Meloxicam 7.5mg khapharco tablets for treating osteoarthritis, joint inflammation (200 tablets)

Dosage form Bottle of 200 tablets
Specifications Meloxicam

Ingredient

Composition information	Content
Meloxicam	7.5mg

Uses

Indications

Meloxicam 7.5 mg drug is indicated for long -term treatment in osteoarthritis, joint spondylitis, chronic joint diseases and age arthritis.

Pharmacy

Meloxicam is the derivative of oxicam, which has anti -inflammatory, analgesic, fever -reducing effect. Like some other nonsteroidal anti-inflammatory drugs, Meloxicam inhibits cyclo-oxygenase enzyme (COX) that reduces prostaglandin synthesis, intermediate substances that play an important role in the pathogenesis of inflammation, fever, pain.

pharmacokinetic

absorption

Meloxicam absorbs well through the gastrointestinal tract, oral bioavailability reaches 89% compared to intravenous injection, food has little effect on absorption. The absorption in the form of tablets, capsules and rectal bullets is similar and achieved the maximum concentration in the blood after 5 hours.

Distribution

In the blood, Meloxicam is mainly attached to albumin with a rate of over 99%. The drug diffuses well into joint fluid, concentration in joint fluid is equivalent to 50% of plasma concentrations, but the free drug of the drug in joint fluid is 2.5 times higher in plasma because there is less protein in joint fluid.

Metabolism

Meloxicam is almost completely metabolized in the liver, with the main catalyst of CYP2C9 and a small part of CYP3A4. The metabolites are no longer active and excreted mainly through urine and feces. A small amount of unproven drugs are eliminated through urine (0.2%) and in feces (1.6%).

Elimination

The exhaust time of the drug on average 20 hours. In liver, or kidney functions (CLCR> 20 ml/ minute) decreased slightly or moderately without the need to adjust the dose of Meloxicam. Meloxicam has an integral distribution of about 10 liters and cannot be separated.

pharmacokinetics on special subjects

Elderly: Elderly patients are men with average pharmacokinetic parameters equivalent to young men. Elderly patients are women showing higher AUC value and longer selling time than young men both men and women. The average plasma clearance in a stable state in the elderly is less than young people.

Children: The maximum concentration in CMAX plasma as well as the area under the AUC curve in the children's group (from 2-6 years old) is lower than children (from 7-14 years old). AUC value in the children's group (from 7-14 years old) is similar or slightly reduced compared to adults. Meloxicam's disposal time in children is 15 hours, lower than adults. Pharmacokinetics in children under 2 years of age have not been established.

Patients with liver failure: Mild to medium liver failure does not affect the pharmacokinetics of Meloxicam. There is no study of pharmacokinetics of Meloxicam in patients with severe liver failure.

Patients with renal failure: Mild to medium renal failure does not significantly affect the pharmacokinetics of Meloxicam. Patients with renal impairment The average level has significantly higher drug clearance. Observed significantly reduced protein bonds in end -stage renal failure patients. In case of end -stage renal failure, increased distribution integral can lead to increased freedom concentration of Meloxicam and should not use more than 7.5 mg/day.

Before taking Meloxicam 7.5mg khapharco tablets for treating osteoarthritis, joint inflammation (200 tablets)

How to use

drug -sold drugs, as directed by the physician.

Used by oral, can be taken at full or at any time.

Because the risk of adverse adverse reactions increases with the dose, and the use time should be used in the shortest possible time and with the lowest dose effectively.

Maximum daily dose recommended by Meloxicam is 15 mg. Patients with dialysis, maximum daily dose of 7.5 mg.

Dosage

rheumatoid arthritis, joint inflammation

Start 7.5 mg/day and may be up to 15 mg/time/day. When long -term treatment, especially the elderly or people with auxiliary complications, the recommended dose is 7.5 mg/time/day. Do not exceed the dose of 15 mg/day.

Acute pain of osteoarthritis

7.5 mg/day/day, can increase to 15 mg/time/day if not supported. For people at high risk of complications, the starting dose is 7.5 mg/day. Treatment period 2-3 days.

For teenagers

Maximum dose recommended is 0.25 mg/kg. In general, the limit is limited for teenagers and adults.

Elderly

Dosage recommended 7.5 mg/day/day.

Hepatic failure, mild and medium kidney failure

There is no need to adjust the dose, if serious, do not use.

kidney failure, dialysis

The dose does not exceed 7.5 mg/day.

There is no special requirement on drug treatment after use.

What to do when overdose?

Symptoms

Symptoms after acute NSAIDs overdose include: drowsiness, nausea, vomiting and epigastric pain. Gastrointestinal bleeding can occur. Serious overdose can lead to hypertension, acute renal failure, liver dysfunction, respiratory failure, coma, convulsions, heart failure and cardiac arrest. Anaphylactic reaction has been reported.

Handling

Currently there is no specific antagonistic drug Meloxicam, so in the case of overdose, in addition to symptomatic treatment, resuscitation, it is necessary to use measures to increase excretion and reduce drug absorption such as gastric wash, drink cholestyramin.

What to do when forgetting 1 dose?

Side Effects

When using Meloxicam 7.5 mg, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Gastrointestinal disorders, nausea, vomiting, abdominal pain, constipation, bloating, diarrhea, anemia, itching, skin rash, upper respiratory tract infections, influenza -like syndrome, cough, pharyngitis, muscle pain and back pain.

Sleek to increase transaminase, bilirubin, belching, esophagitis, stomach - duodenal ulcer, potential gastrointestinal bleeding. Face, tinnitus and drowsiness.

The risk of cardiovascular thrombosis.

Rare, ADR

Colitis, ulcers, gastrointestinal perforation, hepatitis, gastritis.

Warnings

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

Contraindicated

Meloxicam 7.5 mg drug is contraindicated in the following cases:

Hypersensitivity to drugs, people with a history of allergies to aspirin or other nonsteroidal anti -inflammatory drugs. Do not use Meloxicam for people with symptoms of bronchial asthma, nasal polyps, nerve angiema or quincke edema, urticaria appears when taking aspirin or other nonsteroidal anti -inflammatory drugs. Dialysed blood.

Pregnant and lactating women.

Precautions when used

The drug contains lactose, so patients with rare genetic disorders in galactose tolerance, Lactose Lapp deficiency or Glucose - Galactose absorption disorders should not use this drug.

Although COX-2 priority inhibitors may still experience some unwanted effects such as other non-steroid anti-inflammatory drugs, when using Meloxicam must be very cautious in people with a history of stomach-duodenal ulcer, patients are taking anticoagulants because the drug can cause stomach-duodenal ulcer, causing bleeding. To minimize the unwanted effect of Meloxicam, the lowest dose has the lowest doses in the shortest possible time.

NSAIDS increases the risk of cardiovascular thrombosis such as myocardial infarction, stroke, and death.

Meloxicam inhibits prostaglandin synthesis in the kidneys leading to reduced renal perfusion. Patients who have reduced blood flow to the kidneys or hypoglycemia such as heart failure, nephrotic syndrome, cirrhosis, severe kidney disease, are taking diuretic gums or are performing large surgery need to check the volume of urine and kidney function before using Meloxicam.

During the use of the drug, there are abnormalities on the skin, mucosa or showing signs of ulcer or gastrointestinal bleeding must stop immediately.

Meloxicam can cause hypertension or worsen hypertension, so when using the drug, it is necessary to regularly monitor blood pressure. Meloxicam may cause a slight increase in transaminase or different liver function assessment parameters. When these parameters rise beyond the normal limit at a significant level or a prolonged increase must stop using Meloxicam.

In patients with cirrhosis but at a stable stage, the drug does not need to reduce the dose.

Elderly people with poor liver, kidney and heart function should not use Meloxicam.

The risk of cardiovascular thrombosis of nonsteroidal anti -inflammatory drugs (NSAIDs), non -aspirin, using systemic sugar can increase the risk of cardiovascular thrombosis, including myocardial infarction and stroke, which can lead to death. This risk can appear early in the first few weeks of taking the drug and can increase over time. The risk of cardiovascular thrombosis is suspected at high doses.

Doctors need to periodically assess the appearance of cardiovascular events, even if the patient has no previous cardiovascular symptoms. Patients should be warned of symptoms of serious cardiovascular events and need to visit the doctor as soon as they appear.

To minimize the risk of adverse events, Meloxicam is needed at the lowest daily doses in the shortest possible effect as possible.

The ability to drive and operate machinery

There is no evidence of the effect of drugs on driving ability, operating the machine, but due to unwanted effects such as dizziness, drowsiness. Therefore, it is best not to use Meloxicam while participating in these activities.

Pregnancy

There is no evidence that causes teratogenic. However, it is recommended that Meloxicam should not be used for pregnant women, especially in the last 3 months because of concerns of early closed artery or other complications for the fetus.

Breastfeeding period

Do not take Meloxicam during breastfeeding, if you need to use medication for mothers, you should not breastfeed.

Drug interaction

The drug has the effect of increasing the level on the inhibition of cyclo-oxygenase enzyme with other nonsteroidal anti-inflammatory drugs at high doses, increasing the risk of peptic ulcer and bleeding.

aspirin

When used simultaneously with aspirin (1000 mg, 3 times/day) on healthy volunteers tends to increase AUC (10%) and CMAX (24%) of Meloxicam. The clinical significance of this interaction is not known. However, like other NSAIDs, Meloxicam should not be used with aspirin because of the risk of increasing side effects.

Ticlopidin oral anticoagulant, heparin, thrombolytic drugs: Meloxicam increases the risk of bleeding, thus avoiding coordination. During the treatment process, it is necessary to closely monitor the anticoagulant effect.

lithium

Meloxicam increases blood lithium concentration. Therefore, it is necessary to monitor the blood level in the blood during use combining two drugs together.

Other interactions

Combined treatment of Tenofovir Disoproxil Fumarat with Methadon, Ribavirin, Rifampicin or with birth control pills (Norgestimat, Ethinyl Estradiol) does not cause any pharmacokinetic interactions.

methotrexate

Meloxicam increases the toxicity of methotrexate on hematological systems. Therefore, it is necessary to check (count) periodic blood cells.

IUD

Medications reduces the contraceptive effect of the IUD in the uterus.

Ureterial gums

Meloxicam may increase the risk of acute renal failure in dehydration. In case of combination, it is necessary to provide enough water for patients and must monitor the function carefully.

Anti-blood pressure drugs such as alpha-adrenergic inhibitors, angiotensin-shift enzyme inhibitors, vasodilators

Because meloxicam inhibits prostaglandin synthesis, it reduces vasodilation effect, lowering blood pressure of combined drugs.

cholestyramin

cholestyramin attached to meloxicam in the digestive tract reduces the absorption, increasing the elimination of meloxicam.

cyclosporin

Meloxicam increases the toxicity of the kidneys. Therefore, when coordinating, it is necessary to monitor the function carefully.

wafarin

Meloxicam may increase bleeding. Therefore, it is necessary to monitor bleeding time when used.

Furosemid and Thiazid

Medicines reduce the diuretic effects of Furosemid, Thiazid group.

digoxin and cimetidine

There is no pharmacokinetic interaction detected when used simultaneously.

Due to the lack of studies on the correlation of the drug, not mixing this drug with other drugs.

Storage

less than 30 ° C. In a dry place, avoid light

To be out of reach of children.

Other drugs

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