Meloxicam-Teva

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

Meloxicam-Teva: instructions for use and reviews

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

Latin name: Meloxicam-Teva

ATX code: M01AC06

Active ingredient: Meloxicam (Meloxicamum)

Manufacturer: Teva Pharmaceutical Industries, Ltd. (Hungary); Help, S. A. (HELP, SA) (Greece)

Description and photo update: 2019-08-10

Prices in pharmacies: from 128 rubles.

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Meloxicam-Teva is a non-steroidal anti-inflammatory drug (NSAID).

Release form and composition

Dosage forms:

tablets: yellow with slight marbling, with a dividing line on one side; dosage 7.5 mg - round, flat-cylindrical, chamfered, engraved "MLX 7.5" on the side without risks; dosage 15 mg - oval, engraved with "MLX 15" on the side without risks (in a cardboard box 1 or 2 blisters containing 10 tablets each);
solution for intramuscular (intramuscular) injection: yellow with a greenish tinge transparent liquid (in a cardboard box 1 plastic tray, which contains 5 ampoules of neutral colorless glass with a ring indicating the break point of the ampoule containing 1.5 ml of solution each).

Each pack also contains instructions for the use of Meloxicam-Teva.

Composition of 1 tablet of 7.5 / 15 mg, respectively:

active substance: meloxicam - 7.5 / 15 mg;
auxiliary components: magnesium stearate - 1.8 / 1.8 mg; colloidal silicon dioxide - 1.5 / 1.5 mg; crospovidone - 12/12 mg; povidone-KZO - 6/6 mg; sodium citrate dihydrate - 18/18 mg; microcrystalline cellulose - 56/56 mg; lactose monohydrate - 77.2 / 69.7 mg.

Composition of 1.5 ml solution for intramuscular injection:

active substance: meloxicam - 15 mg;
auxiliary components: sodium hydroxide - 0.228 mg; glycine - 7.5 mg; sodium chloride - 4.5 mg; poloxamer 188 - 75 mg; glycofurol (tetrahydrofurfuril macrogol) - 150 mg; meglumine - 9.375 mg; water for injection - up to 1.5 ml.

Pharmacological properties

Pharmacodynamics

Meloxicam is an NSAID belonging to the oxicam class. The drug has anti-inflammatory, analgesic and antipyretic effects. Its anti-inflammatory properties are associated with the selective suppression of the enzymatic activity of cyclooxygenase-2 (COX-2), which is involved in the biosynthesis of prostaglandins in the area of inflammation. A pronounced anti-inflammatory effect of the substance is noted in all standard models of inflammation.

The drug has a lesser effect on cyclooxygenase-1 (COX-1), which is involved in the synthesis of prostaglandin, which protects the mucous membrane of the gastrointestinal tract (GIT) and is involved in the regulation of blood flow in the kidneys.

Pharmacokinetics

The main pharmacokinetic characteristics of meloxicam:

absorption: after oral administration, meloxicam is well absorbed from the gastrointestinal tract, its absolute bioavailability is high and is 90%. Maximum concentration of a substance in blood plasma (C _max) after taking a single dose, it is achieved within 5-6 hours. Simultaneous intake of inorganic substances or food has no effect on absorption. Concentrations of the drug when taken orally (in doses of 7.5 and 15 mg) are proportional to the doses used. Within a period of 3 to 5 days, a steady state of pharmacokinetics is achieved. After taking meloxicam once a day, the range of differences between its maximum and basal concentrations is relatively small, and when using tablets at a dose of 7.5 mg it is 0.4–1 μg per 1 ml, at a dose of 15 mg - 0.8–2 μg per 1 ml (respectively, the indicators of the minimum and maximum concentration at a steady state of pharmacokinetics are given), although values outside this range were also recorded. At steady state pharmacokinetics C_{max is} reached 5-6 hours after taking the pills. After i / m administration, meloxicam is absorbed in full. Its relative bioavailability, in comparison with that for oral administration, is almost 100%. In this regard, when switching from injection of Meloxicam-Teva injections to oral forms of the drug, dose selection is not carried out. C _{max is} determined approximately after 1 hour and is 2.81 mg per 1 liter. The equilibrium state in cases of repeated use is achieved after 3-5 days;
distribution: the connection of meloxicam with plasma proteins, mostly with albumin, is 99%. The substance penetrates into the synovial fluid, the concentration of which is approximately 50% of the plasma concentration. After repeated oral administration of the drug in a dose of 7.5 to 15 mg, the volume of distribution (V _d) is about 16 liters, the coefficient of variation is 11–32%. V _d with i / m administration of the solution is low, on average 11 liters, fluctuations in individual values vary from 30 to 40%;
metabolism: the substance is almost completely metabolized in the liver. In this case, 4 derivatives are formed that do not have pharmacological activity. The main metabolite is 5'-carboxymeloxicam, which makes up 60% of the dose used and is formed by oxidation of the intermediate metabolite, 5'-hydroxymethylmeloxicam. The second metabolite is excreted to a lesser extent and is 9% of the dose used. According to in vitro studies, the isoenzyme CYP2C9 plays an important role in this metabolic conversion, and the isoenzyme CYP3A4 plays an additional role. The remaining metabolites are approximately 4 and 16% of the dose received, respectively. They are formed with the participation of peroxidase, the activity of which, presumably, varies individually;
excretion: meloxicam in the form of metabolites (mainly) is excreted equally through the kidneys and intestines. With feces, no more than 5% of the daily dose of the drug is excreted unchanged, in urine unchanged it is noted only in trace amounts. When administered orally / intramuscularly, the average elimination half-life of meloxicam is 13-25 / 20 h, respectively, and the plasma clearance is 7-12 / 8 ml per minute.

In case of impaired renal and / or liver function, significant changes in the pharmacokinetics of the drug are not observed. The rate of elimination from the body of the oral form of meloxicam is significantly higher in moderate renal failure. Against the background of end-stage renal failure, the drug binds worse to plasma proteins, while an increase in V _d may increase the concentration of the free form of meloxicam. In this connection, in such patients, the daily dose should not exceed 7.5 mg.

In elderly patients, pharmacokinetic parameters are similar to those in young patients. The mean plasma clearance at steady state pharmacokinetics is slightly lower than in young patients. In older women, the area under the concentration-time curve is higher, and the half-life of the drug is longer, in comparison with young patients (regardless of their gender).

Indications for use

Meloxicam-Teva tablets are prescribed for the symptomatic treatment of the following diseases:

ankylosing spondylitis;
rheumatoid arthritis;
osteoarthritis (degenerative joint diseases, arthrosis), including with a pain component;
other degenerative and inflammatory pathologies of the musculoskeletal system, accompanied by pain - arthropathy, dorsopathy (for example, shoulder periarthritis, lower back pain, sciatica and others).

A solution for intramuscular injection is recommended for the symptomatic treatment of such diseases:

osteoarthritis (for short-term therapy);
ankylosing spondylitis or rheumatoid arthritis (for long-term treatment).

Contraindications

Absolute:

active gastrointestinal bleeding;
ulcerative colitis in the acute stage, Crohn's disease (inflammatory bowel disease);
progressive kidney disease;
hemophilia and other blood clotting disorders;
complete / incomplete combination of recurrent polyposis of the nose and paranasal sinuses, bronchial asthma, urticaria or angioedema caused by intolerance to acetylsalicylic acid or other NSAIDs due to the existing likelihood of cross-sensitivity, including history;
pregnancy and lactation;
children's age: tablets - under 12 years old; solution for intramuscular injection - under 18 years old;
individual intolerance to the components of the drug.

Additional absolute contraindications for Meloxicam-Teva tablets:

recently transferred or in the stage of exacerbation of erosive and ulcerative lesions of the stomach and duodenum;
severe renal failure (with confirmed hyperkalemia, creatinine clearance less than 30 ml per minute, as well as in cases where hemodialysis is not performed);
severe liver failure;
recently transferred cerebrovascular bleeding;
severe uncontrolled heart failure;
treatment of perioperative pain during coronary artery bypass grafting;
rare hereditary galactose intolerance (due to the content of lactose in tablets).

Additional absolute contraindications for solution for intramuscular injection:

erosive and ulcerative changes in the mucous membrane of the stomach or duodenum;
active cerebrovascular or other bleeding;
decompensated heart failure;
severe liver failure;
severe renal failure (creatinine clearance less than 30 ml per minute);
confirmed hyperkalemia;
period after coronary artery bypass grafting.

Relative contraindications (Meloxicam-Teva is prescribed under medical supervision): ischemic heart disease, cerebrovascular diseases, hyperlipidemia / dyslipidemia, diabetes mellitus, peripheral arterial pathology, history of gastrointestinal ulcers, Helicobacter pylori infection, severe somatic diseases, frequent use of alcohol, long-term use of NSAIDs, advanced age, combination therapy with selective serotonin reuptake inhibitors (sertraline, fluoxetine, paroxetine, citalopram), oral glucocorticoids (prednisolone), antiplatelet agents (clopidogrel, acetylsalicylic acid), anticoagulants.

Additional relative contraindications for Meloxicam-Teva tablets: chronic heart failure, renal failure (creatinine clearance from 30 to 60 ml per minute).

Additional relative contraindications for solution for intramuscular administration: history of gastrointestinal bleeding, gastritis, esophagitis, liver dysfunction (serum albumin content less than 25 g per 1 liter), nephrotic syndrome, renal dysfunction, congestive heart failure, creatinine clearance less than 60 ml per minute, combined intake of diuretics, hypovolemia, which appeared after significant surgical intervention.

Meloxicam-Teva, instructions for use: method and dosage

Pills

Meloxicam-Teva tablets are taken orally simultaneously with food, washed down with water or other liquid. The total daily dose of the drug is taken at one time.

The recommended doses of Meloxicam-Teva, depending on the indications, are:

osteoarthritis with pain syndrome: daily dose - 1 tablet of 7.5 mg, with the possibility of doubling it (up to 15 mg per day);
rheumatoid arthritis: daily dose - 1 tablet of 15 mg or 2 tablets of 7.5 mg, with a possible decrease in 2 times (up to 7.5 mg per day);
ankylosing spondylitis: daily dose - 1 tablet of 15 mg or 2 tablets of 7.5 mg. Depending on the therapeutic effect, the daily dose can be reduced by 2 times (up to 7.5 mg per day).

With an increased risk of developing adverse events (the presence of risk factors for cardiovascular pathologies, a history of gastrointestinal tract disease), drug therapy is recommended to start with a daily dose of 7.5 mg.

Patients with severe renal failure who are on hemodialysis should not take the drug in a daily dose exceeding 7.5 mg.

Since the potential likelihood of side effects depends on the dose of the drug used and the duration of the course of therapy, it is recommended to use the tablets in the lowest possible doses for a short period.

The maximum dose of Meloxicam-Teva is 15 mg per day. The total dose of the drug in the form of various dosage forms should not exceed 15 mg per day.

The maximum daily dose for adolescents 12-18 years old is set on the basis of the calculation - 0.25 mg per 1 kg of body weight. It should not exceed 15 mg per day.

The drug should not be prescribed in combination with other NSAIDs.

Since the selection of the appropriate dosage for children under the age of 12 is not possible, the appointment of tablets to patients of this age group is contraindicated.

Solution for i / m administration

Meloxicam-Teva injections are injected deep into the muscle.

The use of this dosage form of the drug is indicated only during the first 2-3 days of therapy. Then the patient is transferred to Meloxicam-Teva in the form of tablets.

Depending on the indications, the recommended daily doses are:

osteoarthritis: ½ ampoule (7.5 mg) with a solution, with a possible increase in the dose by 2 times to 1 ampoule (15 mg);
rheumatoid arthritis, ankylosing spondylitis: 1 ampoule (15 mg) with solution. Depending on the therapeutic effect, the dose can be reduced by 2 times to ½ ampoule (7.5 mg).

The maximum daily dose of the solution is 1 ampoule (15 mg).

For patients with a high risk of side effects, the initial dose of Meloxicam-Teva is ½ ampoule (7.5 mg) per day.

The maximum daily dose for patients with severe renal insufficiency on hemodialysis is ½ ampoule (7.5 mg).

In cases of slight or moderate decrease in renal function (creatinine clearance more than 25 ml per 1 min) and liver, the dosage regimen is not adjusted.

Side effects

The scale of the frequency of adverse reactions according to the classification of WHO (World Health Organization):

very often - (> 10%);
often - (> 1% and <10%);
infrequently - (> 0.1% and <1%);
rarely - (> 0.01% and <0.1%);
very rare - (<0.01%, including individual messages).

While taking Meloxicam-Teva tablets, the following side reactions are possible:

blood and lymphatic system: infrequently - anemia; rarely - thrombocytopenia, leukopenia, changes in the number of blood cells, including changes in the leukocyte formula;
nervous system: often - headache; infrequently - drowsiness, dizziness;
sense organs: infrequently - vertigo; rarely - tinnitus;
Gastrointestinal tract: often - nausea, diarrhea, vomiting, dyspepsia, abdominal pain; infrequently - belching, bloating, constipation, stomatitis, latent or overt gastrointestinal bleeding; rarely - esophagitis, colitis, gastroduodenal ulcers; very rarely - gastrointestinal perforation;
liver: infrequently - transient changes in liver function indicators (for example, increased bilirubin / transaminase activity);
skin and subcutaneous tissues: infrequently - itchy skin, rash; rarely - urticaria; with an unspecified frequency - photosensitivity;
respiratory system: rarely - bronchial asthma, which develops against the background of allergy to acetylsalicylic acid or other NSAIDs;
cardiovascular system: infrequently - a feeling of rush of blood to the face, increased blood pressure; rarely - palpitations;
genitourinary system: infrequently - an increase in serum urea and / or creatinine levels (changes in renal function indicators).

Adverse events that were registered in the post-marketing study of Meloxicam-Teva tablets, the relationship of which with taking the drug was regarded as possible:

genitourinary system: infrequently - urination disorders, including acute urinary retention; very rarely - acute renal failure;
skin and subcutaneous tissues: infrequently - angioedema; rarely - toxic epidermal necrolysis, Stevens-Johnson syndrome; very rarely - bullous dermatitis, erythema multiforme;
immune system: infrequently - other immediate hypersensitivity reactions; with an unknown frequency - anaphylactoid reactions, anaphylactic shock;
mental disorders: often - mood changes; with an unknown frequency - disorientation, confusion;
sense organs: rarely - conjunctivitis, visual impairment, including blurred vision;
genitals and mammary gland: infrequently - late ovulation; with an unknown frequency - infertility in women;
Gastrointestinal tract: infrequently - gastritis;
liver: very rarely - hepatitis.

With the combined use of Meloxicam-Teva with drugs that inhibit the bone marrow (for example, methotrexate), cytopenia may occur.

It should be borne in mind that perforation, ulceration, or gastrointestinal bleeding can be fatal.

As with other NSAIDs, the likelihood of developing nephrotic syndrome, renal medullary necrosis, glomerulonephritis or interstitial nephritis is possible.

During the use of the solution for intramuscular administration of Meloxicam-Teva, the following side reactions are possible:

hematopoietic organs: often - anemia; infrequently - agranulocytosis, thrombocytopenia, leukopenia (change in the blood count). A predisposing factor for the appearance of agranulocytosis is the combined use of potentially myelotoxic drugs (methotrexate);
nervous system: often - headache, stunned consciousness; infrequently - drowsiness, tinnitus, dizziness; rarely - nightmares, insomnia, mood changes, confusion;
organ of vision: rarely - visual impairment, including blurring;
cardiovascular system: often - edema, including of the lower extremities; infrequently - a feeling of a rush of blood to the face, an increase in blood pressure, palpitations;
respiratory system: rarely - attacks of bronchial asthma in patients with allergic reactions to acetylsalicylic acid or other NSAIDs;
Gastrointestinal tract: often - diarrhea, flatulence, constipation, abdominal pain, vomiting, nausea, dyspepsia; infrequently - transient changes in liver function indicators (an increase in the activity of transaminases or bilirubin), stomatitis, esophagitis, gastric and duodenal ulcers, gastrointestinal bleeding; rarely - hepatitis, gastritis, colitis, gastrointestinal perforation;
skin: often - itching, rash; infrequently - urticaria; rarely - vascular edema, bullous rash (erythema multiforme), Stevens-Johnson syndrome, toxic epidermal necrolysis, photosensitivity reactions;
urinary system: often - changes in renal function indicators (increased levels of urea and / or serum creatinine); rarely - renal failure;
allergic reactions: rarely - anaphylactoid / anaphylactic reactions.

Overdose

Overdose of meloxicam when taking the drug inside (tablets):

main symptoms: pain in the epigastric region, nausea, vomiting, impaired consciousness. These adverse events are usually reversible. Bleeding of the gastrointestinal tract may develop. In case of severe intoxication, renal / hepatic failure, asystole, and respiratory arrest are possible. There are reports of the appearance of anaphylactoid reactions with an overdose of NSAIDs for oral administration;
therapy: there is no specific antidote. Gastric lavage, the appointment of activated charcoal (for the next 1 hour) and symptomatic treatment are recommended. Clinical studies have shown that cholestyramine, through the binding of meloxicam in the gastrointestinal tract, contributes to its faster elimination. Since the binding of the substance to blood proteins is high, the use of hemodialysis, forced diuresis or alkalization of urine is ineffective.

Overdose of meloxicam with i / m administration of the solution:

main symptoms: pain in the epigastric region, nausea, vomiting, drowsiness, apathy. With supportive treatment, these phenomena are reversible. Gastrointestinal bleeding is possible. As a result of serious poisoning, liver dysfunction, acute renal failure, convulsions, increased blood pressure, respiratory depression, development of cardiovascular failure, coma, cardiac arrest are possible;
therapy: symptomatic and supportive treatment. In clinical studies, an accelerated elimination of meloxicam was noted with oral administration of cholestyramine at a dose of 4 g 3 times a day.

special instructions

General special instructions for oral and parenteral administration of the drug

Regular medical supervision should be established for patients with gastrointestinal pathologies, including a history of (Crohn's disease, ulcerative colitis). If during therapy with Meloxicam-Teva, the occurrence of ulcerative lesions or bleeding of the gastrointestinal tract is noted, the drug is canceled.

Bleeding, perforation, or gastrointestinal ulcers can occur at any time during NSAID use, with or without warning signs or a history of serious gastrointestinal complications. In general, the consequences of these complications are more serious in older patients.

The use of the drug can serve the development of serious adverse reactions from the skin - toxic epidermal necrolysis, Stevens-Johnson syndrome, exfoliative dermatitis. In this regard, it is important to pay special attention to patients who report the occurrence of side effects from the skin and mucous membranes, as well as hypersensitivity reactions to the drug, especially if they were observed during previous courses of therapy. Usually, such reactions are noted in the first month of using Meloxicam-Teva. When the first manifestations of changes in mucous membranes, skin rash or other symptoms of hypersensitivity appear, the question of discontinuing the drug should be considered.

NSAIDs inhibit the synthesis of prostaglandins in the kidneys, which are involved in maintaining renal perfusion. The use of such drugs with a reduced volume of circulating blood or reduced renal blood flow can serve as decompensation of latent renal failure. Kidney function in most cases is restored to its original level after the withdrawal of NSAIDs. The most at risk of such a reaction are:

patients who have undergone surgical interventions leading to hypovolemia;
patients receiving concomitant angiotensin II receptor antagonists, angiotensin-converting enzyme inhibitors, diuretic drugs;
elderly patients;
patients with acute renal dysfunction, nephrotic syndrome, liver cirrhosis, congestive heart failure, dehydration.

In such cases, at the beginning of treatment, it is recommended to carefully monitor renal function and urine output.

The combined use of NSAIDs and diuretics can lead to a decrease in the natriuretic effect of diuretics, water, potassium and sodium retention. As a consequence, in predisposed patients, manifestations of hypertension or heart failure may increase, the condition of such patients should be carefully monitored and ensure adequate hydration is maintained. Before starting therapy, a study of renal function should be performed. It is also important to monitor renal function when prescribing combination therapy.

The use of the drug, like most other NSAIDs, can lead to an episodic increase in serum transaminase activity or other indicators of liver function. Typically, this increase is small and transient. In cases where the identified changes are significant and do not decrease over time, Meloxicam-Teva is canceled, and laboratory changes are monitored.

The appearance of side effects may be worse for debilitated or debilitated patients. In this regard, it is recommended that they be closely monitored.

The drug, like other NSAIDs, can mask the manifestations of the underlying infectious pathology.

Since the drug inhibits prostaglandin / cyclooxygenase synthesis and may interfere with fertility, it should not be used by women who have difficulty conceiving. Given this, in patients with impaired fertility or undergoing examination for infertility, the use of Meloxicam-Teva should be canceled.

Additional special instructions for taking tablets

There are reports of an increase in the likelihood of developing myocardial infarction, serious cardiovascular thrombosis, an attack of angina pectoris, possibly fatal, with the use of NSAIDs. Long-term use of Meloxicam-Teva, the presence of these pathologies in the anamnesis or a predisposition to them increase this probability.

Correction of the dosage regimen for patients with mild or moderate renal insufficiency (creatinine clearance more than 25 ml per 1 min), as well as patients with liver cirrhosis (compensated), is not performed.

Additional special instructions for the / m administration of the solution

Before starting therapy, it is important to establish whether the patient's history of gastric or duodenal ulcers, gastritis or inflammation of the esophagus has been completely cured. It is important to take into account the risk of recurrence of these pathologies in such patients.

The use of NSAIDs in rare cases can lead to the development of nephrotic syndrome, medullary renal necrosis, glomerulonephritis and interstitial nephritis.

With caution, under medical supervision, meloxicam should be used in elderly patients who have an increased risk of impaired heart, liver and kidney function.

It is impossible to exceed the recommended maximum daily doses of Meloxicam-Teva with insufficient therapeutic effect. Also, the combined use of the drug with other NSAIDs is unacceptable, since this can lead to an increase in toxicity, while the therapeutic efficacy of using such a combination has not been proven. In cases where after several days of therapy there is no improvement in the patient's condition, the clinical benefit of treatment should be re-evaluated

Influence on the ability to drive vehicles and complex mechanisms

Patients who, during the period of use of Meloxicam-Teva, notice visual impairment, the appearance of drowsiness or other undesirable phenomena from the central nervous system, it is recommended to refrain from driving vehicles and performing potentially hazardous activities.

Application during pregnancy and lactation

Meloxicam-Teva is not prescribed during pregnancy / lactation.

Since meloxicam inhibits the synthesis of prostaglandin and cyclooxygenase, it may affect fertility. In this connection, the appointment of the drug to patients planning a pregnancy is not recommended. The drug can delay ovulation, therefore, in women who have problems with conception or undergoing examination for infertility, its use should be canceled.

It is known that the use of inhibitors of prostaglandin synthesis in the third trimester of pregnancy can lead to cardiopulmonary toxicity, impaired renal function with the subsequent occurrence of renal failure and a decrease in the amount of amniotic fluid, an increase in the duration of bleeding (the antiplatelet effect may be manifested when using Meloxicam-Teva in low doses), a decrease in the contractility of the uterus and, as a consequence, an increase in the time of labor.

Pediatric use

Meloxicam-Teva tablets are not prescribed for patients under 12 years of age. Solution for intramuscular injection is contraindicated in adolescents under 18 years of age.

With impaired renal function

use is contraindicated: progressive kidney disease, severe renal failure;
use requires caution: renal failure (creatinine clearance varies from 30 to 60 ml per minute).

For violations of liver function

The drug is contraindicated in severe hepatic impairment.

The solution for intramuscular administration is used with caution in case of liver dysfunction (the content of albumin in the blood serum does not exceed 25 g per 1 liter).

Use in the elderly

Elderly patients are prescribed Meloxicam-Teva with caution.

Drug interactions

Oral and parenteral administration of Meloxicam-Teva

Possible interactions of meloxicam with other drugs / substances:

other inhibitors of prostaglandin synthesis, including salicylates and glucocorticoids: due to the synergistic action, the likelihood of gastrointestinal ulcers and gastrointestinal bleeding increases. This combination is not recommended;
thrombolytic drugs, heparin for systemic use, anticoagulants for oral administration: the likelihood of bleeding increases. With the combined use of drugs, careful control over the blood coagulation system should be established;
lithium preparations: the level of lithium in the blood plasma increases due to a decrease in its excretion by the kidneys. The simultaneous use of such funds is not recommended. If the combined use of drugs is necessary, the concentration of lithium in the blood plasma should be carefully monitored throughout the course of the use of lithium preparations;
methotrexate: its secretion by the kidneys decreases, thereby increasing its content in plasma. The combined use of meloxicam and methotrexate (in a dose exceeding 15 mg in 7 days) is not recommended. With the combined use of drugs, renal function and blood count should be carefully monitored. The hematological toxicity of methotrexate can be increased by meloxicam, especially in the presence of impaired renal function. In cases of simultaneous use of drugs for 3 days, the likelihood of increased toxicity of methotrexate increases;
contraceptives: the effectiveness of intrauterine contraceptive devices may decrease, but the connection with the drug has not been proven;
diuretics: the use of the combination in patients with dehydration may be accompanied by the risk of acute renal failure;
antihypertensive drugs (diuretics, vasodilators, angiotensin-converting enzyme inhibitors, beta-blockers): by inhibiting prostaglandins, which have vasodilating properties, the hypotensive efficacy of these drugs decreases;
angiotensin-II receptor antagonists, angiotensin-converting enzyme inhibitors: the decrease in glomerular filtration increases, which can lead to acute renal failure, especially against the background of impaired renal function;
cyclosporine: its nephrotoxicity may increase due to the action of NSAIDs on renal prostaglandins. When carrying out combination therapy, renal function should be monitored, especially in elderly patients;
furosemide, digoxin, cimetidine, antacids: no significant pharmacokinetic interactions have been identified when used simultaneously with meloxicam.

Oral intake

Additionally, drug interactions are possible when taking Meloxicam-Teva tablets with the following drugs / substances:

serotonin reuptake inhibitors, antiplatelet agents: by inhibiting platelet function, the risk of bleeding increases. When prescribing this combination, careful control over the blood coagulation system must be established;
cholestyramine: binds meloxicam in the gastrointestinal tract and promotes its faster elimination.

With the combined appointment of meloxicam with pemetrexed in patients with creatinine clearance ranging from 45 to 79 ml per minute, the first should be discontinued 5 days before the second. The resumption of meloxicam administration is possible 14 days after the end of pemetrexed therapy. If the simultaneous use of drugs is necessary, careful monitoring of the patient should be established, especially with regard to myelosuppression and the development of adverse events from the gastrointestinal tract. In patients with creatinine clearance not exceeding 45 ml per minute, the use of this combination is not recommended.

If meloxicam is prescribed simultaneously with drugs that have a known ability to inhibit CYP2C9 and / or CYP3A4 enzymes (or metabolized with the participation of these enzymes), such as probenecid or sulfonylurea derivatives, the likelihood of a pharmacokinetic interaction should be taken into account. When used in combination with antidiabetic drugs for oral administration (for example, nateglinide, sulfonylurea derivatives), interactions mediated by CYP2C9 are possible, leading to an increase in blood concentrations of both these drugs and meloxicam. With the combined use of meloxicam with nateglinide or sulfonylurea preparations, the blood sugar level should be carefully monitored due to the possible appearance of hypoglycemia.

Parenteral administration

In addition, for a solution for intramuscular administration: the combined use of cholestyramine with meloxicam accelerates the excretion of the second. In this case, intestinal-hepatic circulation is disturbed. Thus, the clearance of meloxicam is increased by 50%, and the half-life is reduced to 13 ± 3 hours. This interaction has clinical significance.

Analogs

The analogues of Meloxicam-Teva are GenITRON, Artrozan, Mirloks, Meloxicam, Mataren, Liberum, B-ksikam, Meloxicam-SZ, Exsen-Sanovel, Flexibon, Revmart, Oksikamoks, etc.

Terms and conditions of storage

Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Meloxicam-Teva

According to reviews, Meloxicam-Teva in tablet form is a safe and fast-acting drug that effectively relieves pain and inflammation. Among the disadvantages, in most cases, the development of adverse events from the gastrointestinal tract is noted.

Reviews of Meloxicam-Teva solution for i / m administration are few. Among the advantages are the absence of pain during injections and the affordable cost of the drug. Short-term action and weak therapeutic effect of the drug are indicated as disadvantages.

Price for Meloxicam-Teva in pharmacies

The approximate price for Meloxicam-Teva in tablets is per package: 10 tablets of 15 mg each - from 166 to 180 rubles; 20 tablets of 15 mg - 274 rubles; 20 tablets of 7.5 mg - 189 rubles.

Meloxicam-Teva: prices in online pharmacies

Drug name

Price

Pharmacy

Meloxicam-Teva 15 mg tablets 10 pcs.

RUB 128

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Meloxicam-Teva 15mg tablets 10 pcs.

139 RUB

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Meloxicam-Teva 15 mg tablets 20 pcs.

RUB 150

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Meloxicam-Teva 7.5 mg tablets 20 pcs.

162 RUB

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Meloxicam-Teva 7,5mg tablets 20 pcs.

188 r

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Meloxicam-Teva 15mg tablets 20 pcs.

226 r

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Anna Kozlova Medical journalist About the author

Education: Rostov State Medical University, 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!