Movalis is the best and most effective of the meloxicam drugs. This means that all other drugs containing meloxicam as a chemical compound came later, and Movalis was the leader, or the first original drug from Boehringer Ingelheim. Movalis is highly effective for spinal hernias; it reduces pain and allows the patient to regain freedom of movement.
How does Movalis work? Does it cure a hernia or not? How should it be used, what side effects might it have, and how much does this medicine cost? These and other questions will be answered in this material. This article is written in simple language and is intended for people without medical education.
Does Movalis cure a hernia or not?
Any injections or tablets work only after the drug has entered the bloodstream. The original meloxicam, or Movalis, is no exception. It acts on tissue, creating a therapeutic concentration in the blood. On the other hand, all cartilages, including intervertebral discs, do not come into contact with blood. The type of nutrition, or trophism, they have is completely different, just like the optically transparent media of the eye. The vessels will only make it impossible for the cartilage, lens and vitreous body in the eyeball to work.
If the cartilage were intertwined with vessels, then any movement in the joints would be impossible. Vessels and capillaries would rupture, permanent hematomas would form, and as a result of their organization, any movement in the joints would be stopped - ankylosis would occur. Nature has found another mechanism for feeding intervertebral discs and cartilage tissue - this is a diffuse method of assimilation of nutrients from the surrounding synovial fluid by the “whole body” of the cartilage.
Movalis, which gets into the blood, cannot directly affect the hernia, and in general, the cartilage. Let's say more. No drug, including potent corticosteroid hormones, can eliminate protrusion or herniated discs. This can only be done through surgery.
It can be said that any physiotherapeutic procedures, massage, manual therapy, as well as newfangled methods of treatment, such as administering the patient’s own platelet-rich plasma, or PRP therapy, electrical stimulation, and carboxytherapy, also have no effect on the protrusion or hernia.
What then is the effect of Movalis? Why does it help with protrusions and hernias? The fact is that protrusion and hernia have nothing to do with it. This medicine simply relieves acute back pain that originates from the musculoskeletal system, regardless of the exact cause. The thing is that the body’s universal reaction to pain, to compression of soft tissues is inflammation. An elementary callus on the heel, which has formed as a result of prolonged rubbing with a new shoe, is a simple model of protrusion or hernia.
Hernia on MRI.
When moving, the resulting defect in the intervertebral disc gradually irritates, rubs, and compresses the surrounding ligaments, muscle structures and nerve roots. The result is the classic symptoms of inflammation: swelling, increased local temperature, and pain with impaired function. Movalis, as a drug belonging to the class of non-steroidal anti-inflammatory drugs, fully lives up to its name. It removes this inflammatory reaction, reduces swelling and pain. And the hernia, as it was, remains in its place. The body simply stops perceiving this cartilage defect as an extremely strong irritant. How does Movalis achieve its anti-inflammatory effect?
Movalis is an anniversary in the NSAID family. Efficiency, safety, application prospects
The article discusses the practical use of one of the most popular representatives of non-steroidal anti-inflammatory drugs, which celebrates the twentieth anniversary of its use in Russia - meloxicam (the drug Movalis). The features of pharmacokinetics, pharmacodynamics and pharmacoeconomics of the drug are discussed. The most common mistakes that doctors make when prescribing non-steroidal anti-inflammatory drugs in general and Movalis in particular are examined. The results of studies on the effectiveness and safety of Movalis are presented, and the prospects for its use are outlined.
NSAIDs in modern clinical practice
Physicians of various specialties routinely prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) in clinical practice. A wide spectrum of action (anti-inflammatory, analgesic, antipyretic effect) and an impressive list of indications for use (colds, diseases accompanied by inflammation, pain, etc.) make NSAIDs popular among both doctors and patients. This demand for NSAIDs has both positive and negative consequences.
On the one hand, the importance of NSAIDs is difficult to overestimate. The number of clinical studies on the effectiveness and safety of certain NSAIDs is enormous. Income from the sale of NSAIDs is comparable to the budgets of some countries.
On the other hand, these drugs also lead in inappropriate use. Each practicing physician has his own preferences among NSAIDs, his own views on their effectiveness and safety, as well as the duration of their use. However, the doctor’s opinion does not always correspond to the truth and is formed under the influence of publications in the scientific press or the work of medical representatives. Errors are made when determining the dose, duration of administration, choosing a dosage form, and prescribing NSAIDs in combination with other drugs. This reduces the effectiveness of treatment and increases the risk of developing a variety of adverse events.
Separately, the problem of uncontrolled use of NSAIDs by patients should be highlighted, including the use of NSAIDs in childhood without a doctor’s recommendation. This is largely due to the intrusive advertising of over-the-counter NSAIDs in the media, which pushes patients towards so-called responsible self-medication. In addition, prescription NSAIDs in practice are prescribed by doctors in the form of oral recommendations and are sold in pharmacies without prescriptions. Note that NSAIDs are divided into over-the-counter and prescription drugs formally, not by mechanism of action, but depending on dosages, forms of release, potential simplicity and frequency of administration.
NSAIDs: myths and reality
The history of the use of anti-inflammatory drugs in pain therapy goes back several millennia, dating back to Ancient Egypt and the times of Hippocrates. Anti-inflammatory drugs have gone from willow leaves and bark, willow bark extract to quinine, salicin and more modern drugs such as phenazone (antipyrine), aminophenazone (pyramidon, amidopyrine), aspirin.
In the 20th century The development of new anti-inflammatory drugs and their dosage forms has accelerated dramatically. Experience in the use of NSAIDs was accumulated, not only the effectiveness of the drugs was assessed, but also the frequency of adverse reactions, the severity of which stopped one or another direction of development of NSAIDs. Even then, due to the demand for effective medicines, counterfeits began to appear, produced in an artisanal way with a violation of production technology, a small amount of active substance and a large proportion of ballast substances, which complicated the control of adverse events accompanying the use of original drugs [1].
As scientific knowledge and practical experience in the use of NSAIDs accumulated, a “snowball” of inadequate and misconceptions about the action, side effects and forms of drug administration grew. This distorted perception is partly a consequence of doctors' personal experiences and the influence of patients and doctors on each other, and partly the result of educational lectures and events. Trainees often perceive information about various adverse reactions and possible complications not as a result of the mechanism of action of a particular drug, but in general, for the entire group of NSAIDs.
Unfortunately, doctors’ ideas about the statistical probability of developing complications do not correspond to frequency characteristics. There are common myths among doctors and patients that the speed of development of the effect and the severity of side effects are related to the route of administration of the drug. Thus, in the opinion of doctors, injection forms of administration correspond to “more rapid development of the effect” and, as a consequence, insignificant severity of side effects. Proponents of injectable forms often forget about the potential risks of any injection, as well as the cost of treating such complications. Another common myth is that oral tablet forms “act slower” and “have a worse effect on the stomach.” According to many, rectal forms are devoid of such shortcomings, which, of course, is not true.
Thus, each method of drug administration has, in addition to physiological characteristics, also a psychological aspect, which largely depends on the initial beliefs of patients and doctors. This is partly due to the placebo effect or a similar effect that enhances the effect of the real drug. Patients, not accepting reasonable arguments, remain true to their opinions and are more likely to change doctors than beliefs. To some extent, this “rigidity” of patients is explained by the extreme heterogeneity of doctors’ opinions on this issue, which naturally confuses patients [2].
In the fall of 2015, a survey was conducted on our website otdeleboli.rf (paindept.ru), in which both doctors and patients (n = 177) participated. To the question: “What works for you better and faster?” The following responses were received:
- droppers – 17%;
- ointments – 3%;
- injections IM or IV – 34%;
- candles – 10%;
- tablets – 8%;
- I don’t see any difference – 25%.
It must be said that doctors dominated among the respondents. The question was deliberately formulated incorrectly; only the forms of administration were indicated without mentioning specific medications. The vast majority mistakenly believed that the effectiveness of treatment depends on the form of administration, and not on the active substance.
Movalis: efficacy, safety, pharmacokinetic characteristics
A significant stage in changing ideas about the safety of NSAIDs was the emergence of selective cyclooxygenase (COX) 2 inhibitors. The first representative of selective, later called moderately selective, COX-2 inhibitors was the original drug meloxicam, known in our country as Movalis, and abroad as Mobic, a Boehringer Ingelheim company.
The largest studies of the effectiveness of meloxicam were MELISSA (Meloxicam Large Scale International Study Safety Assessment) and SELECT (Safety and Efficacy Large scale Evaluation of COX inhibiting Therapies) [3–5]. Almost 20 thousand patients with osteoarthritis took part in these two trials (9323 and 8656 patients, respectively). Meloxicam (7.5 mg/day) was equivalent in clinical efficacy to diclofenac (100 mg/day) and piroxicam (20 mg/day) [4, 5]. Discontinuation of drugs due to low effectiveness in the diclofenac, piroxicam and meloxicam groups did not exceed 1.7% [6].
Currently available in the Russian Federation is a tablet form of Movalis with a possible dosage regimen of 7.5 and 15 mg, a suspension with dose determination by measuring spoons (7.5 mg in 1 ml), which was initially positioned as a form for children and young patients with rheumatic diseases. In addition, there are injection forms for intramuscular administration No. 3, No. 5 and a form for hospital purchases No. 50. Outside Russia, there is also a form for intravenous administration.
The bioavailability of the tablet form of Movalis is close to 100% and practically reaches the values of the injection form. The maximum concentration in plasma with parenteral administration is achieved after 60 minutes, with a single oral administration of the drug - after five to six hours. Stabilization of pharmacokinetic parameters occurs on the third to fifth day of taking the drug. Movalis penetrates into intra-articular tissues in a concentration of 50% of the concentration in the blood plasma. Why is it so important to know the pharmacokinetic characteristics of a drug? The fact is that in clinical practice, doctors often prescribe NSAIDs without taking into account pharmacokinetic characteristics, as a result of which the drugs cannot demonstrate the optimal effect. As a result of inadequate use, patients lose faith in treatment, and the authority of the drug, the doctor, and the medical institution decreases.
For example, a doctor, when determining the duration of treatment with Movalis, can be guided by the number of injection ampoules No. 3 and prescribe the drug for an ultra-short period - for only three days. In reality, treatment should not be limited to a three-day course of injections; parenteral administration should be the initial stage of step therapy with a transition to taking the drug orally. Considering the insufficient motivation of doctors to increase the level of knowledge and not always a correct understanding of the pathophysiology of inflammation and pain, it is possible that general (class-specific) side effects are perceived without taking into account the degree of COX inhibition. Apparently, doctors who recommend a short course of treatment are afraid of the ulcerogenic effect inherent in non-selective COX inhibitors. This also explains the frequent prescription of NSAIDs under the guise of drugs from the group of proton pump inhibitors. Thus, doctors do not take into account the data on the safety profile of the drug and do not know that Movalis can be prescribed for a long term. Meanwhile, in the described MELISSA and SELECT studies, the duration of treatment with Movalis ranged from several weeks to several months and corresponded to safety indicators.
Advantages of original drugs
Taking into account the price category of Movalis and the policy of interchangeability of medicines actively pursued by the Russian Ministry of Health, based only on the international nonproprietary name, the question of choosing between the original drug and the generic becomes relevant. However, not all doctors, much less patients, understand what the difference is between original and generic drugs, besides price. Why do many doctors, calling for special attention to the choice of drug, insist on using the original drug? Will the original drug provide 100% effect? No one can promise this. Let's figure out whether a generic drug can provide any guarantees.
In addition to the main active ingredient - the so-called international non-proprietary name - the composition of the drug also includes ballast substances. Production technology also plays a significant role, compliance with which is ensured by a number of indicators that are not always made public.
In the USA and European countries, unlike Russia, when introducing generic drugs into clinical practice, such a parameter as clinical equivalence is taken into account - the result of a long-term comparison of the effectiveness of the generic drug and the original. In our country, only bioequivalence is mandatory. However, this data is not always provided to end users - doctors who choose the most affordable and effective remedy for their patients.
The quality of the original drug and the generic drug may also vary. Today, many opinions are expressed in the media about the certification of domestic pharmaceutical manufacturers according to GMP (good manufacturing practice) standards. At the same time, many generic medicines are presented on our market not only from Russia, but also from Southeast Asia. It is unknown whether the production technology of such drugs is followed in these countries, what ballast substances are used, and how this affects pharmacokinetic and pharmacodynamic parameters.
Manufacturers of generic drugs often do not conduct their own clinical studies, citing available data obtained from original drugs. Saving costs for conducting clinical trials, creating a design that meets the criteria of evidence-based medicine, and paying for the research itself, of course, allows you to reduce the price of the final product. The results of a number of studies comparing the effectiveness, as well as pharmacokinetic and pharmacodynamic parameters of original drugs and generic drugs, are available in the scientific press. For example, a comparison of the original diclofenac and the generic diclofenac showed significant differences in pharmacokinetic parameters, including the low bioavailability of the generic, which certainly casts doubt on the presence of therapeutic equivalence [7].
Prospects for the use of Movalis
During twenty years of active use in Russia, Movalis has been associated with the choice of safe treatment for chronic pain. The default treatment for acute pain has been the use of non-selective COX inhibitors, despite the fact that they cause known adverse reactions. The concept of choosing not only an effective, but also a safe drug for acute pain was not considered in this context. Such a compromise “effective pain relief with associated adverse events” is a standard situation for our country, since in Russia there is no calculation of the cost of the risks of treating side effects as such. Meanwhile, the choice of an anesthetic drug during surgery or NSAIDs for acute pain should also be made taking into account the relationship between pharmacological characteristics (pharmacodynamics and pharmacokinetics), the risk of side effects and pharmacoeconomic indicators.
In this regard, publications about a new niche that Movalis can occupy are of great interest - about the use of the drug in premedication and for acute pain, namely in perioperative pain relief during manipulations in the maxillofacial area.
T. Aoki et al. on 114 patients demonstrated the advantage of premedication with Movalis (Mobic) at a dose of 10 mg compared with piroxicam 27 mg and placebo [8]. M. A. Isidoria-Espinoza et al. on 50 patients showed more effective analgesia with Movalis at a dose of 15 mg compared with tramadol 50 mg (the drugs were administered 50 minutes before the procedure for wisdom tooth removal) [9]. E. Selimović et al. in 60 patients, the effectiveness of meloxicam at a dose of 15 mg, glucocorticoids (methylprednisolone) and their combination in removing wisdom teeth was compared; combination therapy had an advantage [10]. According to the results of EW Weber et al., the use of Movalis 15 mg, unlike non-selective NSAIDs during surgery, does not significantly increase blood loss [11].
These data allow us to take a fresh look at the drug Movalis, which has long been familiar to patients and practitioners. It may be that to better understand the effectiveness and safety of Movalis, additional studies will be required in a larger patient population with comparisons with other drugs used in premedication and treatment of acute pain. However, even the available data now allow us to safely use Movalis in surgical and dental practice.
Mechanism of action of meloxicam
Any inflammation cannot develop on its own. We need special mediators, or carriers. They are called prostaglandins and are produced by the metabolism of arachidonic acid. It is prostaglandins that trigger the release of biologically active substances from mast cells, which initiate inflammation, pain and dysfunction. These substances include, for example, histamine. For this cascade of reactions to work, the work of cyclooxygenase, COX, is needed, a special enzyme that plays a critical role in the development of inflammation. It is with COX that non-steroidal anti-inflammatory compounds work, including Movalis.
It is very important to understand that this enzyme has two varieties, which are abbreviated as cyclooxygenase type 1 and 2, COX-1 and COX-2. It is COX-2 that causes specific inflammation in any tissue, and type 1 enzyme (COX-1) is necessary to maintain the normal mucous membrane of the stomach and duodenum. And if you block COX-1 and COX-2 at once, then as a side effect you will develop stomach ulcers, erosive gastritis and other diseases that are well known as complications from taking NSAIDs. More precisely, not all NSAIDs, but only first-generation drugs. This is the well-known Diclofenac, ibuprofen and other drugs.
They really help, they are highly active, relieve pain well, but at the same time they block both types of cyclooxygenase, and the most common side effect is heartburn, and with long-term use - exacerbation of stomach ulcers, even bleeding. Since these first-generation drugs did not make any difference between the two types of COX enzymes and blocked both types, these drugs were called non-selective COX inhibitors. Movalis is a selective COX-2 inhibitor that leaves type 1 enzyme alone, does not damage the stomach, and at the same time works only with type 2 cyclooxygenase.
Of course, meloxicam and Movalis still have a slight effect on type 1 cyclooxygenase, but tens and hundreds of times weaker than older, non-selective drugs. This means that Meloxicam (Movalis) is much safer than the same Diclofenac. Therefore, side effects such as heartburn and exacerbation of peptic ulcers occur much less frequently when using Movalis.
Treatment products musculoskeletal system Movalis - reviews
Doc
https://bezboleznej.ru/movalis-ukoly
Among the drugs of choice for the comprehensive treatment of back and joint pain, I prefer the original German drug Movalis (meloxicam) 15 mg per day with fewer side effects
Dmitry T.
https://protabletky.ru/movalis/
Kohl "Movalis" during an exacerbation of rheumatoid arthritis. It starts to help in about a day, and full recovery begins 2-3 days after 3-5 injections. Good drug, soft. There are minimal side effects, it especially protects the stomach. During treatment I feel heat, my legs especially burn, this is because the blood vessels dilate and the blood begins to move quickly through them.
Natalie
https://med-otzyv.ru/lekarstva/155-m/27432-movalis
Great drug! I recommend it to everyone! The pain really disappears. But I advise you to do it at night, in the morning it’s a cucumber! (this is with VERY strong pain!!!!!) ALL HEALTH AND GOOD MOOD!
Vladimir.
https://med-otzyv.ru/lekarstva/155-m/27432-movalis
“It suited me.” From the first injection I felt relief.
Cbytl
https://otzovik.com/review_6087924.html
Advantages:
quick effect, long shelf life of the drug, convenient opening of ampoules
Flaws:
No
My greetings to everyone! Many people probably know the discomfort and inconvenience caused by periodic pain in the lower back; most often they are chronic and associated with wear and tear of the intervertebral discs. Pain can occur completely unexpectedly and take you by surprise at almost any time. Most often, their occurrence is associated with lifting more weight than allowed by your doctor, if you have previously encountered this disease. But there are also completely unusual situations when the pain can recur, for example, when you slip on a slippery surface or when you twist your ankle and try to regroup. The consequences of such pain are the most disappointing, doctors even have such a concept as helplessness to put a sock on your foot on your own; this was exactly the case when I first visited the doctor. Self-treatment with pain-relieving creams and gels, warming patches or applicators will only help dull the pain, but ultimately a visit to the doctors is inevitable, and treatment does not take place in one day, it is a day hospital with IVs, physiotherapy and injections. When such a disease first occurs, those who have encountered it know that it is enough to just give a few intramuscular injections. The most effective such drug is the Movalis solution; doctors simply do not prescribe another more effective drug. I want to tell you about it, because I have been using it for several years now and it has never let me down. The drug "Movalis" is presented for sale in the most ordinary thick paper packaging. On the back of which there is brief information about the drug. At the end of the package, the production series of the drug, the date of its production and its expiration date are indicated. The box contains five ampoules of the drug in a protective plastic container to protect the ampoules during transportation. There are five ampoules in the box precisely because this quantity is the full course of treatment, 1 injection per day for five days. The drug must be accompanied by detailed instructions for its use, but they are printed in very small print, so I will present only its main extracts, such as indications for use, contraindications and side effects. The product has both a positive effect and many contraindications, as you can see for yourself. But I have not encountered any problems with the drug for quite a long time. However, only the attending physician should prescribe this drug. According to the instructions, the drug is available only with a prescription, but I never presented the prescription when purchasing it, they don’t even ask for it, for which reason I find it difficult to answer. The product is produced in Spain. Its average retail price is 1000 rubles. Of course, I simply shared my impressions of its positive use, without any recommendations for its purchase and use. Don't get sick, good health to you and your loved ones. I hope that my review will contain useful and valuable information for you. Thank you for your attention.
ilusha452017
https://otzovik.com/review_6712089.html
Advantages:
The ampoules are easy to open and effective.
Flaws:
Price.
Good day, dear friends and readers of my review. My husband periodically experiences back pain after strenuous physical work. The last time I got sick quite badly and the doctor recommended intramuscular injection of Movalis and the vitamin complex Combilipen. The husband immediately went to the pharmacy and bought everything according to the recommendation, no one told him that the drug Movalis has a cheaper analogue Meloxicam, which is actually the main active ingredient of Movalis. Ampoule Meloxicam would cost about 250 rubles, and for three ampoules of Movalis 650 rubles were paid. The difference is noticeable, almost triple the overpayment. According to the recommendation, Movalis had to be injected every other day, and vitamins every day. The packaging with the drug is cardboard, inside there is a plastic backing with three glass ampoules and instructions for using the drug. The ampoules are easy to open and do not require filing. The ampoule contains 1.5 ml of solution. The solution contains 15 mg of the active substance meloxicam and a number of excipients. The color of the solution is yellowish. The drug is made in Spain. It can be stored without refrigeration, at room temperature, in a dark place. The packaging says that Movalis is available with a doctor’s prescription, but at the pharmacy the pharmacist did not ask for a prescription and my husband calmly bought it that way. That is, the sale of the drug is free. Movalis is a non-steroidal anti-inflammatory drug. It has three spectrums of action: - relieves pain; - relieves inflammation; - brings down the temperature. The drug helped my husband and he felt better after the first injection. We pierced it as expected every other day. A week has passed since the treatment and so far everything is fine, but he tries to do minimal physical activity. Of course, the drug is good and can be recommended, but I would prefer a cheaper analogue with the same effect. I would buy it if I urgently need to start treatment, and there is no equivalent in the pharmacy. Thank you for your attention to my review. Health and good mood to everyone!!!)))
CalypsoBeauty
https://irecommend.ru/content/esli-gde-chto-zaklinilo
Hello, I want to tell you about the non-steroidal anti-inflammatory drug Movalis, which effectively and quickly relieves even the most unpleasant and persistent symptoms of musculoskeletal problems.
Movalis is a serious drug and I strongly recommend that you carefully study the instructions and consult with your doctor before using it!
Pharmachologic effect:
The main active ingredient of the drug is meloxicam. It is a nonsteroidal anti-inflammatory drug that is a selective cyclooxygenase-2 inhibitor. It is a derivative of enolic acid. The active substance has an analgesic, anti-inflammatory and antipyretic effect on the body, and also blocks the work of a specific enzyme, which is directly involved in the development of inflammatory processes.
The drug relieves inflammation as quickly as possible and at the same time its effect is quite long-lasting and persistent. But it all depends on the type of pain. It mainly treats joint and muscle pain, but is also suitable for some nerve pain such as pinching.
Indications for use:
- symptoms of rheumatoid arthritis; - symptoms of osteoarthritis; - symptoms of ankylosing spondylitis (Bechterew's disease): - pain syndromes in osteoarthritis, arthrosis, degenerative joint diseases.
Effect of use:
It copes well with joint pain and pinching - it relieves swelling and inflammation within 1-1.5 minutes after intramuscular administration. Usually one ampoule per day is enough to switch to milder anti-inflammatory drugs and reduce inflammation to nothing. But it is worth noting that it is not recommended to administer it for longer than 3-5 days. This is associated with a number of side effects from many organ systems. Fortunately, I didn’t have them at all, but in general they are very likely. Therefore, when using Movalis you need to be extremely careful, especially if some organs or organ systems are prone to this kind of response.
Side effects
Digestive system:
Up to 5 percent of those taking the drug may experience nausea, vomiting, abdominal pain, flatulence, diarrhea, and constipation. Less than 0.1 percent experience other symptoms (such as belching, esophagitis, gastrointestinal ulcers, hidden or macroscopic gastrointestinal hemorrhage, colitis and gastritis).
Hematopoietic system: Occasionally, the use of the drug can provoke anemia, even less often - leukopenia, thrombocytopenia, and contributes to a change in the number of certain types of leukocytes per unit of measurement.
Skin reactions: Itching, rash, stomatitis, urticaria, photosensitivity. In some cases, an allergic reaction may occur.
Respiratory system: Acute attacks of bronchial asthma can occur extremely rarely.
Nervous system: Headaches, dizziness, tinnitus, drowsiness, mood swings, nervousness.
Cardiovascular system: Edema, changes in blood pressure, hot flashes and palpitations.
Vision: Blurred vision and conjunctivitis.
Appearance:
Cardboard packaging with instructions + 5 ampoules 15 mg/1.5 ml. Standard ampoules with a light yellow, odorless liquid are easy to open, but it is better to trim them first. Movalis is also available in tablet form, 7.5 and 15 mg.
Is it true that the drug in ampoules “hits the liver” less than in tablets?
No it is not true. This is a common myth! Both routes through which the drug enters the body do not pass directly through the liver. In the first case, it directly enters the blood from soft tissues; in the second case, it passes through the main sections of the gastrointestinal tract and enters the blood through the epithelium of the small intestine. In both cases, the drug first of all enters the blood, and then, with the help of the circulatory system, it is carried to the organs and places of localization of inflammation. And all venous blood on its way back, without exception, is “cleaned” by the liver. Since almost any drug is perceived by the liver as a “toxin,” the way it enters the body is not particularly important.
Conclusion:
The drug has a place in the first aid kit as an emergency aid for severe and painful inflammations; it is also worth taking with you on the road in case of unforeseen situations, especially if arthralgia and pinching are frequent guests of yours. But at the same time, it should not be abused.
fedorino-gore
https://irecommend.ru/content/esli-ochen-bolit-spina
Hello! I want to write a review about Movalis injections, maybe some of you will find it useful. This year we decided to complete the renovations in the house, but everything didn’t work out quite as planned. On the second day of labor, my husband had a very bad back pain after lifting a barrel. He was simply bent, but could not straighten out. He rested for the evening, but did not feel better. Yes, and he lay down - this is a strong word, he was rather in agony, considering that he did not sleep all night, since the slightest movement immediately sent a sensation to the lower back. In the morning I ran to the pharmacy, I said, this is how it is, it’s really bad and it’s not getting better. I was offered several drugs to choose from, including Movalis ampoules. The pharmacist said that it was a very good remedy and should help quickly. I bought it. I came home, opened it, and there were 10 ampoules inside. The instructions are very large. Although the pharmacist told me everything, I once again went over the contraindications myself. Trust but check!
I gave my husband the first injection at about 11 am. He moaned a little more, trying to lie down more comfortably, and then became quiet. While I was minding my own business, maybe half an hour had passed, I walked in and he was sleeping. I was happy, apparently the pain had subsided, it was already good. He woke up at four o'clock in the afternoon and not only woke up, but got up himself and went out onto the veranda. I ask how? He replied that he felt fine. This evening, of course, we did nothing, just rested. And the very next morning the husband went to do business. We finished the course, of course. I don’t want to enjoy a relapse. True, now I started tugging at him to make an appointment with the doctor, otherwise, as you know, they don’t joke with their backs. So I advise, but it would be better if the medicines were never needed, although no one is insured, they will take it and grab it. Thank you! Be healthy!
Indications
If you carefully study the official instructions for Movalis, it will not be written anywhere about protrusions and hernias. But it is enough for us that the indications include a disease of the musculoskeletal system and acute back pain. Protrusions and hernias in the form of exacerbation fit well into this definition. What other indications exist for the use of Meloxicam? We can briefly list them:
- all inflammatory rheumatic diseases of connective tissue, such as spondyloarthritis, rheumatoid and psoriatic arthritis;
- osteoarthritis with an inflammatory component;
- glenohumeral periarthritis;
- compression of the nerve roots is what causes protrusions and hernias. Compression radiculopathy is manifested by acute, piercing pain in the back and leg (sciatica, lumbago, radiculitis);
- various plexites.
Movalis is also used for acute periods of sports injury, for sprained ligaments.
Release form and dosage regimen
Since Movalis is the very first, most researched and safest of all meloxicams, the rest of the meloxicam medications, the so-called generics, or commercial copies, are equal to the flagship of the line - Movalis, and are produced in the same dosage and concentration.
Meloxicam is available as:
- solution for intramuscular use - injection solution 15 mg/1.5 ml, three ampoules or five ampoules in a package;
- tablets, tablets in the following dosages: 15 mg No. 10 or 20, 7 mg tablets package No. 10 and 20;
- suspension for oral administration - a 100 ml bottle, with 5 ml of suspension corresponding to one 7 mg tablet. The suspension is prescribed infrequently and is rarely available in pharmacies.
The presence of such dosage forms makes it possible to cover almost all routes of administration, and mainly ampoules and tablets are in demand in pharmacies. But how to start treatment for acute back pain?
As already noted, in the article on drug treatment of hernias, first, on the first or second day, it is necessary to eliminate swelling, inflammation and relieve pain as quickly as possible. Therefore, it is necessary to administer Movalis intramuscularly, and then switch to tablets. There is a special package that contains three ampoules, especially for such a short, three-day course of treatment.
Subsequent intake of tablets is possible according to the following scheme: three days - 15 mg tablets, and another 3 days - 7 mg tablets. If the patient has a history of ulcers or exacerbation of gastritis, then just in case, it is advisable to prescribe proton pump inhibitors for prophylactic purposes while taking the drug. The standard is Omeprazole, one capsule 20 mg 2 times a day. This scheme will allow you to avoid exacerbation of gastric ulcers or exacerbation of erosive gastritis.
Of course, the use of Movalis requires complex therapy, together with the prescription of centrally acting muscle relaxants, vitamins, as well as the use of local remedies. But this will be discussed in other articles.
MOVALIS (tablets)
It appears that Movalis may cause less harm to the body.
We will talk about this further. The main indications for treatment with this drug are the following diseases: ankylosing spondylitis; osteoarthritis (arthrosis, degenerative joint diseases), rheumatoid arthritis. Personally, a neurologist prescribed it for me for minor pain in tense shoulder muscles that arise from sitting for a long time in one position at a work computer.
It is sold in tablets (pale yellow, with one convex side) of 7.5 mg and 15 mg. At the time of purchase, the 7.5 mg dosage was not available at the pharmacy, so they offered me a loading dosage. Apparently, it is also available in suppositories with the same doses, as well as in the form of solutions for intramuscular administration (1.5 ml) and suspensions for oral administration, but I have not tried this.
The dosage regimen is selected individually. I was prescribed 7.5 mg twice a day with meals, but I didn’t “break” my 15 mg and took it once a day, since the maximum daily dose should not exceed 15 mg. The instructions contain a warning: due to the fact that the risk of adverse reactions may depend on the dosage size and duration of use, you should use it for the shortest possible time, which is what I did, especially since the list of possible side effects is impressive: changes in the leukocyte formula ; leukopenia, thrombocytopenia, anemia; headache and dizziness; colitis; gastritis; stomatitis; abdominal pain; diarrhea; nausea, vomiting; skin rash; hives; itching, etc. – the list of about 30 different items makes you think. I didn’t experience anything like this, and I took it for a short course.
The list of contraindications and cases when the drug is taken with caution is also extensive: hypersensitivity to components, pregnancy, lactation, children under 12 years of age, symptoms of bronchial asthma, nasal polyposis, peptic ulcer or perforation of the stomach and duodenum in the acute stage (or recently suffered ) etc. – about 25 points in total. You must carefully read all this in the instructions, and also do not forget to read the paragraphs “special instructions” and “drug interactions” - they also contain very important information, which is undesirable for your health to ignore.
What about its effect? It seemed to me that the effect was still weak. Regular exercise and relaxing movements helped me much more. Massage (including self-massage) and rubbing with ointments are the best helpers in this case. As an analgesic and anti-inflammatory drug, it is rather weak. And, meanwhile, it is quite expensive - for 10 tablets of 15 mg each I paid 665 rubles.
As a result, if we take into account the little help in my problem, the huge list of contraindications and side effects (the instructions for Movalis are almost a meter long), and at the same time the inadequate cost, I will not recommend this drug to everyone. Moreover, it is unlikely that anyone will take it without a doctor’s prescription. And when prescribed, everyone will decide for themselves about its effect, everything is so individual.
Contraindications and side effects
Meloxicam, and therefore Movalis, has standard contraindications for NSAIDs. These include: individual intolerance, the manifestation of allergic reactions, the presence of an allergy to acetylsalicylic acid, and especially the occurrence of aspirin bronchial asthma. If a person has nasal polyposis in combination with aspirin-induced asthma, then NSAIDs in any form are strictly contraindicated for him.
Peptic ulcers of the stomach and duodenum, as well as erosive ulcerative gastritis, have already been discussed above. There are other contraindications, for example, pregnancy and breastfeeding, children under 12 years of age, decompensated heart and kidney failure, as well as ulcerative colitis, which is sometimes called Crohn's disease.
The shorter the course of use of Movalis, the lower the risk of various side effects. Leukopenia, drug-induced hepatitis, and various severe skin lesions, such as Lyell's syndrome, almost never develop. Various allergic reactions and headaches occur much more often, but in any case - no more often than in 10% of all cases.
Gastrointestinal bleeding can be a complication, but it can be easily avoided if the patient's history is collected before prescribing the drug, and if necessary, “covered up” with omeprazole.
It must be remembered that when prescribing Movalis, a second drug from the NSAID group is not prescribed; for example, it makes no sense to use Movalis and ketoprofen (Ketonal) together, and it would be a completely gross and dangerous mistake to prescribe Movalis together with diclofenac. It is also not compatible with drugs from the SSRI antidepressant group, and with some diuretics. A complete and detailed description of compatibility, side effects and contraindications can be read in the official instructions for the drug.
Movalis®
Other prostaglandin synthesis inhibitors, including glucocorticoids and salicylates - concomitant use with meloxicam increases the risk of ulceration in the gastrointestinal tract and gastrointestinal bleeding (due to synergistic action). Concomitant use with other NSAIDs is not recommended.
Anticoagulants for oral administration, heparin for systemic use, thrombolytic agents - simultaneous use with meloxicam increases the risk of bleeding. In case of simultaneous use, careful monitoring of the blood coagulation system is necessary.
Antiplatelet drugs, serotonin reuptake inhibitors - concomitant use with meloxicam increases the risk of bleeding due to inhibition of platelet function. In case of simultaneous use, careful monitoring of the blood coagulation system is necessary.
Lithium preparations - NSAIDs increase plasma lithium levels by reducing its excretion by the kidneys. The simultaneous use of meloxicam with lithium preparations is not recommended. If necessary, simultaneous
use, careful monitoring of plasma lithium concentrations is recommended throughout the course of lithium preparations.
Methotrexate - NSAIDs reduce the secretion of methotrexate by the kidneys, thereby increasing its plasma concentration. The simultaneous use of meloxicam and methotrexate (at a dose of more than 15 mg per week) is not recommended. In case of simultaneous use, careful monitoring of renal function and blood count is necessary. Meloxicam may increase the hematological toxicity of methotrexate, especially in patients with impaired renal function. When meloxicam and methotrexate are used together for 3 days, the risk of increased toxicity of the latter increases.
Contraception - There is evidence that NSAIDs may reduce the effectiveness of intrauterine contraceptive devices, but this has not been proven.
Diuretics - the use of NSAIDs in case of dehydration of patients is accompanied by the risk of developing acute renal failure.
Antihypertensive drugs (beta-blockers, angiotensin-converting enzyme inhibitors, vasodilators, diuretics). NSAIDs reduce the effect of antihypertensive drugs due to inhibition of prostaglandins, which have vasodilating properties.
Angiotensin-II receptor antagonists, as well as angiotensin-converting enzyme inhibitors, when used together with NSAIDs, increase the decrease in glomerular filtration, which can thereby lead to the development of acute renal failure, especially in patients with impaired renal function.
Cholestyramine, by binding meloxicam in the gastrointestinal tract, leads to its faster elimination.
NSAIDs, by acting on renal prostaglandins, may enhance the nephrotoxicity of cyclosporine.
Pemetrexed - When meloxicam and pemetrexed are used concomitantly in patients with a creatinine clearance of 45 to 79 ml/min, meloxicam should be discontinued five days before starting pemetrexed and can be resumed 2 days after the end of the drug. If concomitant use of meloxicam and pemetrexed is necessary, patients should be closely monitored, especially for myelosuppression and gastrointestinal side effects. In patients with creatinine clearance less than 45 ml/min, taking meloxicam with pemetrexed is not recommended.
When used together with meloxicam, drugs that have a known ability to inhibit CYP 2C9 and/or CYP 3A4 (or are metabolized with the participation of these enzymes), such as derivatives
sulfonylureas or probenecid, the possibility of pharmacokinetic interaction should be taken into account.
When used together with oral antidiabetic drugs (for example, sulfonylureas, nateglinide), interactions mediated by CYP 2C9 are possible, which can lead to increased concentrations of both these drugs and meloxicam in the blood. Patients taking meloxicam concomitantly with a sulfonylurea or nateglinide should carefully monitor their blood sugar levels due to the possibility of hypoglycemia.
With the simultaneous use of antacids, cimetidine, digoxin and furosemide, no significant pharmacokinetic interactions were identified.
