Tenotil treatment for rheumatoid arthritis, osteoarthritis (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Tenoxicam

Ingredient

Composition information	Content
Tenoxicam	20mg

Uses

Indications

Tenotil drug are indicated in the following cases:

Treatment of symptoms rheumatoid arthritis and osteoarthritis. cool down. Like other nonsteroidal anti -inflammatory drugs, currently it is unknown to exactly the effect of Tenoxicam's effect, although there are many assumptions that prostaglandin biosynthesis inhibit bloody biosynthesis, reducing leukemia in the inflammation.

pharmacokinetic

absorption

Tenoxicam has a long -lasting effect, taking a daily order will be effective. After taking Tenoxicam, it is absorbed quickly and completely in a constant form. The peak concentration in plasma is achieved after drinking about 2 hours after hunger and may be up to 6 hours slowly. Foods only slow down to absorb rather than reduce bioavailability. The bioavailability of the drug is almost 100%.

Distribution

Tenoxicam is quickly distributed throughout the body. The concentration in plasma has a linear correlation with the dose. High -linked drugs with plasma proteins (about 99%), mainly albumin. Tenoxicam's peak concentration in fluid is about half in plasma.

With the recommended dose mode at 20mg a day, the stable plasma concentration is achieved within 10-15 days and there is no unbreakable accumulation. The average concentration in a stable state is 11mg/l when taking 20mg of Tenoxicam once a day and this concentration does not change the day even when the treatment process is up to 4 years. From kinetics when using a single dose, plasma concentration can be predicted in a stable state 6 times higher than the first drink.

Pass and elimination

Tenoxicam metabolizes not entirely in an inactive form. About two-thirds of oral doses are excreted in the urine, mainly in the form of metabolites without activity 5-hydroxyyrylylylyl, the rest is excreted through the bile in the form of glucuronid complex of metabolites. Less than 1% of the dose is found in urine in the original form. Another life elimination of plasma from 42 to 81 hours. Plasma clearance is 2ml/min.

Before taking Tenotil treatment for rheumatoid arthritis, osteoarthritis (10 blisters x 10 tablets)

How to use

Take oral use.

Do not use high doses because often does not achieve significantly higher effects but increases the risk of unwanted effects.

In the treatment of symptoms of acute musculoskeletal diseases, usually need to take more than 7 days, but in severe cases, it can be used up to 14 days.

Take the medicine at full with a cup of 150ml full water. Avoid alcoholic beverages.

Dosage

adult dose over 18 years old (including the elderly)

Single dose 20mg, oral at the same time every day.

For some patients only need 10mg, once a day is enough.

Must use the lowest dose effectively. The prescription dose usually limits 20mg/day.

Dosage in renal failure:

If the clearinine clearance> 25 ml/minute: normal dose but must be monitored carefully.

If creatinine clearance

Note: The above dose is for reference only. 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

In general, the symptoms of NSAID overdose often include nausea, vomiting, epigastric pain, rarely diarrhea, gastrointestinal hemorrhage, tinnitus, headache, blurred vision, husband's face. There has been a separate report on more serious toxicity after taking a significant amount of drugs, including convulsions, stimuli, sleep, hypotension, apnea, loss of losers with electrolytes and kidney failure. The exacerbation may occur.

Treatment

Patients need symptomatic treatment.

In case of overdose, stopping the drug and using activated carbon, thick skin washing, antacids and proton pump inhibitors can be prescribed.

Within an hour after taking toxic doses, activated carbon can be used. There is no specific antidote. The effect of lavage is not sure. Dialysis does not significantly remove the amount of NSAID in the blood.

Ensure urine to maintain enough moisture. Closely monitor liver and kidney function.

Patients must be monitored for at least 4 hours after overdose.

Regular and prolonged seizures are treated with intravenous diazepam.

Depending on the patient's clinical condition, other treatments may be carried out.

What to do when you forget 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 Tenotil , you may experience unwanted effects (ADR).

Risk of cardiovascular thrombosis

ADR incidence for the digestive system is 11.4%, the nervous system is 2.8%and on the skin is 2.5%. Symptoms include vomiting, nausea (14.7%), indigestion (2.3%), bleeding at the surgical location (4.3%), wound infection (92.7%), dizziness (5.7%), headache (10.7%).

Common, ADR> 1/100

Body: headache , dizziness.

digestive: epigastric pain, nausea, indigestion.

Skin: Outdoor, urticaria, itching.

Uncommon, 1/1 000

Body: Fatigue, edema, anorexia, dry mouth.

Circulation: Brushing the chest. digestive: vomiting, persistent constipation, diarrhea, stomatitis, gastrointestinal bleeding, duodenal and stomach ulcers, gastritis, black blood defecation. Mental: Sleep disorder.

Urinary - genital: edema.

Rare, ADR

Body: Hypersensitivity reaction (asthma, anaphylactic, angioedema).

Blood: Anemia, leukopenia, granulocytosis, thrombocytopenia, bleeding due to platelets inhibitors. circulating: Hypertension. nerve: blurred vision. Skin: Light sensitive, Stevens - Johnson syndrome, poisoned epidermal necrosis (Lyell syndrome).

Urinary - genital: Difficult to urinate.

Instructions on how to handle ADR

If gastrointestinal ulcers or gastrointestinal bleeding, stop immediately.

Using antacids or H2 receptor resistance may be effective. If the liver function tests are not normal or worsening, if the clinical signs and symptoms of the liver disease are found or if there is another systemic reaction (such as eosinophilia, rash), it is necessary to stop the drug immediately.

Symptomatic treatment and support if needed. Some ADRs of NSAIDs such as nephrotic syndrome, nephritis, thrombocytopenia, hemolytic anemia, severe skin reactions or other hypersensitivity reactions, may have response to glucocorticoids.

Warnings

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

Contraindicated

Tenotil drug contraindicated in the following cases:

Progressive or ulcerative gastrointestinal ulcers or a history of gastrointestinal ulcers, gastrointestinal bleeding (bleeding, vomiting blood).

Hen, in case of easily bleeding such as cirrhosis, heart failure, renal failure (creatinine clearance

Hypersensitivity to Tenoxicam.

Patients are susceptible to hypersensitivity reactions (asthma, rhinitis, angioedema or urticaria) with other nonsteroidal anti -inflammatory drugs.

Precautions when using

Need to carefully monitor patients with Tenoxicam when gastrointestinal disease.

It is necessary to carefully monitor the function of the heart, liver, and kidneys in patients who have previously suffered from kidney disease (including people with diabetes with reduced kidney function), nephrotic syndrome, loss of fluid, liver disease, congestive heart failure and when those patients are being treated simultaneously with diuretics or drugs that are toxic to the kidneys.

For elderly patients, they need to monitor regularly to detect interactions when treating simultaneously with other drugs and monitoring the kidney, liver and cardiovascular function because it can be significantly affected by nonsteroidal anti -inflammatory drugs. The risk of hyperkalemia can increase in the elderly.

Be cautious with patients with large surgery (such as joint replacement) because Tenoxicam reduces platelet condensation, so it can extend the bleeding time.

The ability to drive and operate machines

Unwanted effects such as dizziness, drowsiness, fatigue, visual disorders that can occur after taking NSAIDs. If affected, patients should not drive or operate machinery.

Pregnancy

The safety of Tenoxicam with pregnant women has not been determined. It is known that nonsteroidal anti -inflammatory drugs cause artery in infants. Therefore, this medication should not be used for pregnant women. Contraindicated for pregnant women in the last 3 months of pregnancy.

Breastfeeding period

Do not know if the drug has secretion in breast milk, so it should not be used for women who are breastfeeding, or need to consider the use of medication or breastfeeding.

Drug interaction

antacids

may slow down the absorption rate but does not affect the absorption level of Tenoxicam. The difference without clinical significance

Other NSAIDs/Glucocorticosteroid

Salicylate can push Tenoxicam from bonding with protein, due to increasing the clearance and distribution of Tenoxicam's distribution. It is necessary to avoid simultaneous treatment with salicylate, aspirin or other nonsteroidal anti -inflammatory drugs or glucocorticosteroids because of the increased risk of side effects (especially in the digestive tract).

lithium

There has been a notice of nonsteroidal anti -inflammatory drugs that keep lithium, if using tenoxicam for patients who are using lithium therapy, it is necessary to strengthen lithium concentration and notify patients to maintain the amount of water put into the body and symptoms of poisoning to detect lithium poisoning in time.

Diuretics/high blood pressure medications

Non -steroid anti -inflammatory drugs can cause water, sodium, and potassium and can affect the effect of sodium output of diuretics, increase the risk of toxicity on the kidneys of NSAID, so the dose should be adjusted. It should be noted for these properties when treating patients with heart function or hypertension due to worse disease.

Storage

Storage of closed packaging. At room temperature below 30 ° C.

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