Revmoxicam 15 mg No. 10 tablets

Compound

The composition of Revmoxicam 7.5 tablets includes 7.5 mg of the active component meloxicam , as well as additional components: MCC, lactose monohydrate, sodium citrate, crospovidone, povidone, anhydrous colloidal silicon dioxide, magnesium stearate.
The composition of Revmoxicam 15 tablets includes 15 mg of the active component meloxicam , as well as additional components: MCC, lactose monohydrate, sodium citrate, crospovidone, povidone, anhydrous colloidal silicon dioxide, magnesium stearate.

The drug in the form of suppositories contains the active component meloxicam , as well as solid fat as an additional component.

Revmoxicam in ampoules contains the active substance meloxicam , as well as additional components: glycine, meglumine, glycofurol, poloxamer 188, sodium chloride, sodium hydroxide, water for injection.

Release form

The drug is produced in the form of tablets that contain 7.5 or 15 mg of the active ingredient, in the form of suppositories and a solution for injection.

• The tablets are flat, yellow, scored and chamfered. Marbling on the surface of the tablet is allowed. Packed in blisters of 10 pcs. 1 or 2 blisters are placed in a pack.
• Revmoxicam suppositories for rectal use are contained in a contour package of 5 pieces, the packaging is placed in a cardboard pack.
• The solution for injection is contained in ampoules of 1.5 mg, in a cardboard pack - 5 ampoules.

pharmachologic effect

The medicine belongs to the group of selective non-steroidal anti-inflammatory drugs. It contains the active component meloxicam.

There is a pronounced analgesic, anti-inflammatory, antipyretic activity of the drug. Its mechanism of influence is associated with the ability of the active component to inhibit the activity of cyclooxygenase-2 . As a consequence, there is a decrease in the synthesis of pro-inflammatory cytokines, which are mediators of inflammatory processes. The drug has virtually no effect on the activity of cyclooxygenase-1

After taking the drug, pain is eliminated, the severity of inflammatory processes in the body in diseases of the musculoskeletal system decreases. At the same time, the drug does not affect the activity of chondrocytes, in particular, the synthesis of proteoglycan .

Pharmacokinetics and pharmacodynamics

After oral administration, meloxicam is well absorbed from the gastrointestinal tract, its bioavailability level is 89%. Eating does not affect the absorption of the substance. On days 3-5 after the start of treatment, a stable concentration of the substance in the body is observed, regardless of what form of medication is being treated. 99% of meloxicam is bound to proteins in plasma; the concentration of meloxicam in synovial fluid is equal to 50% of its concentration in plasma.

In the liver, the substance is completely metabolized to inactive metabolites. The half-life is 20 hours. It is excreted approximately equally through the kidneys and intestines. Meloxicam is able to penetrate the hematoplacental and blood-brain barriers. There are no changes in the pharmacokinetics of the active component of Revmoxicam in people suffering from moderate or mild renal and liver dysfunction.

Pharmacological properties of the drug Revmoxicam

Meloxicam (4-hydroxy-2-methyl-N-(5-methyl-1,3-thiazol-2-yl)-2H-1,2-benzothiazine-3-carboxamide 1,1-dioxide) is an NSAID of the oxycam class. selective inhibitor of COX-2. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with a decrease in the biosynthesis of prostaglandins as a result of inhibition of the enzymatic activity of COX-2, which is involved in the synthesis of prostaglandins at the site of inflammation; has a slight effect on COX-1, which reduces the risk of side effects. Absorption of meloxicam from the digestive tract after oral or rectal administration is 89%. Eating does not affect the absorption of meloxicam. After intramuscular administration, Revmoxicam is quickly and completely absorbed. The maximum concentration in blood plasma is achieved 1 hour after administration of the drug. The concentration in blood plasma when administered in the dose range of 5–30 mg/day is dose-dependent. Equilibrium concentration is achieved on the 3rd–5th day from the start of treatment. In blood plasma, 99% of meloxicam is bound to proteins. The concentration of meloxicam in synovial fluid is 50% of the concentration in blood plasma. Meloxicam is almost completely metabolized to inactive metabolites in the liver. The half-life of meloxicam is 20 hours, plasma clearance is on average 8 ml/min. Meloxicam is excreted by the kidneys and through the intestines in approximately equal proportions. Mild to moderate hepatic and renal impairment do not significantly affect the pharmacokinetic parameters of meloxicam.

Indications for use

The product in the form of a solution, tablets and suppositories is used to eliminate pain in people who suffer from diseases of the musculoskeletal system of a degenerative-inflammatory nature.

Indicated for use with arthrosis , osteoarthritis . The drug is also prescribed as part of complex treatment for ankylosing spondylitis and rheumatoid arthritis .

Contraindications

The drug Revmoxicam is contraindicated for patients in the following cases:

• high sensitivity to drug components;
• impaired absorption of glucose-galactose, galactose intolerance, lactase deficiency (Revmoxicam tablets);
• stomach and duodenal ulcers;
• severe heart failure;
• severe kidney and liver diseases;
• rehabilitation period after undergoing coronary artery bypass surgery;
• the patient's tendency to bleed , recent cerebrovascular bleeding;
• diseases of the rectum (suppositories);
• pregnancy and breastfeeding;
• The patient's age is up to 15 years.

Revmoxicam injections cannot be administered intravenously.

The drug is prescribed with caution to people who suffer from liver cirrhosis , bronchial asthma , as well as people with dehydration , exhaustion, and elderly patients.

Care is taken to treat those who suffer from diseases of the digestive tract and patients receiving anticoagulants.

Special instructions for the use of the drug Revmoxicam

The drug is prescribed with caution to patients with a history of diseases of the digestive tract, asthma, dehydration, liver cirrhosis, congestive heart failure, the elderly, as well as patients receiving anticoagulants and antiplatelet agents. In patients with kidney disease, at the beginning of therapy with Revmoxicam, it is necessary to monitor the functional state of the kidneys. The solution for injection is not intended for intravenous administration. Meloxicam can cause sodium, potassium, and fluid retention, which increases the risk of progression of heart failure and hypertension (arterial hypertension). If undesirable effects from the central nervous system (drowsiness, dizziness) and visual organs occur during treatment, patients should stop driving vehicles and operating machinery.

Side effects

During treatment, patients may experience the following side effects:

• Digestive tract, liver: disturbances in the digestive process and stool, nausea, vomiting, bloating and abdominal pain, belching, increased activity of liver enzymes; isolated cases - erosive and ulcerative lesions of the gastrointestinal mucosa, bleeding, stomatitis , gastritis .
• Hematopoiesis, blood vessels and heart: swelling of the limbs and face, cardiac arrhythmias, hyperemia , hypertension , leukopenia , anemia , thrombocytopenia ; Heart failure may progress and hypertension may appear in people suffering from heart and vascular diseases.
• Nervous system: dizziness , headache, disturbed rhythm of wakefulness and sleep, emotional lability.
• Urinary system: acute renal failure, glomerulonephritis , interstitial nephritis , changes in creatinine and blood urea levels, nephrotic syndrome ; The manifestation of renal medullary necrosis was noted in isolated cases.
• Sense organs: blurred vision, tinnitus, conjunctivitis .
• Allergies: itching, rash, Stevens-Johnson syndrome , urticaria , bronchospasm , sensitivity to light; Anaphylactic shock may develop .
• Other manifestations: irritation, itching and burning in the anus (suppositories).

If during the use of any form of the drug any negative manifestations are noted, therapy is stopped and consultation with a specialist is sought.

Revmoxicam 15 mg No. 10 tablets

Revmoxicam 15 mg No. 10 tablets

Trade name Revmoxicam® International nonproprietary name Meloxicam Dosage form Tablets of 7.5 mg and 15 mg Composition One tablet contains the active substance - meloxicam 7.5 mg or 15 mg; excipients: lactose monohydrate, microcrystalline cellulose, sodium citrate, povidone, crospovidone, colloidal anhydrous silicon dioxide (aerosil), magnesium stearate. Description Tablets are yellow in color, with a flat surface, chamfered and scored. Marbling is allowed on the surface of the tablet (for dosages of 7.5 mg and 15 mg). Pharmacotherapeutic group Non-steroidal anti-inflammatory drugs. Oxycams. ATC code M01AC06 Pharmacological properties Pharmacokinetics Meloxicam after oral administration is well absorbed from the digestive tract. Bioavailability is 89%. A stable concentration is achieved on the 3rd – 5th day. Eating food does not affect the absorption of meloxicam. In plasma, 99% of meloxicam is bound to proteins. The concentration of meloxicam in synovial fluid is 50% of the concentration in blood plasma. Almost completely metabolized in the liver. Four different metabolites of meloxicam were identified in urine that had no pharmacological activity. The main metabolite 5-arboxymeloxicam (60% of the dose) is formed as a result of the oxidation of the intermediate metabolite 5-hydroxymeloxicam. It is excreted equally in feces and urine, mainly in the form of metabolites. The half-life of meloxicam is 20 hours. Plasma clearance averages 8 ml/min. Mild to moderate hepatic and renal impairment do not significantly affect the pharmacokinetic parameters of meloxicam.

Pharmacodynamics Revmoxicam® belongs to the non-steroidal anti-inflammatory drugs of the oxicam class and is a selective inhibitor of COX-2. It has anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is associated with inhibition of the synthesis of prostaglandins (known mediators of inflammation) due to inhibition of the enzymatic activity of COX-2 at the site of inflammation; has a slight effect on COX-1, which reduces the risk of side effects. Indications for use Symptomatic treatment of: - pain syndrome in osteoarthritis, arthrosis, degenerative joint diseases - rheumatoid arthritis - ankylosing spondylitis Method of administration and dosage Adults. Osteoarthritis: the daily dose is 7.5 mg, if necessary it is increased to 15 mg/day. Rheumatoid arthritis: the drug is prescribed at 15 mg/day; if a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day. Ankylosing spondylitis: the drug is prescribed at 15 mg/day; if a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day. In patients with an increased risk of adverse reactions, the initial therapeutic dose is 7.5 mg/day. In patients with severe renal failure on hemodialysis, the dose should not exceed 7.5 mg/day. It is necessary to use the lowest effective daily dose and the shortest duration of treatment, since the risk of adverse reactions increases with increasing dose and duration of treatment. The maximum recommended daily dose for children over 12 years of age is 0.25 mg/kg body weight. The maximum recommended daily dose of Revmoxicam® is 15 mg. Considering that the dose for children under 12 years of age has not been established, it is necessary to limit the use of the drug only to children over 12 years of age and adults. The tablet should be taken with food, not chewed, or washed down with water or other liquid. The duration of treatment is determined individually depending on the course of the disease and the effectiveness of the therapy. Adverse reactions Uncommon > 1%: - dyspepsia, nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea - anemia - itching, skin rash - headache - swelling Rarely 0.1% -1%: - transient changes in function indicators liver (for example, increased activity of transaminases or bilirubin), belching, esophagitis, gastroduodenal ulcer, hidden or obvious gastrointestinal bleeding - changes in the blood count, including changes in the leukocyte count, leukopenia and thrombocytopenia - stomatitis, urticaria - dizziness, tinnitus, drowsiness - increased blood pressure, palpitations, feeling of a rush of blood to the face - changes in kidney function indicators (increased levels of creatinine and/or urea in the blood serum). Very rarely - perforation of the gastrointestinal tract, colitis, hepatitis, gastritis. Gastrointestinal bleeding, erosive-ulcerative lesions and perforation of the gastrointestinal tract can potentially lead to life-threatening conditions - photosensitization. In rare cases, the development of bullous reactions, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis is possible - in predisposed patients after the appointment of NSAIDs, including Revmoxicam ® - acute development of bronchial asthma - confusion, disorientation, mood changes - acute renal failure. When using NSAIDs, interstitial nephritis, albuminuria and hematuria may occur, but the connection of these changes with the use of meloxicam has not yet been established - conjunctivitis, visual impairment, incl. blurred vision - angioedema and immediate hypersensitivity reactions, incl. anaphylactoid/anaphylactic reactions Contraindications - hypersensitivity to meloxicam and other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid - presence of symptoms (associated with the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (NSAIDs)): bronchial asthma, nasal polyps, history of angioedema or urticaria , since cross-hypersensitivity reactions are possible - gastrointestinal ulcers/perforations (active or recent onset) - active inflammatory bowel disease (Crohn's disease or ulcerative colitis) - severe liver failure - renal failure not subject to hemodialysis - any disorders with bleeding, manifest gastrointestinal bleeding, recent cerebrovascular bleeding - severe uncontrolled heart failure - children under 12 years of age - pregnancy and lactation - treatment to eliminate postoperative pain during coronary artery bypass grafting - congenital disorders in which inactive components of the drug may be harmful ( cm. Section “Peculiarities of Application”) Drug interactions Revmoxicam® together with other NSAIDs may increase the risk of ulcers of the gastrointestinal mucosa and gastrointestinal bleeding due to their synergy. Co-administration of Revmoxicam® and other NSAIDs is not recommended. Together with anticoagulants, antiplatelet agents, thrombolytic agents, heparin and selective serotonin reuptake inhibitors, Revmoxicam® increases the risk of bleeding due to inhibition of platelet function. If their simultaneous use cannot be avoided, the patient's condition must be monitored. Revmoxicam® can reduce the renal excretion of lithium, which leads to an increase in its concentration in the blood plasma to a toxic level. When used simultaneously with methotrexate, the negative effect on the hematopoietic system increases (the risk of developing anemia and leukopenia), so periodic monitoring of blood counts is necessary. There is evidence that the drug may reduce the effectiveness of intrauterine contraceptives, but this statement requires further research and confirmation. When used simultaneously with Revmoxicam® cholestyramine, the elimination of meloxicam is accelerated. Revmoxicam® may reduce the effectiveness of antihypertensive drugs (?-blockers, ACE inhibitors), which is associated with an inhibitory effect on vasodilatory prostaglandins. The risk of acute renal failure may occur with diuretics, so renal function should be monitored and adequate hydration should be maintained. NSAIDs and angiotensin II-converting receptor antagonists, as well as ACE inhibitors, have a synergistic effect on reducing glomerular filtration. In patients with existing renal impairment, this may lead to acute renal failure. NSAIDs, affecting renal prostaglandins, increase the nephrotoxicity of cyclosporine, which requires enhanced monitoring of renal function during simultaneous use of drugs. There may be a pharmacokinetic interaction between Revmoxicam® and other drugs at the metabolic stage due to their influence on SUR 2C9 and/or SUR 3A4. When taking Revmoxicam® simultaneously with antacids, cimetidine, digoxin and furosemide, no interactions were detected at the pharmacokinetic level. Interactions between the drug and oral antidiabetic agents cannot be excluded. Special instructions It is necessary to carefully monitor the condition of patients when using the drug (as well as other NSAIDs) in patients: - with gastrointestinal diseases and in case of simultaneous use of anticoagulants. It is forbidden to prescribe Revmoxicam® to patients with peptic ulcers or gastrointestinal bleeding. At any time during treatment, with or without previous symptoms or a history of serious gastrointestinal disease, potentially fatal gastrointestinal bleeding, ulceration, or perforation may occur. The most serious effects were observed in older people—those with cardiovascular disease or risk factors for developing such diseases. NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with increasing duration of treatment. NSAIDs may increase sodium, potassium and water retention and interfere with the natriuretic effects of diuretics. As a consequence, heart failure or hypertension may develop or worsen in predisposed patients. In such patients, clinical monitoring is recommended - with reduced renal blood flow, since the use of NSAIDs can cause renal failure (NSAIDs inhibit the synthesis of renal prostaglandin, which plays an important role in maintaining renal blood flow), which occurs when anti-inflammatory therapy with non-steroidal drugs is stopped. The greatest risk of such a reaction occurs in patients who are elderly, dehydrated, have chronic heart failure, liver cirrhosis, nephrotic syndrome, chronic kidney disease, who are receiving concomitant therapy with diuretics, ACE inhibitors or angiotensin II receptor antagonists, or after major surgery. interventions that led to hypovolemia. Such patients require monitoring of diuresis and renal function at the beginning of therapy. In isolated cases, NSAIDs can lead to interstitial nephritis, glomerulonephritis, renal medullary necrosis or the development of nephrotic syndromes. During treatment with NSAIDs, isolated cases of increased levels of transaminases or other indicators of liver function have been described, most of which were minor and temporary. If there is a persistent and significant deviation from the norm, treatment with Revmoxicam® should be stopped and control tests performed. In clinically stable patients with liver cirrhosis, it is not necessary to reduce the dose of Revmoxicam®. Weakened patients require more careful monitoring as their side effects are more severe. As with the treatment of other NSAIDs, they should be used with caution in elderly patients, who are more likely to have decreased renal, liver and cardiac function. Meloxicam, like any other NSAID, can mask the symptoms of an underlying infectious disease. The use of meloxicam, like other drugs that inhibit cyclooxygenase/prostaglandin synthesis, may affect fertilization and is therefore not recommended for use in women trying to become pregnant. Women who have difficulty fertilizing or who are undergoing evaluation for infertility should not take meloxicam. In very rare cases, serious skin reactions (some fatal) have been observed with the use of non-steroidal anti-inflammatory drugs, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis. A high risk of such reactions is observed at the beginning of treatment, and in most cases such reactions appeared during the first month of treatment. At the first appearance of skin rashes, lesions of the mucous membranes or other signs of hypersensitivity, you must stop using Revmoxicam®. Due to the possible occurrence of side effects localized to the skin and mucous membranes, special attention should be paid to the appearance of corresponding symptoms. If side effects occur, treatment with Revmoxicam® should be stopped. Revmoxicam® tablets (7.5 mg and 15 mg) contain lactose. When Revmoxicam® is administered at a dose of 7.5 mg, 92.34 mg of lactose enters the body and 122.70 mg of lactose enters the body with a dose of Revmoxicam® 15 mg. Therefore, this drug is not recommended for patients with congenital galactose intolerance, lactase deficiency or impaired absorption of glucose or galactose. Children Considering that the dose for children has not been established, the use of the drug should be limited only to children over 12 years of age and adults. The maximum recommended daily dose for children over 12 years of age is 0.25 mg/kg body weight. Features of the drug's effect on the ability to drive vehicles or operate potentially dangerous mechanisms There are no data regarding the effect of the drug on the ability to drive a car or operate other mechanisms. Patients who notice visual impairment, drowsiness or other disorders of the central nervous system are advised to refrain from driving vehicles and working with potentially dangerous mechanisms. Overdose In case of overdose, the described side effects may increase. Treatment: rinse the stomach, carry out symptomatic therapy. There are no specific antidotes or antagonists. Release form and packaging 10 tablets are placed in a blister pack made of polyvinyl chloride film and aluminum foil. 1 or 2 contour packages together with instructions for medical use in the state and Russian languages ​​are placed in a cardboard pack. Storage conditions Store in a place protected from light at a temperature not exceeding 25? C. Keep out of the reach of children! Shelf life: 2 years Do not use the drug after the expiration date. Conditions for dispensing from pharmacies By prescription

Instructions for use of Revmoxicam (Method and dosage)

Revmoxicam tablets, instructions for use

According to the instructions, the tablets should be swallowed whole, without crushing, with plenty of liquid. It is recommended to take the tablets during meals to reduce the likelihood of developing negative effects from the gastrointestinal tract. The doctor determines the dosage individually. As a rule, patients with osteoarthritis are prescribed 7.5 mg of the drug per day. If necessary, the dose is increased to 15 mg.

Patients with ankylosing spondylitis and rheumatoid arthritis are prescribed 15 mg of Rheumoxicam per day. After the effect of treatment has been achieved, the patient is advised to take a maintenance dose of 7.5 mg of the drug per day.

People who are at increased risk of experiencing negative effects are prescribed a dose of no more than 7.5 mg.

Revmoxicam injections, instructions for use

The solution is administered parenterally, intramuscularly. The solution should be injected deeply into the buttocks. The doctor determines how long the treatment lasts individually. As a rule, the use of 0.75-1.5 ml of the solution contained in ampoules is indicated per day. The injection is carried out once a day, it is recommended to do them no more than five days in a row. If necessary, other forms of medication are then used. The permissible dose per day is 15 mg of the drug.

Revmoxicam suppositories, instructions for use

The drug is used rectally in the form of suppositories. Before its introduction, all hygiene procedures must be carried out. The dosage and duration of treatment is determined by the doctor. As a rule, the use of 1 suppository once a day is indicated. The product should not be used for more than 7 days in a row. Suppositories in gynecology are used only as prescribed by a doctor and according to the scheme prescribed by the gynecologist.

Use of the drug Revmoxicam

Tablets For rheumatoid arthritis and ankylosing spondylitis, Rhevmoxicam is prescribed at a dose of 15 mg/day; if a positive therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day. For osteoarthritis, the daily dose is 7.5 mg, if necessary it is increased to 15 mg/day. Tablets are taken with meals once a day. Solution for injection Adults and children over 15 years of age are prescribed 0.75–1.5 ml (7.5–15 mg of meloxicam) 1 time per day intramuscularly (deeply). The dosage regimen is set individually, taking into account the intensity of the inflammatory process and the severity of the pain syndrome. The use of the injection form of the drug is possible only during the first 3–5 days of treatment, after which they switch to taking oral dosage forms of meloxicam. In persons with an increased risk of side effects, treatment should begin with a dose of 7.5 mg/day. When using Revmoxicam simultaneously with other dosage forms of meloxicam (tablets, capsules, oral suspension, suppositories), the total daily dose of meloxicam should not exceed 15 mg.

Overdose

If high doses of medication have been taken, a person may develop nausea, vomiting, abdominal pain, drowsiness , and lethargy . Also, when taking high doses of Revmoxicam, the likelihood of developing side effects increases and their intensity increases.

with meloxicam may occur , in which the patient's kidney and liver functions are impaired and arterial hypertension . Coma and cardiac arrest are possible .

There is no specific antidote. If an overdose occurs, lavage the stomach (in case of an overdose of tablets) or the rectum (in case of an overdose of suppositories). Symptomatic treatment is also carried out. In case of severe intoxication, the patient is hospitalized.

Side effects of the drug Revmoxicam

From the digestive system: dyspepsia, nausea, vomiting, abdominal pain, constipation, intestinal colic, diarrhea, esophagitis, stomatitis, rarely - erosive and ulcerative lesions of the gastrointestinal tract. From the side of the central nervous system: dizziness, headache, tinnitus, sleep disturbance, mood lability, irritability. From the cardiovascular system: increased blood pressure, palpitations, swelling, hot flashes. From the urinary system: changes in laboratory parameters of renal function (increased creatinine and/or serum urea). Blood disorders: anemia, leukopenia, thrombocytopenia, decreased hematocrit and hemoglobin level in the blood. Allergic reactions: bronchospasm, photosensitivity, itching, rash (urticaria) on the skin. Angioedema, immediate hypersensitivity reactions (injection solution). From the organs of vision: rarely - conjunctivitis, blurred vision (blurredness).

Interaction

When other drugs belonging to the group of non-narcotic analgesics are used simultaneously with Revmoxicam, the likelihood of developing gastrointestinal bleeding and ulcerative lesions increases.

Do not combine the medication with antiplatelet agents serotonin reuptake inhibitors , anticoagulants , thrombolytic drugs, heparin .

When taken concomitantly with diuretics in people with dehydration, the risk of acute renal failure increases. If this combination must be practiced, careful monitoring of renal function is necessary.

Revmoxicam reduces the effect of vasodilators, beta-blockers, diuretics, drugs that inhibit angiotensin-converting enzyme, and intrauterine contraceptives.

The medicine increases the hematotoxic effect of Methotrexate and the negative effect on the kidneys of Cyclosporine . With this combination, monitoring renal function and peripheral blood patterns is important.

The drug increases plasma lithium concentrations.

With the simultaneous use of Revmoxicam and Cholestyramine, the half-life of meloxicam is reduced.

The effectiveness of insulin and oral hypoglycemic drugs may be altered when taken concomitantly. When prescribing this medicine to patients with diabetes mellitus, glucose levels need to be monitored and, if necessary, dose adjustment of hypoglycemic drugs.

Do not mix the injection solution in the same syringe with other medications.

Drug interactions Revmoxicam

Revmoxicam enhances the effect of indirect anticoagulants; when used together and parenteral administration of heparin or ticlopidine, the risk of ulcerogenic effects and the development of gastrointestinal bleeding increases. Meloxicam may reduce the renal excretion of lithium, resulting in an increase in its plasma concentration to a toxic level; may reduce the effectiveness of contraception when using intrauterine contraceptives. With the simultaneous use of Revmoxicam and drugs that inhibit leukopoiesis (methotrexate), the risk of pancytopenia increases. When used simultaneously with Revmoxicam, cholestyramine accelerates the elimination of meloxicam. Meloxicam may reduce the effectiveness of antihypertensive drugs (beta-adrenergic blockers, ACE inhibitors). Meloxicam increases the nephrotoxicity of cyclosporine, so liver function should be monitored during concomitant use. Cholestyramine accelerates the elimination of meloxicam. Pharmacological interaction of meloxicam with oral hypoglycemic drugs is possible. The injection solution should not be mixed in the same syringe with other drugs. When using the injectable form of the drug and diuretics, the risk of developing acute renal failure in patients with dehydration increases, so it is necessary that patients take a sufficient amount of fluid.

special instructions

It should be taken into account that when using the product by patients with gastrointestinal diseases, there is an increased risk of bleeding and ulcerative lesions. Careful monitoring is especially important when treating older people. The risk increases with prolonged treatment.

It should be noted that meloxicam can mask the signs of the underlying disease.

Treatment with meloxicam, as with other drugs that inhibit cyclooxygenase / prostaglandin , may affect fertility. Therefore, women planning pregnancy are not recommended to take this remedy.

There have been very rare cases where serious skin reactions were observed during treatment with non-steroidal anti-inflammatory drugs. If side effects related to the skin develop, you should stop taking the product.

Please note that the product in tablet form contains lactose .

Revmoxicam suppositories in gynecology are used only on the recommendation of a gynecologist and under his supervision.

There was no effect on a person's ability to concentrate when taking the medication. However, for those patients who experience blurred vision or a feeling of drowsiness, it is better to avoid potentially hazardous activities for the period of treatment.

Pharmacological group

Non-steroidal anti-inflammatory drugs.

Pharmacological properties

Pharmacodynamics.

Revmoxicam ® is a non-steroidal anti-inflammatory drug (NSAID) of the enolic acid class, which has anti-inflammatory, analgesic and antipyretic effects.

Meloxicam showed 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 development mechanism for all NSAIDs (including meloxicam): inhibition of the biosynthesis of prostaglandins, which are mediators of inflammation.

Pharmacokinetics.

Absorption. Meloxicam is well absorbed from the gastrointestinal tract when administered orally, the bioavailability of the drug is 90%. After a single use of meloxicam, the maximum concentration in the blood plasma is achieved within 5-6 hours.

With repeated dosing, stable concentrations are achieved on the 3rd-5th day. Dosing 1 time per day leads to an average plasma concentration with relatively small peak fluctuations ranging from 0.4-1 μg / ml for 7.5 mg and 0 .8-2 mcg/ml for 15 mg, respectively (C min and C max at steady state, respectively). Average plasma concentrations of meloxicam at steady state are achieved within 5-6 hours.

Simultaneous ingestion of food or use of inorganic antacids does not affect the absorption of the drug.

Distribution. Meloxicam binds to plasma proteins, mainly albumin (99%). Meloxicam penetrates into the synovial fluid, the concentration of which is half that of blood plasma. The volume of distribution is low, averaging 11 L after intramuscular or intravenous administration, and shows individual variations ranging from 7-20%. The volume of distribution after multiple oral doses of meloxicam (7.5 to 15 mg) is 16 L, with a variation coefficient ranging from 11% to 32%.

Metabolism. Meloxicam undergoes extensive biotransformation in the liver.

Four different meloxicam metabolites have been identified in urine and are pharmacodynamically inactive. The main metabolite 5′-carboxymeloxicam (60% of the dose) is formed by oxidation of the intermediate metabolite 5′-hydroxymethylmeloxicam, and is also released to a lesser extent (9% of the dose). In vitro studies suggest that CYP2C9 plays an important role in metabolism, while CYP3A4 isoenzymes contribute to a lesser extent. Peroxidase activity in patients may be responsible for two other metabolites, which account for 16% and 4% of the prescribed dose, respectively.

Excretion. Excretion of meloxicam occurs mainly in the form of metabolites in equal parts with urine and feces. Less than 5% of the daily dose is excreted unchanged in the feces, a small amount is excreted in the urine. The half-life varies from 13 to 25 hours after dosing, intramuscular and intravenous use. Clearance is approximately 7-12 ml/min after a single dose, intravenous or rectal use.

Dose linearity. Meloxicam exhibits linear pharmacokinetics within the therapeutic dose range from 7.5 mg to 15 mg after administration and intramuscular administration.

Special groups of patients.

Patients with liver/renal failure. Mild to moderate hepatic and renal impairment do not significantly affect the pharmacokinetics of meloxicam. Patients with moderate renal impairment had a significantly higher total clearance. Reduced binding to plasma proteins was observed in patients with end-stage renal failure. In end-stage renal failure, an increase in the volume of distribution may lead to an increase in the concentration of free meloxicam. The daily dose should not exceed 7.5 mg (see Section "Dosage and Administration").

Elderly patients. In elderly male patients, mean pharmacokinetic parameters are similar to those in young male volunteers. In elderly female patients, the AUC value is higher and the half-life is longer compared with those in young volunteers of both sexes. The average plasma clearance at steady state in elderly patients was slightly lower than in young volunteers.

Indications

Short-term symptomatic treatment of exacerbation of osteoarthritis.

Long-term symptomatic treatment of rheumatoid arthritis and ankylosing spondylitis.

Contraindications

• Hypersensitivity to meloxicam or other components of the drug, or to active substances with similar effects, such as NSAIDs, aspirin. Meloxicam should not be prescribed to patients who have experienced asthma symptoms, nasal polyps, angioedema or urticaria after taking aspirin or other NSAIDs;
• history of gastrointestinal bleeding or perforation associated with previous NSAID therapy
• history of active or recurrent ulceration/bleeding (two or more separate documented episodes of ulceration or bleeding)
• severe liver failure
• severe renal failure without dialysis;
• gastrointestinal bleeding, history of cerebrovascular hemorrhage or other bleeding disorders;
• severe heart failure
• PERIOPERATIVE pain during coronary artery bypass grafting (CABG).

Interaction with other drugs

Pharmacodynamic interactions.

Other non-steroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid ≥ 3 g/dose. Combination with other NSAIDs is not recommended (see section “Peculiarities of use”), including acetylsalicylic acid in anti-inflammatory doses (≥ 1 g single dose or ≥ 3 g total daily dose).

Corticosteroids (eg glucocorticoids). Concomitant use with corticosteroids requires caution due to an increased risk of bleeding or ulceration in the gastrointestinal tract.

Anticoagulants or heparin, which is used in geriatric practice or in therapeutic doses. The risk of bleeding increases significantly due to inhibition of platelet function and damage to the gastroduodenal mucosa. NSAIDs may enhance the effects of anticoagulants such as warfarin (see section "Peculiarities of use"). The simultaneous use of NSAIDs and anticoagulants or heparin in geriatric practice or in therapeutic doses is not recommended (see Section "Peculiarities of use").

In other cases of heparin use, caution is required due to the increased risk of bleeding. Careful monitoring of the INR (international normalized ratio) is necessary if it is proven that this combination cannot be avoided.

Thrombolytic and antiplatelet drugs. Increased risk of bleeding due to inhibition of platelet function and damage to the gastroduodenal mucosa.

Selective serotonin reuptake inhibitors (SSRIs). Increased risk of gastrointestinal bleeding.

Diuretics, ACE inhibitors and angiotensin II antagonists. NSAIDs may reduce the effect of diuretics and other antihypertensive drugs. In some patients with impaired renal function (dehydrated patients or elderly patients with impaired renal function), concomitant use of ACE inhibitors or angiotensin II antagonists and drugs that inhibit COX may lead to a further deterioration of renal function, including possible acute renal failure, which is usually reversible. Therefore, the combination should be used with caution, especially in elderly patients. Patients should receive an adequate amount of fluid, and renal function should be monitored after starting joint therapy and periodically thereafter (see Section "Peculiarities of Application").

Other antihypertensive drugs (for example, beta-blockers). The antihypertensive effect of beta-blockers may be reduced (due to inhibition of prostaglandins with a vasodilatory effect).

Calcineurin inhibitors (eg cyclosporine, tacrolimus). The nephrotoxicity of calcineurin inhibitors may be enhanced by NSAIDs due to mediation of the effects of renal prostaglandins. During treatment, renal function should be monitored. Careful monitoring of renal function is recommended, especially in elderly patients.

Intrauterine contraceptives. NSAIDs reduce the effectiveness of intrauterine contraceptives. A reduction in the effectiveness of intrauterine contraceptive devices 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 drugs.

Lithium. There is evidence that NSAIDs increase plasma lithium concentrations (due to decreased renal excretion of lithium), which can reach toxic levels. The simultaneous use of lithium and NSAIDs is not recommended (see Section "Peculiarities of use"). If combination therapy is necessary, plasma lithium levels should be carefully monitored during treatment initiation, dose adjustment, and discontinuation of meloxicam treatment.

Methotrexate. NSAIDs may decrease tubular secretion of methotrexate, thereby increasing plasma concentrations. For this reason, it is not recommended to use NSAIDs concomitantly in patients taking a high dose of methotrexate (more than 15 mg/week) (see section "Peculiarities of use"). The risk of interaction between NSAIDs and methotrexate should also be considered in patients receiving a low dose of methotrexate, in particular

patients with impaired renal function. If combined treatment is needed, it is necessary to monitor blood counts and kidney function. Caution should be used when taking NSAIDs and methotrexate for 3 consecutive days, as plasma levels of methotrexate may increase and increase toxicity. Although the pharmacokinetics of methotrexate (15 mg/week) were not influenced by concomitant treatment with meloxicam, it should be considered that the hematological toxicity of methotrexate may be increased with treatment with NSAIDs (see information above) (see section "Adverse reactions").

Pharmacokinetic interaction: the influence of other drugs on the pharmacokinetics of meloxicam.

Cholestyramine. Cholestyramine accelerates the elimination of meloxicam due to impaired intrahepatic circulation, so the clearance of meloxicam increases by 50% and the half-life decreases to 13 ± 3:00. This interaction is clinically significant.

No clinically significant pharmacokinetic interaction was detected when taken simultaneously with antacids, cimetidine and digoxin.

Features of application

Adverse reactions can be minimized by using the lowest effective dose for the shortest treatment duration necessary to control symptoms (see Dosage and Administration section and information on gastrointestinal and cardiovascular risks below).

The recommended maximum daily dose should not be exceeded in case of insufficient therapeutic effect, and additional NSAIDs should not be used, as this may increase toxicity, while therapeutic benefits have not been proven. The simultaneous use of meloxicam with NSAIDs, including selective COX-2 inhibitors, should be avoided.

Meloxicam is not suitable for the treatment of patients requiring relief of acute pain.

If there is no improvement after several days, the clinical benefits of treatment should be re-evaluated.

Attention should be paid to a history of esophagitis, gastritis and/or peptic ulcers to ensure complete cure before initiating meloxicam therapy. Regular attention should be paid to the possibility 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 doses of NSAIDs in patients with a history of ulcers, especially those complicated by bleeding or perforation (see section "Contraindications"), and in elderly patients. These patients should be started on the lowest effective dose. For such patients, combination therapy with protective drugs (such as misoprostol or proton pump inhibitors) should be considered, as well as for patients requiring concomitant use of low-dose aspirin or other drugs that increase gastrointestinal risks (see information below). and section “Interaction with other drugs and other types of interactions”).

In patients with a history of gastrointestinal toxicity, especially elderly patients, any unusual abdominal symptoms (especially gastrointestinal bleeding) should be reported, primarily during the initial stages of treatment.

Caution should be exercised in patients concomitantly taking medications that may increase the risk of ulceration or bleeding, in particular heparin as definitive therapy or in geriatric practice, anticoagulants such as warfarin or other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid at anti-inflammatory doses ( ≥ 1 g single dose or ≥ 3 g total daily dose) (see section “Interaction with other medicinal products and other types of interactions”).

If gastrointestinal bleeding or ulcers occur in patients using meloxicam, treatment with the drug should be discontinued.

NSAIDs should be used with caution in patients with a history of gastrointestinal diseases (ulcerative colitis, Crohn's disease), since these conditions may be exacerbated (see section "Adverse Reactions").

From the side of the liver.

Up to 15% of patients taking NSAIDs (including Revmoxicam®) may have an increase in one or more liver tests. Such laboratory abnormalities may progress, may remain unchanged, or may be temporary with continued treatment. Marked increases in ALT or AST (approximately three or more times normal) were observed in 1% of patients during clinical trials with NSAIDs. Additionally, rare cases of severe hepatic reactions, including jaundice and fulminant fatal hepatitis, liver necrosis and liver failure, some of them fatal, have been reported.

Patients with symptoms or suspicion of hepatic dysfunction or who have had abnormal liver tests should be assessed for the development of symptoms of more severe liver failure during therapy with Revmoxicam ® . If clinical signs and symptoms are consistent with the development of liver disease or if systemic manifestations of the disease are observed (for example, eosinophilia, rash, etc.), then the use of meloxicam should be discontinued.

Cardiovascular disorders.

In patients with hypertension and/or a history of mild to moderate congestive heart failure, close monitoring is recommended as fluid retention and edema have been observed with NSAID therapy.

In patients with risk factors, clinical monitoring of blood pressure is recommended at the beginning of therapy, especially at the beginning of treatment with meloxicam.

The use of some NSAIDs (especially at high doses and during long-term treatment) may be associated with a small increase in the risk of vascular thrombotic events (eg myocardial infarction or stroke). There is insufficient data to exclude such a 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 evaluation. Such an analysis is necessary at the beginning of long-term treatment of patients with risk factors for cardiovascular diseases (such as arterial hypertension, hyperlipidemia, diabetes mellitus, smoking).

NSAIDs may increase the risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. The increased risk is associated with prolonged use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at increased risk.

From the skin side.

Serious skin reactions, some fatal, have been observed with the use of NSAIDs, including exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis (see Adverse Reactions section). The highest risk of such reactions was observed at the beginning of treatment, with most cases occurring within the first month of treatment. At the first appearance of skin rashes, lesions of the mucous membranes or other signs of hypersensitivity, the use of meloxicam should be discontinued.

Anaphylactic reactions.

As with other NSAIDs, anaphylactic reactions may occur in patients without a known reaction to Revmoxicam ® . Revmoxicam ® should not be used in patients with the aspirin triad. This symptom complex occurs in patients with asthma who have reported rhinitis with or without nasal polyps or who have experienced severe, potentially fatal bronchospasm after use of aspirin or other NSAIDs. If an anaphylactoid reaction is detected, emergency measures should be taken.

Liver parameters and kidney function.

As with the treatment of most NSAIDs, isolated cases of increased levels of transaminases, bilirubin in the blood serum or other parameters of liver function have been described, an increase in serum creatinine and blood urea nitrogen and other laboratory abnormalities are possible. In most cases, these deviations were minor and temporary. If significant or persistent confirmation of such deviations occurs, the use of meloxicam should be discontinued and control tests should be performed.

Functional renal failure.

NSAIDs, by inhibiting the vasodilatory effects 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, monitoring of diuresis and renal function is recommended in patients with the following risk factors:

• elderly age;
• simultaneous use with ACE inhibitors, angiotensin II antagonists, Sartan, diuretics (see section “Interaction with other drugs and other types of interactions”);
• hypovolemia (of any origin);
• congestive heart failure
• renal failure
• nephrotic syndrome
• lupus nephropathy;
• severe liver dysfunction (serum albumin

In rare cases, NSAIDs may lead to interstitial nephritis, glomerulonephritis, renal medullary necrosis, or nephrotic syndrome.

The dose of meloxicam for patients with end-stage renal failure on dialysis should not exceed 7.5 mg. In patients with mild to moderate renal insufficiency, the dose may not be reduced (creatinine clearance level 25 ml/min).

Retention of sodium, potassium and water.

NSAIDs may increase sodium, potassium and water retention and affect the natriuretic effect of diuretics. In addition, a decrease in the antihypertensive effect of antihypertensive drugs may be observed (see Section “Interaction with other drugs and other types of interactions”). Because the result in sensitive patients may be accelerated or worsened by edema, heart failure or arterial hypertension. Therefore, clinical monitoring is recommended for patients with such risks (see Section “Dosage and Administration” and “Contraindications”).

Hyperkalemia.

Hyperkalemia may be promoted by diabetes mellitus or concomitant use of drugs that increase kalemia (see Section "Interaction with other drugs and other types of interactions"). In such cases, potassium levels should be monitored regularly.

Other warnings and safety precautions.

Adverse reactions are often less well tolerated by elderly, frail or debilitated patients who require careful monitoring. As with other NSAIDs, caution should be exercised in the elderly, who are more likely to have decreased renal, hepatic and cardiac function. Elderly patients have a high incidence of adverse reactions to NSAIDs, especially gastrointestinal bleeding and perforation, which can be fatal (see section "Dosage and Administration").

Meloxicam, like any other NSAID, can mask the symptoms of infectious diseases.

The use of meloxicam may negatively affect reproductive function and is not recommended for women who want to become pregnant. Therefore, for women planning pregnancy or undergoing evaluation for infertility, discontinuation of meloxicam should be considered (see section "Use during pregnancy or lactation").

Revmoxicam ® 7.5 mg and 15 mg tablets contain lactose, so the drug is not recommended for patients with rare congenital galactose intolerance, lactase deficiency or impaired absorption of glucose or galactose.

Masking inflammation and fever.

The pharmacological effects of meloxicam ® in reducing fever and inflammation may complicate the diagnosis of a suspected non-infectious pain condition.

Directions for use and doses

Apply orally.

The daily amount of the drug should be taken once, with water or other liquid, during meals.

Adverse reactions can be minimized by using the lowest effective dose for the shortest duration of treatment necessary to control symptoms (see section "Peculiarities of use"). The patient's need for symptomatic relief and response to treatment should be periodically assessed.

Exacerbation of osteoarthritis: 7.5 mg/day. If necessary, the dose can be increased to 15 mg/day.

Rheumatoid arthritis, ankylosing spondylitis: 15 mg/day.

See the “Special Patient Categories” section below.

According to the therapeutic effect, the dose can be reduced to 7.5 mg/day.

Do NOT exceed the dose of 15 mg/day.

Special categories of patients.

Elderly patients and patients at 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 adverse reactions should start with a dose of 7.5 mg / day (see section "Peculiarities of application")

Kidney failure.

In patients with severe renal failure on dialysis, the dose should not exceed 7.5 mg/day. Patients with mild to moderate renal failure (namely, patients with a creatinine clearance of 25 ml/min) do not require a dose reduction (for patients with severe renal failure without dialysis, see section “Contraindications”).

Liver failure.

Patients with mild to moderate hepatic impairment do not require a dose reduction (for patients with severe hepatic impairment, see section "Contraindications").

Children

Revmoxicam ® , tablets 7.5 mg and 15 mg, are contraindicated in children under 16 years of age.

Overdose

Symptoms of acute NSAID overdose are usually limited to lethargy, somnolence, nausea, vomiting and epigastric pain, which are generally reversible with maintenance therapy. Gastrointestinal bleeding may occur. Severe poisoning can lead to hypertension, acute renal failure, liver dysfunction, respiratory depression, coma, seizures, cardiovascular failure and cardiac arrest. Anaphylactoid reactions have been reported with therapeutic use of NSAIDs and may also occur in overdose.

In case of NSAID overdose, symptomatic and supportive measures are recommended for patients. Studies have shown accelerated elimination of meloxicam by administering four oral doses of cholestyramine 3 times daily.

Adverse reactions

The use of some NSAIDs (especially in high doses and in long-term treatment) may be associated with a small increased risk of vascular thrombotic events (for example, myocardial infarction or stroke) (see section "Peculiarities of use").

Edema, hypertension, and heart failure have been observed with NSAID treatment.

From the blood and lymphatic system: anemia, deviations of blood test parameters from the norm (including changes in the number of leukocytes), leukopenia, thrombocytopenia.

Cases of agranulocytosis have been very rarely reported in patients treated with meloxicam and other potentially myelotoxic drugs (see Section "Interactions with other drugs and other types of interactions").

From the immune system: allergic reactions, anaphylactic and/or anaphylactoid reactions, including shock.

Mental disorders: mood changes, nightmares, confusion, disorientation, insomnia.

From the nervous system: headache, dizziness, drowsiness.

On the part of the organ of vision: visual impairment, including blurred vision, conjunctivitis.

On the part of the hearing and vestibular apparatus: dizziness, ringing in the ears.

Cardiac disorders: heart failure Heart failure associated with NSAID treatment has been reported.

Vascular disorders: increased blood pressure, hot flashes.

From the respiratory system, chest and mediastinal organs: asthma in patients allergic to aspirin and other NSAIDs, upper respiratory tract infections, cough.

From the digestive tract: dyspepsia, nausea, vomiting, incl. vomiting blood, abdominal pain, constipation, flatulence, diarrhea, hidden or macroscopic gastrointestinal bleeding, stomatitis, incl. ulcerative stomatitis, gastritis, belching, colitis, gastroduodenal ulcer, esophagitis, gastrointestinal perforation, ground, exacerbation of colitis and Crohn's disease.

Gastrointestinal bleeding, ulceration, or perforation may be severe and potentially fatal, especially in elderly patients (see Precautions).

From the digestive system: impaired liver function indicators (for example, increased transaminases or bilirubin), hepatitis, jaundice, liver failure.

From the skin and subcutaneous tissue: angioedema, itching, rash, Stevens-Johnson syndrome, toxic epidermal necrolysis, urticaria, bullous dermatitis, erythema multiforme, photosensitivity, exfoliative dermatitis.

From the urinary system: sodium and water retention, hyperkalemia (see Sections “Peculiarities of application” and “Interaction with other drugs and other types of interactions”), changes in renal function indicators (increased creatinine and / or serum urea), acute renal insufficiency, in particular in patients with risk factors (see section “Peculiarities of use”), urinary tract infections, impaired frequency of urination.

General and administration site disorders: swelling, including swelling of the lower extremities, flu-like symptoms.

From the musculoskeletal system: arthralgia, back pain, signs and symptoms related to joints.

Adverse reactions were not observed during use of the drug, but which are generally characteristic of other compounds of the class.

Organic renal damage, which probably leads to acute renal failure. Very rarely, cases of interstitial nephritis, acute tubular necrosis, nephrotic syndrome and papillary necrosis have been reported (see section "Peculiarities of application").

Best before date

3 years.

Do not use after the expiration date stated on the packaging.

Storage conditions

Store in original packaging at a temperature not exceeding 25 ° C.

Keep out of the reach of children.
Attention! The description of the drug on this page is simplified. Before purchasing and using the drug, consult your doctor or pharmacist, and also read the instructions approved by the manufacturer. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. ATTENTION! This section is provided for informational purposes only and is not a catalog or price list of our company. To obtain information about the availability of drugs, call + 99871 202 0999 Pharmacy Network Helpline 999.

Analogs

Level 4 ATX code matches:
Mirlox

Xefocam Rapid

Xefocam

Movalis

Mesipol

Lem

Melbek

Movasin

Piroxicam

Lornoxicam

Arthrozan

Texamen

Amelotex

Meloxicam

Analogues of Revmoxicam are drugs with the same active ingredient: Meloxicam , Movalgin , Movalis , Meloxicam-KV , Melox .

It is important to consult with your doctor before replacing the drug with an analogue.

Reviews about Revmoxicam

Those users who write reviews on any thematic forum note that tablets, injections, and suppositories are effective means for relieving pain in osteoarthritis and other diseases of the musculoskeletal system. Some patients write about side effects - high blood pressure, drowsiness, abdominal pain.

There are also negative opinions from those for whom the drug did not help reduce negative manifestations. Reviews of Revmoxicam suppositories in gynecology indicate that the medicine is effective in inflammatory processes of the female genitourinary organs, but it can only be used after being prescribed by a specialist.

Revmoxicam price, where to buy

You can buy the drug in tablets in Ukraine (Kyiv, Kharkov, etc.) for an average price of 50 UAH. per pack 10 pcs. The price of Revmoxicam injections is on average 100 UAH. for 5 ampoules. The price of candles is 46 UAH. for 5 pcs.

• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

Pharmacy24

• Revmoxicam 1% 1.5 ml No. 5 solution for injection
  111 UAH. order
• Revmoxicam 15 mg No. 10 tablets PAT "Farmak", Ukraine

  65 UAH order

• Revmoxicam 7.5 mg No. 20 tablets PAT "Farmak", Ukraine

  76 UAH order

• Revmoxicam 1% 1.5 ml No. 3 injection solution PAT "Farmak", Ukraine

  71 UAH order

• Revmoxicam 15 mg N20 tablets PAT "Farmak", Ukraine

  112 UAH order

PaniPharmacy

• Revmoxicam tablets Revmoxicam tablets. 7.5 mg No. 20 Ukraine, Farmak OJSC

  90 UAH order

• Revmoxicam ampoule Revmoxicam injection solution 1% No. 3 Ukraine, Farmak OJSC

  88 UAH order

• Revmoxicam ampoule Revmoxicam injection solution 1% ampoule 1.5 ml No. 5 Ukraine, Farmak OJSC

  122 UAH order

• Revmoxicam suppository Revmoxicam rectal suppositories 0.015g No. 5 Ukraine, Lekhim-Kharkov JSC

  70 UAH order

• Revmoxicam tablets Revmoxicam tablets. 15 mg No. 10 Ukraine, Farmak OJSC

  81 UAH order

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