Тексаред Лиофилизат, 3 шт, 20 мг, для раствора для инъекций

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Помимо противовоспалительного,\nанальгетического и жаропонижающего действия, препарат также препятствует\nагрегации тромбоцитов. Теноксикам оказывает свое\nпротивовоспалительное действие за счет подавления активности изоферментов\nциклооксигеназы, участвующих в метаболизме арахидоновой кислоты, и, таким\nобразом, подавляет синтез простагландинов. Теноксикам не оказывает воздействия\nна активность липооксигеназ. Кроме того, теноксикам подавляет некоторые функции\nлейкоцитов, включая фагоцитоз, высвобождение гистамина и уменьшает содержание\nактивных радикалов в очаге воспаления."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика \u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eАбсорбция\nи распределение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Абсорбция быстрая и полная. Биодоступность\n– 100%."}},{"type":"paragraph","data":{"text":"В крови препарат связывается с белками на\n99%. Через 15 минут после внутримышечного введения концентрация\nтеноксикама достигает 90% от максимально возможного значения (С\u003csub\u003emax\u003c/sub\u003e).\nПрепарат хорошо проникает в синовиальную жидкость, характеризуется низким\nсистемным клиренсом и продолжительным периодом полувыведения, что позволяет\nприменять теноксикам один раз в сутки."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Почти полностью метаболизируется в печени\nпутем гидроксилирования."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Приблизительно две трети введенного\nтеноксикама выводится почками в виде неактивного 5-гидроксипиридилового\nметаболита, оставшаяся часть препарата выводится с желчью в виде\nконъюгированных гидроксиметаболитов. Менее 1% препарата выводится почками в\nнеизмененном виде. "}},{"type":"paragraph","data":{"text":"При длительном применении кумуляция не\nнаблюдается; сывороточное содержание теноксикама при этом составляет 10-15 мкг/мл."}},{"type":"paragraph","data":{"text":"Средний период полувыведения составляет\nприблизительно 72 ч. "}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Ревматоидный артрит."}},{"type":"paragraph","data":{"text":"Остеоартрит."}},{"type":"paragraph","data":{"text":"Анкилозирующий спондилит."}},{"type":"paragraph","data":{"text":"Суставной синдром при обострении течения\nподагры."}},{"type":"paragraph","data":{"text":"Бурсит."}},{"type":"paragraph","data":{"text":"Тендовагинит."}},{"type":"paragraph","data":{"text":"Болевой синдром (слабой и средней\nинтенсивности): артралгия, миалгия, невралгия, мигрень, зубная и головная боль,\nальгодисменорея."}},{"type":"paragraph","data":{"text":"Боль при травмах, ожогах."}},{"type":"paragraph","data":{"text":"При воспалительных и дегенеративных\nзаболеваниях опорно-двигательного аппарата, сопровождающихся болевым синдромом,\nтаких как ишиалгия, люмбаго, эпикондилит. Препарат предназначен для\nсимптоматической терапии, уменьшения боли и воспаления на момент использования,\nна прогрессирование заболевания не влияет."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к теноксикаму или\nвспомогательным веществам препарата. Существует также вероятность перекрестной\nчувствительности к другим НПВП."}},{"type":"paragraph","data":{"text":"Эрозивно-язвенные поражения желудочно-кишечного\nтракта (ЖКТ), в том числе в анамнезе."}},{"type":"paragraph","data":{"text":"Желудочно-кишечное кровотечение, в том\nчисле в анамнезе."}},{"type":"paragraph","data":{"text":"Воспалительные заболевания ЖКТ (болезнь\nКрона или язвенный колит в стадии обострения)."}},{"type":"paragraph","data":{"text":"Тяжелая почечная недостаточность (клиренс\nкреатинина менее 30 мл/мин)."}},{"type":"paragraph","data":{"text":"Прогрессирующее заболевание почек. "}},{"type":"paragraph","data":{"text":"Тяжелая печеночная недостаточность."}},{"type":"paragraph","data":{"text":"Полное или неполное сочетание бронхиальной\nастмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости\nацетилсалициловой кислоты (АСК) или других НПВП (в том числе, в анамнезе)."}},{"type":"paragraph","data":{"text":"Установленный диагноз заболеваний\nсвертывающей системы крови."}},{"type":"paragraph","data":{"text":"Декомпенсированная сердечная\nнедостаточность."}},{"type":"paragraph","data":{"text":"Терапия периоперационных болей при\nпроведении шунтирования коронарных артерий."}},{"type":"paragraph","data":{"text":"Беременность и период грудного\nвскармливания."}},{"type":"paragraph","data":{"text":"Детский возраст до 18 лет. "}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Язвенная болезнь желудка и\nдвенадцатиперстной кишки, язвенный колит и болезнь Крона вне обострения,\nзаболевания печени в анамнезе, печеночная порфирия, значительное снижение\nобъема циркулирующей крови (в том числе, после хирургического вмешательства),\nхроническая сердечная недостаточность (ХСН), артериальная гипертензия, сахарный\nдиабет, ишемическая болезнь сердца (ИБС), цереброваскулярные заболевания,\nдислипидемия/гиперлипидемия, заболевания периферических артерий, курение,\nхроническая почечная недостаточность (КК 30-60 мл/мин), наличие инфекции \u003ci\u003eH. pylori\u003c/i\u003e, длительное применение\nНПВП, алкоголизм, тяжелые соматические заболевания, одновременное применение\nглюкокортикостероидов (в том числе, преднизолона), антикоагулянтов (в том\nчисле, варфарина), антиагрегантов (в том числе, ацетилсалициловой кислоты,\nклопидогрела), селективных ингибиторов обратного захвата серотонина (в том\nчисле, циталопрама, флуоксетина, пароксетина, сертралина), возраст пациентов\nстарше 65 лет (в том числе, пациенты, получающие диуретики, ослабленные\nпациенты и пациенты с низкой массой тела), бронхиальная астма, аутоиммунные\nзаболевания (системная красная волчанка и смешанное заболевание соединительной\nткани)."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Для\nвнутримышечного и внутривенного введения."}},{"type":"paragraph","data":{"text":"Для\nкратковременной терапии (1-2 дня) в дозе 20 мг 1 раз в сутки. "}},{"type":"paragraph","data":{"text":"При\nнеобходимости дальнейшей терапии переходят на пероральные лекарственные формы\nтеноксикама. Для снижения риска развития нежелательных явлений следует\nприменять минимальную эффективную дозу максимально возможным коротким курсом."}},{"type":"paragraph","data":{"text":"При острых\nскелетно-мышечных нарушениях общая длительность парентерального и перорального\nприменения теноксикама обычно составляет не более 7 дней, однако в тяжелых\nслучаях терапия может быть продолжена максимум до 14 дней. "}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота развития нежелательных реакций\nприведена согласно рекомендациям Всемирной организации здравоохранения: очень\nчасто (>1/10), часто (≥1/100,\n<1/10), нечасто (≥1/1000, <1/100), редко (<1/1000), очень редко (<\n1/10 000) и не установлено."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны крови и лимфатической системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто – агранулоцитоз, лейкопения, редко –\nанемия, тромбоцитопения, панцитопения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны центральной нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто – головокружение, головная боль,\nсонливость, депрессия, возбуждение, снижение слуха, шум в ушах, раздражение\nглаз, нарушение зрения."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны сердца\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Редко – сердечная недостаточность,\nтахикардия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны сосудов\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Редко – повышение артериального давления."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень часто – диспепсия (тошнота, рвота,\nизжога, диарея, метеоризм), НПВП-гастропатия, абдоминальные боли, стоматит,\nанорексия, нарушение функции печени; "}},{"type":"paragraph","data":{"text":"\nредко – изъязвление слизистой оболочки желудочно-кишечного тракта, кровотечение\n(желудочно-кишечное, маточное, геморроидальное), перфорация стенок кишечника."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны кожи и подкожных тканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто – кожный зуд, сыпь, крапивница и\nэритема; очень редко – фотодерматит, синдром Стивенса-Джонсона, синдром\nЛайелла."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения\nсо стороны почек и мочевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто – повышение содержания азота\nмочевины и креатинина в крови."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие\nрасстройства\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"На фоне лечения могут наблюдаться\nпсихические нарушения и нарушение обмена веществ."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛабораторные\nи инструментальные данные\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Гиперкреатининемия, гипербилирубинемия,\nповышение концентрации азота мочевины и активности «печеночных» трансаминаз\n(АЛТ, АСТ, гамма-ГТ), удлинение времени кровотечения."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e (при\nоднократном введении): боль в животе, тошнота, рвота, эрозивно-язвенное\nпоражение желудочно-кишечного тракта, нарушение функции почек и печени,\nметаболический ацидоз."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e симптоматическое\n(поддержание жизненно важных функций организма). Гемодиализ – малоэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Теноксикам обладает высокой степенью\nсвязывания с альбумином и может, как и все НПВП, усиливать антикоагулянтный\nэффект варфарина и других антикоагулянтов. Рекомендуется контролировать\nфункциональные и биохимические показатели крови при совместном применении с\nантикоагулянтами и гипогликемическими препаратами для приема внутрь, особенно\nна начальных стадиях терапии теноксикамом."}},{"type":"paragraph","data":{"text":"Не отмечено возможного взаимодействия с\nдигоксином."}},{"type":"paragraph","data":{"text":"Как и при применении других НПВП,\nрекомендуется с осторожностью применять препарат одновременно с циклоспорином в\nсвязи с увеличением риска развития нефротоксичности."}},{"type":"paragraph","data":{"text":"Совместное применение с хинолонами может\nповышать риск развития судорог."}},{"type":"paragraph","data":{"text":"Салицилаты могут вытеснять теноксикам из\nсвязи с альбумином и, соответственно, повышать клиренс и объем распределения\nпрепарата. Необходимо избегать одновременного применения салицилатов или двух и\nболее НПВП (таким образом увеличивается риск возникновения осложнений со\nстороны ЖКТ)."}},{"type":"paragraph","data":{"text":"Есть данные о том, что НПВП снижают\nвыведение лития. В связи с этим у пациентов, получающих терапию литием,\nнеобходимо чаще контролировать концентрацию лития в крови."}},{"type":"paragraph","data":{"text":"НПВП могут вызывать задержку натрия, калия\nи жидкости в организме, нарушая действие натрийуретических диуретиков.\nТребуется соблюдать осторожность при необходимости одновременного применения\nтеноксикама и диуретиков, выводящих натрий, у пациентов с ХСН и\nартериальной гипертензией."}},{"type":"paragraph","data":{"text":"С осторожностью рекомендуется применять\nНПВП совместно с метотрексатом, так как НПВП уменьшают выведение метотрексата и\nмогут повышать его токсичность."}},{"type":"paragraph","data":{"text":"НПВП не должны применяться в течение 8-12\nч после применения мифепристона, так как могут уменьшать его эффект."}},{"type":"paragraph","data":{"text":"Необходимо учитывать повышенный риск\nразвития желудочно-кишечных кровотечений при одновременном применении с кортикостероидами."}},{"type":"paragraph","data":{"text":"Снижает эффективность урикозурических\nлекарственных средств, усиливает действие антикоагулянтов, фибринолитиков,\nпобочные эффекты минералокортикостероидов и глюкокортикостероидов, эстрогенов;\nснижает эффективность гипотензивных лекарственных средств и диуретиков."}},{"type":"paragraph","data":{"text":"Индукторы микросомального окисления в\nпечени (фенитоин, этанол, барбитураты, \u003ca href=\"http://www.lsgeotar.ru/pharma_mnn/2039.html?XFrom=www.lsgeotar.ru\" target=\"_blank\"\u003eрифампицин\u003c/a\u003e, \u003ca href=\"http://www.lsgeotar.ru/pharma_mnn/2350.html?XFrom=www.lsgeotar.ru\" target=\"_blank\"\u003eфенилбутазон\u003c/a\u003e, трициклические\nантидепрессанты) увеличивают продукцию гидроксилированных активных метаболитов.\nОдновременное применение с антиагрегантами и селективными ингибиторами\nобратного захвата серотонина повышает риск развития желудочно-кишечного\nкровотечения."}},{"type":"paragraph","data":{"text":"Одновременное применение сердечных\nгликозидов и НПВП может усиливать сердечную недостаточность, снижать скорость\nклубочковой фильтрации и увеличивать плазменный уровень сердечных гликозидов."}},{"type":"paragraph","data":{"text":"Не выявлено взаимодействия при применении\nтеноксикама с циметидином. "}},{"type":"paragraph","data":{"text":"Не выявлено клинически значимого\nвзаимодействия при лечении теноксикамом и пеницилламином или парентеральным\nзолотом."}},{"type":"paragraph","data":{"text":"Повышается риск нефротоксичности при одновременном\nприменении НПВП с такролимусом."}},{"type":"paragraph","data":{"text":"Повышается риск гематологической\nтоксичности при применении НПВП с зидовудином."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Во время лечения необходим контроль\nпротромбинового индекса (на фоне приема непрямых антикоагулянтов), концентрации\nглюкозы в крови (на фоне применения гипогликемических средств), картины\nпериферической крови и функционального состояния печени и почек. "}},{"type":"paragraph","data":{"text":"При необходимости определения\n17-кетостероидов, препарат следует отменить за 48 ч до исследования."}},{"type":"paragraph","data":{"text":"Возможно увеличение времени кровотечения,\nчто следует учитывать при хирургических вмешательствах."}},{"type":"paragraph","data":{"text":"Необходимо учитывать возможность задержки\nнатрия и воды в организме при применении с диуретиками у пациентов с\nартериальной гипертензией и сердечной недостаточностью."}},{"type":"paragraph","data":{"text":"Пациенты с неконтролируемой артериальной\nгипертензией, хронической сердечной недостаточностью, заболеваниями\nпериферических артерий, подтвержденной ишемической болезнью сердца и/или\nцереброваскулярными заболеваниями должны принимать препарат под врачебным\nконтролем."}},{"type":"paragraph","data":{"text":"Наличие в анамнезе заболеваний почек может\nпривести к развитию интерстициального нефрита, папиллярного некроза и\nнефротического синдрома. "}},{"type":"paragraph","data":{"text":"Нежелательные эффекты могут быть\nминимизированы применением минимальной эффективной дозы препарата по\nвозможности коротким курсом."}},{"type":"paragraph","data":{"text":"В связи с отрицательным действием на\nфертильность, не рекомендуется применение препарата женщинам, желающим забеременеть.\nУ пациенток с бесплодием (в том числе проходящих обследование) рекомендуется\nотменить препарат. "}},{"type":"paragraph","data":{"text":"У пациентов с системной красной волчанкой\n(СКВ) и смешанным заболеванием соединительной ткани повышается риск развития\nасептического менингита."}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаТеноксикам, представляющий собой тиенотиазиновое производное оксикама, является нестероидным противовоспалительным средством. Помимо противовоспалительного, анальгетического и жаропонижающего действия, препарат также препятствует агрегации тромбоцитов. Теноксикам оказывает свое противовоспалительное действие за счет подавления активности изоферментов циклооксигеназы, участвующих в метаболизме арахидоновой кислоты, и, таким образом, подавляет синтез простагландинов. Теноксикам не оказывает воздействия на активность липооксигеназ. Кроме того, теноксикам подавляет некоторые функции лейкоцитов, включая фагоцитоз, высвобождение гистамина и уменьшает содержание активных радикалов в очаге воспаления.ФармакокинетикаАбсорбция и распределениеАбсорбция быстрая и полная. Биодоступность – 100%. В крови препарат связывается с белками на 99%. Через 15 минут после внутримышечного введения концентрация теноксикама достигает 90% от максимально возможного значения (Сmax). Препарат хорошо проникает в синовиальную жидкость, характеризуется низким системным клиренсом и продолжительным периодом полувыведения, что позволяет применять теноксикам один раз в сутки.МетаболизмПочти полностью метаболизируется в печени путем гидроксилирования.ВыведениеПриблизительно две трети введенного теноксикама выводится почками в виде неактивного 5-гидроксипиридилового метаболита, оставшаяся часть препарата выводится с желчью в виде конъюгированных гидроксиметаболитов. Менее 1% препарата выводится почками в неизмененном виде. При длительном применении кумуляция не наблюдается; сывороточное содержание теноксикама при этом составляет 10-15 мкг/мл. Средний период полувыведения составляет приблизительно 72 ч.","substance":[{"id":2394,"title":"Теноксикам","title_latin":"tenoxicamum","slug":"tenoksikam"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Тексаред - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/222859/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/222859/share_default/"}},"diseases":[],"other_packages":[],"other_product_forms":[{"id":146276,"title":"Тексаред","subtitle":{"full":"Таблетки, коробка, 10 шт, 20 мг, для приема внутрь, покрытые оболочкой","short":"Таблетки, 10 шт, 20 мг","package":"10 шт, 20 мг"},"prescription":true,"catalog_section_id":100267,"manufacturer":{"id":2338,"title":"Dr. Reddy`s 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