Zornika - Instructions For Use, 8 Mg Tablets, Price, Analogs, Reviews

2024 Author: Rachel Wainwright | [email protected]. Last modified: 2023-12-15 07:39

Zornika

Zornika: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation
10. 10. Use in childhood
11. 11. In case of impaired renal function
12. 12. For violations of liver function
13. 13. Use in the elderly
14. 14. Drug interactions
15. 15. Analogs
16. 16. Terms and conditions of storage
17. 17. Terms of dispensing from pharmacies
18. 18. Reviews
19. 19. Price in pharmacies

Latin name: Zornika

ATX code: M01AC05

Active ingredient: lornoxicam (Lornoxicam)

Manufacturer: Micro Labs, Limited (India)

Description and photo update: 2019-11-07

Prices in pharmacies: from 292 rubles.

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Zornika is a non-steroidal anti-inflammatory drug (NSAID) from the oxicam class.

Release form and composition

Dosage form - film-coated tablets: yellow, biconvex, round (in a cardboard pack of 3 blisters, 1 blister contains 10 tablets, and instructions for use of Zorniki).

Composition of 1 tablet of 4/8 mg:

• active substance: lornoxicam - 4/8 mg;
• auxiliary components: magnesium stearate - 0.35 / 0.7 mg; microcrystalline cellulose - 12/24 mg; povidone-K30 - 1.1 / 2.2 mg; croscarmellose sodium - 3.5 / 7 mg; lactose monohydrate - 47.05 / 94.1 mg;
• shell: macrogol 6000 - 0.15 / 0.3 mg; quinoline yellow dye (E104) - 0.1 / 0.2 mg; talc - 0.4 / 0.8 mg; titanium dioxide (E171) - 0.6 / 1.2 mg; hypromellose - 0.75 / 1.5 mg.

Pharmacological properties

Pharmacodynamics

The lornoxicam in Zornik belongs to the oxicam class. It has a pronounced analgesic and anti-inflammatory properties, as well as a complex mechanism of action. The basis of this mechanism is the suppression of the synthesis of prostaglandins, which is due to the inhibition of the activity of cyclooxygenase isoenzymes.

In addition, lornoxicam inhibits the release of free oxygen radicals from activated leukocytes. Its analgesic properties are not related to narcotic effects. The drug has no opiate-like effect on the central nervous system. Unlike narcotic analgesics, it does not cause drug dependence and does not depress breathing.

Pharmacokinetics

• absorption: after oral administration, lornoxicam is rapidly and almost completely absorbed from the gastrointestinal tract (GIT). Its maximum concentration (C _max) in blood plasma is reached after about 1–2 hours. A 30% decrease in C _max in blood plasma and an increase in the time to reach the maximum concentration (T _Cmax) to 2.3 hours occurs with food intake. The drug does not accumulate in the body when taken again. Its absolute bioavailability ranges from 90 to 100%;
• metabolism and distribution: in blood plasma, lornoxicam is present mostly unchanged and to a lesser extent in the form of 3'-hydroxylornoxicam (hydroxylated metabolite), which has no pharmacological activity. Lornoxicam quickly penetrates into the synovial fluid, its area under the concentration-time curve (AUC) after taking a dose of 4 mg 2 times a day is 0.5. The metabolism of the drug completely occurs in the liver. The isoenzyme CYP2C9 is involved in this process. Binding to blood plasma proteins, mostly albumin fraction, is 99% and does not depend on its concentration;
• excretion: regardless of the concentration, the half-life (T _1/2) of lornoxicam averages 4 hours. Approximately 2/3 of the metabolites are excreted from the body in the bile, 1/3 - through the kidneys. T _{1/2 of the} glucuronid metabolites of the drug is approximately 11 hours.

There are no significant changes in the pharmacokinetics of lornoxicam in elderly patients and patients with hepatic / renal insufficiency.

Indications for use

• pain syndrome of various origins (for short-term therapy);
• rheumatic pathologies: osteoarthritis, rheumatic lesions of soft tissues, rheumatoid arthritis, articular syndrome with exacerbation of gout, ankylosing spondylitis (for symptomatic treatment).

Contraindications

Absolute:

• progressive renal pathology, severe renal failure [creatinine clearance (CC) less than 30 ml per minute];
• active liver disease or severe liver failure;
• decompensated heart failure;
• exacerbation of inflammatory bowel pathologies (ulcerative colitis, Crohn's disease);
• confirmed hyperkalemia;
• a history of gastrointestinal bleeding associated with NSAID therapy;
• repeated gastrointestinal bleeding or recurrent gastric ulcer;
• active gastrointestinal bleeding, erosive and ulcerative changes in the mucous membrane of the stomach or duodenum;
• cerebrovascular or other bleeding;
• bleeding disorders, hemorrhagic diathesis, the presence of operations associated with the risk of incomplete hemostasis and bleeding;
• partial or complete combination of recurrent polyposis of the paranasal sinuses / nose, bronchial asthma and intolerance to acetylsalicylic acid (ASA) and other NSAIDs, including history data;
• period after coronary artery bypass grafting;
• dehydration or hypovolemia;
• glucose-galactose malabsorption, lactose intolerance, lactase deficiency;
• pregnancy and lactation;
• age under 18;
• individual intolerance to the components of the drug.

Relative (Zornik tablets 8 mg and 4 mg are used under medical supervision):

• a history of erosive and ulcerative lesions and bleeding from the gastrointestinal tract;
• moderate renal failure;
• cardiac ischemia;
• chronic heart failure (according to NYHA classification II – IV functional class);
• the presence of a risk of developing cardiovascular thrombosis [hemorrhagic or ischemic stroke (acute disorders of cerebral circulation), myocardial infarction];
• hemostasis defects;
• systemic lupus erythematosus;
• peripheral arterial disease;
• diabetes;
• hyperlipidemia (dyslipidemia);
• cerebrovascular pathology;
• conditions after surgical interventions;
• QC less than 60 ml in 1 min;
• severe somatic pathologies;
• smoking, alcoholism;
• presence of Helicobacter pylori infection;
• long-term treatment with NSAIDs;
• combination therapy with selective serotonin reuptake inhibitors (including paroxetine, citalopram, sertraline, fluoxetine), anticoagulants (including warfarin), antiplatelet agents (including clopidogrel) and oral glucocorticosteroids (including prednisolone);
• age over 65.

Zornik, instructions for use: method and dosage

Zornik tablets are taken orally before meals with a glass of water.

Depending on the indications, the dosage of the drug is:

• severe pain syndrome: 8-16 mg per day, divided into 2-3 doses. The maximum dose is 16 mg per day;
• degenerative and inflammatory rheumatic pathologies: the initial dose is 12 mg, the standard dose is from 8 to 16 mg per day (depending on the patient's condition).

The duration of the course of treatment is set depending on the course and nature of the disease.

The daily dose of Zorniki for patients with gastrointestinal tract pathologies, impaired liver / kidney function, persons who have undergone major surgery, as well as elderly patients (aged 65 years and over) is 12 mg, divided into 3 doses.

In order to reduce the likelihood of side effects from the gastrointestinal tract, it is recommended to use Zornik in the minimum effective doses for the minimum possible short course.

Side effects

Possible adverse reactions [> 10% - very common; (> 1% and 0.1% and 0.01% and <0.1%) - rarely; <0.01%, including isolated messages - very rare]:

• nervous system: often - dizziness, headache; infrequently - depression, sleep disturbances; rarely - paresthesia, tremor, agitation, drowsiness; very rarely - aseptic meningitis;
• digestive system: often - heartburn, nausea, diarrhea, vomiting, abdominal pain, dyspepsia; infrequently - an increase in the level of hepatic transaminases, gastritis, flatulence, constipation, erosive and ulcerative lesions of the mucous membrane of the stomach and intestines, including with bleeding and perforation; rarely - stomatitis, liver dysfunction, melena, esophagitis, dry mouth;
• skin: infrequently - alopecia, urticaria, itching, skin rash; rarely - angioedema, Lyell's syndrome, Stevens-Johnson syndrome, edema syndrome; very rarely - ecchymosis;
• urinary system: rarely - acute renal failure, peripheral edema, nephrotic syndrome, papillary necrosis, glomerulonephritis, interstitial nephritis, decreased glomerular filtration rate, dysuria;
• sense organs: infrequently - tinnitus; rarely - visual impairment;
• cardiovascular system: infrequently - tachycardia, the appearance or worsening of heart failure; rarely - an increase in blood pressure;
• hematopoietic organs: rarely - an increase in bleeding time, thrombocytopenia, anemia, leukopenia, agranulocytosis;
• respiratory organs: infrequently - rhinitis; rarely - bronchospasm, cough, dyspnea, pharyngitis;
• others: infrequently - arthralgia, change in body weight, increased sweating, anorexia; rarely - myalgia.

Overdose

The main symptoms of an overdose of lornoxicam: possible increased side effects.

Therapy: the use of activated carbon immediately after taking Zorniki can help reduce its absorption; in order to prevent damage to the gastrointestinal mucosa, antiulcer drugs (ranitidine or prostaglandin analogues) may be prescribed; further symptomatic treatment is recommended. Hemodialysis is ineffective.

special instructions

To reduce the likelihood of developing ulcerogenic action, the drug can be combined with synthetic analogs of prostaglandins and proton pump inhibitors. With the development of bleeding in the gastrointestinal tract, taking Zorniki should be immediately canceled and appropriate urgent measures should be taken. Particular attention is required for the condition of patients with gastrointestinal tract pathology who are receiving therapy with lornoxicam for the first time.

Like other oxicams, Zornika can prolong bleeding time, since it inhibits platelet aggregation. For the timely detection of signs of bleeding, when using it, you should carefully monitor the condition of patients who receive drugs that inhibit blood coagulation (including low doses of heparin), have disorders of the blood coagulation system, or need absolutely normal functioning of the blood coagulation system (for example, with the upcoming surgical intervention).

The appearance of symptoms of liver damage (increased levels of hepatic transaminases, abdominal pain, itching, dark urine, nausea, vomiting, yellowing of the skin) is the basis for discontinuation of treatment. In such cases, you should seek the advice of a doctor.

Zornik cannot be used in combination with other NSAIDs.

The drug can change the properties of platelets, but in cases of cardiovascular pathologies it does not replace the preventive action of ASA.

In case of impaired renal function, which are caused by severe dehydration or large blood loss, the drug as an inhibitor of prostaglandin synthesis can be used only after eliminating hypovolemia and the associated risk of decreased renal perfusion. Its intake, like other NSAIDs, can lead to the development of peripheral edema, arterial hypertension, cause sodium and water retention, an increase in the concentration of creatinine and urea in the blood plasma, and other early symptoms of nephropathy. Long-term therapy with lornoxicam in such cases can lead to the development of glomerulonephritis, papillary necrosis and nephrotic syndrome with the transition to acute renal failure. With a pronounced decrease in kidney function, Zornik cannot be used.

If the drug is prescribed to patients with obesity and / or arterial hypertension, as well as to elderly patients, it is necessary to control the level of blood pressure during therapy.

Monitoring of renal function is especially important in elderly patients, as well as in combination therapy with drugs that can cause kidney damage, or diuretics.

In cases of prolonged use of Zorniki, periodic monitoring of liver / kidney function and hematological parameters is required.

Patients planning a pregnancy should be aware that Zornika can have a negative effect on fertility.

Influence on the ability to drive vehicles and complex mechanisms

During the period of therapy with Zornika, it is important to be careful when driving vehicles and conducting potentially hazardous activities, since its intake may be accompanied by dizziness and other side effects that affect the psychophysiological reactions of the body.

Application during pregnancy and lactation

Zornika is not prescribed during pregnancy / lactation.

Pediatric use

For patients under 18 years of age, Zornika is not prescribed due to the lack of clinical data on its use in this age category.

With impaired renal function

• reception is contraindicated: progressive renal pathology, severe renal failure (CC less than 30 ml in 1 min);
• use requires caution: moderate renal failure.

For violations of liver function

Zornika is not used in patients with active liver disease or severe liver failure.

Use in the elderly

In patients over the age of 65, the use of Zorniki requires medical supervision.

Drug interactions

• platelet aggregation inhibitors, anticoagulants: bleeding time may increase (high probability of bleeding, it is required to control the international normalized ratio);
• cimetidine: increases the concentration of lornoxicam in blood plasma;
• digoxin: its renal clearance decreases;
• angiotensin-converting enzyme inhibitors, β-blockers: it is possible to reduce their hypotensive effect;
• Mifepristone: Possible decreased effectiveness. Lornoxicam therapy should be started no earlier than 8–12 days after taking mifepristone;
• diuretics: it is possible to reduce their hypotensive and diuretic action;
• quinoline antibacterial agents: the likelihood of convulsive syndrome increases;
• glucocorticosteroids, other NSAIDs: the risk of bleeding from the digestive tract increases;
• methotrexate: its concentration in blood plasma increases;
• hypoglycemic drugs for oral administration: it is possible to enhance their hypoglycemic effect;
• selective serotonin reuptake inhibitors (for example, paroxetine, citalopram, sertraline, fluoxetine): the likelihood of bleeding from the digestive tract increases;
• lithium salts: it is possible to increase the C _{max of} lithium in the blood plasma and increase its side effects;
• potassium preparations, corticotropin, alcohol: the risk of side effects from the gastrointestinal tract increases;
• cyclosporine: lornoxicam increases its nephrotoxicity;
• rifampicin: reduces the concentration of lornoxicam in blood plasma;
• cefoperazone, valproic acid, cefotetan, cefamandol: the likelihood of bleeding increases;
• cholestyramine: accelerates the excretion of lornoxicam from ZhKH;
• antacids, ranitidine: no interaction with lornoxicam has been identified.

Analogs

Zorniki's analogues are Ksefokam, Lornoxicam, Ksefokam rapid, etc.

Terms and conditions of storage

Store in a place protected from light and moisture at temperatures up to 30 ° C. Keep out of the reach of children.

Shelf life is 2 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Zornik

The few reviews about Zornik do not allow us to assess the effectiveness and safety of its use. The drug is rarely found in pharmacies.

The price of Zornik in pharmacies

The approximate price of Zorniki 8 mg is 251 rubles, 4 mg is 150 rubles. per pack of 30 film-coated tablets.

Zornika: prices in online pharmacies

Drug name Price Pharmacy

Zornika tablets p.p. 4mg 30 pcs. 292 r Buy

Zornika 4 mg film-coated tablets 30 pcs. 292 r Buy

Zornika tablets p.p. 8mg 30 pcs. 367 r Buy

Zornika 8 mg film-coated tablets 30 pcs. 367 r Buy

Maria Kulkes Medical journalist About the author

Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".

Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!