Flamax ampoules 0.05/ml 2ml №5

Packaging

In the package of 5 ampoules of 2 ml.

Mechanism of action

Flamax - non-steroidal anti-inflammatory drug, a derivative of propionic acid. It has analgesic, anti-inflammatory and antipyretic effects, inhibits platelet aggregation. By acting on the cyclooxygenase and lipoxygenase metabolism of arachidonic acid, Ketoprofen inhibits the synthesis of prostaglandins, leukotrienes and thromboxanes. The analgesic effect is due to both central and peripheral mechanisms. Possesses antibradikininovoy activity, stabilizes lysosomal membranes.

- NSAIDs for the treatment of pain.
- Designed for symptomatic therapy, reducing pain and inflammation at the time of use, does not affect the progression of the disease.
- Inflammatory and degenerative diseases of the musculoskeletal system: rheumatoid arthritis, seronegative arthritis: ankylosing spondylitis (Bechterew's disease), psoriatic arthritis, reactive arthritis (Reiter’s syndrome), gout, pseudogout, osteoarthrosis.
- Pain syndrome: tendonitis, bursitis, myalgia, neuralgia, sciatica, migraine, post-traumatic and postoperative pain, pain in cancer, algomenorrhea.

Contraindications

- hypersensitivity to ketoprofen or other components of the drug, as well as salicylates or other nonsteroidal anti-inflammatory drugs;
- bronchial asthma, rhinitis or urticaria in history, caused by the intake of Acetylsalicylic acid or other NSAIDs;
- peptic ulcer of the stomach or duodenum in the acute stage;
- non-specific ulcerative colitis, Crohn's disease in the acute stage;
- hemophilia and other bleeding disorders;
- children's age (up to 15 years);
- severe liver failure;
- severe renal failure (creatinine clearance less than 30 ml / min);
- decompensated heart failure;
- The postoperative period after coronary artery bypass surgery;
- gastrointestinal, cerebrovascular and other bleeding (or suspected bleeding);
- III trimester of pregnancy, lactation.

Carefully:
- Bronchial asthma in history, data on the development of ulcerative lesions of the gastrointestinal tract in history, the presence of confirmed Helicobacter pylori infection, clinically pronounced cardiovascular, cerebrovascular and peripheral artery diseases, congestive heart failure, dyslipidemia / hyperlipidemia, hyperbilirubinemia, diabetes mellitus, renal failure, liver failure, arterial hypertension, blood diseases, dehydration, smoking, glucose-6-phosphate dehydrogenase deficiency, creatinine clearance less than 60 ml / min, elderly age, long-term use of NSAID, heart failure, creatinine clearance less than 60 ml / min, elderly age, prolonged use of NSAID;, alcoholic cirrhosis, severe somatic diseases, concomitant therapy with the following drugs: anticoagulants (for example, warfarin), antiplatelet agents (for example, acetylsalicylic acid a, clopidogrel), oral glucocorticosteroids (for example, prednisone), selective serotonin reuptake inhibitors (for example, citalopram, Fluoxetine, paroxetine, sertraline).
- Pregnancy (I, II trimester) (only if the intended benefit to the mother outweighs the potential risk to the fetus).

Pregnancy and Breastfeeding

Contraindicated in the III trimester of pregnancy and lactation.

Dosage and administration

Intravenous, intramuscularly. Intramuscular administration: 100 mg (1 ampoule) 1-2 times a day. Intravenous infusion of the drug should be carried out only in a hospital. Short intravenous infusion: 100 - 200 mg (1-2 ampoules) of the drug, diluted in 100 ml of 0.9% sodium chloride solution, injected within 0.5-1 hour. Perhaps re-introduction after 8 hours. Prolonged intravenous infusion: 100 - 200 mg (1-2 ampoules) of the drug diluted in 500 ml of infusion solution (0.9% sodium chloride solution, lactated Ringer's solution, 5% dextrose solution)is introduced within 8 hours. Perhaps re-introduction after 8 hours. Ketoprofen can be combined with centrally acting analgesics; it can be mixed with morphine in one bottle; it cannot be mixed in one bottle with tramadol due to precipitation. Parenteral administration of ketoprofen can be combined with the use of oral forms (tablets, capsules) or rectal suppositories. The maximum dose is 200 mg / day. The minimum effective dose should be used with the shortest possible short course.

Digestive system: abdominal pain, dyspepsia, stomatitis, abnormal liver function, rarely - a change in taste.
Nervous system: insomnia, agitation, nervousness, depression, asthenia, rarely - confusion or loss of consciousness, impaired memory, migraine, peripheral neuropathy.
Sense organs: tinnitus, blurred vision, rarely - conjunctivitis, dryness of the mucous membrane of the eyes, pain in the eyes, conjunctival hyperemia, hearing loss, dizziness.
The cardiovascular system: increased blood pressure, rarely - tachycardia.
Blood formation organs: rarely - agranulocytosis, anemia, hemolytic anemia, thrombocytopenia, leukopenia.
Urinary system: edematous, syndrome, rarely - cystitis, urethritis, impaired renal function, interstitial nephritis, nephrotic syndrome, rarely - hematuria.
Allergic reactions: skin rash (incl.erythematous, urticaria), itchy skin, rhinitis, angioedema, rarely - bronchospasm, exfoliative dermatitis, anaphylactic shock.
Other: increased sweating, rarely - hemoptysis, epistaxis, myalgia, muscle twitching, shortness of breath, thirst, photosensitization, with prolonged use in large doses - vaginal bleeding.

With simultaneous use of ketoprofen and Warfarin or lithium salts, patients should be under the strict supervision of a physician. Care must be taken when prescribing the drug to patients with ulcerative diseases of the gastrointestinal tract in history, renal or hepatic insufficiency, as well as receiving coumarin anticoagulants. Like the rest of the drugs in this group, it can mask the symptoms of infectious diseases. During treatment, it is necessary to control the picture of peripheral blood and the functional state of the liver and kidneys. If necessary, determine the 17-ketosteroids drug should be canceled 48 hours before the study. In violation of the functions of the liver and kidneys, a dose reduction and careful observation are necessary. During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.

Drug Interactions

With the simultaneous appointment of ketoprofen and loop diuretics nephrotoxic effect of both drugs is enhanced. Reduces the effectiveness of uricosuric drugs, enhances the effect of anticoagulants, antiplatelet agents, fibrinolytics, ethanol, side effects of glucocorticosteroids and mineralocorticosteroids, estrogens; reduces the effectiveness of antihypertensive drugs and diuretics. Joint reception with other NSAIDs, glucocorticosteroids, ethanol, corticotropin can lead to the formation of ulcers and the development of Gastrointestinal bleeding, to an increase in the risk of development of renal impairment. The simultaneous appointment with oral anticoagulants, Heparin, thrombolytic agents, antiplatelet agents, cefaperazon, cefamundol and cefotetan increases the risk of bleeding. Increases the hypoglycemic effect of insulin and oral hypoglycemic drugs (dose recalculation is required). Inductors of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants) increase the production of hydroxylated active metabolites. Joint appointment with sodium valproate leads to a decrease in platelet aggregation. Increases plasma concentration of Verapamil and Nifedipine, lithium preparations, Methotrexate . Antacids and colestyramine reduce absorption. Enhances the hematotoxicity of myelotoxic drugs.In order to avoid sediment, do not mix ketoprofen and tramadol in one bottle.

Cases of overdose are not described. Dizziness, vomiting, headache, shortness of breath, abdominal pain, bleeding, and abnormal liver and kidney function may occur. Symptomatic treatment.

Store at a temperature not higher than 25 ° С.