Movalis tablets and injections: instructions for use. Non-steroidal anti-inflammatory tablets Movalis: instructions for use, price, reviews, analogues and daily dosage

Selective anti-inflammatory agent. Cups pathological process directly at the site of inflammation and causes less side effects than other NSAID drugs. It is used as a means of symptomatic therapy, mainly for rheumatological diseases. Contraindicated in patients under 18 years of age.

Dosage form

The medicine Movalis is a product of the pharmaceutical company Boehringer Ingelheim (Austria). Available in several dosage forms:

• Tablets 7.5 mg and 15 mg.
• Rectal suppositories 7.5 mg and 15 mg.
• Injections for injections in 1.5 ml ampoules.
• Suspension for oral administration.

Choice dosage form It always remains with the attending physician, who will be able to select the dose of medication depending on the severity of the disease, diagnosis, and characteristics of the patient’s body.

Description and composition

Movalis is a non-steroidal anti-inflammatory drug based on. The drug is often used in the treatment of degenerative diseases affecting the musculoskeletal system. motor system person. The main principle of action of the drug is to relieve pain, reduce inflammatory process. Movalis is a drug from the group of phenolic acids. The medicine is often used in the treatment of diseases such as rheumatoid arthritis, osteoarthritis, osteochondrosis and others. Based on the reviews left on various forums, we can conclude that Movalis is one of effective drugs, but at the same time it has many contraindications, so it must be used correctly and only as prescribed by a doctor.

Pharmacological group

Movalis from the group of non-steroidal anti-inflammatory drugs has pronounced anti-inflammatory, analgesic and antipyretic properties. Often used to treat diseases of inflammatory origin. The properties of the drug are determined by its composition, which contains. This component reacts with prostaglandins, thereby eliminating pain and inflammation.

Movalis belongs to a new generation of drugs, has a smaller list of contraindications, but is not inferior in effectiveness to its analogues. The advantage of the drug is that this drug belongs to COX-2 inhibitors, which allows it not to have any negative impact on the body, act only in the area of ​​inflammation. Unlike others similar drugs From the group of non-steroids, Movalis inhibits platelet aggregation.

The bioavailability of the drug, regardless of the release form, is practically the same, but the most quick effect from the drug can be obtained by using ampoules for intravenous or intramuscular administration. The process of drug metabolism occurs in the liver. The drug is removed from the body 20 hours after use.

Indications for use

The medicine Movalis can be used for almost all diseases of the musculoskeletal system - musculoskeletal system which are accompanied by pain and an inflammatory reaction.

For adults

The main indications for prescribing the drug may be the following diseases:

• osteoarthritis;
• osteochondrosis of the cervical, thoracic or lumbar region spine;
• Bekhterev's disease;
• rheumatoid arthritis.

Other diseases with severe pain syndrome may also be indications for the use of the drug.

For children

Movalis is contraindicated in children under 14 years of age, therefore there is no information about the indications, as well as the doses of the drug in the instructions.

During pregnancy, Movalis in any form or dose is contraindicated. Moreover, reception this tool can provoke pathologies in fetal development, provoke miscarriage early stages or premature birth in the later trimesters.

Contraindications

Movalis is a potent drug, so it has enough wide list contraindications.

1. heart failure;
2. bronchial asthma;
3. intolerance to the composition;
4. ulcerative intestinal lesions;
5. age up to 14 and after 80 years;
6. pregnancy period.

Applications and dosages

The drug Movalis can be prescribed only to adults and only to those who have no contraindications to it. IN acute period illness, the doctor may prescribe injections with the drug, a course of 3–4 days. When the pain decreases, the patient can switch to tablets or rectal suppositories.

After intramuscular or intravenous injection, the effect of the drug is observed after 30 minutes and lasts for 6 hours. Regardless of the diagnosis, stage of the disease and symptoms, the daily dose of the drug should not exceed 7.5 - 15 mg.

For adults

The dosage of the drug is determined by the doctor individually for each patient.

• Injection ampoules are prescribed only once a day at a dose of 7.5 or 15 mg. The dose is determined by the attending physician. Duration of administration is 2–3 days, then the patient is transferred to tablets or suppositories.
• Movalis tablets can be used 2 times a day, 7.5 or 15 mg.
• Suppositories of the drug are administered into the rectum before bedtime 1 time per day.

Average treatment course is 10 – 28 days.

For children

For pregnant women and during lactation

During pregnancy, as well as during lactation, the drug cannot be used.

Side effects

Movalis has enough big list contraindications, but all of them are too rare and only if the recommended doses of the drug are not observed or there is a history of contraindications. In practice, the most common side effects are:

• heart rhythm disturbance;
• headache;
• nausea, ;
• skin rash;
• blood pressure surges;
• swelling of the limbs.

Patient complaints about such symptoms are a reason to discontinue the drug or reduce the dose of the drug.

Interaction with other drugs

Taking Movalis together with other drugs may cause unwanted reaction body, so if the patient is taking any other medications, the doctor should be informed about this.

Taking diuretics and Movalis increases the risk of developing kidney failure or dehydration.

special instructions

• Persons with a history of serious illnesses Gastrointestinal tract, kidneys, liver or heart, can take the drug in minimal dosages and only under the supervision of medical specialists.
• At long-term use of the drug, you need to monitor your kidney and liver function, take lab tests urine and blood.

Analogs

The following medications can be used instead of Movalis:

1. is a complete analogue of the drug Movalis. In the pharmacy the drug comes in injections, tablets and suppositories. It can be prescribed to patients over 15 years of age. Contraindicated in pregnant and breastfeeding women, as well as in patients planning to conceive.
2. Artrum belongs to non-steroidal anti-inflammatory drugs. As active ingredient the drug contains. It is commercially available in long-acting tablets, gel, suppositories, and injection solution. The medication is taken for pathologies of the musculoskeletal system of an inflammatory and degenerative nature, to relieve pain of various origins. Artrum can be prescribed to patients over 15 years of age, including in the first and second trimester of pregnancy.
3. belongs to Movalis substitutes in the therapeutic group. The medicine contains as an active ingredient. In the pharmacy, the medicine comes in the form of regular and dissolving tablets, oral suspension, and gel. The drug can be prescribed to children whose weight has reached 7 kg.
4. as active component contains . The drug is available in rectal suppositories, gel, injections, transdermal patches, tablets. The medication is recommended as a painkiller for pathologies of the locomotor system, liver and renal colic, migraine pain, after injuries and surgical treatment. According to strict indications, it can be used up to.

Overdose

If the prescribed doses of the drug are not observed, there is a high risk of developing overdose symptoms:

• nausea, ;
• fainting;
• drowsiness;
• increased risk of intestinal bleeding.

If such symptoms appear, you should seek medical help as soon as possible.

Storage conditions

When storing the drug, it is necessary to limit access to light and sun rays. The optimal temperature of the drug is 25 degrees. The shelf life of the medicine is indicated on the packaging and is 5 years from the date of release.

Price

The cost of the medicine is on average 677 rubles. Prices range from 452 to 1150 rubles.

Movalis anti-inflammatory medicinal product nonsteroidal structure (NSAID), which, when administered, has analgesic, antipyretic and anti-inflammatory effects.

Injections are often prescribed at the very beginning of treatment, when the inflammatory and pain syndrome is more pronounced. After the patient's condition has eased, therapy is continued with rectal suppositories or oral tablets, the duration of the course of treatment is determined by the doctor.

In this article we will look at why doctors prescribe the drug Movalis, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Movalis, leave your feedback in the comments.

Composition and release form

The drug Movalis ( active substance– meloxicam) is available in the following forms:

1. Tablets with a dosage of 7.5 or 15 mg. They have a pale yellow color, round shape, as well as engraving of the manufacturer’s logo and meloxicam content (“59D” – 7.5 mg, “77C” – 15 mg). Packed in blisters of 10 pieces and carton boxes, which contain 10 or 20 tablets.
2. Suspension for internal use– a viscous liquid with a yellow-green tint. 5 ml of suspension contains 7.5 mg of meloxicam. Available in dark glass bottles. The box contains a measuring spoon.
3. Solution for injection, for intramuscular injections – clear liquid with a faint yellow-green tint. Available in 1.5 ml glass ampoules of 3 and 5 pieces, placed in plastic trays and cardboard packaging. Each ampoule contains 15 mg of meloxicam.

Clinical and pharmacological group: NSAIDs.

What is Movalis used for?

Basics active substance medications - meloxicam suppresses inflammatory processes occurring in the body, and also significantly relieves the sensation of pain, which makes the drug Movalis effective for use in a number of diseases, such as:

• rheumatoid arthritis;
• osteoarthritis;
• Ankylosing spondylitis (ankylosing spondylitis);
• at pain syndromes in joints and spine (sciatica, osteochondrosis, etc.).

The use of Movalis for osteochondrosis of the lumbar or cervical has virtually no restrictions (except special occasions). It is important that the drug, unlike its analogues, does not have a negative effect on cartilage tissue, and the analgesic effect appears within half an hour and lasts about a day.

pharmachologic effect

MOVALIS is a non-steroidal anti-inflammatory drug (NSAID) from the oxicam group, has anti-inflammatory, analgesic and antipyretic effects. The anti-inflammatory effect of meloxicam has been established in all standard models inflammation.

The mechanism of action of meloxicam is its ability to inhibit the synthesis of prostaglandins, known mediators of inflammation.

Instructions for use

Movalis solution for intramuscular administration:

• The recommended daily dose is 7.5 mg or 15 mg (maximum), frequency of use is 1 time per day. The dose is determined by the severity of the inflammatory process and the intensity of pain.

The injection solution must be injected deeply intramuscularly ( intravenous use contraindicated). Mix Movalis with others medicines in one syringe should not. Intramuscular administration Movalis is usually prescribed only for the first 2-3 days of therapy, after which they switch to the use of enteral forms of the drug.

Depending on the disease, the dosage of tablets may have some differences:

• Ankylosing spondylitis: prescribed at a rate of 15 mg/day. Upon reaching therapeutic effect the dose can be reduced to 7.5 mg/day.
• Osteoarthritis: tablets are prescribed at a rate of 7.5 mg/day, suppositories - 15 mg/day (1 suppository). If necessary, the dose can be increased to 15 mg/day (2 tablets) 1 time per day.
• Rheumatoid arthritis: prescribed at the rate of 15 mg/day. When a therapeutic effect is achieved, the dose can be reduced to 7.5 mg/day.

In patients with increased risk adverse reactions the initial dose is 7.5 mg/day. In dialysis patients with severe renal failure the dose should not exceed 7.5 mg/day. Since the risk of adverse reactions increases with increasing doses and increasing duration of treatment, it is necessary to use the drug at the minimum effective level. daily dose and with the shortest duration of treatment.

Contraindications for use

The use of this drug is prohibited for people who have the following diseases:

• active gastrointestinal bleeding, recent cerebrovascular bleeding or established diagnosis diseases of the blood coagulation system;
• concomitant therapy with anticoagulants, because there is a risk of intramuscular hematoma formation;
• severe liver failure;
• severe heart failure;
• severe renal failure (if hemodialysis is not performed, CC<30 мл/мин, а также при подтвержденной гиперкалиемии);
• active liver disease;
• erosive and ulcerative lesions of the stomach and duodenum in the acute phase or recently suffered;
• inflammatory bowel diseases (Crohn's disease or ulcerative colitis in the acute phase);
• therapy of perioperative pain during coronary artery bypass grafting;
• pregnancy;
• lactation period (breastfeeding);
• age under 18 years;
• hypersensitivity to the active substance or auxiliary components of the drug.
• hypersensitivity (including to other NSAIDs), complete or incomplete combination of bronchial asthma, recurrent polyposis of the nose or paranasal sinuses, angioedema or urticaria caused by intolerance to acetylsalicylic acid or other NSAIDs (including a history) due to existing potential for cross-sensitivity.

Carefully:

• history of gastrointestinal diseases (presence of Helicobacter pylori infection);
• congestive heart failure;
• cerebrovascular diseases;
• dyslipidemia/hyperlipidemia;
• diabetes;
• peripheral arterial disease;
• renal failure (creatinine clearance 30-60 ml/min);
• elderly age;
• long-term use of NSAIDs;
• smoking;
• frequent drinking of alcohol;
• concomitant therapy with the following drugs: anticoagulants, oral corticosteroids, antiplatelet agents, selective serotonin reuptake inhibitors.

Side effects

When using the drug, you must follow the dosage indicated in the instructions for use, otherwise the following adverse reactions may develop:

1. From the urinary system: edema, hypercreatininemia, increased urea concentration. In rare cases - interstitial nephritis, glomerulonephritis, renal medullary necrosis, nephrotic syndrome.
2. From the digestive system: nausea, vomiting, belching, abdominal pain, constipation or diarrhea, flatulence, increased activity of “liver” transaminases, hyperbilirubinemia, stomatitis, erosive and ulcerative lesions of the gastrointestinal tract, gastrointestinal bleeding (latent or obvious).
3. From the cardiovascular system: increased blood pressure, “flushes” of blood to the skin of the face and upper chest, palpitations.
4. From the nervous system: dizziness, headache, drowsiness.
5. From the hematopoietic organs: anemia, leukopenia, thrombocytopenia.
6. Allergic reactions: skin rash, itching, blisters.
7. Other: ringing in the ears.

As with the use of other non-steroidal anti-inflammatory drugs, during treatment with Movalis there is a possibility of developing nephrotic syndrome, glomerulonephritis, renal medullary necrosis and interstitial nephritis.

When Movalis is used together with drugs that depress the bone marrow (for example, methotrexate), cytopenia may develop. Treatment-related gastrointestinal bleeding, perforation, or ulceration may be fatal.

Overdose

In case of acute overdose of NSAIDs, the following symptoms may be observed, which are usually reversible with maintenance therapy:

• weakness, drowsiness, nausea, vomiting and epigastric pain, there may be gastrointestinal bleeding.

Severe intoxication can lead to hypertension, acute renal failure, liver failure, respiratory depression, coma, seizures and cardiovascular failure. As with the treatment of NSAIDs, their overdose may cause anaphylactoid reactions.

Analogs

Many people wonder: what to replace Movalis with? Some of the cheapest analogues of Movalis today are the following medications: Mirlox, Artrosan, Melox, Meloxicam, Mataren.

Prices

The average price of MOVALIS injections in pharmacies (Moscow) is 580 rubles.

Storage conditions

Store in a cool place, protected from light. The maximum temperature at which the drug can be stored should not exceed 30 degrees. Shelf life: 5 years.

During attacks of exacerbation of arthrosis, doctors advise patients to use Movalis tablets - this is more convenient than the solution that is used in the hospital, and gives a faster effect than suppositories. However, the negative effect of the drug on the digestive tract when taken orally increases, which raises the question: is the risk justified? Is it worth taking this drug given the number of side effects it has?

Movalis - what it helps with

Similar to all non-steroidal drugs, this drug relieves inflammation, has antipyretic and analgesic properties. Movalis is recommended in the presence of chronic joint diseases, during exacerbation of osteochondrosis, even in juvenile arthritis. If you study the reviews of patients who took these pills, you can see non-standard ways of using them - to relieve pain during menstruation and sciatica.

Compound

Due to the presence of several dosage forms, the composition of Movalis must be considered for each of them separately. The only constant component will be the active substance meloxicam - a derivative of enolic acid, a representative of the oxicam group. Tablets and suppositories contain 7.5 mg of this substance, and an ampoule with solution contains 15 mg. Full composition of tablets:

Release form

The tablets are pale yellow, round, convex on one side. The concentration of the active substance can be 7.5 or 15 mg, which is easy to identify by the appearance of the tablet: “59” will be stamped on the first, “77” on the second. Additionally, the manufacturer indicates a slight roughness of the tablets. The patient is offered 10 or 20 pcs. packaged. They have no taste, but the shell quickly dissolves on the tongue, so they cannot be kept in the mouth for a long time.

Pharmacodynamics and pharmacokinetics

Movalis shows high anti-inflammatory activity similar to all non-steroidal drugs that inhibit the synthesis of prostaglandins by suppressing the activity of COX-2. The active component is a selective cyclooxygenase-2 inhibitor, which partially reduces the risk of adverse reactions, but does not completely eliminate the load on the kidneys, bone marrow and liver. Meloxicam is chondroneutral: it has no effect on proteoglycan production in articular cartilage.

Additionally, the drug has several other properties:

• antipyretic;
• analgesic;
• antipyretic.

On the pharmacokinetics of tablets you need to know the following:

• Binding to plasma proteins (doctors especially emphasize albumin) is almost absolute.
• Movalis has almost no effect on the synthesis of renal prostaglandins.
• The active substance penetrates into the interarticular fluid, where its level is diagnosed equal to half the concentration in the plasma.
• Metabolism of the active component of Movalis occurs in the liver, the result of this process is excreted by the kidneys and intestines (equal distribution). Only traces of meloxicam can be detected in urine.
• Plasma clearance is determined by the age of the patient - in the elderly it decreases; experts call the average level 8 ml/min.

Indications for use

Movalis differs from most non-steroidal anti-inflammatory drugs in a short list of situations in which it can be used, especially for tablets. Doctors prescribe them only for the following purposes:

• elimination of pain syndromes due to joint diseases;
• symptomatic treatment of persons with rheumatoid arthritis;
• relief of spondylitis;
• treatment of osteoarthritis (if it is not possible to use the solution).

Take the medicine with food, with liquid (it is better if it is clean water or a non-carbonated drink). The duration of the course is determined by the doctor, but due to the fact that Movalis only relieves pain, but does not cure, it is advisable to reduce this period to 3-5 days. The daily dosage is determined according to the disease to be fought:

• Treatment of rheumatoid arthritis accompanied by acute pain involves 15 mg per day for an adult. To maintain the condition, the dose is reduced to 7.5 mg. Likewise for spondylitis.
• For painful symptoms of osteoarthritis, take 7.5 mg. If the condition is severe, the dose can be doubled one-time.
• Separately, doctors note that it is inadmissible to take more than 7.5 mg of meloxicam by patients on hemodialysis.

special instructions

In the blood serum while taking Movalis, an increase in transaminase activity can be detected, which returns to normal by the next test. Additionally, one must take into account the ability of all NSAIDs to mask symptoms, so they should not be taken for a long course, especially in the presence of chronic inflammatory processes in the joints and infectious diseases in the same area.

If Movalis is used for a long time, the risk of:

• myocardial infarction;
• thrombosis;
• stroke.

During pregnancy

All non-steroidal drugs are prohibited during pregnancy due to penetration into the bloodstream and active suppression of prostaglandin production, which increases the risk of negative effects on the fetus and the course of pregnancy. According to studies, the following were observed in pregnant women using meloxicam:

• spontaneous abortions;
• heart defects in a newborn.

The risk of the latter complication is 1.5% if non-steroidal drugs are used as the main long-term therapy and with high dosages. Doctors call taking Movalis especially dangerous in the last stage of pregnancy - the negative effect of meloxicam will be expressed in:

• fetal pulmonary hypertension;
• kidney dysfunction and fetal renal failure;
• increasing the risk of bleeding (and increasing its duration) during childbirth in the mother.

In childhood

The manufacturer does not recommend the use of Movalis tablets in children under 12 years of age, however, the instructions do not exclude the use of the medicine in small doses and under medical supervision if the child has been diagnosed with juvenile rheumatoid arthritis. However, if possible, specialists in this situation prescribe suppositories in order to less irritate the gastric mucosa, which in children is often more sensitive than in adults.

For impaired renal and liver function

The use of non-steroidal drugs orally in case of problems with the kidneys/liver is undesirable, since metabolism and excretion are carried out through these organs. Doctors advise that in case of serious kidney disease (especially if a person has severe renal failure with hyperkalemia), stop taking Movalis tablets. Experts and official instructions give the same recommendation to persons who have:

• kidney damage;
• impaired liver function (especially in the severe stage);
• cirrhosis of the liver.

Drug interactions

It is undesirable to take the drug Movalis in conjunction with other non-steroidal drugs, especially those also used orally - this will increase the risk of damage to the gastrointestinal mucosa. Additionally, the official instructions note:

• You should not take diuretics at the same time as Movalis tablets for kidney disease.
• Meloxicam increases the toxicity of methotrexate (especially when using high doses).
• When taking Movalis together with anticoagulants, you should see a doctor.
• Cholestyramine accelerates the elimination of meloxicam.
• The simultaneous use of Movalis tablets and lithium preparations is not recommended.

Movalis - contraindications

Any dosage form of this drug, according to the official instructions, cannot be used during pregnancy and breastfeeding, since there is a risk of transferring meloxicam through milk to the baby. You should not use tablets:

• for gastrointestinal diseases (especially gastric ulcers, duodenal perforation, ulcerative colitis);
• in the presence of gastrointestinal bleeding;
• in patients with heart failure or who have undergone coronary artery bypass surgery;
• during exacerbation of bronchial asthma;
• with hypersensitivity to meloxicam and acetylsalicylic acid;
• in case of lactose intolerance;
• if polyps are observed in the nose.

Side effects

Sensitivity to the tablets is observed already in the first days of use, which requires stopping the therapeutic course. With long-term use of meloxicam, patients in reviews often notice the appearance of headaches in the digestive tract, vomiting, stool disorders, flatulence and allergic skin reactions. With a probability of less than 0.1% the following may be observed:

• temperature;
• dizziness;
• stomatitis;
• photosensitivity;
• angioedema;
• flushes of blood to the face.

Overdose

If the official standards for tablets have been exceeded, the instructions recommend gastric lavage. However, even with oral administration, serious deterioration in well-being in the event of an overdose has not been recorded enough by specialists to generate data on this issue, so a general picture cannot be ruled out for all non-steroidal drugs:

• nausea, vomiting;
• stomach pain;
• hypertension;
• impaired kidney function;
• stopping breathing.

Terms of sale and storage

Movalis is available exclusively by prescription; tablets are stored at temperatures below 25 degrees for 5 years.

Analogue of Movalis in tablets

There are many substitutes for Movalis, even among budget drugs. If we consider drugs that are structurally similar to it, we can distinguish:

• Mirloks (Poland);
• Meloxicam (Russia);
• Amelotex (Russia);
• Movasin (Russia);
• Artrosan (Russia);
• Meloflex Ropharm (Romania).

Among the drugs that give a similar effect, but differ in composition from Movalis, are the following tablets:

• Diclofenac;
• Indomethacin;
• Ketoprofen.

Movalis price

Moscow pharmacies offer to buy these tablets for 460-600 rubles if we are talking about a package of 10 pieces, and for 700-860 rubles if you plan to take 20 pieces. The price will vary according to the concentration of the active substance, but even the lowest will cost you 570-600 rubles. Packages of Movalis 7.5 mg contain only 20 tablets, so they are even more expensive than 10 tablets. in higher concentrations of meloxicam. Price picture for 20 pcs. in different dosages as follows:

Reviews

Lena, 35 years old

I got joint disease in my youth due to high physical activity, so I periodically take pills if the situation worsens. I bought Movalis on the advice of a friend who was saved by hernia. The list of side effects was terrifying, but I tried it at my own risk. It works well, a couple of days were enough to improve the condition, but it’s hard for the gastrointestinal tract.

Yana, 22 years old

I encountered NSAIDs for the first time during office work, when my lower back began to hurt wildly due to incorrect body position. I had to look for a painkiller, the doctor recommended the German Movalis. I took the minimum dosage - 7.5 mg, took one tablet in the evening. I combined it with Neuromultivit and endured the week of “treatment” normally.

Natalya, 28 years old

I've been using Movalis for four years (I buy mostly tablets) - it helps a lot with sciatica and joint pain, but it needs to be taken very carefully. I have chronic gastritis, so I try to get by with a couple of tablets in the first days and stop, and this is not a drug for long-term therapy, but only to relieve symptoms.

Alina, 31 years old

For arthritis, Movalis works great, and even with an exacerbation of a hernia, the saw quickly relieves pain. However, the number of disadvantages is frightening: firstly, gastritis, which had been dormant for a couple of years, immediately made itself felt, although I drank a low dosage. Secondly, nausea haunted me all week, and towards the end I felt slightly dizzy.

sovets.net

Release form and composition

Movalis is available in the following dosage forms:

• Tablets: from pale yellow to yellow, on one side - a concave line and code, on the other (convex with a beveled edge) - the manufacturer's logo, surface roughness is allowed (in blisters of 10 pcs., 1 or 2 blisters in a cardboard box );
• Suspension for oral administration: viscous, yellowish with a green tint (in dark glass bottles of 100 ml, 1 bottle in a cardboard box complete with a dosage spoon);
• Solution for intramuscular administration: transparent, yellow with a green tint (in colorless glass ampoules of 1.5 ml, 3 or 5 ampoules in blister packs or trays, 1 or 2 packs or trays in a cardboard box);
• Rectal suppositories: yellowish-green, smooth, with a depression at the base (in blister packs of 6 pcs., 1 or 2 packs in a cardboard box).

1 tablet contains:

• Excipients (7.5 mg/15 mg): magnesium stearate – 1.7/1.7 mg, povidone K25 – 10.5/9 mg, lactose monohydrate – 23.5/20 mg, sodium citrate dihydrate – 15/30 mg, crospovidone – 16.3/14 mg, microcrystalline cellulose – 102/87.3 mg, colloidal silicon dioxide – 3.5/3 mg.

The composition of 5 ml of oral suspension includes:

• Active ingredient: meloxicam – 7.5 mg;
• Auxiliary components: raspberry flavor - 10 mg, sodium benzoate - 7.5 mg, 70% sorbitol - 1750 mg, citric acid monohydrate - 6 mg, sodium saccharinate - 0.5 mg, hyaetellose - 5 mg, sodium dihydrogen phosphate dihydrate - 100 mg , xylitol – 750 mg, 85% glycerol – 750 mg, colloidal silicon dioxide – 50 mg, purified water – 2463.5 mg.

The composition of 1 ml of solution for intramuscular injection includes:

• Active ingredient: meloxicam – 10 mg;
• Auxiliary components: glycine - 7.5 mg, meglumine - 9.375 mg, sodium chloride - 4.5 mg, sodium hydroxide - 0.228 mg, poloxamer 188 - 75 mg, glycofurfural - 150 mg, water for injection - 1279.482 mg.

1 rectal suppository includes:

• Active ingredient: meloxicam – 7.5 or 15 mg;
• Auxiliary components: supposir VR (suppository mass), polyethylene glycol glyceryl hydroxystearate (macrogol glyceryl hydroxystearate).

Pharmacological properties

Pharmacodynamics

Movalis is a non-steroidal anti-inflammatory drug belonging to the category of enolic acid derivatives. All standard models of inflammation confirm the pronounced anti-inflammatory effect of meloxicam. Its mechanism of action is to inhibit the production of prostaglandins, known as mediators of inflammation.

Meloxicam in vivo inhibits the synthesis of prostaglandins at the site of inflammation to a greater extent than in the kidneys or gastric mucosa. This is due to the greater selectivity of inhibition of cyclooxygenase-2 (COX-2) compared to cyclooxygenase-1 (COX-1). Experts believe that the therapeutic effect of NSAIDs (non-steroidal anti-inflammatory drugs) is associated specifically with the inhibition of COX-2, while inhibition of COX-1, which is one of the constantly present isoenzymes, can contribute to the development of adverse reactions from the kidneys and stomach. The selectivity of the active component of Movalis for COX-2 is confirmed using various test systems both in vivo and in vitro.

The ability of meloxicam to selectively inhibit COX-2 has been proven when used as a test system in human whole blood in vitro. During the experiment, it was found that the substance (in doses of 7.5 and 15 mg) more actively inhibits COX-2, having a more significant inhibitory effect on the production of prostaglandin E2, the stimulator of which is lipopolysaccharide (a reaction occurring under the control of COX-2) than for the synthesis of thromboxane, which is involved in the process of blood clotting (a reaction occurring under the control of COX-1). The severity of these effects is determined by the dose. Results from ex vivo studies indicate that meloxicam (7.5 and 15 mg doses) does not affect bleeding time or platelet aggregation.

In clinical studies, adverse reactions from the gastrointestinal tract were observed generally less frequently when taking Movalis in doses of 7.5 and 15 mg than when using other NSAIDs taken for comparison. This difference in the incidence of side effects from the gastrointestinal tract in practice is manifested by the rarer occurrence of symptoms such as abdominal pain, nausea, vomiting, and dyspepsia. The incidence of bleeding, ulceration and perforation in the upper gastrointestinal tract, which is believed to be associated with the use of meloxicam, appears to be low and is determined by the dose of Movalis.

Pharmacokinetics

Meloxicam is well absorbed from the gastrointestinal tract, as evidenced by its high absolute bioavailability after oral administration (reaches 90%). After a single dose of the drug, the maximum concentration of the substance in plasma is achieved within 5–6 hours. The degree of absorption does not change when Movalis is combined with food or inorganic antacids. When taking the drug orally in doses of 7.5 and 15 mg, its content in the blood is proportional to the dose. Stable pharmacokinetic parameters of meloxicam are established within 3–5 days after the start of therapy. The maximum and basal concentrations of the drug after taking it once a day have a relatively small range of differences, which is 0.4-1 mcg/ml when administering a dose of 7.5 mg, and 0.8-2 mcg/ml when administering a dose of 15 mg. (the minimum and maximum concentrations during the period of stable values ​​of pharmacokinetic parameters are indicated, respectively). Sometimes there are values ​​outside the specified ranges.

After intramuscular administration, meloxicam is completely absorbed. Relative bioavailability compared to oral bioavailability reaches 100%. In this regard, when switching from a solution for intramuscular administration to oral dosage forms of Movalis, there is no need for dose adjustment. After intramuscular administration of 15 mg of the drug, the maximum concentration of the drug in plasma is reached within approximately 60–96 minutes and is equal to 1.6–1.8 μg/ml.

Meloxicam is characterized by a high degree of binding to plasma proteins, mainly to albumin (approximately 99%). It is determined in synovial fluid, the content of which is about 50% of the content of the substance in plasma. After repeated oral administration of Movalis in the dose range of 7.5–15 mg, the volume of distribution is approximately 16 l (coefficient of variation ranges from 11 to 32%).

Meloxicam is almost completely metabolized in the liver, forming 4 derivatives that have virtually no pharmacological activity. The main metabolite is 5′-carboxymeloxicam (60% of the dose taken), which is formed through the oxidation of the intermediate metabolite 5′-hydroxymethylmeloxicam. The latter is also excreted from the body, but in smaller quantities (9% of the dose taken). In vitro studies confirm that the CYP2C9 isoenzyme plays a significant role in this metabolic process. It also additionally involves the CYP3A4 isoenzyme. The formation of two other metabolites (to which 16% and 4% of the dose taken, respectively) occurs with the participation of peroxidase, the activity of which presumably varies depending on the individual characteristics of the organism.

Meloxicam is excreted in equal proportions with urine and feces, mainly in the form of metabolites. Less than 5% of the daily dose is excreted unchanged through the intestines. Only trace concentrations of unchanged meloxicam are found in urine. The average half-life is 13–25 hours.

Plasma clearance varies from 7 to 12 ml/min after a single dose of Movalis.

Liver dysfunction, as well as mild renal failure, have virtually no effect on the pharmacokinetics of meloxicam. The rate of excretion of the drug from the body is significantly higher in patients with moderate renal failure. In patients with end-stage renal failure, meloxicam binds less well to plasma proteins. In this case, an increase in the volume of distribution may cause higher concentrations of free meloxicam, so patients in this category are not recommended to prescribe Movalis in a daily dose of more than 7.5 mg.

In elderly patients, the pharmacokinetic parameters of meloxicam remain almost the same as in young patients. In such patients, the average plasma clearance during the period of stable equilibrium values ​​of pharmacokinetic parameters is slightly lower than in young patients. Observations show that older women have higher values ​​of the area under the concentration-time curve (AUC) and an increased half-life compared to younger patients, both male and female.

Indications for use

According to the instructions, Movalis is prescribed for the symptomatic treatment of the following diseases:

• Rheumatoid arthritis;
• Osteoarthritis, including degenerative joint diseases, arthrosis;
• Ankylosing spondylitis.

Contraindications

Absolute:

• A combination of bronchial asthma (complete or partial), recurrent polyposis of the paranasal sinuses and nose with intolerance to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs (currently or in the history);
• Peptic ulcer and/or perforation of the stomach and duodenum (during exacerbation or recently suffered);
• Active gastrointestinal bleeding; recent cerebrovascular bleeding or confirmed diseases of the blood coagulation system;
• Crohn's disease or ulcerative colitis (with exacerbation);
• Progressive kidney disease, severe renal failure (with confirmed hyperkalemia; with creatinine clearance less than 30 ml per minute; in cases where hemodialysis is not performed);
• Severe liver failure;
• Uncontrolled severe heart failure;
• Postoperative pain associated with coronary artery bypass surgery;
• Rare hereditary galactose intolerance (when the drug is prescribed in tablet form (the maximum daily dose of Movalis 7.5/15 mg, respectively, includes 47/20 mg of lactose));
• Rare hereditary fructose intolerance (when the drug is prescribed in the form of an oral suspension (the maximum daily dose of the drug includes 2450 mg of sorbitol));
• Age up to 18 years (if the drug is prescribed in the form of an injection solution); up to 12 years (when prescribing the drug in the form of tablets, oral suspension, suppositories, with the exception of the use of Movalis in the treatment of juvenile rheumatoid arthritis);
• Pregnancy and breastfeeding period;
• Hypersensitivity to the components of the drug, as well as to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs (there is a possibility of developing cross-hypersensitivity).

Relative (Movalis should be used with caution in the following diseases/conditions):

• Peripheral artery disease;
• Congestive heart failure;
• History of gastrointestinal tract diseases (with Helicobacter pylori infection);
• Cardiac ischemia;
• Cerebrovascular diseases;
• Renal failure (with creatinine clearance from 30 to 60 ml per minute);
• Diabetes;
• Hyperlipidemia and/or dyslipidemia;
• Frequent drinking and smoking;
• Long-term therapy with non-steroidal anti-inflammatory drugs;
• Simultaneous administration with methotrexate at a dose of 15 mg per week;
• Combined use with selective serotonin reuptake inhibitors, antiplatelet agents, anticoagulants, oral glucocorticosteroids;
• Elderly age.

Instructions for use of Movalis: method and dosage

Tablets and suspension for oral administration

It is preferable to take Movalis orally before meals.

As a rule, the following dosage regimen (daily dose) is prescribed:

• Osteoarthritis – 7.5 mg (possibly increasing the dose by 2 times);
• Rheumatoid arthritis, ankylosing spondylitis – 15 mg (possibly reducing the dose by 2 times).

If there is an increased risk of side effects, it is recommended to start treatment with a dose of 7.5 mg per day.

Frequency of application – 1 time per day.

Children under 12 years of age are prescribed Movalis in the form of an oral suspension for the treatment of juvenile rheumatoid arthritis. The dose is calculated based on body weight - 0.125 mg/kg (maximum - 7.5 mg per day). It is recommended to use the following dosage regimen (amount of active substance/volume of suspension):

• 12 kg: 1.5 mg/1 ml;
• 24 kg: 3 mg/2 ml;
• 36 kg: 4.5 mg/3 ml;
• 48 kg: 6 mg/4 ml;
• From 60 kg: 7.5 mg/5 ml.

The maximum dose of Movalis in children 12-18 years old with juvenile rheumatoid arthritis is 0.25 mg/kg, but not more than 15 mg per day.

Solution for intramuscular administration

Movalis injections intramuscularly are usually prescribed only during the first 2-3 days of therapy, after which they switch to the use of enteral forms of the drug.

The injection solution must be administered deeply intramuscularly (intravenous use is contraindicated). Movalis should not be mixed with other medications in the same syringe.

Rectal suppositories

For patients with end-stage renal failure on hemodialysis, Movalis in any dosage form is prescribed at a dose of no more than 7.5 mg per day. No dosage adjustment is required for moderate or minor renal impairment (with creatinine clearance of 30 ml per minute).

When using different dosage forms of the drug simultaneously, the total daily dose of Movalis should not exceed 15 mg per day.

Side effects

• Respiratory system: rarely - bronchial asthma (in patients with allergies to acetylsalicylic acid or other non-steroidal anti-inflammatory drugs);
• Digestive system: often – abdominal pain, dyspepsia, diarrhea, vomiting, nausea; uncommon – gastrointestinal bleeding (obvious or hidden), bloating, gastritis, constipation, belching, stomatitis; rarely – esophagitis, gastroduodenal ulcers, colitis; very rarely - perforation of the gastrointestinal tract;
• Nervous system: often – headache; infrequently – drowsiness, dizziness;
• Cardiovascular system: infrequently – increased blood pressure, a feeling of “flushing” of blood to the face; rarely – palpitations;
• Urinary system: infrequently - changes in renal function parameters (increased serum urea and/or creatinine levels), urinary disorders, including acute urinary retention; very rarely - acute renal failure;
• Hematopoietic system: infrequently – anemia; rarely - thrombocytopenia, leukopenia, changes in the number of blood cells, including changes in the leukocyte formula;
• Immune system: uncommon – immediate hypersensitivity reactions; with unknown frequency - anaphylactoid and/or anaphylactic reactions, anaphylactic shock;
• Mental health: rarely – mood swings; with unknown frequency – confusion, disorientation;
• Sense organs: infrequently – vertigo; rarely - conjunctivitis, tinnitus, visual impairment, including blurred vision;
• Subcutaneous tissues and skin: uncommon – angioedema, itching, skin rash; rarely - urticaria, Stevens-Johnson syndrome, toxic epidermal necrolysis; very rarely - bullous dermatitis, erythema multiforme; with unknown frequency – photosensitivity;
• Biliary tract and liver: uncommon - transient changes in liver function indicators (in particular, increased bilirubin or transaminase activity); very rarely - hepatitis;
• General disorders and reactions at the injection site: often - swelling and pain at the injection site; infrequently - swelling.

When Movalis is used together with drugs that depress the bone marrow (for example, methotrexate), cytopenia may develop.

Treatment-related gastrointestinal bleeding, perforation, or ulceration may be fatal.

As with the use of other non-steroidal anti-inflammatory drugs, during treatment with Movalis there is a possibility of developing nephrotic syndrome, glomerulonephritis, renal medullary necrosis and interstitial nephritis.

Overdose

Information on overdose of Movalis is currently limited. Presumably, it will be accompanied by signs characteristic of overdose with other NSAIDs. Severe intoxication when a large dose of the drug is introduced into the body can be manifested by symptoms such as asystole, changes in blood pressure, pain in the epigastric region, nausea, vomiting, gastrointestinal bleeding, respiratory arrest, acute renal failure, drowsiness, and disturbances of consciousness.

There is no specific antidote. In case of overdose, it is recommended to evacuate the stomach contents and prescribe general supportive therapy. The administration of cholestyramine accelerates the elimination of meloxicam.

special instructions

When using Movalis, significant skin disorders may develop such as Stevens-Johnson syndrome, toxic epidermal necrolysis and exfoliative dermatitis. Particular attention should be paid to patients with adverse events from the mucous membranes and skin, as well as hypersensitivity reactions to the action of the drug, especially if such reactions were observed during previous courses of treatment. In most cases, skin disorders develop during the first 30 days of using the drug. Sometimes such side effects can cause Movalis to be discontinued.

During treatment, bleeding, perforation and ulcers of the gastrointestinal tract may occur in patients with or without warning symptoms or a history of gastrointestinal diseases. For older patients, the consequences of these complications are more serious.

Patients with gastrointestinal diseases should undergo regular monitoring. If gastrointestinal bleeding or ulcerative lesions of the gastrointestinal tract develop, the use of Movalis should be interrupted.

Treatment with the drug may lead to an increased risk of developing cardiovascular thrombosis, angina attacks, and myocardial infarction (sometimes with death). The risk of such disorders increases with long-term therapy, as well as in patients with a history of the above diseases and in cases of predisposition to their occurrence.

Treatment with Movalis in patients with a reduced circulating blood volume or with reduced renal blood flow may cause the development of decompensation of latent renal failure, since the drug inhibits the synthesis of prostaglandins in the kidneys, which are involved in maintaining renal perfusion. As a rule, after discontinuation of Movalis, functional disorders of the kidneys disappear. Elderly patients are most at risk of developing these reactions; patients with congestive heart failure, dehydration, liver cirrhosis, acute renal impairment or nephrotic syndrome; patients after major surgical interventions that can lead to hypovolemia. In such patients, renal function and diuresis should be carefully monitored at the beginning of therapy. Also, the likelihood of developing latent renal failure increases with simultaneous use with angiotensin II receptor antagonists, diuretics, and angiotensin-converting enzyme inhibitors.

When Movalis is used simultaneously with diuretics, sodium, potassium and water retention may develop, and the natriuretic effect of diuretics may also decrease. Because of this, in predisposed patients, signs of heart failure or hypertension may increase (it is necessary to provide adequate hydration and carefully monitor the condition of such patients).

Periodically during therapy, it is possible to increase the activity of transaminases in the blood serum or other functional indicators of the liver. This increase was in most cases minor and transient. If such disturbances are significant or their severity does not decrease over time, it is necessary to interrupt treatment and further monitor the identified laboratory changes.

Before prescribing Movalis, as well as during combined treatment, it is necessary to conduct a study of the functional state of the kidneys.

Depleted or weakened patients need to be closely monitored as they may be less able to tolerate treatment-related side effects.

It must be borne in mind that Movalis can mask the symptoms of an underlying infectious disease.

The drug may affect fertility, so the use of Movalis is not recommended for women who have difficulty conceiving.

When performing potentially hazardous types of work that require rapid psychomotor reactions and increased concentration (including driving), it is necessary to take into account the possibility of developing visual impairment, dizziness, drowsiness or other disorders of the central nervous system.

Use during pregnancy and lactation

The use of Movalis during pregnancy is contraindicated. Since NSAIDs pass into breast milk, the drug should not be prescribed to nursing mothers.

Meloxicam inhibits cyclooxygenase/prostaglandin synthesis and may affect fertility. Women planning pregnancy are not recommended to use it. Meloxicam may inhibit ovulation. Therefore, patients who have problems conceiving and are being examined for this reason should not take the drug.

For liver dysfunction

In patients with compensated liver cirrhosis, there is no need for dose adjustment.

Drug interactions

When Movalis is used together with certain drugs, the following effects may occur:

• Selective serotonin reuptake inhibitors: increases the risk of gastrointestinal bleeding;
• Other inhibitors of prostaglandin synthesis, including salicylates and glucocorticoids: increases the risk of gastrointestinal bleeding and ulceration in the gastrointestinal tract (due to the synergism of the action of drugs; combination of drugs is not recommended);
• Antihypertensive drugs (diuretics, beta-blockers, vasodilators, angiotensin-converting enzyme inhibitors): their effectiveness decreases;
• Methotrexate: tubular secretion decreases and its concentration in plasma increases without changing pharmacokinetics and hematological toxicity (simultaneous use with doses of more than 15 mg of methotrexate per week is not recommended; renal function and the number of blood cells must be constantly monitored);
• Angiotensin II receptor antagonists: there is an increased decrease in glomerular filtration, which can lead to the development of acute renal failure, especially against the background of functional renal impairment (when prescribing a combination of these drugs, renal function must be monitored);
• Cyclosporine: its nephrotoxicity increases;
• Lithium preparations: the concentration of lithium in plasma increases (during the period of prescribing Movalis, changing the doses of lithium preparations, or when discontinuing them, it is necessary to monitor the concentration of lithium);
• Diuretics: the risk of developing acute renal failure increases with dehydration;
• Cholestyramine: increases the rate of elimination of meloxicam;
• Intrauterine contraceptive drugs: their effectiveness decreases.

Also, when prescribing combination treatment, the following precautions should be taken into account:

• Other non-steroidal anti-inflammatory drugs: joint use is not recommended;
• Oral hypoglycemic drugs: the possibility of interaction must be taken into account;
• Diuretics: adequate hydration should be provided, and renal function should be tested before starting therapy;
• Medicines with a known ability to inhibit CYP2C9 and/or CYP3A4: the possibility of pharmacokinetic interaction must be considered.

Analogs

Analogs of Movalis are: Artrosan, Amelotex, Meloxicam, Meloxicam-Teva, Movasin, Melbek, Liberum, Bi-xicam, Mesipol.

Terms and conditions of storage

Keep out of the reach of children.

Best before date:

• Tablets and oral suspension: 3 years at temperatures up to 25°C;
• Solution for intramuscular administration: 5 years in a place protected from light at temperatures up to 30°C;
• Rectal suppositories: 3 years at temperatures up to 30°C.

The shelf life of Movalis in the form of a suspension after opening the bottle is 30 days.

Conditions for dispensing from pharmacies

Dispensed by prescription.

Reviews about Movalis

According to reviews, Movalis received a fairly high rating from patients. It is known that meloxicam accumulates quickly in the body, is excreted rather slowly, and its bioavailability is higher than that of most analogues. A variety of dosage forms allows you to choose the most convenient one in accordance with individual preferences and indications.

High clinical effectiveness and minimal incidence of adverse reactions compared to other NSAIDs are confirmed by numerous reviews from patients and doctors. For this reason, Movalis is used to treat many pathological conditions that accompany rheumatic diseases of an inflammatory and degenerative nature, as well as to eliminate pain during fever and primary dysmenorrhea.

According to patients, Movalis injections, due to the immediate release of the drug into the blood, allow you to quickly get rid of even severe excruciating pain. There are also favorable reviews about Movalis tablets, the advantage of which is the possibility of long-term use (from 1 month to 1.5 years).

Price for Movalis in pharmacies

The approximate price of Movalis in the form of tablets with a dosage of 7.5 mg is 556-680 rubles (pack includes 20 pieces), and with a dosage of 15 mg - 452-573 rubles (pack includes 10 pieces) or 631-795 rubles (pack includes includes 20 pieces). You can purchase a solution for intramuscular injection on average for 571-690 rubles (package includes 3 ampoules) or 789-940 rubles (package includes 5 ampoules). The cost of the oral suspension varies from 462 to 850 rubles. Rectal suppositories are currently not commercially available.

www.neboleem.net

MOVALIS: instructions for use and reviews *

Release form, composition and packaging

Pills

Excipients: sodium citrate dihydrate - 15 mg, lactose monohydrate - 23.5 mg, microcrystalline cellulose - 102 mg, povidone K25 - 10.5 mg, colloidal silicon dioxide - 3.5 mg, crospovidone - 16.3 mg, magnesium stearate - 1.7 mg.

Pills from pale yellow to yellow, round, one side is convex with a beveled edge, on the convex side there is a company logo, on the other side there is a code and a concave line; Roughness of tablets is allowed.

Excipients: sodium citrate dihydrate - 30 mg, lactose monohydrate - 20 mg, microcrystalline cellulose - 87.3 mg, povidone K25 - 9 mg, colloidal silicon dioxide - 3 mg, crospovidone - 14 mg, magnesium stearate - 1.7 mg.

10 pieces. - blisters (1) - cardboard packs.
10 pieces. - blisters (2) - cardboard packs.

Indications

Symptomatic treatment:

— osteoarthritis (arthrosis, degenerative joint diseases), incl. with a pain component;

- rheumatoid arthritis;

- ankylosing spondylitis;

- other inflammatory and degenerative diseases of the musculoskeletal system, such as arthropathy, dorsopathies (for example, sciatica, low back pain, shoulder periarthritis), accompanied by pain.

Contraindications

- complete or incomplete combination of bronchial asthma, recurrent nasal polyposis and paranasal sinuses, angioedema or urticaria caused by intolerance to acetylsalicylic acid or other NSAIDs (including a history) due to the existing likelihood of cross-sensitivity;

- erosive and ulcerative lesions of the stomach and duodenum in the acute stage or recently suffered;

- inflammatory bowel diseases (Crohn's disease or ulcerative colitis in the acute stage);

- severe liver failure;

- severe renal failure (if hemodialysis is not performed, CC<30 мл/мин, а также при подтвержденной гиперкалиемии);

- progressive kidney disease;

- active gastrointestinal bleeding, recent cerebrovascular bleeding or an established diagnosis of diseases of the blood coagulation system;

- severe uncontrolled heart failure;

— therapy of perioperative pain during coronary artery bypass grafting;

- pregnancy;

- lactation period (breastfeeding);

- children under 12 years of age;

- rare hereditary galactose intolerance (the maximum daily dose of the drug with a dosage of meloxicam of 7.5 mg and 15 mg contains 47 mg and 20 mg of lactose, respectively);

- hypersensitivity to the active substance or auxiliary components of the drug.

WITH caution:

- history of gastrointestinal diseases (peptic ulcer of the stomach and duodenum, liver disease);

- congestive heart failure;

- renal failure (creatinine clearance 30-60 ml/min);

- cerebrovascular diseases;

— dyslipidemia/hyperlipidemia;

- diabetes;

- concomitant therapy with the following drugs: oral corticosteroids, anticoagulants (including warfarin), antiplatelet agents, selective serotonin reuptake inhibitors (including citalopram,
fluoxetine, paroxetine, sertraline);

— diseases of peripheral arteries;

- elderly age;

- long-term use of NSAIDs;

- smoking;

- Frequent drinking of alcohol.

Dosage

The drug is taken orally 1 time/day, during meals, with water or other liquid.

At osteoarthritis with pain syndrome The daily dose is 7.5 mg; if necessary, the dose can be increased to 15 mg/day.

At rheumatoid arthritis

At ankylosing spondylitis the drug is prescribed at a dose of 15 mg/day; depending on the therapeutic effect, the dose can be reduced to 7.5 mg/day.

In patients with an increased risk of adverse reactions (history of gastrointestinal diseases, presence of risk factors for cardiovascular diseases), it is recommended to begin treatment with a dose of 7.5 mg/day.

Because The potential risk of adverse reactions depends on the dose and duration of treatment; the minimum effective dose should be prescribed for the shortest possible short course.

U patients with severe renal failure on hemodialysis, the dose of Movalis should not exceed 7.5 mg/day.

Maximum dose teenagers aged 12-18 years is 0.25 mg/kg and should not exceed 15 mg.

The use of the drug is contraindicated in children up to 12 years old, due to the impossibility of selecting an appropriate dose for this age group.

Combined use

The drug should not be used simultaneously with other NSAIDs.

The total dose of Movalis, used in different dosage forms, should not exceed 15 mg/day.

Side effects

The following describes side effects that were considered possible to be associated with the use of Movalis.

Side effects registered during post-marketing use, the connection of which with the use of the drug was regarded as possible, are marked with *.

Within systemic organ classes, the following categories are used according to the frequency of side effects: very often (≥1/10); often (≥1/100,<1/10); нечасто (≥1/1000, <1/100); редко (≥1/10 000, <1/1000); очень редко (<1/10 000); не установлено.

From the blood and lymphatic system: infrequently - anemia; rarely - changes in the number of blood cells, including changes in the leukocyte formula, leukopenia, thrombocytopenia.

From the immune system: uncommon - other immediate hypersensitivity reactions*; frequency not established - anaphylactic shock*, anaphylactoid reactions*.

From the nervous system: often - headache; infrequently - dizziness, drowsiness.

Mental disorders: often - mood changes*; frequency not established - confusion*, disorientation*.

From the senses: infrequently - vertigo; rarely - conjunctivitis*, visual impairment, including blurred vision*, tinnitus.

From the gastrointestinal tract: often - abdominal pain, dyspepsia, diarrhea, nausea, vomiting; uncommon - hidden or obvious gastrointestinal bleeding, gastritis*, stomatitis, constipation, bloating, belching; rarely - gastroduodenal ulcers, colitis, esophagitis; very rarely - perforation of the gastrointestinal tract.

From the liver: infrequently - transient changes in liver function indicators (for example, increased transaminase activity or bilirubin concentration); very rarely - hepatitis*.

For the skin and subcutaneous tissues: uncommon - angioedema*, itching, skin rash; rarely - toxic epidermal necrolysis*, Stevens-Johnson syndrome*, urticaria; very rarely - bullous dermatitis*, erythema multiforme*; frequency not established - photosensitivity.

From the respiratory system: rarely - bronchial asthma in patients with allergies to acetylsalicylic acid or other NSAIDs.

From the cardiovascular system: infrequently - increased blood pressure, a feeling of a “rush” of blood to the face; rarely - palpitations.

From the urinary system: uncommon - changes in renal function (increased levels of creatinine and/or urea in the blood serum), urinary disorders, including acute urinary retention*; very rarely - acute renal failure*.

From the genital organs and breast: infrequently - late ovulation*; frequency not established - infertility in women*.

Combined use with drugs that inhibit bone marrow hematopoiesis (for example, methotrexate) can provoke cytopenia.

Gastrointestinal bleeding, ulceration, or perforation can be fatal.

As with other NSAIDs, the possibility of interstitial nephritis, glomerulonephritis, renal medullary necrosis, and nephrotic syndrome cannot be excluded.

Overdose

There is insufficient data on cases associated with drug overdose. Will likely be present symptoms, characteristic of an overdose of NSAIDs, in severe cases: drowsiness, disturbances of consciousness, nausea, vomiting, epigastric pain, gastrointestinal bleeding, acute renal failure, changes in blood pressure, respiratory arrest, asystole.

Treatment: the antidote is not known; in case of drug overdose, gastric emptying and general supportive therapy should be performed. Cholestyramine accelerates the elimination of meloxicam.

Drug interactions

When used simultaneously with meloxicam, other inhibitors of prostaglandin synthesis, incl. GCS and salicylates increase the risk of gastrointestinal ulcers and gastrointestinal bleeding (due to synergistic action). The simultaneous use of meloxicam and other NSAIDs is not recommended.

Anticoagulants for oral administration, heparin for systemic use, and thrombolytic agents when used simultaneously with meloxicam increase the risk of bleeding. In case of simultaneous use, careful monitoring of the blood coagulation system is necessary.

Antiplatelet drugs, serotonin reuptake inhibitors, when used simultaneously with meloxicam, increase the risk of bleeding due to inhibition of platelet function. In case of simultaneous use, careful monitoring of the blood coagulation system is necessary.

NSAIDs increase plasma lithium concentrations by decreasing renal excretion. The simultaneous use of meloxicam with lithium preparations is not recommended. If simultaneous use is necessary, careful monitoring of plasma lithium concentrations is recommended throughout the course of lithium use.

NSAIDs reduce the tubular secretion of methotrexate, thereby increasing its plasma concentration. The simultaneous use of meloxicam and methotrexate (at a dose of more than 15 mg per week) is not recommended. In case of simultaneous use, careful monitoring of renal function and blood count is necessary. Meloxicam may increase the hematological toxicity of methotrexate, especially in patients with impaired renal function. When meloxicam and methotrexate are used together for 3 days, the risk of increased toxicity of the latter increases.

There is evidence that NSAIDs may reduce the effectiveness of intrauterine contraceptive devices, but this has not been proven.

The use of NSAIDs while taking diuretics in case of dehydration of patients is accompanied by a risk of developing acute renal failure.

NSAIDs reduce the effect of antihypertensive drugs (beta-blockers, ACE inhibitors, vasodilators, diuretics) due to inhibition of prostaglandins that have vasodilating properties.

The combined use of NSAIDs and angiotensin II receptor antagonists, as well as ACE inhibitors, enhances the effect of reducing glomerular filtration, and thereby can lead to the development of acute renal failure, especially in patients with impaired renal function.

Cholestyramine, by binding meloxicam in the gastrointestinal tract, leads to its faster elimination.

NSAIDs, by acting on renal prostaglandins, may enhance the nephrotoxicity of cyclosporine.

In patients with a creatinine clearance of 45 to 79 mL/min, meloxicam should be discontinued 5 days before starting pemetrexed and possibly resumed 2 days after stopping pemetrexed. If there is a need for concomitant use of meloxicam and pemetrexed, patients should be carefully monitored, especially for myelosuppression and the occurrence of gastrointestinal side effects. In patients with CC<45 мл/мин применение мелоксикама совместно с пеметрекседом не рекомендуется.

When co-administering medicinal products with meloxicam that are known to inhibit CYP2C9 and/or CYP3A4 (or are metabolized by these enzymes), such as sulfonylureas or probenecid, the possibility of pharmacokinetic interaction should be taken into account.

When used concomitantly with oral antidiabetic agents (eg, sulfonylureas, nateglinide), a CYP2C9-mediated interaction is possible, which may lead to increased blood concentrations of both the antidiabetic agent and meloxicam. Patients taking meloxicam concomitantly with a sulfonylurea or nateglinide should carefully monitor blood glucose concentrations due to the potential for hypoglycemia.

With the simultaneous use of antacids, cimetidine, digoxin and furosemide, no significant pharmacokinetic interaction was detected.

special instructions

Patients with gastrointestinal diseases should be monitored regularly. If ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding occur, Movalis should be discontinued.

Gastrointestinal ulcers, perforation, or bleeding may occur at any time during the use of NSAIDs, with or without warning symptoms or a history of serious gastrointestinal complications. The consequences of these complications are generally more serious in older people.

When using Movalis, serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis may develop. Therefore, special attention should be paid to patients reporting the development of adverse events from the skin and mucous membranes, as well as hypersensitivity reactions to the drug, especially if such reactions were observed during previous courses of treatment. The development of such reactions is observed, as a rule, during the first month of treatment. If the first signs of skin rash, changes in mucous membranes or other signs of hypersensitivity appear, discontinuation of Movalis should be considered.

Cases have been described of an increased risk of developing serious cardiovascular thrombosis, myocardial infarction, and an attack of angina, possibly fatal, when taking NSAIDs. This risk increases with long-term use of the drug, as well as in patients with a history of the above diseases and those predisposed to such diseases.

NSAIDs inhibit the synthesis of prostaglandins in the kidneys, which are involved in maintaining renal perfusion. The use of NSAIDs in patients with reduced renal blood flow or reduced volume may lead to decompensation of latent renal failure. After discontinuation of NSAIDs, renal function usually returns to baseline levels. Those most at risk for developing this reaction are elderly patients, patients with dehydration, congestive heart failure, liver cirrhosis, nephrotic syndrome or acute renal impairment, patients concomitantly taking diuretics, ACE inhibitors, angiotensin II receptor antagonists, and also patients who have undergone major surgical interventions that lead to hypovolemia. In such patients, diuresis and renal function should be carefully monitored when initiating therapy.

The use of NSAIDs in combination with diuretics can lead to sodium, potassium and water retention, as well as a decrease in the natriuretic effect of diuretics. As a result, predisposed patients may experience increased signs of heart failure or hypertension. Therefore, careful monitoring of the condition of such patients is necessary, as well as maintaining adequate hydration. Before starting treatment, a kidney function test is necessary.

In case of combination therapy, renal function should also be monitored.

When using the drug Movalis (as well as most other NSAIDs), episodic increases in transaminase activity or other indicators of liver function in the blood serum have been reported. In most cases, this increase was small and transitory. If the identified changes are significant or do not decrease over time, Movalis should be discontinued and the identified laboratory changes should be monitored.

Frail or malnourished patients may be less able to tolerate adverse events and should be monitored closely.

Like other NSAIDs, Movalis can mask the symptoms of an infectious disease.

As a drug that inhibits COX/prostaglandin synthesis, Movalis may have an effect on fertility and is therefore not recommended for women who have difficulty conceiving. In women undergoing examination for this reason, it is recommended to discontinue taking Movalis.

In patients with mild to moderate renal failure (CR >

Impact on the ability to drive vehicles and operate machinery

No special clinical studies have been conducted on the effect of the drug on the ability to drive a car or use machinery. However, when driving and operating machinery, the possibility of dizziness, drowsiness, visual impairment or other central nervous system disorders should be taken into account. Patients should be careful when driving a car and operating machinery.

Pregnancy and lactation

The use of Movalis is contraindicated during pregnancy.

It is known that NSAIDs are excreted in breast milk, therefore the use of Movalis during breastfeeding is contraindicated.

As a drug that inhibits COX/prostaglandin synthesis, Movalis may have an effect on fertility and is therefore not recommended for women planning pregnancy. Meloxicam may delay ovulation. In this regard, in women who have problems conceiving and are undergoing examination for such problems, it is recommended to discontinue taking the drug Movalis.

Use in childhood

The use of the drug in children under 12 years of age is contraindicated.

For impaired renal function

The drug is contraindicated in severe renal failure (if hemodialysis is not performed, CC<30 мл/мин, а также при подтвержденной гиперкалиемии), прогрессирующем заболевании почек.

The drug should be prescribed with caution in case of renal failure (creatinine clearance 30-60 ml/min).

In patients with severe renal failure undergoing hemodialysis, the dose should not exceed 7.5 mg/day.

In patients with mild to moderate renal insufficiency (creatinine clearance >25 ml/min), no dose adjustment is required.

For liver dysfunction

The drug is contraindicated in severe liver failure.

In patients with liver cirrhosis (compensated), no dose adjustment is required.

Use in old age

The drug should be prescribed with caution to elderly patients.

Conditions for dispensing from pharmacies

The drug is available with a prescription.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life: 3 years.

The description of the drug MOVALIS is based on officially approved instructions for use and approved by the manufacturer.
MOVALIS - description and instructions provided by the Vidal reference book of medicines Medicine for joints

The non-steroidal anti-inflammatory drug Movalis belongs to the group of phenolic acids. The medicine has antipyretic, analgesic, and pronounced anti-inflammatory effects. Used to treat ankylosing spondylitis, rheumatoid arthritis, osteoarthritis.

Movalis - instructions

Judging by the reviews of doctors, the drug Movalis is the most effective remedy for treating pathologies of the musculoskeletal system. The medication is prescribed for osteochondrosis of any location. The instructions for Movalis contain information that the main active ingredient of the drug is Meloxicam. This component has the ability to inhibit the synthesis of inflammatory mediators. The use of Meloxicam is justified when other medications are powerless. Release forms of Movalis, which do not differ much in price:

• ampoules for intramuscular administration;
• tablets for oral administration;
• rectal suppositories (suppositories);
• suspension for internal use.

Movalis injections

The drug in ampoules is used, as a rule, in the very first days of exacerbation of the disease, when inflammation is significantly expressed. After the symptoms have reduced, patients are prescribed the drug in other dosage forms. Injections are the fastest way to relieve acute joint pain. When administered intramuscularly, the drug is very quickly absorbed into the blood, where the maximum concentration is reached in just an hour. For this reason, Movalis injections are prescribed to be administered once a day. Long-term use of injections is not recommended due to the risk of local complications.

Movalis tablets

Although the medication in ampoules relieves inflammatory processes faster, Movalis in tablets is not capable of causing the death of muscle tissue. The difference between this NSAID and its traditional analogues is that Movalis produces much fewer adverse reactions that are typical for drugs in this group. The tableted drug acts slowly and gently. To obtain a lasting therapeutic effect, the medication should be taken for several days. For moderate pain, it is often combined with injections.

Movalis candles

The doctor may prescribe the use of the drug in the form of suppositories for hemorrhoids, endometritis, and lumbar chondrosis. The use of rectal suppositories provides very quick results, as they are easily absorbed into the blood. For the same reason, Movalis suppositories are popular in gynecology when a woman is diagnosed with uterine inflammation. The drug quickly relieves pain in the lower abdomen and lowers body temperature if necessary.

Movalis suspension

Also prescribed for oral administration. Movalis suspension is a viscous liquid of yellowish-green color. Indicated for use in degenerative joint diseases, arthritis and other inflammatory processes of the musculoskeletal system, which are accompanied by pain. Movalis suspension - instructions for use state that you should drink it once a day with meals. The maximum dose is 15 mg. The duration of therapy is determined by a specialist, because it depends on the diagnosis and age of the patient.

Movalis - application

In case of severe inflammation, treatment should begin with injections, since they quickly relieve pain. How to inject Movalis? The average daily dose of the drug is 7.5 mg. Unlike tablets, you can inject at any time, regardless of food intake. It is allowed to use the drug 1 time/day. After 3-5 days, when the acute symptoms subside, the injections can be changed to taking tablets or a suppository.

How to take Movalis tablets? The daily amount of medication is prescribed from 7.5 mg to 15, depending on the severity of the pathology. If the patient is predisposed to side effects, then doctors prescribe the drug in a dose not exceeding 7 mg/day. Tablets should be taken 2-3 times/day with meals. Suppositories are used once at night. The average course of treatment is 14-28 days (selected individually).

Movalis - contraindications

According to the annotation, the drug should not be used for the following conditions:

• heart failure;
• blood clotting disorder;
• severe liver or kidney failure;
• polyps in the nasal cavity;
• bronchial asthma;
• hypersensitivity to components;
• age up to 14 and after 80 years;
• inflammation of the rectum or anus (for suppositories).

According to the instructions, it is not advisable to use Movalis during pregnancy, especially the first two trimesters, during which the development of fetal organs occurs. The period of breastfeeding is an absolute contraindication to taking the drug. If therapy is necessary during lactation, then feeding the baby should be stopped. Prescribing the drug to women wishing to become pregnant should be done with caution, because the drug affects fertility. As for alcohol, it is not a contraindication.

Movalis - side effects

The list of negative reactions of the body to the drug is very long. But such symptoms are very rare if you follow the instructions for use and exclude individual intolerance. However, when starting to take the medicine, you need to know what reactions may occur. Movalis - side effects:

• tachycardia;
• dizziness;
• nausea, vomiting;
• skin rash;
• alternating constipation with diarrhea;
• intestinal colic;
• exacerbation of ulcers;
• blood pressure surges;
• swelling of the limbs;
• increased drowsiness.

Movalis - analogues

This drug has many medications that are similar in pharmacological action, but cheaper in price. However, do not forget that an inexpensive drug may be much worse in effectiveness. The most famous substitute for Movalis is Artrosan. Other analogues of the drug:

• Celebrex;
• Nimesil;
• Mydocalm;
• Diclofenac;
• Voltaren.

Price for Movalis

Buying medicine at a pharmacy is not difficult. If it is not on sale, it is just as easy to replace it with another drug. Buying from an online store (ordering from a catalog) is also not a problem, but you will have to pay extra for delivery, so the price may be higher. How much does Movalis cost in Russian pharmacies? Depending on the manufacturer and form of release, the price of the drug ranges from 500 (tablets) to 900 (ampoules) rubles.

Movalis is a drug from the group of non-steroidal anti-inflammatory drugs (NSAIDs), a selective inhibitor of COX-2 (cyclooxygenase-2 enzyme). It contains the substance meloxicam. There are several forms of release of this product:

• Tablets for oral administration - 7.5 and 15 mg of active substance each
• Oral suspension – 500 ml, 7.5 mg of active substance in 5 ml of liquid
• Solution for injection – 15 mg of active substance in a 1.5 ml ampoule
• Suppositories for rectal use - 15 mg of active substance in each suppository

Indications for use in diseases of the spine

Movalis is most often used for diseases of the musculoskeletal system, in particular for diseases of the spine. The main ones are:

• Postoperative period
• Back pain of unknown etiology

Contraindications

Movalis is contraindicated for use under the following conditions:

• Allergy to the drug and its components
• Peptic ulcer of the stomach or duodenum
• Kidney failure
• Liver failure
• Pregnancy
• Lactation period
• Age after 80 years (relative contraindication)
• Combination of bronchial asthma with allergy to Aspirin
• Taking blood thinning medications (for injection form)
• Inflammation of the anus and rectum (for suppositories)
• Children under 14 years old
• Heart failure, decompensation

Operating principle

Once in the systemic bloodstream, Movalis penetrates the affected cells and tissues of the spine and its structures. There it inhibits the enzyme cyclooxygenase-2, which is directly involved in the production of inflammatory mediators (prostaglandins). The patient feels an anti-inflammatory, antipyretic and analgesic effect.

Instructions for use

Movalis in tablet form

Movalis tablets should be taken orally, during meals or within 15-20 minutes after meals, with a sufficient amount of liquid. Depending on the severity of the disease and its symptoms, the dosage is 7.5-15 mg per day at a time. The duration of treatment depends on the severity of symptoms. However, usually 14-28 days are enough to relieve pain and inflammation. If necessary, the course of treatment can be extended or repeated.

Movalis in suspension form

The liquid form of Movalis is used if it is impossible to take tablets for one reason or another. Once a day, during or immediately after meals, you should drink 5-10 ml of the suspension. If necessary, you can drink it with water. The course of treatment is calculated in the same way as when taking tablets - 14-28 days. If necessary, extended or repeated.

Movalis in the form of a solution for injection

Injections are given intramuscularly, 7.5-15 mg of the drug once a day for 3-5 days. After which it is necessary to switch to the tablet form of release until the symptoms completely stop. The maximum daily dosage of Movalis in any form of release is 15 mg. You can also combine injections and tablets of the drug, 7.5 mg of each release form.

Movalis in the form of candles

Movalis suppositories are used if taking tablet forms is not possible for one reason or another. The suppository should be inserted deep into the rectum, 1 per day. The course of treatment ranges from 2 weeks to 1 month and is selected individually, depending on the severity of the symptoms of the disease.

Side effects

The list of side effects from taking Movalis is quite long, but all these symptoms are extremely rare and occur in cases of individual intolerance to the drug. The main ones include the following:

• Dizziness
• Headache
• Rapid heartbeat (tachycardia)
• Rash and itching on the skin
• Abdominal pain
• Vomit
• Nausea
• Constipation or diarrhea, or alternating between the two
• Noise in ears
• Bloating
• Gastrointestinal bleeding
• Exacerbation of peptic ulcer
• Attacks of bronchial obstruction and bronchial asthma
• Increased sleepiness
• Blood pressure surges
• Swelling of the legs

If these symptoms occur, you should stop taking the drug and consult your doctor. If the recommended dosage of Movalis is exceeded several times, the following symptoms may develop:

• Drowsiness
• Vomit
• Nausea
• Abdominal pain
• Bleeding from the stomach or intestines
• Breathing problems
• Convulsions
• Interruptions in heart function
• Cardiac and respiratory arrest
• Acute renal failure

If the dosage of the drug is exceeded, it is necessary to urgently call a doctor, rinse the stomach and start taking symptomatic medications.

special instructions

It is not advisable to take Movalis during pregnancy, especially in the first 2 trimesters, when organ formation and development occurs. The lactation period is a contraindication to taking Movalis. If therapy with this drug is necessary, breastfeeding should be discontinued.

Movalis is contraindicated for children under 14 years of age because there is no reliable data on its effect on the child.

Alcoholic drinks do not affect the effect of the drug.

Analogues of Movalis

Arthrozan, Melox, Meloxicam, Movasin, Amelotex, etc.