Препарат рекомендуется при невозможности применения мелоксикама в иных лекарственных формах. Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет. Краткосрочная симптоматическая терапия при остеоартрите (артроз, дегенеративные заболевания суставов), ревматоидном ...
- Гиперчувствительность к активному веществу или вспомогательным компонентам препарата, к ацетилсалициловой кислоте и другим НПВП;
- полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза слизистой оболочки носа и околоносовых пазух, ангионевротического отека или крапивницы, вызванных непереносимостью ацетилсалициловой кислоты или ...
Препарат рекомендуется при невозможности применения мелоксикама в иных лекарственных формах. Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет. Краткосрочная симптоматическая терапия при остеоартрите (артроз, дегенеративные заболевания суставов), ревматоидном артрите, анкилозирующем спондилите, других воспалительных и дегенеративных заболеваниях костно-мышечной системы, таких как артропатии, дорсопатии (например, ишиас, боль внизу спины, плечевой периартрит и другие), сопровождающихся болью.
Противопоказания
- Гиперчувствительность к активному веществу или вспомогательным компонентам препарата, к ацетилсалициловой кислоте и другим НПВП;
- полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза слизистой оболочки носа и околоносовых пазух, ангионевротического отека или крапивницы, вызванных непереносимостью ацетилсалициловой кислоты или других НПВП из-за существующей вероятности перекрестной чувствительности (в том числе в анамнезе);
- эрозивно-язвенные изменения слизистой оболочки желудка и двенадцатиперстной кишки в стадии обострения или недавно перенесенные;
- воспалительные заболевания кишечника - болезнь Крона или язвенный колит в стадии обострения;
- активное желудочно-кишечное кровотечение, недавно перенесенные цереброваскулярные кровотечения или установленный диагноз заболеваний свертывающей системы крови;
- тяжелая печеночная недостаточность или активное заболевание печени;
- тяжелая почечная недостаточность (если не проводится гемодиализ, клиренс креатинина менее 30 мл/мин), прогрессирующие заболевания почек, в том числе подтвержденная гиперкалиемия;
- пожилые пациенты (старше 65 лет) (в т.ч. получающие диуретики, ослабленные пациенты и с низкой массой тела);
- длительное использование НПВП;
- курение;
- частое употребление алкоголя.
Для снижения риска развития нежелательных явлений со стороны желудочно-кишечного тракта (ЖКТ) следует использовать минимальную эффективную дозу минимально возможным коротким курсом.
Способ применения и дозы
Препарат вводится посредством глубокой внутримышечной инъекции.
Препарат нельзя вводить внутривенно.
Остеоартрит с болевым синдромом: 7,5 мг в день. При необходимости эта доза может быть увеличена до 15 мг в день.
Ревматоидный артрит: 15 мг в день. В зависимости от лечебного эффекта эта доза может быть снижена до 7,5 мг в день.
Анкилозирующий спондилит: 15 мг в день. В зависимости от лечебного эффекта эта доза может быть снижена до 7,5 мг в день.
У пациентов с повышенным риском побочных реакций (заболевания ЖКТ в анамнезе, наличие факторов риска сердечно-сосудистых заболеваний) рекомендуется начинать лечение с дозы 7,5 мг в день.
У пациентов с выраженной почечной недостаточностью, находящихся на гемодиализе, доза не должна превышать 7,5 мг в день.
Общие рекомендации
Так как потенциальный риск побочных реакций зависит от дозы и продолжительности лечения, следует использовать максимально возможные низкие дозы и длительность применения.
Максимальная рекомендуемая суточная доза - 15 мг.
Комбинированное применение
Не следует применять препарат одновременно с другими НПВП.
Суммарная суточная доза препарата Мелоксикам, применяемого в виде разных лекарственных форм, не должна превышать 15 мг. Внутримышечное введение препарата показано только в течение первых 2-3 дней терапии. В дальнейшем лечение продолжают с применением пероральных лекарственных форм. Рекомендуемая доза составляет 7,5 мг или 15 мг 1 раз в день, в зависимости от интенсивности болей и тяжести воспалительного процесса.
Учитывая возможную несовместимость, препарат не следует смешивать в одном шприце с другими лекарственными средствами.
Особые указания
Пациенты, страдающие заболеваниями ЖКТ, должны регулярно наблюдаться. При возникновении язвенного поражения ЖКТ или желудочно-кишечного кровотечения препарат необходимо отменить.
Язвы желудочно-кишечного тракта, перфорация или кровотечения могут возникнуть в ходе применения НПВП в любое время, как при наличии настораживающих симптомов или сведений о серьезных желудочно-кишечных осложнениях в анамнезе, так и при отсутствии этих признаков. Последствия данных осложнений в целом более серьезны у лиц пожилого возраста.
При применении препарата могут развиваться такие серьезные реакции со стороны кожи, как эксфолиативный дерматит, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Поэтому следует уделять особое внимание пациентам, сообщающим о развитии нежелательных явлений со стороны кожи и слизистых оболочек, а также реакций повышенной чувствительности к препарату, особенно, если подобные реакции наблюдались в течение предыдущих курсов лечения. Развитие подобных реакций наблюдается, как правило, в течение первого месяца лечения. В случае появления первых признаков кожной сыпи, изменений слизистых оболочек или других признаков гиперчувствительности должен рассматриваться вопрос о прекращении применения препарата.
При приеме НПВП описаны случаи повышения риска развития серьезных сердечно-сосудистых тромбозов, инфаркта миокарда, приступа стенокардии, возможно со смертельным исходом. Такой риск повышается при длительном применении препарата, а также у пациентов с вышеуказанными заболеваниями в анамнезе и предрасположенных к таким заболеваниям.
НПВП ингибируют в почках синтез простагландинов, которые участвуют в поддержании почечной перфузии. Применение НПВП у пациентов со сниженным почечным кровотоком или уменьшенным объемом циркулирующей крови может привести к декомпенсации скрыто протекающей почечной недостаточности. После отмены НПВП функция почек обычно восстанавливается до исходного уровня. В наибольшей степени риску развития этой реакции подвержены пожилые пациенты; пациенты, у которых отмечается дегидратация, хроническая сердечная недостаточность, цирроз печени, нефротический синдром или острые нарушения функции почек; пациенты, одновременно принимающие диуретические средства, ингибиторы ангиотензинпревращающего фермента, антагонисты ангиотензин-II рецепторов, а также пациенты, перенесшие серьезные хирургические вмешательства, которые ведут к гиповолемии. У таких пациентов в начале терапии следует тщательно контролировать диурез и функцию почек. Применение НПВП совместно с диуретиками может приводить к задержке натрия, калия и воды, а также к снижению натрийуретического действия мочегонных средств. В результате этого у предрасположенных пациентов возможно усиление признаков сердечной недостаточности или гипертензии. Поэтому необходим тщательный контроль состояния таких пациентов, а также должна поддерживаться адекватная гидратация. До начала лечения необходимо исследование функции почек.
В случае проведения комбинированной терапии следует также контролировать функцию почек.
При использовании мелоксикама (так же, как и большинства других НПВП) возможно эпизодическое повышение активности трансаминаз в сыворотке крови или других показателей функции печени. В большинстве случаев это повышение было небольшим и преходящим. Если выявленные изменения существенны или не уменьшаются со временем, препарат следует отменить и проводить наблюдение за выявленными лабораторными изменениями.
Ослабленные или истощенные пациенты могут хуже переносить нежелательные явления, в связи с чем такие пациенты должны тщательно наблюдаться.
Подобно другим НПВП, мелоксикам может маскировать симптомы основного инфекционного заболевания.
Применение мелоксикама, как и других препаратов блокирующих циклооксигеназу и синтез простагландинов, может влиять на фертильность, поэтому не рекомендуется женщинам, желающим забеременеть. При нарушении способности к зачатию у женщин или проведении обследования по поводу бесплодия необходимо рассмотреть вопрос об отмене мелоксикама.
У пациентов со слабой или умеренной почечной недостаточностью (клиренс креатинина более 25 мл/мин) коррекция дозы не требуется.
У пациентов с циррозом печени (компенсированным) коррекция дозы не требуется.
У пациентов с протезом тазобедренного сустава инъекции следует вводить в другую ягодицу.
Как препарат, ингибирующий синтез циклооксигеназы/простагландина, мелоксикам может оказывать влияние на фертильность, и поэтому не рекомендуется женщинам, имеющим трудности с зачатием. В связи с этим у женщин, проходящих обследование по этому поводу, рекомендуется отмена мелоксикама.
Влияние на способность управлять транспортными средствами, механизмами
Специальных клинических исследований влияния препарата на способность управлять автомобилем и механизмами не проводилось. Однако, при управлении автомобилем и работе с механизмами следует принимать во внимание возможность развития головокружения, сонливости, нарушения зрения или других нарушений со стороны центральной нервной системы. Пациентам следует соблюдать осторожность при вождении автомобиля и управлении механизмами.
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Препарат предназначен для симптоматической терапии, уменьшения боли и воспаления на момент использования, на прогрессирование заболевания не влияет. Краткосрочная симптоматическая терапия при остеоартрите (артроз, дегенеративные заболевания суставов), ревматоидном артрите, анкилозирующем спондилите, других воспалительных и дегенеративных заболеваниях костно-мышечной системы, таких как артропатии, дорсопатии (например, ишиас, боль внизу спины, плечевой периартрит и другие), сопровождающихся болью."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"\n\n- Гиперчувствительность к активному веществу или вспомогательным компонентам препарата, к ацетилсалициловой кислоте и другим НПВП;"}},{"type":"paragraph","data":{"text":"- полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза слизистой оболочки носа и околоносовых пазух, ангионевротического отека или крапивницы, вызванных непереносимостью ацетилсалициловой кислоты или других НПВП из-за существующей вероятности перекрестной чувствительности (в том числе в анамнезе);"}},{"type":"paragraph","data":{"text":"- эрозивно-язвенные изменения слизистой оболочки желудка и двенадцатиперстной кишки в стадии обострения или недавно перенесенные;"}},{"type":"paragraph","data":{"text":"- воспалительные заболевания кишечника - болезнь Крона или язвенный колит в стадии обострения;"}},{"type":"paragraph","data":{"text":"- активное желудочно-кишечное кровотечение, недавно перенесенные цереброваскулярные кровотечения или установленный диагноз заболеваний свертывающей системы крови;"}},{"type":"paragraph","data":{"text":"- тяжелая печеночная недостаточность или активное заболевание печени;"}},{"type":"paragraph","data":{"text":"- тяжелая почечная недостаточность (если не проводится гемодиализ, клиренс креатинина менее 30 мл/мин), прогрессирующие заболевания почек, в том числе подтвержденная гиперкалиемия;"}},{"type":"paragraph","data":{"text":"- выраженная неконтролируемая сердечная недостаточность;"}},{"type":"paragraph","data":{"text":"- терапия периоперационных болей при проведении шунтирования коронарных артерий;"}},{"type":"paragraph","data":{"text":"- сопутствующая терапия антикоагулянтами, так как есть риск образования внутримышечных гематом;"}},{"type":"paragraph","data":{"text":"- беременность;"}},{"type":"paragraph","data":{"text":"- период грудного вскармливания;"}},{"type":"paragraph","data":{"text":"- возраст до 18 лет.\n\n"}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"\n\n- заболевания желудочно-кишечного тракта (ЖКТ) в анамнезе (наличие инфекции Helicobacter pylori); язвенная болезнь желудка и 12-перстной кишки;"}},{"type":"paragraph","data":{"text":"- хроническая сердечная недостаточность;"}},{"type":"paragraph","data":{"text":"- ишемическая болезнь сердца;"}},{"type":"paragraph","data":{"text":"- артериальная гипертензия;"}},{"type":"paragraph","data":{"text":"- почечная недостаточность (клиренс креатинина 30-60 мл/мин);"}},{"type":"paragraph","data":{"text":"- прогрессирующие заболевания печени, гипербилирубинемия, печеночная недостаточность;"}},{"type":"paragraph","data":{"text":"- цереброваскулярные заболевания;"}},{"type":"paragraph","data":{"text":"- дислипидемия/гиперлипидемия;"}},{"type":"paragraph","data":{"text":"- сахарный диабет;"}},{"type":"paragraph","data":{"text":"- сопутствующая терапия следующими препаратами: антикоагулянтами, пероральными глюкокортикостероидами, антиагрегантами, селективными ингибиторами обратного захвата серотонина;"}},{"type":"paragraph","data":{"text":"- бронхиальная астма, туберкулез, выраженный остеопороз;"}},{"type":"paragraph","data":{"text":"- заболевания периферических артерий;"}},{"type":"paragraph","data":{"text":"- пожилые пациенты (старше 65 лет) (в т.ч. получающие диуретики, ослабленные пациенты и с низкой массой тела);"}},{"type":"paragraph","data":{"text":"- длительное использование НПВП;"}},{"type":"paragraph","data":{"text":"- курение;"}},{"type":"paragraph","data":{"text":"- частое употребление алкоголя."}},{"type":"paragraph","data":{"text":"Для снижения риска развития нежелательных явлений со стороны желудочно-кишечного тракта (ЖКТ) следует использовать минимальную эффективную дозу минимально возможным коротким курсом.\n\n"}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"\n\nПрепарат вводится посредством глубокой внутримышечной инъекции."}},{"type":"paragraph","data":{"text":"Препарат нельзя вводить внутривенно."}},{"type":"paragraph","data":{"text":"Остеоартрит с болевым синдромом: 7,5 мг в день. При необходимости эта доза может быть увеличена до 15 мг в день."}},{"type":"paragraph","data":{"text":"Ревматоидный артрит: 15 мг в день. В зависимости от лечебного эффекта эта доза может быть снижена до 7,5 мг в день."}},{"type":"paragraph","data":{"text":"Анкилозирующий спондилит: 15 мг в день. В зависимости от лечебного эффекта эта доза может быть снижена до 7,5 мг в день."}},{"type":"paragraph","data":{"text":"У пациентов с повышенным риском побочных реакций (заболевания ЖКТ в анамнезе, наличие факторов риска сердечно-сосудистых заболеваний) рекомендуется начинать лечение с дозы 7,5 мг в день."}},{"type":"paragraph","data":{"text":"У пациентов с выраженной почечной недостаточностью, находящихся на гемодиализе, доза не должна превышать 7,5 мг в день."}},{"type":"paragraph","data":{"text":"Общие рекомендации"}},{"type":"paragraph","data":{"text":"Так как потенциальный риск побочных реакций зависит от дозы и продолжительности лечения, следует использовать максимально возможные низкие дозы и длительность применения."}},{"type":"paragraph","data":{"text":"Максимальная рекомендуемая суточная доза - 15 мг."}},{"type":"paragraph","data":{"text":"Комбинированное применение"}},{"type":"paragraph","data":{"text":"Не следует применять препарат одновременно с другими НПВП."}},{"type":"paragraph","data":{"text":"Суммарная суточная доза препарата Мелоксикам, применяемого в виде разных лекарственных форм, не должна превышать 15 мг. Внутримышечное введение препарата показано только в течение первых 2-3 дней терапии. В дальнейшем лечение продолжают с применением пероральных лекарственных форм. Рекомендуемая доза составляет 7,5 мг или 15 мг 1 раз в день, в зависимости от интенсивности болей и тяжести воспалительного процесса."}},{"type":"paragraph","data":{"text":"Учитывая возможную несовместимость, препарат не следует смешивать в одном шприце с другими лекарственными средствами.\n\n"}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"\n\nПациенты, страдающие заболеваниями ЖКТ, должны регулярно наблюдаться. При возникновении язвенного поражения ЖКТ или желудочно-кишечного кровотечения препарат необходимо отменить."}},{"type":"paragraph","data":{"text":"Язвы желудочно-кишечного тракта, перфорация или кровотечения могут возникнуть в ходе применения НПВП в любое время, как при наличии настораживающих симптомов или сведений о серьезных желудочно-кишечных осложнениях в анамнезе, так и при отсутствии этих признаков. Последствия данных осложнений в целом более серьезны у лиц пожилого возраста."}},{"type":"paragraph","data":{"text":"При применении препарата могут развиваться такие серьезные реакции со стороны кожи, как эксфолиативный дерматит, синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Поэтому следует уделять особое внимание пациентам, сообщающим о развитии нежелательных явлений со стороны кожи и слизистых оболочек, а также реакций повышенной чувствительности к препарату, особенно, если подобные реакции наблюдались в течение предыдущих курсов лечения. Развитие подобных реакций наблюдается, как правило, в течение первого месяца лечения. В случае появления первых признаков кожной сыпи, изменений слизистых оболочек или других признаков гиперчувствительности должен рассматриваться вопрос о прекращении применения препарата."}},{"type":"paragraph","data":{"text":"При приеме НПВП описаны случаи повышения риска развития серьезных сердечно-сосудистых тромбозов, инфаркта миокарда, приступа стенокардии, возможно со смертельным исходом. Такой риск повышается при длительном применении препарата, а также у пациентов с вышеуказанными заболеваниями в анамнезе и предрасположенных к таким заболеваниям."}},{"type":"paragraph","data":{"text":"НПВП ингибируют в почках синтез простагландинов, которые участвуют в поддержании почечной перфузии. Применение НПВП у пациентов со сниженным почечным кровотоком или уменьшенным объемом циркулирующей крови может привести к декомпенсации скрыто протекающей почечной недостаточности. После отмены НПВП функция почек обычно восстанавливается до исходного уровня. В наибольшей степени риску развития этой реакции подвержены пожилые пациенты; пациенты, у которых отмечается дегидратация, хроническая сердечная недостаточность, цирроз печени, нефротический синдром или острые нарушения функции почек; пациенты, одновременно принимающие диуретические средства, ингибиторы ангиотензинпревращающего фермента, антагонисты ангиотензин-II рецепторов, а также пациенты, перенесшие серьезные хирургические вмешательства, которые ведут к гиповолемии. У таких пациентов в начале терапии следует тщательно контролировать диурез и функцию почек. Применение НПВП совместно с диуретиками может приводить к задержке натрия, калия и воды, а также к снижению натрийуретического действия мочегонных средств. В результате этого у предрасположенных пациентов возможно усиление признаков сердечной недостаточности или гипертензии. Поэтому необходим тщательный контроль состояния таких пациентов, а также должна поддерживаться адекватная гидратация. До начала лечения необходимо исследование функции почек."}},{"type":"paragraph","data":{"text":"В случае проведения комбинированной терапии следует также контролировать функцию почек."}},{"type":"paragraph","data":{"text":"При использовании мелоксикама (так же, как и большинства других НПВП) возможно эпизодическое повышение активности трансаминаз в сыворотке крови или других показателей функции печени. В большинстве случаев это повышение было небольшим и преходящим. Если выявленные изменения существенны или не уменьшаются со временем, препарат следует отменить и проводить наблюдение за выявленными лабораторными изменениями."}},{"type":"paragraph","data":{"text":"Ослабленные или истощенные пациенты могут хуже переносить нежелательные явления, в связи с чем такие пациенты должны тщательно наблюдаться."}},{"type":"paragraph","data":{"text":"Подобно другим НПВП, мелоксикам может маскировать симптомы основного инфекционного заболевания."}},{"type":"paragraph","data":{"text":"Применение мелоксикама, как и других препаратов блокирующих циклооксигеназу и синтез простагландинов, может влиять на фертильность, поэтому не рекомендуется женщинам, желающим забеременеть. При нарушении способности к зачатию у женщин или проведении обследования по поводу бесплодия необходимо рассмотреть вопрос об отмене мелоксикама."}},{"type":"paragraph","data":{"text":"У пациентов со слабой или умеренной почечной недостаточностью (клиренс креатинина более 25 мл/мин) коррекция дозы не требуется."}},{"type":"paragraph","data":{"text":"У пациентов с циррозом печени (компенсированным) коррекция дозы не требуется."}},{"type":"paragraph","data":{"text":"У пациентов с протезом тазобедренного сустава инъекции следует вводить в другую ягодицу."}},{"type":"paragraph","data":{"text":"Как препарат, ингибирующий синтез циклооксигеназы/простагландина, мелоксикам может оказывать влияние на фертильность, и поэтому не рекомендуется женщинам, имеющим трудности с зачатием. В связи с этим у женщин, проходящих обследование по этому поводу, рекомендуется отмена мелоксикама."}},{"type":"paragraph","data":{"text":"Влияние на способность управлять транспортными средствами, механизмами"}},{"type":"paragraph","data":{"text":"Специальных клинических исследований влияния препарата на способность управлять автомобилем и механизмами не проводилось. Однако, при управлении автомобилем и работе с механизмами следует принимать во внимание возможность развития головокружения, сонливости, нарушения зрения или других нарушений со стороны центральной нервной системы. Пациентам следует соблюдать осторожность при вождении автомобиля и управлении механизмами.\n\n"}}]}],"source":null},"description_toggle":false,"short_description":"","substance":[{"id":126,"title":"Мелоксикам","title_latin":"Meloxicamum","slug":"meloksikam_126"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Мелоксикам - фото упаковки","image_share":{"isTouch":{"default":null},"isFromTablet":{"default":null}},"diseases":[],"other_packages":[{"id":92146,"title":"Мелоксикам","subtitle":{"full":"Раствор, 3 шт, 1,5 мл","short":"Раствор, 3 шт, 1,5 мл","package":"3 шт, 1,5 мл"},"prescription":true,"catalog_section_id":100267,"manufacturer":null,"is_advert":false,"product_form":"Раствор","slug":"92146-meloksikam","attributes":{"count":"3 шт","dose":"","volume":"1,5 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