Back pain is a common reason for patients to visit a doctor. There are many pathologies characterized by back pain: osteochondrosis, osteoarthritis, rheumatoid arthritis, spinal hernia. Movalis is one of the most effective drugs that can relieve pain.
Active ingredient
The active component of the drug, meloxicam, relieves any inflammation. This has been proven by clinical trials. Meloxicam inhibits the synthesis of prostaglandins (Pg), which are known to be mediators of inflammation. That is, Movalis acts precisely. As for cartilage tissue, it does not experience any negative effects during a course of taking the drug.
The pharmacological market boasts a variety of dosage forms of the drug: tablets, injection solution, rectal suppositories (suppositories), suspensions.
Movalis against arthritis of the fingers
It is worth noting that the injections are intended for the first 2-3 days of therapy, when the inflammatory and pain syndrome is most pronounced. After pain and inflammation are relieved, treatment continues using available dosage forms.
The analgesic effect can be observed after 30 minutes and lasts about a day after taking Movalis.
Compound
The drug contains the active substance meloxicam , as well as the following auxiliary components:
Movalis tablets: sodium citrate, lactose monohydrate, MCC, povidone, anhydrous colloidal silicon dioxide, magnesium stearate, crospovidone.
Ingredients of the injections: meglumine, glycofurol, poloxamer 188, glycine, sodium hydroxide, sodium chloride, purified water.
Movalis suppositories: basis for the manufacture of suppositories suppositir BP, cremophor RH40 (polyethylene glycol glyceryl hydroxystearate).
Movalis suspension: colloidal silicon dioxide, hyaetellose, sorbitol , glycerol , xylitol; benzoate, saccharinate and sodium dihydrogen phosphate dihydrate; citric acid monohydrate, raspberry flavor, purified water.
Release form
The drug is available in:
- tablet form (active substance dosage 7.5 mg (package No. 20) and 15 mg (package No. 10 or No. 20));
- solution for injection 10 mg/ml (ampoules 1.5 ml, package No. 5);
- rectal suppositories 7.5 and 15 mg (package No. 6);
- suspension 1.5 mg/ml (100 ml bottle).
The tablets have a flat-cylindrical shape and beveled edges. One side is marked with the company logo, the other has a fault line. The color of the tablets is from pastel yellow to lemon yellow; roughness on the surface is allowed.
The solution is yellow with a greenish tint, transparent.
The suppositories are smooth, yellowish-green, and have a funnel-shaped depression at the base.
The suspension is a viscous substance of yellowish-green color.
The manufacturer does not produce external therapy products (ointment, gel).
Pharmacological properties of the drug Movalis
Pharmacodynamics. Meloxicam is an NSAID of the enolic acid class, has anti-inflammatory, analgesic and antipyretic effects. Meloxicam exhibits high anti-inflammatory activity in all standard models of inflammation. The mechanism of action is due to the ability to inhibit the biosynthesis of prostaglandins - mediators of inflammation due to the selective inhibition of COX-2, while providing a safer mechanism of action due to the selective inhibition of COX-2 compared to COX-1. It has now been proven that the therapeutic effect of NSAIDs is associated with inhibition of COX-2 synthesis, while inhibition of COX-1 leads to side effects from the stomach and kidneys. The selectivity of COX-2 inhibition by meloxicam has been confirmed by many researchers both in vitro and ex vivo . Meloxicam (7.5 and 15 mg) preferentially inhibits COX-2 ex vivo , as evidenced by greater inhibition of PGE2 production in response to lipopolysaccharide stimulation compared with clotted blood thromboxane (COX-1) production. These effects are dose dependent. Meloxicam does not affect platelet aggregation or bleeding time when used at recommended ex vivo , whereas indomethacin, diclofenac, ibuprofen and naproxen significantly inhibit platelet aggregation and increase bleeding time. Clinical studies have shown a low incidence of gastrointestinal side effects (perforation, ulceration and bleeding) when using meloxicam at recommended doses compared to standard doses of other NSAIDs. Pharmacokinetics. Meloxicam is well absorbed from the gastrointestinal tract when administered orally; The absolute bioavailability of the drug is 89%. Concomitant consumption of food does not affect the absorption of the drug. The concentration of the drug when taken orally is 7.5 and 15 mg per day, respectively, dose-dependent. A stable concentration is achieved on days 3–5. Continuous treatment over a long period (eg 6 months) did not lead to changes in pharmacokinetic parameters compared to parameters after 2 weeks of oral administration of meloxicam at a dose of 15 mg per day. Any changes are also unlikely if treatment lasts more than 6 months. More than 99% of meloxicam is bound to plasma proteins. The drug penetrates into the synovial fluid, its concentration there is 2 times lower than in the blood plasma. After intramuscular injection, meloxicam is completely absorbed, indicating its absolute bioavailability (almost 100%). The pharmacokinetics of meloxicam is linear and dose-dependent when administered intramuscularly in doses of 7.5 and 15 mg. The concentration of meloxicam in blood plasma reaches a maximum 60 minutes after intramuscular injection. Meloxicam undergoes extensive biotransformation in the liver. Meloxicam is almost completely metabolized to 4 pharmacological inert metabolites. The main metabolite, 5-carboxymeloxicam (60% of the dose), is formed by oxidation of the intermediate metabolite 5-hydroxymethylmeloxicam, which is excreted to a lesser extent (9% of the dose). In vitro studies suggest that CYP 2C9 plays an important role in metabolism, CYP 3A4 to a lesser extent. Peroxidase activity in patients is likely responsible for 2 other metabolites, which account for 16 and 4% of the dose received, respectively. Meloxicam is excreted, predominantly in the form of metabolites, in equal amounts in urine and feces. Less than 5% of the daily dose is excreted unchanged in the feces, while only traces of the unchanged substance are excreted in the urine. The half-life is about 20 hours. Hepatic and renal failure do not significantly affect the pharmacokinetics of meloxicam. Plasma clearance is 8 ml/min. Clearance decreases in older women. The volume of distribution is low, averaging 11 L. Individual deviations are 30–40% after IM application.
Pharmacodynamics and pharmacokinetics
Pharmacodynamics: what is Meloxicam and how does it work?
Wikipedia states that the mechanism of action of the drug is based on its ability to suppress the production of Pg. Its pronounced anti-inflammatory activity has been established in all standard models of inflammation.
In vivo, it suppresses the synthesis of Pg in the pathological focus to a greater extent than in the kidneys or in the gastric mucosa, which is associated with a more selective inhibition of the COX-1 isoenzyme compared to COX-2.
It is generally accepted that the therapeutic effectiveness of NSAIDs is due to the inhibition of COX-2, while the renal and gastrointestinal side effects of these drugs arise from the suppression of the constitutively present isoenzyme COX-1.
Selectivity for COX-2 has been confirmed in various tests, both in vitro and ex vivo. In ex vivo models, liposaccharide-stimulated production of PgE2, which is controlled by COX-2, was more actively suppressed than the production of thromboxane, which is involved in the hemocoagulation process, which is controlled by COX-1. The effects were dose-dependent.
It has also been shown in ex vivo models that, at recommended doses, the drug does not alter bleeding time or affect platelet . This fundamentally distinguishes Meloxicam from Ibuprofen , Indomethacin , Diclofenac and Naproxen .
Clinical studies have established that NSAID gastropathy develops significantly less frequently when taking Meloxicam than when taking other NSAIDs. Vomiting, abdominal pain, nausea, and dyspepsia were reported less frequently in patients taking Meloxicam than in patients taking other NSAIDs.
meloxicam- related upper gastrointestinal bleeding, perforation , and was low and dose-related.
Pharmacokinetics:
- absorption from the digestive canal is good, does not change with simultaneous food intake;
- bioavailability - 89% (when taken orally);
- TSmax for a single dose is 5-6 hours, during the period of steady state pharmacokinetic parameters (when taking Meloxicam in tablets and suspension form) - 5-6 hours;
- the time to achieve a steady state of pharmacokinetic parameters with repeated use is 3-5 days;
- binding to albumin (plasma proteins) - 99%; T1/2 (average) - 20 hours.
Dosing 1 r./day. leads to an average plasma concentration with slight fluctuations in peak values: for 7.5 mg within 0.4-1, for 15 mg - within 0.8-2 μg/ml (Cmax and Cmin during the period of steady state pharmacokinetic parameters).
Honey concentrations of the drug after systematic use for more than six months are similar to the concentrations observed after 14 days. oral dose 15 mg.
The pharmacokinetics indicators (Cmax, Cmin, TCmax) of Meloxicam in the form of suppositories are similar to those for tablets.
The drug penetrates well into the synovium.
Metabolism occurs in the liver. The resulting substances are pharmacologically inactive. Meloxicam is excreted equally in urine and feces, in pure form - up to 5% of the dose. Only trace concentrations of the pure substance are found in urine.
Analogs
Analogues of Movalis on the pharmaceutical market are the following drugs: Mirlox, Artrosan, Melox, Meloxicam, Mataren.
As for Movalis injections, the doctor can replace them with medications containing the same active ingredient: Amelotex, Arthrozan, Meloxicam, Melbek, Liberum, Bi-xicam, Movasin, Mesipol.
Analogues of the drug Movalis
Movalis/Meloxicam
The drugs are based on the same active substance, so their therapeutic effect is identical. The only difference is the price.
Movalis/Voltaren
The active substance of Voltaren is diclofenac. Frequent development of side effects is noted. Unlike Voltaren, Movalis has a positive effect on cartilage metabolism. Therefore, both drugs are effective for pain relief, but for osteoarthritis, Movalis is better.
Movalis/Nise
The active substance of Nise is nimesulide. Both drugs are characterized by effectiveness in treating heat, inflammation and pain.
But nimesulide is toxic to the liver, but Movalis is not and does not have a similar effect.
Movalis relieves pain more slowly, but its effect is prolonged, while Nise is good for quickly relieving pain.
Indications for use of Movalis
What do pills help with?
Indications for use of tablets:
- symptomatic treatment of aggravated osteoarthritis ;
- long-term treatment of infectious nonspecific polyarthritis and rheumatoid spondylitis (reviews and numerous studies that were carried out in compliance with all requirements for drug testing confirm the effectiveness and good tolerability of Movalis, including its long-term use).
What are Movalis injections for?
Injections of the drug are prescribed for short-term treatment of an acute attack of infectious nonspecific polyarthritis or rheumatoid spondylitis , when the rectal and oral routes of administration of the drug Movalis are impossible.
What are suppositories prescribed for?
According to the annotation, the suppositories are intended to relieve pain in degenerative joint diseases ( osteoarthritis ), rheumatoid arthritis / spondylitis .
Indications for use of Movalis in suspension form
The suspension is used for the symptomatic treatment of osteoarthritis (including with a pain component), rheumatoid arthritis (including juvenile arthritis ), rheumatoid spondylitis .
Contraindications
The drug is not prescribed for:
- known intolerance to Meloxicam or other components of the drug, as well as to active substances with a similar effect ( aspirin , NSAIDs);
- history of “ aspirin asthma
- pregnancy (the 3rd trimester is a contraindication for the d/i solution);
- lactation;
- history of gastric and intestinal bleeding/perforation associated with the use of NSAIDs;
- a history of active/recurrent peptic ulcer
- severe liver or uncontrolled heart failure ;
- severe renal failure , chronic renal failure in patients not undergoing hemodialysis (with Clcr below 30 ml/min), as well as with established hyperkalemia and progressive kidney pathologies ;
- of hemocoagulation disorders (including gastric, intestinal, cerebrovascular bleeding);
The use of Movalis is also contraindicated for perioperative pain relief during CABG ( coronary artery bypass grafting ).
Additional contraindications to the prescription of the rectal form of Meloxicam are rectal bleeding and proctitis .
Since the suspension contains sorbitol (2.45 g at the highest daily dose), it should not be administered to persons with rare hereditary fructose intolerance.
The tablets, since they contain lactose, are contraindicated in persons with lactase deficiency and monosaccharide intolerance.
The medicine is used with caution in case of of ulcerative lesions of the digestive canal , CHF, renal failure (patients with Clcr in the range of 30-60 ml/min), diabetes mellitus , peripheral arterial diseases , coronary artery disease, hyper- or dyslipidemia , alcohol and/or nicotine addictions, in old age; in persons receiving anticoagulants, SSRIs, antiplatelet agents, oral corticosteroids, other NSAIDs, methotrexate at a dose exceeding 15 mg/week; with long-term use of NSAIDs.
Contraindications for use in pediatrics:
- tablets - age up to 16 years;
- d/i solution - age up to 18 years;
- candles - age up to 12 years;
- suspension - age up to 12 years (for juvenile arthritis, use is restricted
- is under 2 years of age).
Special instructions for the use of the drug Movalis:
- for patients with an increased risk of adverse reactions (history of gastrointestinal diseases, presence of risk factors for cardiovascular diseases), the recommended initial daily dose is 7.5 mg;
- For patients with severe renal failure on hemodialysis and the elderly, a dose of 7.5 mg/day is recommended, which should not be exceeded;
- patients with insufficient renal function in which Clcr exceeds 25 ml/min., patients with mild/moderate liver failure, as well as clinically stable cirrhosis do not require dose adjustment.
Important! The required dosage and course duration are determined by the attending physician.
Side effects
Side effects common to all forms of the drug:
- quantitative changes in the cellular composition of blood. A factor predisposing to the development of cytopenias is most likely the use of myelotoxic drugs (in particular, methotrexate ) in combination with Movalis.
- Anaphylactic reactions and anaphylactoid reactions.
- Dizziness, tinnitus, headache, drowsiness, mood lability, confusion, disorientation.
- Perforation of the digestive canal, obvious or hidden gastric/intestinal bleeding (in some cases fatal), colitis , dyspepsia , gastroduodenal ulcer , esophagitis , vomiting, gastritis , abdominal pain, bloating, stomatitis , constipation / diarrhea , belching, nausea, hepatitis , transient changes in biochemical parameters of the liver.
- Erythema multiforme , Lyell's syndrome , bullous dermatitis , Stevens-Johnson syndrome , angioedema , skin rashes, itching, increased sensitivity to UV radiation, urticaria .
- Bronchial asthma (in persons allergic to other NSAIDs or acetylsalicylic acid ).
- Swelling, flushing of the face, palpitations, increased blood pressure.
- acute renal failure, renal dysfunction , dysuria (including acute urinary retention).
- Visual impairment, conjunctivitis .
In the case of using a d/i solution, the following are also possible:
- glomerular or interstitial nephritis ;
- papillary necrosis;
- nephrotic syndrome;
- swelling and pain at the injection site.
Movalis tablets 7.5 mg 20 pcs. in St. Petersburg
Patients suffering from 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 who report 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 a skin rash, changes in the mucous membranes or other signs of hypersensitivity appear, discontinuation of the drug Movalis should be considered. Cases have been described when taking NSAIDs to increase the risk of developing serious cardiovascular thrombosis, myocardial infarction, angina, possibly fatal. This risk increases with long-term use of the drug, as well as in patients with a history of the above diseases and predisposed to such diseases.
NSAIDs inhibit the synthesis of PGs 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, ARB II, and patients those 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, such patients should be closely monitored and adequate hydration maintained. Before starting treatment, a kidney function test is necessary. In case of combination therapy, renal function should also be monitored. When using Movalis® (as well as most other NSAIDs), episodic increases in serum transaminase activity or other indicators of liver function are possible. 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. Weakened 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 underlying infectious disease.
As a drug that inhibits the synthesis of COX/PG, Movalis® may have an effect on fertility and is therefore not recommended for women who have difficulty conceiving. In this regard, in women undergoing examination for this reason, it is recommended to discontinue taking the drug Movalis®. In patients with mild or moderate renal failure (creatinine clearance more than 25 ml/min), no dose adjustment is required.
In patients with liver cirrhosis (compensated), no dose adjustment is required.
Influence on the ability to drive vehicles and 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 a car and working with machinery, the possibility of developing dizziness, drowsiness or other central nervous system disorders should be taken into account.
Instructions for use of Movalis
Movalis tablets: instructions for use
The medicine is administered orally.
The daily dose is taken at one time, with liquid, during meals.
To minimize adverse reactions, the patient is given the minimum effective dose and the shortest possible course, which is necessary to control the symptoms of the disease.
During treatment with Movalis, it is recommended to periodically evaluate the patient's need for symptomatic therapy and his body's response to treatment.
The dose for aggravated osteoarthritis is 1 tablet * 7.5 mg or 0.5 tablet * 15 mg per day (if necessary, you can take 1 whole tablet of 15 mg).
For nonspecific polyarthritis and rheumatoid spondylitis, take 15 mg/day. In accordance with the therapeutic effects, the dose is reduced to 7.5 mg/day.
Movalis injections: instructions for use
The description of the drug states that Movalis injections should be given into the muscle. The medicine is administered once in a dose of 15 mg.
Treatment is usually limited to the 1st injection. In particularly severe cases, 2-3 doses of Meloxicam .
How to inject Movalis?
The medicine is administered slowly, by deep injection into the gluteus maximus muscle, observing all aseptic conditions. If it is necessary to administer a second dose, the injection is given in the other buttock.
Before injecting the solution, you need to make sure that the needle does not fall into the vessel.
If the patient experiences severe pain during the injection, the procedure is stopped immediately.
For patients with a hip replacement, the injection is given in the other buttock.
Movalis suppositories: instructions for use
For adults with osteoarthritis , rheumatoid arthritis or spondylitis , suppositories are administered 1 r./day. at a dose of 15 mg. The same dose is the maximum permissible (including if the treatment is combined with the use of different forms of Meloxicam ).
The course of treatment should be as short as possible, and the dose should be as low as possible.
Instructions for use of the suspension
The daily dose for osteoarthritis is 7.5 mg, which corresponds to the volume of 1 measuring spoon (ml). If necessary, it is increased to 2 ml.
For rheumatoid arthritis/spondylitis, the patient should be given 2 ml. suspension 1 r./day. Depending on the response to treatment, the dose can be reduced to 1 ml.
The highest dose is 2 mL/day. The entire volume of the medicine is taken at one time, during meals.
For children under 12 years of age with juvenile arthritis, the drug is dosed at the rate of 0.125 mg/kg. (1.5 mg for every 12 kg of weight). The frequency of use is the same as for adults - 1 r./day.
The highest dose is 7.5 mg/day.
Adolescents over 12 years of age should not be given more than 0.25 mg/kg/day.
Additional recommendations
The maximum permissible dose of meloxicam (including if the patient is prescribed different dosage forms of the drug) is 15 mg/day.
For patients with severe renal failure (provided they are on dialysis ) and the elderly, the optimal dose for long-term treatment of nonspecific polyarthritis and rheumatoid spondylitis is 7.5 mg/day.
If there is a high probability of adverse reactions, treatment is also started with a similar dose.
Patients with insufficient renal function in which Clcr exceeds 25 ml/min., patients with mild/moderate liver failure , as well as clinically stable cirrhosis do not require dose adjustment.
Movalis is not available in ointment or gel form.
How to take Movalis
General advice for the use of any of the dosage forms of Movalis is that the drug is recommended to be used in the minimum effective dose, and the therapeutic course should last as short as possible. Moreover, during treatment, it is recommended to assess the need for taking the drug and the body’s response. During the day, you can take, regardless of the dosage form of the drug Movalis, only 15 mg/day. This is the maximum for the day.
How to take Movalis medicine correctly?
Movalis tablets and suspension are taken orally during meals with a sufficient amount of water.
- osteoarthritis: 7.5 mg/day. If indicated and the severity of the pain syndrome, it is possible to increase the dose to 15 mg/day;
- rheumatoid arthritis, ankylosing spondylitis: 15 mg/day. (possibly reducing the dose by 2 times);
- Children under 12 years of age are prescribed Movalis in the form of a 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).
- children 12-18 years old with juvenile rheumatoid arthritis: 0.25 mg/kg, but not more than 15 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.
Overdose
Acute overdose of NSAIDs is usually accompanied by lethargy, nausea, drowsiness, abdominal pain, and vomiting. With adequate supportive treatment, these symptoms are reversible.
In some cases, bleeding from the gastrointestinal tract may develop. Severe poisoning can provoke arterial hypertension , acute renal failure, liver dysfunction, respiratory depression, convulsions , coma , heart failure and cardiac arrest .
Also, the possibility of the patient developing anaphylactoid reactions cannot be excluded.
In case of an overdose of NSAIDs, symptomatic treatment is indicated for the patient. Studies have shown that taking 4 oral doses of cholestyramine twice a day allows meloxicam in the digestive canal and speed up its elimination.
Interaction
NSAIDs (including salicylates and corticosteroids) in combination with Meloxicam , due to the synergy of their action, increase the risk of ulceration of the digestive canal and the development of gastric and intestinal bleeding.
of Meloxicam in combination with other NSAIDs, as well as Methotrexate and lithium preparations should be avoided .
Thrombolytic agents , systemic heparin oral anticoagulants , SSRIs, and antiplatelet agents in combination with meloxicam may cause bleeding; diuretics and AT1 receptor blockers - ARF.
NSAIDs, due to the suppression of Pg, which has vasodilating properties, reduce the effect of antihypertensive drugs . In addition, drugs in this group increase the nephrotoxicity of Cyclosporine .
Cholestyramine binds meloxicam in the digestive canal and thereby accelerates its elimination.
The presence of sorbitol in the suspension can cause the development of necrosis of the large intestine with possible death if Movalis is taken with sodium polystyrene sulfonate.
Pharmacokinetic interaction is not excluded in case of combined use with drugs that suppress CYP3A4 and/or CYP2C9, and oral hypoglycemic drugs. The drug may reduce the effectiveness of the IUD.
Use in combination with Digoxin , Cimetidine , antacids and Furosemide does not lead to significant changes in pharmacokinetic parameters.
Interactions of the drug Movalis
Other prostaglandin synthetase inhibitors, including corticosteroids and salicylates (acetylsalicylic acid): simultaneous administration of prostaglandin synthetase inhibitors due to their synergistic effect may lead to an increased ulcerogenic effect and the risk of bleeding, therefore such combined treatment is not recommended. Meloxicam should not be used concomitantly with other NSAIDs. Oral anticoagulants, antiplatelet agents, systemically administered heparin, thrombolytic agents, and selective serotonin reuptake inhibitors: the risk of bleeding increases due to decreased platelet function. If it is not possible to avoid the simultaneous use of Movalis with the drugs listed above, careful monitoring of the blood coagulation system is necessary. Lithium: There is evidence regarding the ability of NSAIDs to increase lithium concentrations in the blood. It is recommended to monitor the lithium content in the blood plasma at the beginning of treatment, when selecting a dose and in case of discontinuation of treatment with Movalis. Methotrexate: Like other NSAIDs, Movalis may increase the hematological toxicity of methotrexate, which requires close monitoring when prescribing this combination. Contraceptives: NSAIDs can reduce the effectiveness of hormonal contraceptives. Diuretics: prescribing NSAIDs to patients with dehydration may lead to a potential risk of developing acute renal failure, therefore, before starting treatment, disturbances in water and electrolyte balance should be eliminated, and in the future, when Movalis and diuretics are simultaneously prescribed, patients should consume an adequate amount of fluid. Antihypertensive drugs (for example, β-adrenergic receptor blockers, ACE inhibitors, vasodilators, diuretics): the effectiveness of antihypertensive drugs (β-adrenergic receptor blockers, ACE inhibitors, vasodilators, diuretics) when used simultaneously with NSAIDs is reduced, which is associated with an inhibitory effect on vasodilatory prostaglandins. NSAIDs and angiotensin II receptor antagonists, as well as ACE inhibitors, have a synergistic effect on reducing glomerular filtration. In patients with impaired renal function, this may lead to the development of acute renal failure. Cholestyramine binds to meloxicam in the digestive tract. NSAIDs increase the nephrotoxicity of cyclosporine due to their effect on the synthesis of prostaglandins in the kidneys, which requires monitoring of renal function when prescribing drugs simultaneously. Meloxicam is almost completely eliminated by hepatic metabolism, approximately two-thirds of which occurs with the participation of cytochrome P450 and one-third by peroxidase oxidation. The potential interaction should be taken into account when meloxicam is used concomitantly with drugs that inhibit or are metabolized by CYP 2C9 and/or CYP 3A4. There may be a pharmacokinetic interaction between Movalis and other drugs at the metabolic stage due to their effect on CYP 2C9 and/or CYP 3A4. No pharmacokinetic interaction of Movalis with antacids, cimetidine, digoxin and furosemide was detected when used simultaneously. The possibility of drug interaction with oral hypoglycemic agents cannot be excluded.
Analogues of Movalis
Level 4 ATX code matches:
Mirlox
Revmoxicam
Xefocam Rapid
Xefocam
Mesipol
Lem
Melbek
Movasin
Piroxicam
Lornoxicam
Arthrozan
Texamen
Amelotex
Meloxicam
What can replace injections?
Analogs in injections (with the same active ingredient): Amelotex , Artrosan , Meloxicam , Melbek , Liberum , Bi-xicam , Movasin , Mesipol .
Movalis and its analogues in ampoules differ mainly in price: a significant disadvantage of Movalis is its high cost. Inexpensive substitutes are the drugs Artrosan , Meloxicam , Liberum .
Similar drugs in tablet form
You can replace Movalis in this dosage form with the following drugs: Lem , Mataren , Mixol-Od , Mirlox , M-Kam , Medsikam , Oxycamox , Movix . The drugs listed in the list of analogues for the solution are also available in tablet form.
The price of Movalis analogues in tablets is from 120 rubles.
Which is better: Movalis or Meloxicam?
Meloxicam is the active ingredient in Movalis, so these drugs do not differ in their action. The main advantage of Meloxicam is its significantly lower cost.
Movalis or Voltaren - which is better?
Voltaren is a drug based on diclofenac . The difference between this substance and meloxicam is that it non-selectively inhibits COX-1 and COX-2. Consequently, the use of Voltaren is more often accompanied by the development of adverse reactions that are associated with inhibition of COX-1.
Unlike Voltaren, Movalis also affects the metabolism of cartilage tissue and increases the reparative capabilities of chondrocytes.
Thus, for pain relief, both drugs are equally effective, but for osteoarthritis, Movalis is the drug of choice.
Xefocam or Movalis - which is better?
If we compare Movalis with Xefocam , the latter is characterized by more pronounced analgesic activity and a higher incidence of adverse reactions due to its use. Movalis relieves inflammation better and is better tolerated by patients.
Thus, we can conclude that Movalis is preferable for patients with gastric ulcers , as well as for patients currently suffering from gastritis .
Movalis is more effective for inflammatory-degenerative joint diseases , which are accompanied by mild or moderate pain, and Xefocam is recommended for intense pain of various origins, as well as for course use in patients with a healthy gastrointestinal tract.
Nise or Movalis - which is better?
The active substance of the drug Nise - nimesulide - is, like meloxicam , a conditionally selective NSAID. Both drugs are effective for fever and pain, and also relieve symptoms of inflammatory reactions equally well.
Nimesulide is toxic to the liver, therefore, in the presence of acute and chronic pathologies of the hepatobiliary system, meloxicam is more preferable, since it does not have similar effects.
Reviews from patients indicate that Nise , while Movalis is more effective for recurrent pain. Meloxicam relieves pain more slowly, but its effect lasts longer than the effect after using nimesulide .
Is it possible to take Milgamma, Movalis and Mydocalm at the same time?
If the pain is severe, causes discomfort, cannot be tolerated, and affects the usual rhythm of life, then the doctor may prescribe a combined treatment system. Milgamma and Mydocalm are often prescribed along with Movalis, which have shown good results in the treatment of certain diseases (intervertebral hernia, osteochondrosis). But before injecting Movalis, Milgamma and Mydocalm, you need to visit a doctor, since these drugs in any case have contraindications and the risk of developing negative reactions in the patient’s body.
- Movalis is a non-steroidal anti-inflammatory drug. Its use is indicated in the treatment of diseases of the musculoskeletal system to relieve inflammation, pain and lower temperature.
- Milgamma is a combined multivitamin product consisting of B vitamins. When diagnosing diseases of the musculoskeletal system, Milgamma injections are prescribed to improve blood circulation, nourish cartilage and bone tissue, and strengthen the nervous system.
- Mydocalm is a muscle relaxant. The drug relieves muscle spasms, reduces muscle tension, reduces compression of nerve endings and eliminates pain.
The classic treatment regimen with Movalis, Milgamma and Mydocalm looks like this: during the first three days, Movalis injections are administered once a day, then the patient is transferred to the tablet form of the drug. Milgamma is administered 2 ml IM once a day. Then injections are given two to three times a week, or the tablet form of Milgamma is prescribed.
Mydocalm injections (100 mg) are indicated 2 times a day, the dosage is 100 mg. To enhance the effect, injections can be given on the same day.
Thus, Movalis, Milgamma and Mydocalm are prescribed to eliminate the symptoms of the disease. Despite the fact that the drugs belong to different pharmacological groups, when used together they give positive dynamics during therapy.
It is worth remembering that for patients who are sensitive or intolerant to lidocaine, this treatment regimen is contraindicated.
During pregnancy
Like other drugs that have the ability to inhibit the activity of COX-2 and Pg, meloxicam can have a negative effect on reproductive function. When planning pregnancy, it is recommended to stop treatment with Movalis.
Suppression of Pg synthesis negatively affects the development of pregnancy and/or fetal development. In particular, when a mother takes meloxicam in early pregnancy, the risk of miscarriages, as well as the occurrence of gastroschisis and heart defects in the child, . It is believed that the likelihood of this type of disorder increases with increasing duration of treatment and dose of the drug.
In the 1st and 2nd trimesters, the prescription of Movalis is possible for health reasons, but the dose prescribed to the woman should be minimal.
In the 3rd trimester, all Pg inhibitors pose a risk to the fetus:
- cardiorespiratory toxicity;
- renal dysfunction , which can develop into renal failure with oligohydramnios .
In addition, taking the drug in the last weeks of pregnancy can increase bleeding time, develop an antiplatelet effect , inhibit uterine contractions and, as a result, delay or prolong labor.
Due to the risk of meloxicam into breast milk, Movalis is not recommended for use during breastfeeding.
Reviews about Movalis
Reading reviews on forums, you can see that the majority of patients who took Movalis give this drug a fairly high rating.
The medicine quickly accumulates in the body, is slowly eliminated, its bioavailability is higher than that of its analogues, and the variety of forms allows you to choose the most convenient one, depending on the indications and subjective sensations.
The drug has a relatively small range of undesirable side effects compared to other NSAIDs and proven high clinical effectiveness.
This allows it to be included in the complex therapy of many pathological conditions that accompany inflammatory and degenerative rheumatic diseases , as well as to be used to relieve pain in primary dysmenorrhea and fever .
Reviews of Movalis injections indicate that immediately entering the bloodstream after administration, the drug in this dosage form quickly relieves even severe excruciating pain.
Reviews of Movalis tablets are also mostly positive. The main advantage of this form of meloxicam is that it can be used for a long time (from 4 weeks to one and a half years) of time.
Movalis and alcohol
Is it possible to combine Movalis with alcohol?
There is no clear prohibition on the simultaneous use of Movalis and alcohol in the instructions for use. True, this does not mean that such a combination will not cause harm. Thus, drinking alcohol during therapeutic treatment with the drug can lead to acute renal failure. This occurs due to dehydration, which is caused by alcohol.
Movalis price: how much do ampoules, suspension, suppositories and tablets cost?
The average price of Movalis in injections in Ukraine is 270 UAH. The price of Movalis in tablets of 15 mg is 340 UAH, the cost of tablets of 7.5 mg is 255 UAH. The price of Movalis candles is also within the range of 270-340 UAH.
The difference between the cost of medicine in Kharkov, Dnepropetrovsk or Kyiv is insignificant.
The average price of Movalis ampoules in Russian pharmacies is 650 rubles; you can buy suppositories in Moscow for an average of 500-600 rubles. The cost of the injection solution is 665-720 rubles, 15 mg tablets are 750 rubles, 7.5 mg tablets are 640 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in UkraineUkraine
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
- Movalis solution for intramuscular injection.
15mg/1.5ml 1.5ml 5 pcs. Boehringer Ingelheim Spain SA RUB 891 order - Movalis solution for intramuscular injection. 15mg/1.5ml 1.5ml 3 pcs.Boehringer Ingelheim Spain SA
RUB 653 order
- Movalis tablets 15 mg 20 pcs. Boehringer Ingelheim Ellas AE
RUB 755 order
- Movalis tablets 15 mg 10 pcs. Boehringer Ingelheim Ellas AE
RUR 522 order
- Movalis tablets 7.5 mg 20 pcs. Boehringer Ingelheim Ellas AE
RUB 684 order
Pharmacy Dialogue
- Movalis (tab. 15 mg No. 20) Boehringer Ingelheim
RUR 783 order
- Movalis (tab. 7.5 mg No. 20) Boehringer Ingelheim
RUR 662 order
- Movalis (amp. 1.5 ml No. 3) Boehringer Ingelheim
RUR 674 order
- Movalis (tab. 15 mg No. 10) Boehringer Ingelheim
RUR 544 order
- Movalis (amp. 1.5 ml No. 5) Boehringer Ingelheim
1106 rub. order
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Pharmacy24
- Movalis 7.5 mg No. 20 tablets Boehringer Ingelheim Pharma GmbH & Co. KG/Boehringer Ingelheim Ellas A.E., Nimechina/Greece
309 UAH.order - Movalis 15 mg/1.5 ml N5 solution for injection
185 UAH order
- Movalis 15 mg No. 10 tablets Boehringer Ingelheim Pharma GmbH & Co. KG/Boehringer Ingelheim Ellas A.E., Nimecchina/Greece
220 UAH order
- Movalis 15 mg No. 20 tablets Boehringer Ingelheim Pharma GmbH & Co. KG/Boehringer Ingelheim Ellas A.E., Nimecchina/Greece
403 UAH order
PaniPharmacy
- Movalis ampoule Movalis solution for injection 15 mg ampoule 1.5 ml No. 5 Spain, Boehringer Ingelheim Espana
227 UAH order
- Movalis tablets Movalis tablets 15 mg No. 10 Germany, Boehringer Ingelheim Pharma
268 UAH order
- Movalis tablets Movalis tablets 15 mg No. 20 Germany, Boehringer Ingelheim Pharma
437 UAH. order
- Movalis tablets Movalis tablets 7.5 mg No. 20 Germany, Boehringer Ingelheim Pharma
317 UAH. order
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