Mekinkocin 25mg Mekophar treats joints caused by inflammation (100 tablets)

Dosage form Box of 100 capsules
Specifications Indometacin

Ingredient

Composition information	Content
Indometacin	25mg

Uses

Indications

Mekoindocin 25 is indicated in the following cases:

Treatment of inflammatory joints, such as rheumatoid arthritis, joint spondylitis, Reiter syndrome.

Treatment of osteoarthritis damage in other diseases, osteoarthritis damage when treating the stage of increased inflammation and muscle pain caused by low, but in a short time. Gout.

Treatment of menstruation.

ATC code: M01AB01.

Indomethacin is an non -steroid anti -inflammatory drug, derived from indolacetic acids. Indomethacin has analgesic, antipyretic, anti -inflammatory and platelet aggregation inhibitors. The mechanism of action of the drug is not yet known, but it is thought that the drug is mainly impacted by inhibiting the prostaglandin synthetase enzyme and thus preventing prostaglandin, thromboxan and other products of cyclooxyase enzymes. The effect of inhibiting platelet gathering within 24 hours after stopping the drug and the bleeding time returns to the original level. Indomethacin inhibits the synthesis of Prostaglandin D2, E2 and L2 should reduce kidney perfusion.

pharmacokinetics

Indomethacin absorbed well through the digestive tract, 90% of oral dose is absorbed within 4 hours, bioavailability is 100%. The peak concentration of plasma depends on the dose and reaches about 2 hours after drinking. The absorption of drugs is reduced when food is available, but bioavailability does not change. At the usual dose of treatment, Indomethacin is highly attached to plasma proteins (99%). The drug is absorbed into the joint fluid (the concentration rate in the joint disease/serum concentration is about 20%), the drug can pass through the placenta, the bloody barrier, in breast milk and saliva. The sale time is about 2.5 -11.2 hours, 60% of oral doses are discharged through the urine in the form of constant or converted, about 33% remaining in feces.

Before taking Mekinkocin 25mg Mekophar treats joints caused by inflammation (100 tablets)

How to use

Should take the medicine immediately after meals or during meals or in combination with antacids.

Dosage

The usual dose:

Muscle and joint diseases: 1 tablet/time, drink 2-3 times/day. If tolerated well, it can increase weekly 1-2 tablets/ day, up to a maximum of 6-8 tablets/ day. To relieve pain at night and stiffening in the morning, you can take 4 capsules before going to bed. Avoid combining with aspirin. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Symptoms of overdose:

Nausea, vomiting, severe headache, dizziness, mental disorders, disorientation, coma. Some other symptoms have been reported paresthes, numbness and convulsions.

How to handle:

often treat symptoms and support. If used overdose, the following measures should be applied to increase elimination and inactivity: Stomach suction, gastric lavage, vomiting and diuretic, active carbon or laxative. Severe cases must be considered for other measures such as blood transfusions, dialysis with artificial kidneys. Because the unwanted effect causes stomach ulcers and hemorrhage that occurs slowly, it is necessary to monitor patients in the next few days.

Actively monitor for timely management measures.

What to do when forgetting a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not drink twice as prescribed.

Side Effects

When using Mekoidocin 25, you may experience unwanted effects (ADR).

Indomethacin causes ADR over 30-60% of patients using indomethacin; Patients with serious ADR occur and stop the drug 10%. Indomethacin often causes a lot of ADR, especially prolonged bleeding time (the risk of bleeding gastrointestinal ulcers) and the risk of kidney dysfunction (causing water stasis).

Common, ADR> 1/100

Systemic: headache, dizziness, insomnia, hypotension.

digestive: vomiting, nausea, epigastric pain, diarrhea, constipation. nerve: depression, headache (especially a lot of morning pain accompanied by a forehead circuit), vomiting and nausea, tremor, convulsions, dizziness.

Few, 1/100> 1/1000

Body: poor appetite, fainting.

Hearing: Reducing hearing, deafness, hearing disorders. blood: leukemia, hemorrhage, thrombocytopenia, scattered intravascular coagulation, secondary anemia due to persistent bleeding inside, hemolytic anemia inhibiting bone marrow, non -regenerated anemia. circulating: arrhythmia, heart failure. Digestive: Multi -episodes of gastric and duodenum, gastrointestinal puncture, gastrointestinal bleeding (is the heaviest ADR), bleeding in the excess bags or in the tumor if available, intestinal inflammation, stenosis, mouth ulcers. kidney: Reduce kidney function, kidney failure. Skin: Hematoma under the skin, bleeding, hemorrhage, erythema, itching, sweating.

Metabolism: edema, water stasis.

Neurological: Patriarch, peripheral neuropathy.

Urinary - genital: bleeding, vaginal bleeding, breast enlargement in men.

Respiratory: apnea.

Rare, ADR

Body: urticaria, rhinitis, asthma, anaphylaxis, edema, shock.

vision: blurred vision, changes in the cornea, poisoning in the retina. Hearing: hearing disorders, deafness. blood: Anemia is deficient, granulocyte.

Hypertension, hypotension. digestive: gastric ulcer, narrow leads to intestinal obstruction, sigma colon puncture. nerve: Eye hole or around the eye hole, epilepsy, Parkinson, convulsions, psychosis. skin: dermatitis, diverse roses, Stevens - Johnson syndrome, poisoned epidermal necrosis. liver: Hepatitis (there have been cases of death), jaundice, increased liver enzymes.

Metabolism: Hyperglycemia, urinary tract, hyperkalemia.

Urinary - genital: proteinuria, interstitial nephritis, nephrotic syndrome.

osteoarthritis: Change the speed of cartilage destruction.

Unknown frequency: blood vessels (risk of cardiovascular thrombosis).

Notice immediately to the doctor or pharmacist the harmful reactions encountered when using the drug.

Instructions on how to handle ADR

can minimize the effect of the gastrointestinal adr of Indomethacin by taking the medication immediately after meals or taken during meals, or taking with antacids. For patients with a risk of stomach ulcers, it is advisable to consider coordinating with Misoprostol or proton pump blockers to reduce ADR on the gastrointestinal tract of the drug. It is necessary to periodically check the division of persistent bleeding inside in people who are being treated for long -term indomethacin.

Inhibiting the platelet gathering effect of Indomethacin will run out after stopping the drug 24 hours.

It is necessary for patients to stop using drugs if cases such as gastrointestinal bleeding, signs or symptoms of severe reactions in the liver, severe ADRs in the nerve during Indomethacin treatment, persistent headache despite the decrease in the dose.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Mekoidocin 25 contraindicated in the following cases:

People with a history of sensitivity to indomethacin and similar substances, including aspirin (rhinitis, asthma, urticaria when taking aspirin or other nonsteroidal anti -inflammatory drugs).

Hypersensitivity to other ingredients of the drug (excipients: corn starch, Povidon K29/32, Sodium Lauryl Sulfate, Colloidal Silicon Dioxide, Magnesi Stearate, Lactose, Crospovidon).

Gastrointestinal ulcer, duodenum or a history of peptic ulcer.

Heavy liver failure, cirrhosis.

Severe renal failure (glomerular filtration level is less than 30 ml/min). heart failure.

Children from 2 to 4 years old, except for special cases and must monitor children closely when children take the drug.

Precautions when using

avoiding drugs for elderly patients because the elderly often has the risk of gastrointestinal bleeding or central neurological disorders (headache, confusion, hallucinations).

Indomethacin can make the disease worse in people with mental disorders, epilepsy and Parkinson's disease.

Indomethacin can cover the symptoms of infection.

Need to closely monitor people with coagulation disorders.

Need to evaluate the blood recipe regularly in patients using indomethacin for a long time.

Indomethacin increases blood pressure or worsens more hypertension.

Indomethacin can reduce blood flow through the kidneys. Using this medication for people with hypertension, heart failure, kidney disease, diabetes, liver disease, especially patients who are taking diuretics need to be carefully monitored to detect early water and edema signs.

Indomethacin increases cardiovascular factors. The risk of cardiovascular events of Indomethacin increases in patients with cardiovascular disease or with cardiovascular disease.

Risk of cardiovascular thrombosis: nonsteroidal anti -inflammatory drugs (NSAIDs), non -aspirin, using systemic sugar, may increase the risk of cardiovascular thrombosis, including myocardial infarction and stroke, which can lead to death. The risk of cardiovascular thrombosis is recorded mainly at high doses.

Doctors need to periodically evaluate the appearance of cardiovascular events, even if the patient has no previous cardiovascular symptoms. Patients need to be warned of symptoms of serious cardiovascular events and need to see a doctor as soon as they appear. It is necessary to inform the patient about the symptoms of toxicity on the heart (chest pain, shortness of breath, weakness, difficulty speaking) and guide patients to handle when these symptoms occur.

To minimize the risk of adverse events, indomethacin is required at the lowest daily doses to be effective in the shortest possible time.

Need to closely monitor blood potassium, because the risk of increased potassium caused by indomethacin can occur in patients with normal kidney function.

Drinking alcohol when using indomethacin can cause prolonged bleeding time.

The ability to drive and operate machinery

Indomethacin can cause headaches, dizziness, and attention. Be careful when used for drivers, operate machines, people working on high and other cases.

Pregnancy

Despite the experimental evidence that there is evidence that causes fetal development disorders in animals. Like other nonsteroidal anti -inflammatory drugs, the drug can cause the fetal arteriosus to close early if used in the last 3 months of pregnancy. Therefore, absolute contraindications during pregnancy.

Breastfeeding period

Indomethacin secreted through breast milk, should not use indomethacin during breastfeeding.

Drug interaction

Because the indomethacin is strongly linked to the protein, it competes to link the protein with other drugs.

Do not use indomethacin in combination with:

Oral and heparin anticoagulant: The risk of severe bleeding.

aspirin and other salicylate: reducing indomethacin concentration in plasma and increasing risk, level of gastric damage. Diflunisal: using Diflunisal simultaneously with indomethacin may increase the concentration of indomethacin in plasma, reducing indomethacin clearance and can cause bleeding in the gastrointestinal tract leading to death. lithium: Indomethacin can increase lithium concentration in serum to toxicity. If forced to use simultaneously, it is necessary to monitor the patient carefully to detect the signs of lithium poisoning promptly and to regularly check the lithium concentration in the blood. Must adjust the lithium dose during and after treatment with indomethacin. Digoxin: Indomethacin can increase the concentration of Digoxin in the serum and prolong the semi -waste time of digoxin. Digoxin concentration is required and it is necessary to reduce the dose of digoxin if taken simultaneously both drugs.

ticlopidin: increases the risk of bleeding.

methotrexate: indomethacin increases the toxicity of methotrexate.
The contraceptive device placed in the uterus: There is a document that the use of the drug loses the effect of contraceptive tools.

Can use indomethacin, but must be closely monitored when combined with the following drugs:

Cyclosporin: The risk of cyclosporin poisoning. Need to regularly monitor the kidney function of the patient.

Diuretic: indomethacin and diuretics that keep potassium can increase potassium.
Medications neutralizing stomach acid such as magnesi salt, aluminum and calcium, oxyd or hydroxyd: can reduce intestinal irritation by indomethacin, but can reduce the indomethacin level in serum.
Hypertension remedies (Angiotensin -shaped enzyme inhibitors, beta blockers, diuretics).

Aminoglycoside: Indomethacin increases the peak and bottom concentration of aminoglycosides in newborn babies, so it is necessary to monitor the kidney function and aminoglycoside concentration.

Prednisolone: When combined with prednisolone in the treatment of rheumatoid arthritis, indomethacin increases the free concentration of prednisolone in the blood, but the total prednisolone concentration in the blood is constant.
phenylpropanolamine: Coordinate with indomethacin causes serious hypertension.

phenylbutazon: indomethacin worsen renal failure due to phenylbutazon. penicillin, nafcilin: When used simultaneously with indomethacin causes acute kidney failure (occurring on 2 patients). dexamethason: When combined with indomethacin with dexamethasone reduces blood cortisol levels.
Desmopressin: Increases the efficiency of desmopressin.

Cimetidin protects the duodenum from the harmful effects of indomethacin. Cimetidine can reduce serum indomethacin levels but do not reduce the anti -inflammatory effect of the drug. Probenecid can doubling indomethacin levels if used simultaneously. This can have good clinical effects in patients with arthritis, but can occur indomethacin poisoning, especially in people with impaired renal function. The effect of eliminating uric acid is not affected. If necessary, reduce the dose of indomethacin.
If using indomethacin, the body's response to immunity with live vaccine may occur.

Cavalry of the drug: Due to no studies on the correspondence of the drug, not mixing this drug with other drugs.

Storage

Store in a dry place, avoid light, temperature not exceeding 30 ° C.

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