Trosicam 15mg Alpex treatments for osteoarthritis pain (30 tablets)

Dosage form Box of 3 blisters x 10 tablets
Specifications Meloxicam

Ingredient

Composition information	Content
Meloxicam	15mg

Uses

indications

trosicam drugs are indicated in the following cases:

Treatment of osteoarthritis symptoms (arthritis, osteoarthritis).

Treatment of rheumatoid arthritis symptoms. Prostaglandin combination, reducing the formation of intermediate substances that cause inflammation. Meloxicam inhibits Prostaglandin synthesis in more effective inflammatory position in the stomach and kidney mucosa related to selective inhibition of COX - 2 more than COX - 1.

Pharmacokinetics

absorption

Good absorption through the gastrointestinal tract, bioavailability reaches 89% by oral. After taking 1 dose, the maximum concentration reaches after 5-6 hours, after a few stable doses achieved after 3-5 days. Using continuously for more than 6 months does not show any dynamic change, so it does not use for more than 6 months. The level of absorption of Meloxicam oral is constant when used with food.

Distribution

Meloxicam is attached to plasma proteins, mainly 99%albumin. Meloxicam diffuses in the epidemic, the concentration in joint fluid is nearly half of the plasma. The average distribution volume is 11 liters, 30-40% ranging between individuals.

Metabolism

Almost entirely through the liver, the main metabolite 5 ' - Carboxyloxicam (60% dose), formed by the oxidation of intermediate metabolites 5' - Hydroxymethylmeloxicam, less than the lower level (9% dose), CYP2C9 plays a major role in this transformation process, a small part through CYP 3A4. The enzyme activity peroxidase plays a role with the remaining substance accounting for 16%, 4% of the dose.

Elimination

Mainly metabolites, half through the kidney, half through the stool. Under 5% of daily dose is excreted without metabolism through feces. The average selling time is about 20 hours. The clearance of the total plasma is 8 ml/min.

Before taking Trosicam 15mg Alpex treatments for osteoarthritis pain (30 tablets)

How to use

Put the pills on the tongue.

The tablet will dissolve slowly with saliva (do not chew or swallow the pill).

If you have dry mouth, use water to moisten your mouth first. 15 mg tablets can be broken for the dose of 7.5 mg.

Dosage

osteoarthritis: 7.5mg/time, if necessary, can increase to 15 mg/day.

rheumatoid arthritis: 15 mg/day. Depending on the response, the dose can be reduced to 7.5 mg/day.

Age arthritis: 15 mg/day.

If the patient is 65 years of age or older, the recommended dose in long -term treatment of rheumatoid arthritis and spine arthritis is 7.5 mg/day.

Children and adolescents: Contraindicated for children and teenagers under 16 years old.

Patients are at risk of increasing harmful reactions: Starting treatment at a dose of 7.5 mg/day.

Patients with severe renal impairment must be clinical: Do not use more than 7.5 mg/day.

The maximum recommended dose is 15 mg/day.

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 do

do when overdose? A clinical trial has shown that cholestyramine increases meloxicam excretion.

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. Note that it should not be used double the prescribed dose.

Side Effects

When using trosicam you can experience unwanted effects (ADR).

digestive system

Indigestion, nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea.

Unusual abnormalities of parameters of liver function (such as increased transaminase or bilirubin), heartburn, esophagitis, peptic ulcer, potential or general gastrointestinal bleeding.

Gastroenterosol, colitis, hepatitis, gastritis, hemorrhage, ulcers or gastrointestinal perforation are likely to cause death.

Hematology system

Anemia.

Blood formula disorders include white blood cell count, leukopenia and thrombocytopenia. Simultaneous use with 1 drug can be poisoned with bone marrow, especially methotrexate, may be a favorable factor for the onset of blood cells.

Skin itching, rash.

Healthy, urticaria.

Light sensitivity. Rare case: Water polished dermatitis, diverse roses, Stevens - Johnson syndrome, poisoned epidermal necrosis.

Respiratory system

has recorded the onset of acute asthma in some individuals when using aspirin or NSAIDs, including Meloxicam.

Central nervous system

Dizziness, headache.

Dizziness, tinnitus, sleeping.

Confusion and loss of direction, mood change.

Cardiovascular

fit.

Hypertension, brushing chest, blushing.

Urinary - genitals

Abnormal renal function parameters (increased serum creatinine levels and/or serum urea levels).

Acute renal failure.

visual disorders

Conjunctivitis, visual disorders include blurred vision.

Hypersensitivity reaction

Tharms and instant hypercertia reactions include anaphylactic reaction or anaphylactic.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

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

contraindicated

Trosicam drugs contraindicated in the following cases:

Patients with a history of sensitivity to Meloxicam or any ingredients of the drug.

Patients with aspirin sensitivity and other nonsteroidal anti -inflammatory drugs.

Patients with a history of asthma, nasal polyps, angiography or urticaria after taking aspirin or other nonsteroidal anti -inflammatory drugs.

Progressive peptic ulcer patient.

Inflammation (Crohn's disease or ulcerative colitis).

Patients with severe liver failure.

Patients with severe renal failure.

Heartless heart failure.

Children and teenagers under 16 years old.

Pregnant and lactating women.

Treatment of pain during the cycle of coronary artery transplant surgery.

Be cautious when using

Precautions when treating patients with a history of gastrointestinal disease or patients being treated with anticoagulant drugs. Patients should be monitored with gastrointestinal symptoms. Meloxicam should be stopped when stomach ulcers or gastrointestinal ulcers occur.

Stop using Meloxicam as soon as the skin rash appears, mucosal damage or any other signs of sensitivity.

Nsais may increase the risk of serious cardiovascular thrombosis, myocardial infarction and stroke can lead to death. The risk increases over time. This risk will be higher in patients with cardiovascular disease with cardiovascular risk factors.

Be careful and closely monitor the volume of urine and kidney function when taking drugs for patients with dehydration, patients with congestive heart failure, cirrhosis, nephrotic syndrome, clear kidney disease, patients who are using diuretics or have undergone surgery, leading to reduced blood flow.

In some rare cases, NSAIDs may be the cause of interstitial nephritis, glomerulonephritis, nephropathy or nephrotic syndrome.

Do not take a dose greater than 7.5 mg of meloxicam for patients with end -stage renal impairment is being clinical. No need to reduce the dose in patients with mild or medium renal failure.

Sometimes the drug can cause increased serum transaminase concentration or other parameters of liver function. Most cases are light and transient. This abnormal case is long -term to stop taking medication and testing.

No need to reduce the dose in patients with clinical stability.

Patients with weak or depression may endure less side effects and need to carefully monitor these patients. Similar to other NSAIDs, should be cautious when used for older patients who are more likely to suffer from kidney, liver or heart function.

NSAIDs can cause sodium, potassium and water retention and interfere with the effect of sodium - urinary tract of diuretics. This can promote or worsen heart failure or high blood pressure in sensitive patients. Therefore, clinical monitoring in patients at risk.

Meloxicam can hide the symptoms of potential infections.

Using Meloxicam can impair fertility and are not recommended in women who want to get pregnant. Therefore, women are difficult to conceive, or are being treated infertility should consider stopping using Meloxicam.

The ability to drive and operate machinery

There is no specialized research on the ability to drive and operate machinery. However, based on the brief descriptions of the pharmacological and side effects of the drug, Meloxicam does not seem to have no cause and effect. Patients with visual disorders, other central nervous system disorders should limit driving or operating machinery.

Pregnancy

contraindicated trosicam during pregnancy.

Prostaglandin inhibitor may have a disadvantage for pregnant women in the fetal development.

During the last three months of pregnancy, all prostaglandin synthetic inhibitors can cause fetal: heart toxicity (early arteriosclerosis and pulmonary hypertension). Kidney dysfunction can lead to renal failure with amniotic fluid. For mothers and newborns or at the end of pregnancy: can extend the bleeding time and anti -platelet effects can occur even at very low doses, inhibiting uterine contractions leading to delayed or prolonged labor.

The period of breastfeeding

Although there is no clear experience for Meloxicam, NSAIDs are known to be through breast milk. Therefore, avoid being used for breastfeeding women.

Interactive drugs

Other prostaglandin synthesis (PSI) inhibitors include glucocorticoids and salicylate (acetylsalicylic acid): It is not recommended to use meloxicam combination with these drugs because it has a force that increases the risk of ulcer and gastrointestinal bleeding. It is not recommended to simultaneously use Meloxicam with other nonsteroidal anti -inflammatory drugs.

Oral anticoagulants, anti -platelet drugs, systemic heparin systems, thrombolytic drugs and Serotonin recovery inhibitors (SSRIs): Increases the risk of machine flowing due to inhibition of platelet function. If the above combination cannot be avoided, it is necessary to closely monitor.

Lithium: NSAIDs increase lithium concentration in plasma due to reduced lithium secretion through the kidneys, which can reach poison threshold. It is not recommended to simultaneously use NSAID and Lithium. If it is necessary to use a combination, careful monitoring of lithium concentrations in plasma when starting treatment, adjustment or stopping using Meloxicam.

methotrexate: NSAIDs can reduce the secretion of meloxicam in the renal tubules, thus increasing the concentration of methotrexate in plasma. Therefore, methotrexate must not be used simultaneously with NSAIDs in high -dose methotrexate patients.

birth control pills: There have been NSAID reports that reduce the effectiveness of the IUD.

Diuretics: Treatment with NSAID drugs related to the possibility of acute renal failure in patients with dehydration. Patients with Meloxicam and diuretics should also drink enough water and monitor kidney function at the beginning of combination of treatment.

High blood pressure treatment: Reducing the effects of antihypertensive drugs due to inhibition of prostaglandin vasodilation when treated with NSAID.

NSAIDs and Angiotensin II receptor antagonistic drugs as well as ACE inhibitors cause a powerful effect on the reduction of glomerular filtration. Patients with previous renal failure can lead to acute renal failure.

Cyclosporin's kidney toxicity may increase by NSAIDs due to the intermediate effect of prostaglandin in the kidneys. Need to evaluate kidney function when using combination.

Storage

Store at temperatures below 30 ° C.

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