Suppositories "Loxidol" - an anti-inflammatory non-steroidal anti-rheumatic drug. Meloxicam, present in its composition, is a derivative of enolic acid and belongs to the category of anti-inflammatory non-steroidal substances, it has a pronounced analgesic, anti-inflammatory and antipyretic effect. The mechanism of its work is due to the property to inhibit the biological synthesis of prostaglandins, which are mediators of inflammation as a result of selective inhibition of COX-2.
What can be learned from the instructions for candles “Loxidol”?
The composition of the medication
This pharmacological agent is produced in the form of suppositories for rectal use. The composition of one suppository includes an active element - meloxicam 15 mg, and additional substances: solid fat and macrogolglyceryl hydroxystearate.
Pharmacokinetics
Absorption parameters are similar to oral forms of a medicinal product. The maximum plasma concentration is observed 6 hours after administration of the suppository rectally.
The main active element of suppositories “Loxidol” binds very well to plasma proteins, mainly to albumin (98%). It is able to penetrate into the synovial fluid, the concentration of which is approximately 50% of the plasma level. The main substance is completely metabolized in the liver with the formation of four inactive derivatives. The main metabolite is 5'-carboxymeloxicam, which is formed due to the oxidation of intermediate metabolites, 5'-hydroxymethylmeloxicam, which is also excreted, only to a lesser extent. The drug is excreted from the body in equal amounts with urine and feces, mainly in the form of metabolites. In an unchanged form, approximately 5% of the daily dose is excreted through the intestine; in urine, it is found in the medicine in trace amounts.
The average half-life of the active element is 19 hours. Plasma clearance - 8 ml / min. In elderly patients, this figure is slightly lower. The pharmacokinetic parameters for liver or kidney failure do not change.
Indications for use
Indications for the use of candles "Loxidol" are described in detail in the instructions.
This medication is used for the symptomatic treatment of pain in diseases such as osteoarthritis (arthrosis, degenerative joint damage), ankylosing spondylitis, rheumatoid arthritis.
Dosage and Administration
Suppositories "Loxidol" are administered rectally, once a day (15 mg meloxicam). The likelihood of side effects depends on the dosage and duration of use. The drug should be used for the shortest possible time. The highest permitted dosage per day is 15 mg.
Side effects
Candles "Loxidol" can provoke the development of the following negative reactions of the body:
- digestive disorders, vomiting, nausea, pain in the abdomen, constipation, flatulence, the development of diarrhea;
- gastrointestinal bleeding, perforation and ulceration of a severe degree, especially in elderly patients;
- anemia, thrombocytopenia, leukopenia, agranulocytosis, especially in cases of simultaneous use of methotrexate;
- itching, rashes on the skin;
- photosensitivity reactions, Stevens-Johnson syndrome and epidermal toxic necrolysis, urticaria, cystic dermatitis, angioedema;
- anaphylactoid or anaphylactic reactions;
- asthma attacks, especially in people allergic to aspirin or other anti-inflammatory non-steroid drugs;
- feeling of intoxication, headaches, dizziness, drowsiness, ringing in the ears, disorientation, confusion;
- swelling;
- increased pressure, palpitations, hot flashes;
- a temporary increase in bilirubin or transaminase levels;
- a change in the functionality of the kidneys (increased concentration of creatinine or urea in the blood), rarely - acute renal failure;
- hepatitis;
- visual impairment.
Contraindications
According to the instructions for suppositories "Loxidol", the conditions in which the use of this medication is contraindicated are:
- hypersensitivity to the main element of the drug or to additional substances;
- with cross sensitivity to aspirin and other NSAIDs;
- history of bleeding in the digestive tract or perforations due to NSAIDs;
- peptic ulcer in the acute stage;
- severe liver failure;
- renal failure (if hemodialysis is not performed);
- gastrointestinal bleeding, cerebrovascular or any other bleeding;
- heart failure of a chronic or complex acute form;
- history of proctitis or rectal bleeding;
- age up to 15 years;
- lactation, pregnancy.
Drug interaction
Other NSAIDs, including salicylates: the simultaneous use of more than one such medication significantly increases the risk of ulcers in the digestive tract and gastrointestinal bleeding as a result of synergism of exposure. The combined use of meloxicam and other NSAIDs is not recommended.
Antiplatelet agents, anticoagulants, heparin for systemic use, thrombolytic drugs: increase the likelihood of bleeding. In cases of inability to avoid the concomitant use of these drugs, monitoring of the anticoagulant effect is necessary.
Lithium: the drug increases the concentration of lithium in plasma due to a decrease in its renal excretion. The combined use of lithium and NSAIDs is prohibited. If such a combined treatment is necessary, control the level of lithium in the plasma at the beginning of therapy, when selecting a dosage and discontinuing the drug “Loxidol”.
"Methotrexate": NSAIDs can reduce the tubular secretion of this medication and thus increase plasma methotrexate levels. If complex therapy is necessary, it is necessary to control the properties of blood and kidney function. Some caution must be exercised in cases where NSAIDs and methotrexate are used simultaneously for three days, since the concentration of methotrexate in the blood can increase significantly, as a result, various toxic reactions can occur.
"Cyclosporin": NSAIDs, acting on the renal prostaglandins, are able to increase the toxicity of cyclosporin to the kidneys. In the case of complex therapy using these drugs, kidney function should be monitored.
Intrauterine contraceptives: Loxidol reduces the effect of intrauterine contraceptives.
Diuretics: the use of this pharmacological drug with diuretics simultaneously increases the likelihood of developing acute renal failure in patients with dehydration. Patients who take meloxicam and diuretics at the same time should receive a large amount of fluid. Before starting therapy, an examination of kidney function is necessary.
Antihypertensive drugs (for example, angiotensin-converting enzyme inhibitors, beta-blockers, vasodilators) Loxidol® reduces the effectiveness of antihypertensive drugs as a result of inhibition of prostaglandins, which have a vasodilating effect.
"Cholestyramine": significantly enhances the elimination of meloxicam as a result of its binding in the digestive tract.
Instructions for candles "Loxidol" in gynecology will be presented below.
Special recommendations
The use of the drug, like other NSAIDs, requires strict monitoring of patients with a history of digestive system diseases, as well as patients taking anticoagulant medications. NSAIDs inhibit the production of renal prostaglandins, which are necessary for maintaining blood flow in the kidneys. In patients with reduced renal blood flow, the use of this medication can cause the development of renal failure, which disappears after discontinuation of the drug. In patients with moderate changes in renal function, the dosage of the drug can not be changed, however, constant monitoring of renal function is necessary. In rare cases, Loxidol can cause interstitial nephritis, renal medullary necrosis and glomerulonephritis, or the development of symptoms of nephrotic syndrome. The following categories of patients are prone to similar complications:
- with chronic kidney failure;
- people who have undergone extensive surgical interventions (which provoked hypovolemia);
- patients suffering from cirrhosis of the liver.
As indicated by the instructions for use with Loxidol, a pharmacological drug when used together with diuretics can enhance the retention of potassium, sodium and water in the body and affect the natriuretic efficacy of diuretics, as a result of which, in predisposed patients, heart failure or arterial insufficiency may occur hypertension
With some caution, a medication is prescribed for weakened patients, the elderly, as well as those who have heart failure.
What else does the instruction for application to Loxidol candles tell us? The medicine, like any other NSAIDs, can lubricate the symptoms of the main infectious pathology. Like other medications that inhibit the production of COX / prostaglandins, Loxidol can interfere with fertilization processes, so it is not recommended for women planning pregnancy.
The peculiarities of the effect of this drug on the ability to drive a vehicle or dangerous mechanisms is that when using the medication various negative reactions from the central nervous system can occur, which is why it is necessary to refuse to control the above technical devices for the treatment period.
Instructions for use with Loxidol must be strictly observed.
Application in gynecology
Due to its properties, this anti-inflammatory agent is today widely used in clinical gynecology in the event of the following infectious diseases and the accompanying pain syndrome:
- adnexitis;
- endometritis;
- cervicitis;
- colpitis;
- salpingoophoritis;
- other inflammatory processes in the female reproductive organs that cause severe pain.
According to reviews, suppositories "Loxidol" in gynecology are considered effective, because they quickly help get rid of the pathology.
Analogs
The list of analogues of this pharmacological drug is quite large. Some of these medicines:
- "Amelotex" - a drug that belongs to the pharmacological category of anti-inflammatory non-steroidal drugs, catalyzes the production of prostaglandins. Due to the selectivity, the main substance blocks COX-2, due to which the anti-inflammatory effectiveness of this agent and the minimal damaging effect on the mucous membranes of the digestive organs are observed.
- Zeloxim - NSAIDs, the absolute analogue of Loxidol, a selective COX-2 inhibitor. It can be attributed to the category of oxycams, since it is a derivative of enolic acid. It has analgesic, anti-inflammatory and antipyretic effects. The mechanism of influence is associated with a decrease in prostaglandin biosynthesis due to inhibition of the COX enzymatic activity.
- "Melox" - in composition and pharmacological properties is similar to the medication under consideration. It blocks prostaglandins, has an anti-inflammatory, analgesic effect.
Reviews about the drug
The drug "Loxidol" is considered one of the most prescribed medications among non-steroidal anti-inflammatory drugs that are produced in the dosage form - suppositories. There are a lot of reviews about this tool, which is due to the wide scope of this medical tool. It is used to eliminate the pain syndrome caused by a wide variety of diseases of an infectious nature - the field of neurology, traumatology, urology, gynecology, etc. Patients say in reviews of Loxidol suppositories that the drug helps to quickly get rid of intolerable pain when other drugs this does not help.
The medication is used mainly to relieve soreness in the development of bone and joint diseases, however, patients who used it for other pathologies also noted its high effectiveness.
Suppositories "Loxidol" in gynecology is often prescribed to women with the development of inflammatory processes in the pelvis, for example, with adnexitis. Patients observed that after administration of the suppository the pain subsided quickly, however, there were some negative side effects.
Among the side effects, severe nausea, dizziness, and stool disturbance in the form of diarrhea are most often observed. Many of the patients who left reviews about this medication had significantly negative reactions in which they had to stop using Loxidol and replace it with analogues.
We reviewed the instructions and reviews for Loxidol candles. In gynecology, their use is also described.