Medication

Xefokam

Structure

  • 1 xefocam tablet may include 4 or 8 mg lornoxicam. Auxiliary components: povidone K25, magnesium stearate, cellulose, talc, croscarmellose sodium, lactose monohydrate, titanium dioxide, macrogol 6000hypromellose.
  • One vial with Xefocam lyophilisate includes 8 mg lornoxicam. Auxiliary components: disodium edetate, trometamol, mannitol.

Release form

White oblong tablets (dosage 4 mg) with an engraved inscription "LO4«.

  • 10 pieces in a blister - 10, 1, 2, 3 or 5 blisters in a pack of paper.

White oblong tablets (dosage 8 mg) with an engraved inscription "LO8«.

  • 10 pieces in a blister - 10, 1, 2, 3 or 5 blisters in a pack of paper.

The lyophilisate for the manufacture of the solution is a dense yellow mass.

  • 5 glass bottles in a pack of paper.
  • 5 glass bottles in a plastic tray; 1 pallet in a pack of paper.

Pharmachologic effect

Anti-inflammatory and analgesic effect.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Anti-inflammatory non-steroidal drug. It has a pronounced analgesic and anti-inflammatory effect. Lornoxicam has a rather complicated mechanism of action, which includes inhibition of prostaglandin synthesis caused by inhibition of activity cyclooxygenase. Blocking cyclooxygenase leads to the suppression of peripheral pain receptors and to the relief of signs of inflammation.

Lornoxicamalso reduces the production of oxygen radicals by leukocytes subjected to activation. The analgesic effect of the drug is not associated with an opiate-like effect on the nervous system and is not accompanied by respiratory depression or drug dependence.

It does not affect important vital signs: respiratory rate, ECG, body temperature, heart rate, blood pressure, spirometry.

Pharmacokinetics of tablets

After oral administration lornoxicam quickly and completely adsorbed from the intestine. In this case, the highest concentration in the blood occurs after an hour and a half. Eating reduces the maximum concentration by 30% and increases the half-life up to 2.3 hours. Bioavailability lornoxicamreaches 92-100%. Binding to blood proteins is 99% and does not depend on its content.

The active substance is completely transformed in the liver. Involved in the transformation enzyme CYP2C9. In plasma, the drug is present mainly in unchanged form and, only to a small extent, in the form of a hydroxylated metabolite that does not have pharmacological activity.

The elimination half-life approaches 4 hours. About a third of the metabolites are excreted in the urine and the remainder in the bile.

In elderly people, as well as in patients with impaired liver and kidney function, no pharmacokinetics of the drug were detected.

Pharmacokinetics of a solution for parenteral administration

When administered intramuscularly, the highest content lornoxicam in the blood is reached after 25 minutes. The bioavailability in this case reaches 97%, and the reaction with blood proteins is 99%.

Lornoxicam is in plasma in unchanged form, as well as in the form of a hydroxylated metabolite that does not have pharmacological activity.

The half-life is approaching 3.5 hours. Completely metabolized. About a third of the metabolites are excreted in the urine and the remainder in the bile.

In elderly people, as well as in patients with impaired liver and kidney function, no pharmacokinetics of the drug were detected.

Indications for use

Indications for use Xefocam in the form of tablets:

  • short-term therapy pain syndromeregardless of origin;
  • symptomatic treatment rheumatic diseases (butnkylosing spondylitis, osteoarthrosis, articular syndrome at acute gout, rheumatoid arthritis, rheumatic affection of periarticular soft tissues).

The use of the drug in the form of injections is carried out for short-term treatment of acute pains of moderate, mild and moderately strong nature.

Contraindications

  • Combination (full or incomplete) polyposis of the paranasal sinuses or nose, bronchial asthma and intolerance non-steroidal anti-inflammatory drugs (including history).
  • Thrombocytopenia.
  • Hemorrhagic diathesis or blood coagulation disorders, including conditions after surgical interventions associated with the likelihood of bleeding or inadequate hemostasis.
  • The period after the transfer coronary artery bypass grafting.
  • Changes in the mucous membranes of the duodenum or stomach of an erosive-ulcerative type, active bleeding from the organs of the gastrointestinal tract, as well as cerebrovascular or other bleeding.
  • Previous bleeding from the digestive system associated with taking non-steroidal anti-inflammatory drugs.
  • Recurrent stomach ulcer or repeated bleeding from the digestive system.
  • Exacerbation of inflammatory bowel disease (Crohn's disease).
  • Decompensated heart failure.
  • Lack of liver function or liver disease in the active phase.
  • Severe renal failure, progressive kidney disease, hyperkalemiadehydration or hypovolemia.
  • Pregnancy and lactation.
  • Age less than 18 years.
  • Allergy to the components of the drug.

Care should be taken to prescribe a medicine in the presence of at least one of the following conditions: lesions of the digestive tract of an erosive and ulcerative nature and bleeding of the indicated localization, moderate renal failure, conditions after operations, arterial hypertensionover 65 years old coronary heart diseasecerebrovascular disease, chronic heart failure, dyslipidemiaperipheral artery disease diabetes, smoking, clearance creatinine up to 60 ml / min, availability Helicobacter pylori, ulcerative lesions of the digestive tract in the past, prolonged use anti-inflammatory non-steroid drugssevere somatic diseases, alcoholismoral administration glucocorticosteroids, anticoagulants, antiplatelet agents, diuretics, selective serotonin uptake blockers or nephrotoxic drugs.

Joint therapy anti-inflammatory non-steroid drugsand Tacrolimus able to increase the risk of nephrotoxicity.

Concomitant userotive inflammatory non-steroidal drugs and Heparina on the background epiduralor spinal anesthesiaincreases the likelihood of epidural and spinal hematomas.

Side effects

The most common adverse reactions to taking anti-inflammatory non-steroid drugsare: appearance peptic ulcersperforation of a hollow organ or bleeding of the gastrointestinal localization. Also noted are abdominal pain, vomiting, nausea, diarrhea, constipation, flatulence, dyspeptic symptomsbloody vomiting melenaaggravation colitis, ulcerative stomatitisaggravation Crohn's disease, gastritis. Approximately 20% of patients taking the described drug are able to develop adverse reactions.

  • Reactions from hematopoiesis: anemia, leukopenia, thrombocytopeniaan increase in the duration of bleeding, ecchymoses.
  • Reactions from the immune system: allergy.
  • Reactions from metabolism: anorexiaincrease or decrease in weight.
  • Reactions from psyche: depression, sleep disturbance, nervousness, confusion, anxious agitation.
  • Reactions from nervous activity: temporary mild headaches, dizziness, paresthesia, doubt, tremortaste violation, migraine.
  • Reactions from of view: conjunctivitisvision impairment.
  • Reactions from vestibular apparatus: tinnitus, dizziness.
  • Reactions from blood circulation: tachycardiaheartbeat heart failureswelling tideshemorrhages arterial hypertension, hematoma.
  • Reactions from respiratory organs: rhinitis, dyspnea, pharyngitis, bronchospasmcoughing.
  • Reactions from digestion: abdominal pain, nausea, dyspeptic symptomsvomiting diarrhea, flatulence, constipation, dry mouth, belching, peptic ulcer, gastritisulceration in the mucous membranes of the mouth, bloody vomiting, glossitis, melena, stomatitis, gastroesophageal reflux, esophagitis, aphthous stomatitis, dysphagia, perforated ulcer.
  • Reactions from hepatobiliary system: increased concentration glutamate pyruvate transaminases and glutamate oxaloacetate transaminases, damage to hepatocytes, impaired liver function.
  • Reactions from skin: itching, rash, sweating, hives, dermatitis, alopecia, purpurabullous reactions, edema, epidermal toxic necrolysis, Stevens-Johnson syndrome.
  • Reactions from musculoskeletal system: arthralgiamuscle cramps, bone pain, myalgia.
  • Reactions from urinary system: urination disorders, nocturiaincreasing concentration urea or creatinine in blood.
  • General reactions: facial swelling, malaise, asthenia.

Instructions for use Xefocam (Method and dosage)

Xefocam tablets, instructions for use

The medicine is taken orally before meals with 100 ml of water.

At moderate to severe painthe drug is taken in a dose of 8-16 mg per day, which is divided into 2-3 doses. The maximum daily dose is 16 mg.

At inflammatory rheumatic diseases 12 mg is recommended as the initial dose. The usual daily dose is 8-16 mg.

The exact selection of the dose is carried out by the doctor based on the patient's condition, and the duration of treatment depends on the clinic and the course of the disease.

In case of damage to the digestive system, persons with impaired kidney or liver function, elderly patients or after volumetric operations, the maximum daily dose is set at the rate of 12 mg of the drug per day, divided into 3 doses.

To reduce the likelihood of adverse events, the minimum effective dose size should be assigned the least short course.

Xefokam injections, instructions for use

Injections are used only parenterally.

In the treatment pain after surgeryXefocam injections are administered intravenously or intramuscularly in the treatment of acute lumbago or ischalgia - only intramuscularly.

The initial dose of injection may be 8 or 16 mg. With a weak analgesic effect after the administration of 8 mg of the drug, it is allowed to additionally introduce another same dose.

Injections of the medicine used as maintenance therapy are prescribed in a dose of 8 mg twice a day. The maximum daily dosage is 16 mg.

Injections should be assigned the minimum effective dose in the least short course.

A solution for parenteral administration is prepared before use by dissolving the contents of the vial with 2 ml of water for injection. Then the needle is replaced. Intramuscular injections are done only with a long needle. The drug solution prepared in the described manner is administered intramuscularly or intravenously. The duration of the injection with the intravenous method should be more than 15 seconds, with intramuscular - more than 5 seconds.

Overdose

With an overdose of the drug, the following symptoms are possible: dizziness, nausea and vomiting, ataxia, visual impairment, cramps coma. Changes in the liver and kidneys, as well as clotting disorders, are not ruled out.

Overdose treatment: stop administering or taking the medicine. Lornoxicamquickly evacuated from the body. Application dialysis inefficient. Selective antidote is not known. In case of poisoning with tablets, emergency measures, including taking enterosorbents and gastric lavage. For the treatment of digestive disorders, it is allowed to use Ranitidine or prostaglandin analogues.

Interaction

When combined with Cimetidine concentration increases lornoxicam in blood.

When used simultaneously with anticoagulantsor platelet aggregation blockersan increase in the duration of bleeding and an increase in the likelihood of bleeding are not ruled out.

Joint use with Fenprokumon reduces its therapeutic effectiveness.

At reception anti-inflammatory non-steroid drugs together with Heparin during spinal or epidural anesthesia increased risk spinal and epidural hematomas.

When combined with ACE blockers and beta blockers their hypotensive effect is reduced.

The drug weakens the hypotensive and diuretic effect. diureticsand also lowers clearance Digoxin.

When combined with other anti-inflammatory non-steroid drugsor glucocorticosteroidsincreases the risk of bleeding from the digestive system.

When combined with quinoline antibiotics increased risk convulsive syndrome.

The drug increases the content Methotrexate in the blood when used together.

When used simultaneously with selective serotonin uptake blockersincreases the risk of bleeding from the digestive system.

Xefocam can cause increased concentration lithium in the blood, enhancing the side effects of the latter when taken together.

Xefocam stimulates nephrotoxic effects Cyclosporin and hypoglycemic effect sulfonylurea preparations.

In conjunction with potassium preparations, CorticotropinAlcohol increases the risk of undesirable effects from the digestive system.

When used simultaneously with Cefotetan, cefoperazone, cefamandol, valproic acidthe likelihood of bleeding increases.

In conjunction with Tacrolimus increased risk of occurrence nephrotoxicity.

Terms of sale

On prescription.

Storage conditions

Store at room temperature. Lyophilisate must be stored in the dark. The prepared solution is stored for no more than a day. Keep out of the reach of children.

Shelf life

Five years.

Special instructions

The likelihood of ulcerogenic effects of the drug can be reduced by taking proton pump inhibitors and artificial prostaglandin analogues. If bleeding from the digestive organs appears, the medication should be stopped immediately and emergency measures taken. It is especially necessary to carefully monitor patients with pathology of the gastrointestinal tract, who are taking the drug for the first time.

Like any other oksikama, the described drug inhibits platelet aggregation, which causes an increase in the duration of bleeding. When using the drug, it is necessary to carefully monitor the condition of patients who need the normal physiological functioning of the coagulation system (including those who are planning to undergo a surgical operation), who have blood clotting disorders or are receiving coagulation suppressants, in order to timely identify signs of bleeding.

If signs of liver damage are found (yellowness of the skin, itching, vomiting, nausea, dark urine, abdominal pain, increased content hepatic transaminases) you must immediately stop using the medicine and consult a doctor.

It is forbidden to use the medicine at the same time other anti-inflammatory non-steroid drugs.

Ksefokam is able to change the properties of platelets, but it does not replace the preventive effect Aspirin with cardiovascular disorders.

Patients with impaired renal function provoked by severe blood loss or dehydration, the drug, as an inhibitor of prostaglandin biosynthesis, is allowed to be prescribed only after stopping hypovolemia and the danger it causes to reduce kidney perfusion.

The described medicine may cause an increase in content. urea and creatinine in the blood as well as the delay sodium, water, arterial hypertensionperipheral edema and some other initial symptoms nephropathy. Long-term therapy of such patients with Xefocam may cause glomerulonephritis, nephrotic syndromeand even acute kidney failure.

In the elderly, as well as in sufferers arterial hypertensionor obese, you need to monitor blood pressure.

It is especially important to monitor renal function in elderly patients, as well as in individuals taking diuretics or agents that potentially cause damage to kidney tissue.

With long-term use of the drug, it is necessary to regularly monitor hematological parameters, as well as indicators of the kidneys and liver.

Persons receiving the drug are strongly advised to refrain from driving and drinking alcohol.

Xefokama's analogs

Matches for ATX Level 4 code:MirloxRevmoxicamKsefokam RapidMovalisMesipolLemMelbekMovasinPiroxicamLornoxicamArthrosanTexamenAmelotexMeloxicam

Zornika, Ksefokam Rapid, Larfiks, Lorakam, Aroksikam, Aspikam, Loksidol, Melbek, Meloksikam, Revmalim, Rekoksa.

The price of Xefokam's analogues, which are indicated above, in almost all cases is higher than the price of Xefokam itself.

For children

Xefokam injections and tablets are not prescribed for patients under 18 years of age.

With alcohol

The combined use of alcohol and Xefocam can enhance the toxic effects of the drug. It is recommended to avoid the use of alcohol-containing drinks during treatment with the drug.

During pregnancy and lactation

It is forbidden to take the drug in these periods.

Xefokam reviews

Reviews of Xefokam injections are identical to reviews on the tablets of the same name and highly appreciate their analgesic effect. However, the drug is quite toxic and can cause severe damage to the liver, kidneys and stomach, which is confirmed by the reviews of doctors and patients, therefore it is unsuitable for systematic use for the purpose of stopping chronic pain.

Xefokam's price, where to buy

The price of Xefocam in tablets of 8 mg No. 10 in Russia is 150-200 rubles. For comparison, the price of an ampoule with a lyophilisate is approximately 160 rubles, 5 ampoules - 750 rubles.

Buy Ksefokam 8 mg No. 10 in Ukraine will cost an average of 80-105 hryvnia, and the price of injections Ksefokam No. 5 reaches 410 hryvnia.

  • Online Pharmacies in Russia
  • Online pharmacies in UkraineUkraine
  • Online pharmacies in Kazakhstan

ZdravCity

  • Ksefokam lyof iv and v / m 8mg n5 Wasserburger Artsneymittelwerk GmbH 625 rub.order
  • Ksefokam Rapid Tab. p.p.o. 8mg n12Takeda Pharma A / S303 rub.order
  • Ksefokam tab. p.p.o. 8mg n30Takeda GmbH 474 rub.order
  • Ksefokam tab. p.p.o. 8mg n10Takeda GmbH 227 rub.order

Pharmacy Dialog

  • Ksefokam Rapid (tab.pl./pl. 8mg No. 12) 320 rub.
  • Ksefokam (fl. 8mg No. 5) 692 rub.order
  • Ksefokam (tab.pl./ab. 8mg No. 30) 525 rubles to order
  • Ksefokam (tab. N / a 8mg No. 10) 231 rubles to order

Eurofarm * 4% discount on the promotional code medside11

  • Xefocam 8 mg n10 tabletTakeda GmbH / PharmFirma Soteks, ZAO260 rub.order
  • Xefocam Rapid 8 mg No. 12 tabletsTakeda Pharma A / C / Takeda GmbH 360 rubles to order
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Pharmacy24

  • Ksefokam Rapid 8 mg No. 6 tablets Takeda GmbH, a month of medicine Oranіnburg, Nіmechchina / Takeda Pharma A / C, Dania93 UAH to order
  • Ksefokam 8 mg No. 10 tablets Nikomed Avstria GmbH.Austria / Nikomed Avstria GmbH.Austria, Nimechchina / Takeda GmbH, Nimechchina94 UAH to order
  • Ksefokam 4 mg N10 tablets Takeda GmbH, Moscow State University, Nimechchina59 UAH order
  • Ksefokam 8 mg No. 5 lyophilisate Nycomed Austria Austria GmbH. Austria / Takeda Austria GmbH, Austria 446 UAH order

Pani Pharmacy

  • Xefocam tablets Xefocam tablets p / o 8 mg No. 10 Germany, Takeda 110 UAH
  • Xefocam Rapid tablets Xefocam Rapid tablets 8 mg 8 mg Denmark, Takeda Pharma 98 UAH order
  • Xefocam vial Xefocam pore. d / in. 8ml fl. №5 Austria, Takeda Austria 481 UAH to order
  • Xefocam tablets Xefocam tablets PO 4mg No. 10 Germany, Takeda 75 UAH
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BIOSPHERE

  • Xefocam 8 mg No. 10 tab.p.po.Takeda GmbH, Oranienburg (Germany) 990 tg.order
  • Ksefokam Rapid 8 mg No. 6 tab.p.Nycomed Denmark Aps (Denmark) 985 tg.order
  • Xefocam 4 mg No. 10 tab.po.Takeda GmbH, Oranienburg (Germany) 680 tg.order
  • Ksefokam 8 mg No. 5 por.liof.d / in.Wasserburger Artsnaymittelverk GmbH (Germany) 5 tg.order
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