Movalis: instructions for use of tablets,suspensions, pricks, candles

Update: October 2018 Movalis – a modern drug from the group
NSAIDs, which is prescribed for a number of diseases of the joints.
Active ingredient – meloxicam – is derived from
enolic acid, characterized by anti-inflammatory and
analgesic effects, as well as antipyretic effects.
The strongest anti-inflammatory effect of movalis is set at
all variants of inflammation.

The drug is represented in several forms, which allows
choose the best tool for complex pathology therapy
joints.

Composition, physico-chemical properties, price

Movalis is presented in 4 dosage forms:

Tablets movalis Solution in ampoules Suspension Movalis Rectal Candles
Main substance 7.5 / 15 mg meloxicam in 1 tab. 15 mg meloxicam in 1 amp. 7.5 mg of meloxicam in 5 ml. 7.5 / 15 mg meloxicam in one suppository.
ATспомога­т­ельные вещества 15 mg sodium citrate dihydrate, 23.5 mg lactose monohydrate,
102 mg of cellulose, 10.5 mg of povidone K25, 3.5 mg of colloidal silicon
dioxide, 16.3 mg of crospovidone, 1.7 mg of magnesium stearate.
9.375 mg of meglumine, 75 mg of poloxamer 188, 150 mg
glycofurfural, 4.5 mg of sodium chloride, 7.5 mg of glycine, 228 mcg
sodium hydroxide, 1279.482 mg of water for injection.
1750 mg of sorbitol 70%, 50 mg of colloidal silicon dioxide, 5
mg of gietellose, 750 mg of glycerol 85%, 750 mg of xylitol, 100 mg
sodium dihydrate dihydrophosphate, 500 μg of sodium saccharinate, 7.5
Sodium benzoate, 6 mg citric acid monohydrate, 10 mg
raspberry flavor, 2463.5 mg of purified water.
Suppository mass of macrogol glyceryl hydroxystearate.
Физико-хими­ч­еские свойства Pale yellow or yellow pills, round on one side
bulging. On одной стороне – логотип, на второй —  вогнутая
risk and code. Light surface roughness possible
pills.
Transparent solution of a greenish-yellow shade. Viscous suspension of yellowish-green color. Yellowish-green suppositories, smooth, dimpled
in the middle.
Packaging 10 tab. in blisters, one or two blisters in
a pack.
On 1.5 ml of a solution in ampoules from transparent glass, on 3 and 5 ampoules
in plastic contour pallets, 1 or 2 pallets in a pack
cardboard.
On 100 ml in glass darkened bottles, with a spoon measured, in
carton packs.
On 6 suppositories in packagings planimetric, packs
cardboard.
Appearance мовалис таблетки мовалис раствор мовалис суспензия мовалис свечи
Price № 10 15 mg: 480-630 rubles. № 3: 560-800 rubles. 430-700 rub. ~

pharmachologic effect

Being a derivative of enolic acid, movalis has
antipyretic, anti-inflammatory and analgesic effect,
which are due to the ability of meloxicam to inhibit
the formation of inflammatory mediators called prostaglandins.
The peculiarity of the drug is the most depressing effect.
on the synthesis of prostaglandins in the focus of inflammation, whereas
other NSAIDs have the same effect in the inflammatory focus, and
in the stomach and in the kidneys.

Such directed action is associated with more selective
suppression of COX-2, rather than COX-1. Inhibition of COX-2 determines
therapeutic effect of NSAIDs, and the suppression of the COX-1 isoenzyme,
present in the body constantly, responsible for
negative effects on the part of the kidneys and stomach characteristic of
this group of drugs.

The selective effect of meloxicam on COX-2 is repeatedly
it is confirmed as in test systems, as on live organisms. AT
Unlike popular drugs such as indomethacin, ibuprofen,
naproxen and diclofenac, meloxicam in therapeutic doses not
enhances platelet aggregation and does not lengthen the period
bleeding.

AT ходе клинических исследований установлено, что побочные
gastrointestinal effects (dyspepsia, abdominal pain, vomiting) with
treatment with meloxicam occurs less frequently than with other
НПATС.

Pharmacokinetics

  • Solution after i / m injection is fully absorbed
    (bioavailability of 100%). After 60 min after the introduction is determined
    peak plasma concentration (99% due to albumin).
    Penetrates into the articular synovial fluid, the level of which
    is 50% compared to plasma.
  • Tablets are well absorbed by the gastrointestinal mucosa (bioavailability of 89%),
    and after 5-6 hours the meloxicam level reaches a maximum in the plasma
    blood. AT экспериментах доказано, что при регулярном приеме в
    for half a year, the plasma concentrations of the drug are equal to
    observed after 14-day treatment. ATсасывание препарата не
    disturbed by eating.
  • Suppositories. Maximum plasma concentration after
    celebrated after 5 hours (bioequivalent tablets).

Metabolized by the liver – eventually 4 derivatives are formed,
pharmacologically inactive. ATыводится в равных количествах мочой и
feces (unchanged form is displayed no more than 5% from
feces).

Indications

Solution for injections:

  • Initial Pain Treatment and Symptomatic Arthritis Therapy
    (rheumatoid), ankylosing spondylitis, short osteoarthritis
    scheme.
  • Other diseases of the musculoskeletal system of the degenerative and
    inflammatory nature, accompanied by pain: dorsopathies,
    arthropathy.

Tablets and suppositories:

  • Symptomatic therapy of osteoarthritis, spondylitis
    ankylosing and rheumatoid arthritis and other pathologies
    musculoskeletal system associated with pain symptom.

Contraindications

The instructions for use of Movalis are as follows:
contraindications for all forms:

  • hypersensitivity to active v-vu or auxiliary
    constituents of the drug. It is necessary to take into account the probable cross
    hypersensitivity to aspirin and other NSAIDs (for these patients
    use with caution);
  • phenomena of asthma, urticaria, edema
    angioedema, nasal polyps in patients receiving NSAIDs (any);
  • aggravation of GU and duodenum, as well as 2-3 weeks after
    aggravations;
  • acute form of Crohn’s disease or ulcerative colitis;
  • severe liver failure;
  • severe kidney failure, with hyperkalemia or
    progressive;
  • acute bleeding from the intestines and stomach;
  • a history of cerebrovascular bleeding;
  • bleeding disorders;
  • severe heart failure;
  • pregnancy;
  • breast-feeding;
  • the period of treatment of postoperative pain after
    bypass of arteries of the heart.

Additionally for solution:

  • age up to 18 l;

Additionally for suppositories and tablets:

  • age up to 12 years (except for rheumatoid arthritis therapy
    (juvenile).

special instructions

With moderate and mild renal failure and
dysfunction of the liver is not required to reduce the recommended doses. On
end-stage renal insufficiency daily dose
install no more than 7.5 mg.

The solution is used with caution in diseases of the gastrointestinal tract, cardiac
failure (congestive), ischemic heart disease, peripheral pathologies
arteries, renal failure, cerebrovascular pathologies,
dis- or hyperlipidemia, diabetes, concomitant treatment
oral anticoagulants, glucocorticosteroids,
antiplatelet agents.

It is also used with caution when long
previously treated with other NSAIDs, in old age, while smoking and
alcoholism.

Tablets and suppositories: при терапии пациентов с уменьшенным ОЦК
or hidden renal blood flow may develop latent renal
insufficiency (most likely in the elderly and with comorbidities
internal organs).

Dosage

Solution for injections

Movalis injections are injected in / m, deeply, in the first 2-3 days of treatment
then go on enteric forms. Dose for administration of 15 or 7.5
mg / once a day. (maximum single – 15 mg).

Mixing with other dosage forms in one syringe
is unacceptable.

In patients with severe kidney failure, on hemodialysis:
daily dose should not exceed 7.5 mg.

Attention! The drug is not allowed to enter
intravenously!

Tablets and Candles

Tablets are used with food and water. Candles are introduced
rectally

Daily dose for adults:

  • Rheumatoid arthritis and osteoarthritis – 7.5 mg. Dose permissible
    increase to 15 mg / day and reduce further to
    recommended.
  • Ankylosing spondylitis – 15 mg. With good dynamics dose
    reduced to 5.5 mg.

For anyone who has a high risk of forming negative
adverse reactions, the daily therapeutic dose is 7.5
mg.

Maximum day dose for teens is calculated – 
0.25 mg / kg.

To minimize the risk of side effects
There is a recommendation for all patients: to apply in the least
dose and only a short period.

With combined treatment with multiple forms of movalis
суточная доза общая не должна превышать 15 mg.

Overdose

There is no information about such cases. With an overdose, there will likely be
develop effects similar to side effects.

Side effects

Are common:

  • Hematopoietic system: change in the number of cells
    blood (leukocyte, thrombocytopenia, leukopenia), anemia.
    The emergence of cytopenia contributes to the simultaneous treatment
    myelotoxic drugs.
  • Immune system: anaphylactic type reactions.
  • CNS: headache, disorientation in space, drowsiness,
    tinnitus, confusion, dizziness, change
    moods.
  • Gastrointestinal: gastrointestinal perforation, gastrointestinal bleeding (latent
    or explicit), with the probability of death in case of untimely
    appeal to doctors, gastroduodenal ulcers, esophagitis, colitis,
    gastritis, stomatitis, abdominal pain, dyspepsia, nausea, diarrhea,
    vomiting, abdominal distension, constipation, belching, increased activity
    bilirubin or transaminases, hepatitis.
  • Skin: epidermal toxic necrolysis, urticaria, syndrome
    Stevens-Johnson, bullous dermatitis, erythema multiforme, pruritus,
    rash, photosensitivity.
  • Respiratory: bronchial asthma, which is possible in people with
    allergic to other NSAIDs.
  • SSS: increase in blood pressure, blood rush to the face, heartbeat,
    swelling.
  • Urogenital system: urination disorders, acute renal failure, increased
    serum creatinine or urea levels.
  • Bodies of sight: blurred vision, conjunctivitis.

Additionally for solution:

Possible development of glomerulonephritis, interstitial nephritis,
medullary necrosis of the kidneys, nephrotic syndrome. Also in place
introducing it is possible to maintain pain on some time.

Drug interactions

  • In combination with prostaglandin formation inhibitors
    the risk of ulceration and bleeding from the gastrointestinal tract increases.
    Movalis with other NSAIDs is not assigned.
  • Use with serotonin reuptake inhibitors
    selective type increases the risk of bleeding from the gastrointestinal tract.
  • In combination with lithium drugs increases
    plasma concentration of the latter.
  • Simultaneous treatment with methotrexate and movalis not
    recommended due to increased hematological activity
    first.
  • Movalis lowers the effectiveness of intrauterine contraceptives
    therefore, additional contraception should be used.
    for this period.
  • Simultaneous treatment with diuretics is accompanied by risk
    development of acute kidney failure character. Should
    provide adequate hydration to eliminate this negative
    effect.
  • All NSAIDs, including Movalis, reduce the therapeutic effect.
    antihypertensive drugs.
  • Movalis may increase cyclosporine nephrotoxicity.

Movalis or diclofenac?

Both the first and second means are the drug of choice for
relief of symptoms accompanying diseases of the joints. Both
drug are representatives of one group – NSAIDs, with the reservation
that movalis has a selective action and a valid basis
they are different.

On сегодняшний день мовалис считается самым удачным конкурентом
diclofenac, with a more pronounced therapeutic effect, better
portability, less likely and less pronounced
side effects. Movalis quickly reduces the severity of pain
syndrome, therefore, will require a shorter treatment regimen than
diclofenac

Meanwhile, choosing between expensive movalis and cheap
Diclofenac patients often choose the last of the economic
considerations. With good health and sporadic
use of the drug from the group of NSAIDs may be justified. If a
there are risks of complications and undesirable effects, and to treatment
have to resort often, it is better not to save on health,
more that the relief of syndromes with movalis will require
shorter treatment regimens than diclofenac.

In any case, the decision on treatment is taken by the doctor and determines
which is better in a particular clinical case.

Analogs of Movalis

Amelotex 100-170 rubles. Artrozan 150-230 rubles. Matarin plus cream 250 rub. Bi-Psikam 180 rub.

Автор: врач-гигиенист, эпидемиолог

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