► Aglan (meloxicam) - Practical Medicine

Aglan (meloxicam) - solution for injection

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Aglan solution for injection; 10 mg / ml (15 mg / 1.5 ml); 5 amps 1.5 ml Zentiva 23.99

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:meloxicam

The drug is available on prescription

What is Aglan?

It is a preparation with general action containing a non-steroidal anti-inflammatory drug.

What does Aglan contain and how does it work?

The active substance is meloxicam , a non-steroidal anti-inflammatory drug (NSAID) from the oxicam group. It has anti-inflammatory, analgesic and antipyretic effects. Meloxicam counteracts the synthesis of prostaglandins, substances that play a significant role in the development of inflammation. The effect of meloxicam is primarily the inhibition of cyclooxygenase, mainly cyclooxygenase-2 (COX-2), and to a small extent cyclooxygenase-1 (COX-1). These enzymes take part in the reactions leading to the formation of prostaglandins from the lipids of cell membranes. Meloxicam does not have an antimicrobial effect. It reduces the symptoms of inflammatory response (swelling, elevated temperature, pain, joint stiffness). After intramuscular administration, meloxicam is completely absorbed. The maximum concentration in the blood is obtained after about 60 minutes after administration. Meloxicam passes into the synovial fluid, where it reaches a concentration equal to half the concentration in the plasma. Meloxicam crosses the placenta and into breast milk.

When to use Aglan?

The preparation is indicated for short-term symptomatic treatment:
· Exacerbation of rheumatoid arthritis and ankylosing spondylitis when oral or rectal administration of meloxicam is impossible
· Exacerbations of osteoarthritis.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You can not use the product if you are allergic (you are hypersensitive) to any of the ingredients or other NSAIDs , including Acetylsalicylic acid .
The product is contraindicated if you have ever experienced allergy to acetylsalicylic acid (colloquially called Aspirin ) or to other nonsteroidal anti-inflammatory drugs (eg Ibuprofen , Ketoprofen ). This sensitization may have manifested in the form of hypersensitivity reactions such as eg asthma attack, bronchospasm, allergic rhinitis, nasal polyps, angioedema or skin reactions, including urticaria, rash, erythema.
The use of the preparation is contraindicated in people:
with hemostasis disorders or those treated with anticoagulants
with active or recurrent gastric and / or duodenal ulcer disease, bleeding or perforation, including NSAIDs
with bleeding from cerebral vessels or other abnormal bleeding
with severe liver failure
with severe renal failure and not undergoing dialysis
with severe uncontrolled heart failure
· In women in the third trimester of pregnancy.
It should not be used in women who are breast-feeding.
The efficacy and safety of the preparation in children and adolescents up to 18 years of age have not been established.

When should you take extra care with Aglan?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.
Use of the product at the lowest effective dose over the shortest possible period reduces the risk of side effects.
The use of other non-steroidal anti-inflammatory drugs (including selective COX-2 inhibitors) should be avoided.
In elderly patients, the risk of side effects (especially Gastrointestinal bleeding , which can cause death) is increased.
The use of non-steroidal anti-inflammatory drugs is associated with the risk of gastrointestinal haemorrhage, ulceration or perforation, which may be the cause of death and may not be preceded by warning signs. These symptoms can occur at any time during treatment, also in people without previous gastrointestinal disorders. These complications are particularly dangerous in the elderly. Always tell your doctor immediately if you have any unusual symptoms on the part of the digestive tract (especially bleeding). If there is bleeding from the gastrointestinal tract, immediate discontinuation of the preparation is necessary.
In the case of people with gastrointestinal diseases, after bleeding ulcers or perforations, the use of the preparation is possible only under medical supervision. The lowest effective doses should be used in these patients. Large doses and advanced age increase the risk of gastrointestinal bleeding. Your doctor may prescribe curing agents, such as proton pump inhibitors or misoprostol. Be cautious and consult a doctor immediately if any unusual symptoms occur.
Protective drugs may also be indicated in patients taking medications that increase the risk of gastrointestinal adverse reactions, including peptic ulceration or bleeding (eg corticosteroid s with a general effect, anticoagulants, eg Warfarin , drugs that inhibit platelet aggregation, including even small doses of acetylsalicylic acid [colloquially called aspirin], drugs from the group of selective serotonin reuptake inhibitors). Be careful.
Due to the possibility of exacerbation of the disease, the preparation can be used only under strict medical supervision and with caution in patients with ulcerative colitis or Leśniowski and Crohn's disease.
Particular care should be taken if the product is used in people with hypertension, congestive heart failure, fluid retention, and edema (the use of NSAIDs may cause fluid retention and edema). Patients should remain under medical supervision. Monitoring of cardiac and renal function is recommended.
Prolonged use of NSAIDs at high doses may increase the risk of a heart attack or stroke. Particular caution and close medical supervision is required when using the product in hypertensive patients with congestive heart failure, with ischemic heart disease, peripheral artery disease or cerebrovascular disease, and in patients with risk factors for cardiovascular disease (diabetes, smoking, hyperlipidemia). If you belong to any of the above groups, consult a physician before using the preparation.
The preparation should be used with caution by people with reduced blood flow through the kidneys and with reduced circulating blood volume. Renal impairment may occur in these patients, which usually disappear after discontinuation of the preparation. The group of increased risk of these disorders includes patients with congestive heart failure, cirrhosis, nephrotic syndrome, kidney disease, using diuretics, significantly dehydrated and after major surgery. In these patients, close monitoring of renal function and urine output during the use period is recommended.
In patients undergoing dialysis, with the final phase of renal failure, the dose administered should not exceed 7.5 mg.
The preparation, like other NSAIDs, may cause severe skin reactions, sometimes leading to death, such as Stevens and Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. These reactions are very rare and most often appear in the first month of application. In the event of the first symptoms of skin lesions (rash, mucosal lesions) or any symptoms of hypersensitivity, the preparation should be discontinued immediately and a physician should be consulted.If severe skin reactions associated with the use of meloxicam occur, it must not be re-used.
The use of the preparation may be associated with an increase in liver enzymes and changes in other parameters characterizing liver or kidney function. These changes are usually transient. In the event of their occurrence, immediately consult a physician who may recommend discontinuation of the preparation.
In patients who are weak and / or low in weight, side effects may be more severe; patients in this group should remain under strict medical supervision. Increased caution is also required for the elderly, who are more likely to have problems with their kidneys, liver or heart.
The preparation, like other NSAIDs, can mask the symptoms of infection. If you suspect an infection, consult your doctor, as appropriate treatment may be necessary. The preparation does not have an antimicrobial effect.
The use of the preparation may cause fertility problems in women and is not recommended in women who are planning to become pregnant.
If the symptoms persist, consult a doctor after a few days of using the product.

Does this preparation affect the ability to drive vehicles?
There was no significant effect on the ability to drive vehicles and operate equipment / machines. However, the preparation may cause side effects such as blurred vision, drowsiness, dizziness, tiredness or other central nervous system disorders, and if they occur, it is not recommended to drive vehicles and operate machinery / equipment.

Dosage of Aglan

The preparation is in the form of an injection solution. It is intended for intramuscular administration only. If you have any doubts regarding the use of the preparation, consult a physician.
Intramuscular administration: the recommended dose is 15 mg once daily.
The maximum daily dose is 15 mg.
The use of the parenteral form of meloxicam should be limited to a single starting dose; in justified cases, the doctor may recommend the use of the preparation for a maximum of 2-3 days.
In older patients or with an increased risk of side effects, dosage adjustment by a physician is necessary. The usual recommended dose is 7.5 mg / day (1/2 ampoule / day).
In patients undergoing dialysis with severe renal impairment, the dose should not exceed 7.5 mg / day (1/2 ampoule / day).
In patients with mild or moderate renal impairment (creatinine clearance greater than 25 ml / min) or liver, no dose adjustment is necessary.
In patients with severe renal dysfunction who are not subjected to hemodialysis and in patients with severe hepatic impairment, the use of the preparation is contraindicated.
The efficacy and safety of the preparation in children and adolescents up to 18 years of age have not been established.
Application method:
The preparation is administered only intramuscularly, a slow injection, deep into the gluteus gluteus (the upper outer quadrant of the buttock). With multiple administrations alternately in the left and right buttocks. Prior to the injection, to prevent unintentional vascular infusions, make sure that the tip of the needle is not in the lumen of the vessel. If you experience severe pain during the injection, stop taking the medicine immediately. In patients with hip joint endoprosthesis, the injection should be performed on the opposite side.

Can Aglan be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!
It is very important that before using any medicine during pregnancy or breastfeeding, consult a physician and explain beyond any doubt the potential risks and benefits associated with the use of the drug. If you are pregnant or planning to become pregnant, please inform the doctor prescribing the prescription for this medicine (see the warnings in the section "When should you take extra care with the preparation?").
The use of the preparation is contraindicated in women in the third trimester of pregnancy. Do not use the preparation in the first and second trimester of pregnancy.The use of the preparation in the first and second trimester of pregnancy, and in women planning pregnancy, is allowed only at the express request of the doctor in cases when considering the ratio of expected benefits for the mother to possible risk to the fetus he considers the use of the preparation absolutely necessary (only the shortest effective dose). Only a doctor can assess the benefit / risk ratio in your case.
It should not be used in women who are breast-feeding.

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.
It is not recommended to use the preparation with:
· Acetylsalicylic acid (in painkillers) or other non-steroidal anti-inflammatory drugs, including selective COX-2 inhibitors (increased risk of side effects, especially ulcers and gastrointestinal bleeding)
· Anticoagulants such as warfarin (possible increase in their effect and increased risk of haemorrhage, if parallel use of these preparations can not be avoided, blood clotting parameters should be closely monitored)
methotrexate at doses higher than 15 mg per week (possible increase in Methotrexate concentration and intensification of its toxic effects, sometimes severe intoxication, also in the case of methotrexate in doses lower than 15 mg per week it is possible to increase its toxicity to the hematopoietic system; blood count and renal function, special care should be taken in people with impaired renal function, and also if the interval between taking the drug and methotrexate does not exceed 3 days)
diuretics, eg Furosemide and antihypertensive drugs, including angiotensin converting enzyme inhibitors, angiotensin antagonists (possible reduction in their effectiveness, increased risk of renal dysfunction and the development of acute renal failure , especially in dehydrated patients, care should be taken to properly hydrate and control the activity kidney)
corticosteroids or serotonin reuptake inhibitors (increased risk of side effects, especially gastrointestinal bleeding)
drugs that inhibit platelet aggregation, such as ticlopidine, Clopidogrel (increased risk of bleeding)
thrombolytics (increased risk of bleeding)
drugs from the group of beta blockers (possible reduction of their effectiveness)
ciclosporin and tacrolimus (increased risk of renal damaging effects, renal function should be monitored, especially in elderly patients)
antibiotics from the group of quinolones (risk of convulsions)
lithium (possible increase of lithium concentration and intensification of its toxic effects, it is recommended to control the concentration of lithium in the blood)
cholestyramine (cholestyramine significantly accelerates the excretion of meloxicam).
Women with intrauterine inserts should consult a physician before using meloxicam.

What side effects can occur?

Like all medicines, Aglan can also cause side effects, although they will not occur in all patients who use this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.
The most common are gastrointestinal side effects, which include: nausea, vomiting, indigestion, abdominal pain, bloating, diarrhea, constipation, gastritis, oral or esophagitis, gastrointestinal bleeding (including tarry stools, bloody vomiting) and gastrointestinal ulceration, sometimes with bleeding and perforation (including fatal outcome, especially in the elderly), colitis, exacerbation of colitis, exacerbation of Leśniowski and Crohn's disease, increased liver enzymes, rarely hepatitis . Possible: headache and dizziness, fatigue, drowsiness, mood disorders, insomnia, nightmares, confusion, nervousness, blurred vision (including blurred vision), tinnitus. Possible: heart failure, palpitations, edema, hypertension, haematological abnormalities, including anemia, agranulocytosis, leukopenia, thrombocytopenia (if you experience symptoms such as fever, sore throat, flu-like symptoms, superficial ulceration of the oral mucosa, fatigue, bleeding from the nose, bruising, ecchymosis or purpura should immediately consult a doctor, because they may be the first signs of hematological disorders). Possible impaired renal function, sodium and water retention, renal failure, increased urea and creatinine in the blood.Hypersensitivity reactions (rash, urticaria, pruritus, photosensitivity) and Anaphylactic reactions , including life-threatening anaphylactic shock, angioneurotic edema (swelling of the face, larynx, tongue, throat that may impede breathing), bronchospasm, asthma attack and severe skin reactions: toxic epidermal necrolysis, Stevens and Johnson syndrome, erythema multiforme. Long-term use of meloxicam in high doses may increase the risk of heart attack or stroke. In the injection site, swelling may occur.

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Moilec (tablets)
Movalis (tablets)
Movalis (solution for injection)
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Remolexam (tablets)
Reumelox (tablets)
Trosicam (orodispersible tablets)