Полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты и других НПВП (в т.ч. в анамнезе)
Эрозивно-язвенные изменения слизистой оболочки желудка или двенадцатиперстной кишки
НПВП. Оказывает анальгезирующее, противовоспалительное и жаропонижающее действие. Противовоспалительное действие связано с торможением ферментативной активности циклооксигеназы-2 (ЦОГ-2), участвующей в биосинтезе простагландинов в области воспаления. В меньшей степени мелоксикам действует на циклооксигеназу-1 (ЦОГ-1), участвующую в синтезе простагландина, защищающего слизистую оболочку ЖКТ и принимающего участие в регуляции кровотока в почках.
Показания к применению
Симптоматическое лечение:
Ревматоидного артрита
Остеоартроза
Анкилозирующего спондилита (болезнь Бехтерева)
Других воспалительных и дегенеративных заболеваний суставов, сопровождающихся болевым синдромом
Противопоказания
Полное или неполное сочетание бронхиальной астмы, рецидивирующего полипоза носа и околоносовых пазух и непереносимости ацетилсалициловой кислоты и других НПВП (в т.ч. в анамнезе)
Эрозивно-язвенные изменения слизистой оболочки желудка или двенадцатиперстной кишки
Период после проведения аортокоронарного шунтирования
Декомпенсированная сердечная недостаточность
Цереброваскулярное кровотечение или иные кровотечения
Выраженная печеночная недостаточность или активное заболевание печени
Выраженная почечная недостаточность у больных, не подвергающихся диализу (КК менее 30 мл/мин)
Прогрессирующие заболевания почек, в т.ч. подтвержденная гиперкалиемия
Беременность
Период грудного вскармливания
Детский возраст до 18 лет
Повышенная чувствительность к активному веществу или вспомогательным компонентам. С осторожностью: пожилой возраст, ИБС, хроническая сердечная недостаточность, цереброваскулярные заболевания, дислипидемия/гиперлипидемия, сахарный диабет, заболевания периферических артерий, курение, КК менее 60 мл/мин, язвенные поражения ЖКТ в анамнезе, наличие инфекции Helicobacter pylori, длительное использование НПВП, частое употребление алкоголя, тяжелые соматические заболевания, одновременный прием пероральных ГКС (в т.ч. преднизолона), антикоагулянтов (в т.ч. варфарина), антиагрегантов (в т.ч. ацетилсалициловой кислоты, клопидогрела), селективных ингибиторов обратного захвата серотонина (в т.ч. циталопрама, флуоксетина, пароксетина, сертралина)
Применение при беременности и в период грудного вскармливания
Препарат противопоказан при беременности и в период грудного вскармливания. Применение мелоксикама, как и других препаратов, блокирующих синтез простагландинов может влиять на фертильность, поэтому не рекомендуется женщинам, желающим забеременеть.
Способ применения и дозы
В/м введение препарата показано только в течение первых 2-3 дней. В дальнейшем лечение продолжают с применением пероральных форм (таблетки). Рекомендуемая доза составляет 7.5 мг или 15 мг 1 раз/сут, в зависимости от интенсивности болей и тяжести воспалительного процесса. Препарат вводится посредством глубокой в/м инъекции. Учитывая возможную несовместимость, содержимое ампул Месипол не следует смешивать в одном шприце с другими лекарственными средствами. У пациентов с повышенным риском побочных реакций и с выраженной почечной недостаточностью, находящихся на гемодиализе, доза не должна превышать 7.5 мг/сут. Препарат нельзя вводить в/в. Максимальная суточная доза мелоксикама составляет 15 мг. Комбинированное применение: суммарная суточная доза препарата Месипол, применяемого в виде таблеток, свечей, суспензии для приема внутрь и инъекций, не должна превышать 15 мг.
Побочное действие
Со стороны пищеварительной системы: более 1% - диспепсия, в т.ч. тошнота, рвота, абдоминальные боли, запор, метеоризм, диарея . 0.1-1% - преходящее повышение активности печеночных трансаминаз, гипербилирубинемия, отрыжка, эзофагит, эрозивно-язвенные поражения ЖКТ, скрытое или явное кровотечение из ЖКТ, стоматит . менее 0.1% - перфорация органов ЖКТ, колит, гепатит, гастрит. Со стороны системы кроветворения: более 1% - анемия . 0.1-1% - изменение формулы крови, в т.ч. лейкопения, тромбоцитопения. Со стороны кожных покровов: более 1% - зуд, кожная сыпь . 0.1-1% - крапивница . менее 0.1% - фотосенсибилизация, буллезные высыпания, многоформная эритема, в т.ч. синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Со стороны дыхательной системы: менее 0.1% - бронхоспазм. Со стороны ЦНС: более 1% - головокружение, головная боль . 0.1-1% - вертиго, шум в ушах, сонливость . менее 0.1% - спутанность сознания, дезориентация, эмоциональная лабильность. Со стороны сердечно-сосудистой системы: более 1% - периферические отеки . 0.1-1% - повышение АД, ощущение сердцебиения, приливы крови к коже лица. Со стороны мочевыделительной системы: 0.1-1% - гиперкреатининемия и/или повышение мочевины в сыворотке крови . менее 0.1% - острая почечная недостаточность . связь с приемом мелоксикама не установлена - интерстициальный нефрит, альбуминурия, гематурия. Со стороны органа зрения: менее 0.1% - конъюнктивит, нарушение зрения (в т.ч. нечеткость зрения). Аллергические реакции: менее 0.1% - ангионевротический отек, анафилактоидные, анафилактические реакции. Местные реакции: возможны жжение и боль в месте инъекции.
Особые указания
Со стороны пищеварительной системы: более 1% - диспепсия, в т.ч. тошнота, рвота, абдоминальные боли, запор, метеоризм, диарея . 0.1-1% - преходящее повышение активности печеночных трансаминаз, гипербилирубинемия, отрыжка, эзофагит, эрозивно-язвенные поражения ЖКТ, скрытое или явное кровотечение из ЖКТ, стоматит . менее 0.1% - перфорация органов ЖКТ, колит, гепатит, гастрит. Со стороны системы кроветворения: более 1% - анемия . 0.1-1% - изменение формулы крови, в т.ч. лейкопения, тромбоцитопения. Со стороны кожных покровов: более 1% - зуд, кожная сыпь . 0.1-1% - крапивница . менее 0.1% - фотосенсибилизация, буллезные высыпания, многоформная эритема, в т.ч. синдром Стивенса-Джонсона, токсический эпидермальный некролиз. Со стороны дыхательной системы: менее 0.1% - бронхоспазм. Со стороны ЦНС: более 1% - головокружение, головная боль . 0.1-1% - вертиго, шум в ушах, сонливость . менее 0.1% - спутанность сознания, дезориентация, эмоциональная лабильность. Со стороны сердечно-сосудистой системы: более 1% - периферические отеки . 0.1-1% - повышение АД, ощущение сердцебиения, приливы крови к коже лица. Со стороны мочевыделительной системы: 0.1-1% - гиперкреатининемия и/или повышение мочевины в сыворотке крови . менее 0.1% - острая почечная недостаточность . связь с приемом мелоксикама не установлена - интерстициальный нефрит, альбуминурия, гематурия. Со стороны органа зрения: менее 0.1% - конъюнктивит, нарушение зрения (в т.ч. нечеткость зрения). Аллергические реакции: менее 0.1% - ангионевротический отек, анафилактоидные, анафилактические реакции. Местные реакции: возможны жжение и боль в месте инъекции.
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