Pharmacy No. 84. Delivery of medicines to your home and office.

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Side effects

Possible abdominal pain, constipation, flatulence, diarrhea; anemia, itching, dizziness, headache, peripheral edema.

Rarely, transient increases in liver function tests (increased transferase activity or plasma bilirubin concentration), esophagitis, peptic ulcer or gastrointestinal bleeding may occur; leukopenia and thrombocytopenia; stomatitis, urticaria, tinnitus, drowsiness; increased blood pressure, facial erythema with a feeling of heat, tachycardia; changes in kidney function parameters (increased levels of creatinine and/or urea in the blood plasma). When taking a drug with a potential negative effect on bone marrow cells (especially methotrexate), pancytopenia may develop.

Very rarely - perforation, hepatitis, photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis, asthma attack that occurs as a result of taking acetylsalicylic acid, acute renal failure, conjunctivitis, visual impairment, angioedema, anaphylactoid/anaphylactic reactions.

Interaction

Combined use with salicylates and other NSAIDs increases the possibility of bleeding and erosive and ulcerative complications of the gastrointestinal tract .

Concurrent administration of anticoagulants , Heparin , Ticlopidine , and thrombolytics increases the risk of bleeding .

Use with lithium-containing drugs may lead to an increase in lithium .

Combined use with Methotrexate increases the risk of pancytopenia .

In patients with symptoms of dehydration , with the parallel administration of diuretics renal failure may develop , and therefore their function should be monitored and dehydration .

Meloxicam reduces the antihypertensive effectiveness of ACE inhibitors , β-blockers , diuretics and vasodilators .

Cholestyramine in the gastrointestinal tract can bind meloxicam , thereby preventing its absorption.

Combined use with Cyclosporine leads to increased nephrotoxicity .

There is a potential for drug interactions with oral antidiabetic drugs .

Co-administration of ACE inhibitors and angiotensin II receptor antagonists increases the effect of reducing glomerular filtration , which in patients with kidney pathologies can lead to renal failure .

Melbek may reduce the effectiveness of intrauterine contraceptives .

Compound

1 Melbek tablet contains 7.5 mg of meloxicam , the active ingredient.
Minor Ingredients: Lactose anhydrous, microcrystalline cellulose, povidone, magnesium stearate, crospovidone, sodium citrate, colloidal anhydrous silica. 1 tablet of Melbek Forte contains 15 mg of meloxicam - the active ingredient. Minor Ingredients: Lactose anhydrous, crospovidone, microcrystalline cellulose, povidone, sodium citrate, magnesium stearate, colloidal silicon dioxide.

1 ampoule of Melbek contains 15 mg of meloxicam , the active ingredient. Minor ingredients: glycofurol, meglumine, poloxamer 188, glycine, sodium chloride, sodium hydroxide, water for injection.

Overdose

In case of an overdose of meloxicam, the following manifestations are possible: lethargy, drowsiness , lethargy , nausea, epigastric pain , vomiting, gastrointestinal bleeding , as well as anaphylactoid reactions .

In case of severe intoxication , the following were observed: acute kidney failure , increased blood pressure , impaired liver function , respiratory depression, convulsions , coma , cardiac arrest and vascular collapse .

Symptomatic and supportive therapy is prescribed using forced diuresis , urine alkalization, hemoperfusion or hemodialysis , which are not effective enough due to the high degree of binding of meloxicam to plasma proteins.

Analogs

Level 4 ATX code matches:
Mirlox

Revmoxicam

Xefocam Rapid

Xefocam

Movalis

Mesipol

Lem

Movasin

Piroxicam

Lornoxicam

Arthrozan

Texamen

Amelotex

Meloxicam

Xefocam;
Piroxicam;
Vero-Piroxicam;
Texamen;
Pyroxyfer;
Tenoctil , etc.

Pharmacodynamics and pharmacokinetics

The drug Melbek belongs to the group of NSAIDs ( non-steroidal anti-inflammatory drugs ) and is a selective (selective) COX-2 inhibitor .

A derivative of enolic acid , meloxicam, belongs to the class of oxicams , which exhibit analgesic, anti-inflammatory and antipyretic effectiveness due to their ability to reduce the synthesis of prostaglandins due to the suppression of cyclooxygenase . The inhibitory effect of Melbek is largely directed at COX-2 prostaglandins at the site of inflammation ) and insignificantly at COX-1 .

When taken orally, meloxicam , regardless of food, is well absorbed from the gastrointestinal tract. Bioavailability is 89%, plasma Cmax is observed after 5–6 hours and is 0.4–1 mg/ml at a dose of 7.5 mg and 0.8–2.0 mg/ml at a dose of 15 mg.

When administered intramuscularly, it is completely absorbed, reaching peak concentrations within 60 minutes. Plasma concentration, with daily use of 5-30 mg, is dose-dependent.

Equilibrium concentration values are detected on days 3–5. Long-term use (more than 12 months) does not lead to an increase in plasma levels.

Communication with plasma proteins is 99.5%, the average volume of distribution is 11 liters. The content in synovial fluid is 2 times less than in plasma.

Through the oxidation of methyl groups, it undergoes biotransformation in the liver with the release of 4 inactive metabolites.

Approximately 43% is excreted by the kidneys, the rest with bile (less than 5% unchanged). T½ about 20 o'clock.

Pathologies of the liver and/or kidneys do not significantly affect pharmacokinetics. Plasma clearance is 8 ml/min and decreases in old age.

special instructions

Use with caution to treat patients with gastrointestinal diseases and patients receiving anticoagulants . If gastrointestinal bleeding , therapy is discontinued.

Patients with kidney pathologies should be under constant monitoring, due to the excretion of metabolites by the kidneys.

Patients with reduced blood circulation and renal blood flow are at risk of renal failure , which is reversible after discontinuation of the drug. Typically, this complication occurs in patients with signs of congestive heart failure , dehydration , liver cirrhosis , kidney disease, nephrotic syndrome , hypovolemia after major surgery, as well as patients using ACE inhibitors and diuretics .

This category of people should carefully monitor renal function and daily diuresis . In some cases, Melbek can lead to interstitial nephritis , renal medullary necrosis , glomerulonephritis and the formation of nephrotic syndrome .

During therapy with meloxicam, changes in enzyme activity and other liver parameters may be observed, which are most often reversible and insignificant. In case of a significant and persistent change in these indicators, therapy should be discontinued.

Melbek should be prescribed with caution to elderly patients.

The use of meloxicam , especially by injection, can lead to anaphylactoid reactions , which require emergency treatment.

anemia may occasionally occur due to fluid retention , heavy or hidden gastrointestinal bleeding , and the effect of erythropoiesis . If symptoms of anemia hematocrit and hemoglobin levels should be monitored .

Meloxicam bleeding time by inhibiting platelet and may also interfere with platelet function, in particular by inhibiting coagulation . For this reason, patients taking anticoagulants should exercise special caution.

edema and fluid retention were noted , and therefore, the appointment of Melbek to patients with hypertension , heart failure or edema should be carried out with extreme caution.

The use of meloxicam is not recommended during continuous hemodialysis .

Melbek injection solution should not be mixed with other drugs in the same syringe.

Indications for use

Osteoarthritis and other degenerative pathologies of the spine and joints that occur with pain .
Symptomatic treatment of rheumatic painful conditions: rheumatoid arthritis , ankylosing spondylitis , reactive arthritis .
Pain syndrome that has developed for various reasons: dorsalgia , pain with bursitis , myalgia , tendinitis , sciatica , fasciitis , lumbago , postoperative pain, toothache , pain with sprains and bruises.

Contraindications

heart failure ;
hypersensitivity to meloxicam or minor ingredients of the drug;
mention of bronchial asthma , conjunctivitis , nasal polyposis angioedema or skin rashes NSAIDs ;
phase of exacerbation of gastrointestinal ulcer;
hemorrhagic pathologies ( gastrointestinal bleeding , cerebrovascular bleeding , etc.);
pain syndrome that developed after the coronary artery bypass ;
breast-feeding;
phase of exacerbation of inflammatory bowel diseases ( nonspecific ulcerative colitis , Crohn's disease , etc.);
pregnancy;
severe renal and/or hepatic pathologies;
age up to 15 years.