Meloxicam-Teva 7.5mg 20 tablets — Made in Germany — Free Delivery
(Meloxicam-Teva)
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Description Meloxicam-Teva 7.5mg 20 tablets — Made in Germany — Free Delivery
Pharmacological properties
Pharmacodynamics. Meloxicam is an NSAID of the oxicam group of substances with anti-inflammatory, analgesic and antipyretic properties. Meloxicam exhibited high anti-inflammatory activity in all standard models of inflammation. As with other NSAIDs, its exact mechanism of action remains unknown. However, there is a common mechanism of action for all NSAIDs (including meloxicam): inhibition of the biosynthesis of prostaglandins, which are inflammatory mediators.
Pharmacokinetics. Absorption: meloxicam is almost completely absorbed in the gastrointestinal tract. Oral bioavailability is 89%. After a single oral administration, Cmax in blood plasma is reached after 5-6 hours (tablets). After repeated administration, the state of equilibrium is achieved within 3-5 days from the start of meloxicam administration.
In the case of oral administration of 7.5 or 15 mg of meloxicam once a day in a stationary mode, the concentration in blood plasma reaches 0.4-1.0 mg / l (7.5 mg) or 0.8-2.0 mg / l (15 mg) (Cmin – Cmax).
In the case of long-term treatment, the concentration in blood plasma under stationary conditions does not change. The simultaneous intake of food or the use of inorganic antacids does not affect the absorption of the preparation.
Meloxicam is completely absorbed after i / m injection. The relative bioavailability compared to that for oral administration is almost 100%. Therefore, it is not required to adjust the dose when switching from intramuscular to oral administration. After i / m injection of 15 mg Cmax in blood plasma is about 1.6-1.8 mcg / ml and is achieved in 1-6 hours.
Distribution: meloxicam has a high degree of binding to proteins, mainly albumin (99%). Meloxicam enters the synovial fluid. In this case, the concentration in it is equal to half the concentration in the blood plasma.
The volume of distribution is on average 11 liters. Individual fluctuations are approximately 7–20%. The volume of distribution after multiple oral doses of meloxicam (7.5–15 mg) is 16 liters with a deviation rate of 11–32%.
Biotransformation: meloxicam is metabolized by liver enzymes. Four different inactive metabolites of meloxicam are identified in urine. The main metabolite of 5'-carboxymeloxicam (60%) is formed by oxidation of intermediate metabolites of 5'-hydroxymethylmeloxicam. The amount of unchanged 5'-hydroxymethylmeloxicam recovered is 9%. In vitro, it has been established that the initial stage of this transformation is carried out mainly through CYP 2C9 with a minor participation of CYP 3A4. The formation of two other metabolites (16 and 4% of the dose) is associated with the action of peroxidase.
Excretion: meloxicam is excreted in the form of metabolites, in equal parts with urine and feces. In urine, meloxicam is detected in small amounts (traces). Average T½ is about 20 hours. Total plasma clearance is an average of 8 ml / min.
Linearity: when administered orally at therapeutic doses (7.5 and 15 mg), meloxicam exhibits linear pharmacokinetics.
Special patient groups
Hepatic / renal impairment. Neither mild nor moderate hepatic or renal impairment has a significant effect on the pharmacokinetics of meloxicam. In end-stage renal disease, an increase in the volume of distribution may lead to higher concentrations of free meloxicam, therefore, the daily dose of 7.5 mg should not be exceeded.
Elderly patients. The mean value of plasma clearance in the plateau phase in elderly patients was slightly lower than that recorded for younger patients.
Indications
Short-term symptomatic treatment of exacerbation of osteoarthritis. Long-term symptomatic treatment of rheumatoid arthritis and ankylosing spondylitis.
Application
Apply orally. The daily dose should be taken once with a glass of water or other liquid during meals.
Adverse reactions can be minimized by using the lowest effective dose for the shortest treatment period necessary to control symptoms. The patient's need for symptom relief and his response to treatment should be periodically assessed.
Exacerbation of osteoarthritis: 7.5 mg / day (1 tablet 7.5 mg or half a tablet 15 mg). If necessary, the dose can be increased to 15 mg / day (1 tablet 15 mg or 2 tablets 7.5 mg).
Rheumatoid arthritis, ankylosing spondylitis: 15 mg / day (1 tablet 15 mg or 2 tablets 7.5 mg). Depending on the therapeutic effect, the dose can be reduced to 7.5 mg / day (1 tablet 7.5 mg or half a tablet 15 mg).
Do not exceed the daily dose of meloxicam 15 mg.
Special patient groups
Elderly patients and patients with an increased risk of adverse reactions. The recommended dose for long-term treatment of rheumatoid arthritis and ankylosing spondylitis in elderly patients is 7.5 mg / day. Patients with an increased risk of developing adverse reactions should start treatment with 7.5 mg / day.
Renal failure For patients with severe renal failure on dialysis, the dose should not exceed 7.5 mg / day. Patients with mild to moderate renal impairment (namely, with creatinine clearance of 25 ml / min) do not require dose reduction. For patients with severe renal impairment without dialysis.
Liver failure. No dose reduction is required in patients with mild to moderate hepatic impairment. For patients with severe hepatic impairment.
Children. Meloxicam, 7.5 mg and 15 mg tablets, is contraindicated in children under the age of 16.
Contraindications
Hypersensitivity to meloxicam or other constituents of the preparation, or to active substances with a similar effect, such as NSAIDs, acetylsalicylic acid. meloxicam should not be prescribed to patients who develop BA symptoms, nasal polyps, angioedema or urticaria after taking acetylsalicylic acid or other NSAIDs; iii trimester of pregnancy (see use during pregnancy and lactation); the patient's age up to 18 years; a history of gastrointestinal bleeding or perforation associated with prior NSAID therapy; a history of active or recurrent ulcer / bleeding (two or more separate confirmed cases of ulcer or bleeding); severe liver failure; severe renal failure without dialysis; gastrointestinal bleeding, history of cerebrovascular bleeding, or other bleeding disorders; disorders of hemostasis or the simultaneous use of anticoagulants (contraindications associated with the route of use); severe heart failure; treatment of perioperative pain in coronary artery bypass grafting.
Side effects
Research data and epidemiological data suggest that the use of some NSAIDs (especially at high doses and with long-term treatment) may be associated with a slight increased risk of vascular thrombotic events (for example, myocardial infarction or stroke) (see special instructions).
Edema, hypertension, and heart failure have occurred with NSAID treatment.
Most of the observed side effects are of gastrointestinal origin. Possible ulcer, perforation or gastrointestinal bleeding, sometimes fatal, especially in elderly patients (see SPECIAL INSTRUCTIONS). After application, nausea, vomiting, diarrhea, flatulence, constipation, dyspepsia, abdominal pain, melena, blood vomiting, ulcerative stomatitis, exacerbation of colitis and Crohn's disease occurred. Gastritis was recorded with a lesser frequency.
On the part of the blood and lymphatic system: anemia, abnormal blood test parameters (including a change in the number of leukocytes), leukopenia, thrombocytopenia. Very rare cases of agranulocytosis have been reported (see Description of Selected Serious and / or Frequent Adverse Reactions).
From the immune system: allergic reactions, including anaphylactic shock, anaphylactoid reactions, anaphylactic reactions.
Mental disorders: confusion, mood changes, nightmares, insomnia, disorientation.
From the nervous system: dizziness, headache, drowsiness.
From the side of the organ of vision: visual impairment, including blurred vision, conjunctivitis.
On the part of the organ of hearing and vestibular apparatus: dizziness, ringing in the ears.
From the heart: palpitations, heart failure.
From the vascular system: increased blood pressure, hot flashes.
From the respiratory system: in patients with allergic reactions to acetylsalicylic acid or other NSAIDs in history, asthma attacks, upper respiratory tract infections, and coughing may occur.
From the digestive system: abdominal pain, nausea, vomiting, dyspepsia, diarrhea, latent or macroscopic gastrointestinal bleeding, gastroduodenal ulcer, esophagitis, stomatitis, constipation, flatulence, belching, gastrointestinal perforation, gastritis, colitis. A peptic ulcer, perforation, or gastrointestinal bleeding can be severe and potentially fatal, especially in elderly patients.
Hepatobiliary disorders: impaired liver function indicators (for example, increased levels of transaminases or bilirubin), hepatitis, jaundice, liver failure.
Skin and subcutaneous tissue disorders: itching, rash, angioedema, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, bullous dermatitis, erythema multiforme, photosensitivity, exfoliative dermatitis.
From the urinary system: sodium and water retention, hyperkalemia, impaired renal function (increased levels of creatinine and / or urea in the blood plasma), acute renal failure, in particular in high-risk patients, urinary tract infections, urinary disorders, including acute urinary retention ...
From the musculoskeletal system: arthralgia, back pain, signs and symptoms of the joints.
General disorders and reactions at the injection site: induration at the injection site, pain at the injection site; edema, including edema of the lower extremities, flu-like symptoms.
Description of selected serious and / or frequent adverse reactions. Cases of agranulocytosis have been reported in patients treated with meloxicam and other potentially myelotoxic preparations.
Adverse reactions that were not previously observed with the use of this preparation, but are characteristic of other preparations of this pharmacotherapeutic group. Renal dysfunction up to renal failure: cases of interstitial nephritis, acute tubular necrosis, nephrotic syndrome, papillary necrosis have been reported.
Special instructions
Adverse reactions can be minimized by applying the lowest effective dose for the shortest period of treatment necessary to control symptoms (see application and information on gastrointestinal and cardiovascular risks below).
The recommended maximum daily dose should not be exceeded if the therapeutic effect is insufficient, and additional NSAIDs should not be used, as this may increase toxicity, while the therapeutic benefits have not been proven. The simultaneous use of meloxicam with NSAIDs, including selective COX-2 inhibitors, should be avoided.
Meloxicam is not used to treat patients who require a reduction in the severity of acute pain.
If there is no improvement after several days, the clinical benefits of treatment should be reassessed.
You should pay attention to the history of esophagitis, gastritis and / or peptic ulcer in order to ensure their complete cure before starting therapy with meloxicam. You should regularly pay attention to the possible manifestations of relapse in patients treated with meloxicam and in patients with a history of such cases.
Gastrointestinal disorders. As with other NSAIDs, potentially fatal gastrointestinal bleeding, ulceration, or perforation may occur at any time during treatment with or without prior symptoms or a history of serious gastrointestinal disease.
The risk of gastrointestinal bleeding, ulceration or perforation is higher with increasing NSAID doses in patients with a history of ulcers, especially those complicated by bleeding or perforation (see CONTRAINDICATIONS), and in elderly patients. Such patients should begin treatment with the lowest effective dose. For such patients, combination therapy with protective preparations (such as misoprostol or proton pump inhibitors) should be considered, as well as for patients requiring the combined use of low-dose acetylsalicylic acid or other preparations that increase gastrointestinal risks (see information, below and the INTERACTIONS section).
Patients with a history of gastrointestinal toxicity, especially elderly patients, should be reported about all unusual abdominal symptoms (especially gastrointestinal bleeding), mainly during the initial stages of treatment.
Caution should be exercised in patients concurrently taking preparations that may increase the risk of ulcers or bleeding, in particular heparin, as radical therapy or in geriatric practice, anticoagulants such as warfarin or other NSAIDs, including acetylsalicylic acid at anti-inflammatory doses (≥1 d - single dose or ≥3 g - total daily dose) (see INTERACTIONS).
If gastrointestinal bleeding or ulceration occurs in patients using meloxicam, treatment should be discontinued.
NSAIDs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), as these conditions may worsen (see SIDE EFFECTS).
Liver disorders. In patients who are using NSAIDs (including meloxicam), the level of one or more liver function tests may increase. Such laboratory abnormalities may progress, may remain unchanged, or may be temporary with continued treatment. An increase in ALT or ASAT is possible (approximately ≥3 times higher than normal). Rare cases of severe hepatic reactions have been reported, including jaundice and fulminant lethal hepatitis, hepatic necrosis and hepatic failure, some of them fatal.
The condition of patients with symptoms and / or signs of hepatic dysfunction or with abnormal liver tests should be assessed in relation to the development of symptoms of more severe hepatic impairment during therapy with meloxicam. If clinical signs and symptoms are associated with the development of hepatic diseases or if systemic manifestations of the disease occur (for example, eosinophilia, rash, and others), then the use of meloxicam should be discontinued.
Cardiovascular disorders. Patients with hypertension and / or mild to moderate congestive heart failure in history are recommended to be closely monitored, since fluid retention and edema have been noted during NSAID therapy.
Patients with risk factors are recommended clinical observation of blood pressure at the beginning of therapy, especially at the beginning of the course of treatment with meloxicam.
Research data and epidemiological data suggest that the use of some NSAIDs (especially in high doses and with long-term treatment) may be associated with a slight increased risk of vascular thrombotic events (for example, myocardial infarction or stroke). Insufficient data are available to rule out this risk for meloxicam.
Patients with uncontrolled hypertension, congestive heart failure, established coronary artery disease, peripheral arterial disease and / or cerebrovascular disease should be treated with meloxicam only after careful analysis. Such an analysis is necessary at the beginning of long-term treatment of patients with risk factors for cardiovascular diseases (such as hypertension, hyperlipidemia, diabetes mellitus, smoking).
NSAIDs can increase the risk of serious cardiovascular thrombotic complications, myocardial infarction and stroke, which can be fatal. The increased risk is associated with the duration of use. Patients with cardiovascular disease or cardiovascular risk factors may be at increased risk.
Skin disorders. With the use of NSAIDs, in very rare cases, serious skin reactions developed, some of them were fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis (see SIDE EFFECTS). The highest risk of such reactions was recorded at the beginning of treatment, and in most cases such reactions occurred during the first month of treatment. At the first appearance of skin rashes, lesions of the mucous membranes or other signs of hypersensitivity, it is necessary to stop using meloxicam.
Anaphylactic reactions. As with the use of other NSAIDs, anaphylactic reactions can develop in patients without a known reaction to meloxicam. The preparation should not be used in patients with the aspirin triad. This symptomatic complex is detected in patients with asthma who have reported rhinitis with or without nasal polyps or who have developed severe, potentially fatal bronchospasm after using acetylsalicylic acid or other NSAIDs. Emergency measures should be taken when an anaphylactoid reaction is detected.
Liver parameters and kidney function. As in the treatment of most NSAIDs, isolated cases of an increase in the level of transaminases in the blood plasma, the level of bilirubin in the blood plasma or other indicators of liver function, as well as an increase in the level of creatinine in the blood plasma, urea nitrogen in the blood and other deviations of laboratory parameters have been described. In most cases, these deviations were insignificant and temporary. If there is a significant or persistent confirmation of such deviations, the use of meloxicam should be discontinued and control tests should be carried out.
Functional renal failure. NSAIDs, by inhibiting the vasodilating effect of renal prostaglandins, can induce functional renal failure due to a decrease in glomerular filtration. This side effect is dose dependent. At the beginning of treatment or after increasing the dose, careful monitoring of urine output and renal function is recommended in patients with risk factors such as: old age; simultaneous use with ACE inhibitors, angiotensin II antagonists, sartans, diuretics (see INTERACTIONS); hypovolemia (of any genesis); congestive heart failure; renal failure; nephrotic syndrome; lupus nephropathy; severe hepatic dysfunction (plasma albumin 25 g / l or ≥10 according to Child-Pugh classification).
In rare cases, NSAIDs can lead to interstitial nephritis, glomerulonephritis, renal medullary necrosis, or nephrotic syndrome.
The dose of meloxicam in patients with end-stage renal failure on dialysis should not exceed 7.5 mg. Patients with mild to moderate renal insufficiency need not reduce the dose (creatinine clearance level 25 ml / min).
Retention of sodium, potassium and water. NSAIDs can increase sodium, potassium and water retention and interfere with the natriuretic effect of diuretics. In addition, there may be a decrease in the antihypertensive effect of antihypertensive preparations (see INTERACTIONS). In this regard, in sensitive patients, the development or exacerbation of edema, heart failure, or hypertension may be accelerated. Therefore, patients with such risks are advised to conduct clinical monitoring (see USE and CONTRAINDICATIONS).
Hyperkalemia. Diabetes mellitus or the concomitant use of preparations that increase potassium levels can lead to hyperkalemia (see INTERACTIONS). In such cases, you need to regularly monitor the level of potassium.
Other warnings and safety measures. Adverse reactions are often worse tolerated by elderly patients, weak or debilitated patients requiring careful monitoring. As with other NSAIDs, care should be taken in the elderly, who are more likely to have decreased kidney, liver and heart function. Elderly patients have a high incidence of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, which can be fatal (see APPLICATION).
Meloxicam, like any other NSAID, can mask the symptoms of infectious diseases.
The use of meloxicam can negatively affect reproductive function and is not recommended for women who want to become pregnant. Therefore, for women planning pregnancy or undergoing examination for infertility, the possibility of discontinuing meloxicam should be considered (see Use during pregnancy and lactation).
Masking inflammation and fever. The pharmacological action of meloxicam to reduce fever and inflammation may complicate the diagnosis of a suspected non-infectious pain condition.
GCS treatment. Meloxicam cannot be a likely substitute for GCS in the treatment of GCS deficiency.
Hematological effects. Anemia can occur in patients receiving NSAIDs, including meloxicam. It may be due to fluid retention, gastrointestinal bleeding of unknown origin, or gross bleeding, or an incompletely described effect on erythropoiesis. Patients on long-term treatment with NSAIDs, including meloxicam, should monitor hemoglobin or hematocrit levels if there are symptoms and signs of anemia.
NSAIDs inhibit platelet aggregation and may prolong bleeding time in some patients. Unlike acetylsalicylic acid, their effect on platelet function is less, short-lived and reversible. The condition of patients taking meloxicam and in whom side effects are possible due to changes in platelet function, in particular blood clotting disorders, or patients receiving anticoagulants, should be carefully monitored.
Application in patients with existing asthma. Patients with asthma may have aspirin-sensitive asthma. The use of acetylsalicylic acid in patients with aspirin-sensitive asthma is associated with severe bronchospasm, which can be fatal. Given the cross-reaction, including bronchospasm, between acetylsalicylic acid and other NSAIDs, meloxicam should not be used in patients sensitive to acetylsalicylic acid, and should be used with caution in patients with existing asthma.
Other. As with other injectable NSAIDs, abscess and necrosis may develop at the injection site. The preparation contains a very small amount of sodium, that is, it is virtually free of sodium.
Use during pregnancy and lactation. Pregnancy. Inhibition of prostaglandin synthesis can negatively affect pregnancy and / or the development of the embryo and fetus. Epidemiological data suggest an increased risk of miscarriage and the development of heart defects and gastroschisis after the use of prostaglandin synthesis inhibitors in early pregnancy. The absolute risk of developing heart disease increased from less than 1% to about 1.5%. It is believed that this risk increases with dose and duration of treatment.
During the I and II trimester of pregnancy, meloxicam should not be used unless absolutely necessary. If a woman tries to get pregnant or uses meloxicam during the first and second trimester of pregnancy, the dosage and duration of treatment should be minimal.
In the third trimester of pregnancy, all inhibitors of prostaglandin synthesis can pose a risk to the fetus:
cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension);
impaired renal function, which can develop into renal failure with oligohydroamnion.
Possible risks in the last stages of pregnancy for the mother and the newborn:
the possibility of prolonging the bleeding time, antiaggregatory effect even at very low doses;
inhibition of uterine contractions, which leads to a delay or an increase in the duration of labor.
Therefore, meloxicam is contraindicated in the third trimester of pregnancy.
Lactation. Although there is no specific data on meloxicam, NSAIDs are known to pass into breast milk. Therefore, the use is not recommended for women who are breastfeeding.
Fertility Meloxicam, like other preparations that inhibit the synthesis of COX / prostaglandin, can negatively affect reproductive function and is not recommended for women who want to become pregnant. Therefore, for women planning pregnancy or undergoing examination for infertility, the possibility of discontinuing meloxicam should be considered.
The ability to influence the reaction rate when driving or working with other mechanisms. There are no special studies on the effect of the preparation on the ability to drive a car or work with mechanisms. However, based on the pharmacodynamic profile and the adverse reactions that have occurred, it can be assumed that meloxicam tends to have no or little effect on these activities. However, patients who have experienced visual impairment, including blurred vision, dizziness, drowsiness, vertigo or other CNS disorders, are advised to refrain from driving or operating machinery.
Interactions
Pharmacodynamic interactions
Other NSAIDs and acetylsalicylic acid ≥3 g Combination with other NSAIDs is not recommended (see SPECIAL INSTRUCTIONS), including acetylsalicylic acid in anti-inflammatory doses (≥1 g - single dose or ≥3 g - total daily dose).
Corticosteroids (eg GCS). Simultaneous use with GCS requires caution due to the increased risk of bleeding or the appearance of ulcers in the gastrointestinal tract.
Anticoagulants or heparin, which is used in geriatric practice or at therapeutic doses. The risk of bleeding is significantly increased due to inhibition of platelet function and damage to the gastroduodenal mucosa. NSAIDs can enhance the effects of anticoagulants such as warfarin (see SPECIAL INSTRUCTIONS). The simultaneous use of NSAIDs and anticoagulants or heparin in geriatric practice or in therapeutic doses is not recommended (see SPECIAL INSTRUCTIONS).
In other cases of using heparin, caution is necessary because of the increased risk of bleeding. Careful monitoring of the international normalized relationship is required if it is proven impossible to avoid this combination.
Thrombolytic and antiaggregatory preparations. Increased risk of bleeding due to suppression of platelet function and damage to the gastroduodenal mucosa.
Selective serotonin reuptake inhibitors. Increased risk of gastrointestinal bleeding.
Diuretics, ACE inhibitors and angiotensin II antagonists. NSAIDs can reduce the effect of diuretics and other antihypertensive preparations. In some patients with impaired renal function (in patients with dehydration or elderly patients with impaired renal function), the simultaneous use of ACE inhibitors or angiotensin II antagonists and preparations that depress COX, may lead to a further decrease in renal function, including possible ARF, which usually is reversible. Therefore, the combination should be used with caution, especially in elderly patients. Patients need to receive an adequate amount of fluid, and kidney function should be monitored after the start of combination therapy and periodically thereafter (see SPECIAL INSTRUCTIONS).
Other antihypertensive preparations (eg β-adrenergic receptor blockers). As in the case of the use of the following preparations , it is possible to reduce the antihypertensive effect of β-adrenergic receptor blockers (due to the inhibition of prostaglandins with a vasodilating effect).
Calcineurin inhibitors (eg cyclosporin, tacrolimus). The nephrotoxicity of calcineurin inhibitors may be exacerbated by NSAIDs through mediation of the effects of renal prostaglandins. During treatment, kidney function should be monitored. Careful monitoring of renal function is recommended, especially in elderly patients.
Intrauterine contraception. NSAIDs reduce the effectiveness of intrauterine contraceptives. A decrease in the effectiveness of intrauterine contraceptives with the use of NSAIDs has previously been reported, but this requires further confirmation.
Pharmacokinetic interaction: the effect of meloxicam on the pharmacokinetics of other preparations
Lithium. There is evidence of NSAIDs that increase the concentration of lithium in the blood plasma (due to a decrease in renal excretion of lithium), which can reach toxic values. The simultaneous use of lithium and NSAIDs is not recommended (see SPECIAL INSTRUCTIONS). If combination therapy is necessary, the lithium content in the blood plasma should be carefully monitored at the beginning of treatment, when choosing a dose and when discontinuing meloxicam therapy.
Methotrexate. NSAIDs can reduce the tubular secretion of methotrexate, thereby increasing plasma concentration. For this reason, the concomitant use of NSAIDs is not recommended in patients taking high dose methotrexate (15 mg / week) (see SPECIAL INSTRUCTIONS). The risk of interaction between NSAIDs and methotrexate should also be considered in patients receiving low-dose methotrexate, in particular in patients with impaired renal function. If combined treatment is required, it is necessary to monitor blood counts and kidney function. Caution should be exercised when taking NSAIDs and methotrexate for 3 consecutive days, as plasma levels of methotrexate can rise and increase toxicity. Although the pharmacokinetics of methotrexate (15 mg / week) was not affected by concomitant treatment with meloxicam, it should be considered that the hematological toxicity of methotrexate may increase with NSAID treatment (see information above; SIDE EFFECTS).
Pharmacokinetic interaction: the effect of other preparations on the pharmacokinetics of meloxicam
Cholestyramine. Accelerates the elimination of meloxicam due to impaired intrahepatic circulation, therefore, the clearance of meloxicam increases by 50% and T½ decreases to 13 ± 3 hours. This interaction is clinically significant.
There was no clinically significant pharmacokinetic interaction when taken simultaneously with antacids, cimetidine and digoxin.
Overdose
Symptoms of acute NSAID overdose are usually limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which are generally reversible with maintenance therapy. gastrointestinal bleeding may occur. severe poisoning can lead to ag, opn, liver dysfunction, respiratory depression, coma, seizures, cardiovascular failure, and cardiac arrest. anaphylactoid reactions have been reported with the therapeutic use of NSAIDs, which can also occur with overdose.
In case of an overdose of NSAIDs, patients are recommended symptomatic and supportive measures. Studies have shown an acceleration of the withdrawal of meloxicam by taking 4 oral doses of cholestyramine 3 times a day.
Storage conditions
At a temperature not exceeding 25 ° c.
Tags: Meloxicam
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