of ACE inhibitors and angiotensin II receptor antagonists increases the effect of reducing glomerular filtration , which in patients with kidney pathologies can lead to renal failure .
Melbek may reduce the effectiveness of intrauterine contraceptives .
Reviews about Melbek
Reviews of Melbek in tablets, as well as reviews of injections of this drug as an analgesic and anti-inflammatory agent, are in most cases positive and indicate its high effectiveness in relieving pain syndromes of various origins.
However, it is worth remembering that the use of this drug, as well as other NSAIDs , is associated with a high risk of developing gastrointestinal complications , such as bleeding and erosive and ulcerative manifestations , especially with long-term use of high doses of the drug.
Because of this, Melbek should be used only on the recommendation of a doctor and only when absolutely necessary, using minimal doses and for the shortest possible period of time.
Overdose
In case of an overdose of meloxicam, the following manifestations are possible: lethargy, drowsiness , lethargy , nausea, epigastric pain , vomiting, gastrointestinal bleeding , as well as anaphylactoid reactions .
In case of severe intoxication , the following were observed: acute kidney failure , increased blood pressure , impaired liver function , respiratory depression, convulsions , coma , cardiac arrest and vascular collapse .
Symptomatic and supportive therapy is prescribed using forced diuresis , urine alkalization, hemoperfusion or hemodialysis , which are not effective enough due to the high degree of binding of meloxicam to plasma proteins.
Contraindications
- heart failure ;
- hypersensitivity to meloxicam or minor ingredients of the drug;
- mention of bronchial asthma , conjunctivitis , nasal polyposis angioedema or skin rashes NSAIDs ;
- phase of exacerbation of gastrointestinal ulcer;
- hemorrhagic pathologies ( gastrointestinal bleeding , cerebrovascular bleeding , etc.);
- pain syndrome that developed after the coronary artery bypass ;
- breast-feeding;
- phase of exacerbation of inflammatory bowel diseases ( nonspecific ulcerative colitis , Crohn's disease , etc.);
- pregnancy;
- severe renal and/or hepatic pathologies;
- age up to 15 years.
Analogs
Level 4 ATX code matches:
Mirlox
Revmoxicam
Xefocam Rapid
Xefocam
Movalis
Mesipol
Lem
Movasin
Piroxicam
Lornoxicam
Arthrozan
Texamen
Amelotex
Meloxicam
- Xefocam;
- Piroxicam;
- Vero-Piroxicam;
- Texamen;
- Pyroxyfer;
- Tenoctil , etc.
Melbek price, where to buy
In Russian pharmacies, the price of Melbek No. 3 injections varies between 1200-1500 rubles.
Tablets No. 30 can be purchased for an average of 1,000 rubles, tablets forte No. 30 for 1,800 rubles.
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
Pharmacy24
- Melbek 15 mg No. 30 tablets NobelPharma Ilach Sanai Ve Tijaret A.Sh, Turechchina
364 UAH.order - Melbek 15 mg/1.5 ml No. 3 injection solution Idol Ilach Dolum Sanai ve Tidzharet A.Sh., Turechchina
109 UAH order
- Melbek 7.5 mg No. 30 tablets Nobel Ilach Sanai Ve Tijaret A.Sh., Turechchina
196 UAH order
PaniPharmacy
- Melbek solution d/in 15 mg/1.5 ml No. 3 Australia, Nobel
132 UAH order
- Melbek tablets Melbek tablets. 15 mg N30 Türkiye, Nobel
384 UAH order
- Melbek tablets Melbek tablets. 7.5 mg N30 Türkiye, Nobel
207 UAH. order
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