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INTRODUCTION
FLEXILOR INJECTION contains Lornoxicam which belongs to the group of medicines called Non-steroidal anti-inflammatory drugs (NSAIDs). It is used for short-term treatment of acute mild to moderate pain and it treats symptoms such as pain and inflammation of joints associated with conditions such as rheumatoid arthritis (a chronic inflammatory condition affecting the joints) and osteoarthritis (type of arthritis that occurs when flexible tissue at the end of bones wears down).
FLEXILOR INJECTION is not recommended for use in patients with severe heart failure, severe liver or kidney impairment, low blood platelet count (which increases the risk of bleeding or bruising), active or history of recurrent stomach ulcer, history of gastrointestinal bleeding or perforation (due to therapy with NSAIDs such as ibuprofen), rupture and bleeding of a blood vessel in the brain or other bleeding disorders and varicella (chickenpox) infections.
Before taking FLEXILOR INJECTION inform your doctor if you have impaired kidney function, history of high blood pressure or heart failure, ulcerative colitis or crohn’s disease, a history of bleeding tendency or asthma, systemic lupus erythematosus (rare immunological disease) and may be at increased risk of developing diabetes or high cholesterol.
FLEXILOR INJECTION is not recommended for use in the first 6 months of pregnancy unless clearly advised by the doctor and it is not recommended for use in last three months of pregnancy. FLEXILOR INJECTION is also not recommended for use in breastfeeding women unless advised by the doctor. Your doctor may recommend you to take relevant tests to understand your existing condition.
FLEXILOR INJECTION is not recommended for use in children and adolescents (less than 18 years of age) and it should be used with caution in elderly patients. The common side effects of taking FLEXILOR INJECTION are nausea, vomiting, stomach pain or upset and diarrhea. Consult your doctor if any of the side effects get worse.
USES OF FLEXILOR INJECTION
- For short-term treatment of acute mild to moderate pain
- Treats pain and inflammation of joints (in conditions such as rheumatoid arthritis and osteoarthritis)
HOW FLEXILOR INJECTION WORKS
FLEXILOR INJECTION has an anti-inflammatory and analgesic activity that works by preventing the release of chemical messengers by inhibiting an enzyme called cyclooxygenase and also inhibits the prostaglandin synthesis that results in relieving pain and swelling associated with various conditions.
SIDE EFFECTS OF FLEXILOR INJECTION
COMMON
- nausea, vomiting
- diarrhoea
- stomach pain or upset
- mild and passing headache and dizziness
UNCOMMON
- weight loss
- inability to sleep
- fluid discharge from the eye (conjunctivitis)
- ringing sensation in the ears (tinnitus)
- cardiac failure, irregular or rapid heartbeat, feeling blushed
- constipation, flatulence, belching, dry mouth, gastritis, peptic or duodenal ulcer and mouth ulcers
- feeling unwell
- rash, itching, increased sweating, redness of the skin (erythema), angioedema (rapid swelling of the deeper layers of skin, usually of the face), hives (urticaria)
- oedema (fluid retention), stuffy nose as a result of an allergy (rhinitis)
- hair loss
- joint pain
RARE
- sore throat
- weakness
- confusion, nervousness or agitation
- feeling sleepy, tingling sensation
- abnormal taste sensation
- tremor, migraine
- visual disturbances
- increased blood pressure, hot flush
- abnormal bleeding, bruising
- difficulty in breathing (dyspnea), cough, bronchospasm
- perforated ulcer, vomiting of blood, gastrointestinal bleeding, black or red-colored stools
- swelling of the mouth, tongue or oesophagus, difficulty swallowing
- stomach acid reflux
- eczema, rash
- muscle pain or cramps, bone pain
- urinary problems such as urination at night
- hypersensitivity (characterized usually by face swelling, flushing, difficulties breathing and lightheadedness)
Stop taking FLEXILOR INJECTION and contact your doctor immediately if you experience any of the following side effects:
- difficulty in breathing, chest pain, appearance of ankle swelling or it get worse
- severe continuous stomach pain or black colored stool or abdominal bleeding
- signs of liver problems (such as yellowish discoloration of the skin or white part of the eyes (jaundice))
- allergic reaction (signs include ulcer or blistering, or swelling of the face, lips, tongue or throat which may cause difficulty in breathing)
- fever, blistering eruption in the skin or swelling of hands and feet or in the mouth area (stevens-johnson syndrome)
- severe skin infection in case of varicella (chickenpox)
- skin reactions (signs include skin rash, damage to the internal lining of the nostrils, mouth, eyelids, ears, genitals or anus)
HOW TO MANAGE SIDE EFFECTS
Nausea or vomiting:
Stick to simple meals while taking this medicine. Avoid eating oily rich, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve
Headache:
Drink ample amount of water. Get adequate rest. Try to be relaxed and stress-free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve
Diarrhea:
Drink lot of fluids such as water to keep yourself hydrated. Avoid eating high-fat or spicy foods. Try to avoid taking any medicine on your own to treat diarrhea and consult your doctor if the symptom gets worse.
Stomach pain:
Try to rest and relax. Eat and drink slowly or try to have smaller meals more frequently. Keep a heating pad on your stomach. If the symptom does not improve, consult your doctor.
Constipation:
Try to eat more high-fibre foods such as fresh fruit, vegetables, cereals and drink plenty of water. Try doing exercise regularly (going for a daily walk or run). If this does not help, consult your doctor for receiving alternate treatment for constipation.
WARNING & PRECAUTIONS
PREGNANCY
FLEXILOR INJECTION is not recommended for use in the first 6 months of pregnancy unless advised by the doctor and it is not recommended for use in the last three months of pregnancy. Also, it is not recommended for women attempting to become pregnant as it may impair fertility. Consult your doctor for advice before taking FLEXILOR INJECTION.
BREASTFEEDING
FLEXILOR INJECTION is not recommended for use in breastfeeding women unless advised by the doctor. Consult your doctor for advice before taking FLEXILOR INJECTION.
DRIVING AND USING MACHINES
FLEXILOR INJECTION has negligible or no effect on your ability to drive or use machines.
KIDNEY
FLEXILOR INJECTION is not recommended for use in patients with severe kidney impairment and it should be used with caution in patients with kidney impairment. Consult your doctor before taking FLEXILOR INJECTION.
LIVER
FLEXILOR INJECTION is not recommended for use in patients with severe liver impairment. Consult your doctor before taking FLEXILOR INJECTION.
ALLERGY
Do not take FLEXILOR INJECTION if you are allergic to Lornoxicam or other non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or any other ingredients of this medicine.
LUNGS
FLEXILOR INJECTION should be used with caution in patients with a history of asthma. Consult your doctor before taking FLEXILOR INJECTION.
HEART DISEASE
FLEXILOR INJECTION is not recommended for use in patients with severe heart failure. It should be used with caution in patients with a history of high blood pressure and heart failure. Consult your doctor before taking FLEXILOR INJECTION.
OTHERS
FLEXILOR INJECTION is not recommended for use if you:
- have low blood platelet count (which increases the risk of bleeding or bruising)
- have gastrointestinal bleeding, rupture and bleeding of a blood vessel in the brain or other bleeding disorders
- history of gastrointestinal bleeding or perforation (related to previous therapy with non-steroidal anti-inflammatory drugs (NSAIDs))
- have active or history of recurrent stomach ulcer
- varicella (chickenpox) infections
Before taking FLEXILOR INJECTION, inform your physician if you:
- have ulcerative colitis or crohn’s disease
- have systemic lupus erythematosus (rare immunological disease)
- have bleeding tendency
- previously had stroke
- are at risk of developing high cholesterol or diabetes
- are a smoker
- have an intolerance to some sugars
Use in pediatrics:
FLEXILOR INJECTION is not recommended for use in children and adolescents (less than 18 years of age) due to lack of data. Consult your child’s doctor for advice.
Use in geriatrics:
FLEXILOR INJECTION should be used with caution in elderly patients. Your doctor may monitor your laboratory tests frequently during treatment with this medicine. Consult your doctor before taking FLEXILOR INJECTION.
INTERACTIONS
A. Drug-Drug interactions:
Before taking FLEXILOR INJECTION, inform your doctor if you are taking any of the following medicines:
- non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and Cox-2 inhibitors such as celecoxib (used to treat pain)
- phenprocoumon or heparin (used to prevent or treat blood clots)
- cimetidine (used to treat heartburn and stomach ulcers)
- methotrexate, pemetrexed (used to treat cancer and immunological disease)
- selective serotonin reuptake inhibitors (SSRIs) Ex. fluoxetine, fluvoxamine, paroxetine, sertraline and lithium (used to treat depression)
- tacrolimus, cyclosporine (used to decrease the action of the immune system to prevent organ rejection)
- rifampicin and quinolone antibiotics such as moxifloxacin, ciprofloxacin, gemifloxacin, ciprofloxacin (used to treat bacterial infection)
- sulphonylureas such as glibenclamide (used to treat diabetes)
- fluconazole (used to treat fungal infections)
- angiotensin-converting-enzyme (ACE) inhibitors such as captopril, enalapril or angiotensin II receptor blockers such as candesartan, irbesartan, telmisartan and beta-blockers such as atenolol, bisoprolol, metoprolol (used to treat high blood pressure)
- digoxin (used to treat heart disease)
- prednisone, prednisolone, methylprednisolone, dexamethasone (used to treat the inflammatory condition)
- diuretics such as furosemide (used to remove excess water from the body)
- anti-platelet agents (Ex. clopidogrel, ticlopidine) (used to prevent heart attack and stroke)
B. Drug - Food interaction:
Do not take FLEXILOR INJECTION with food as it may reduce the effectiveness of the medicine.
Overdosage:
If you or anyone else accidentally take too much of FLEXILOR INJECTION consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of FLEXILOR INJECTION are nausea, vomiting, dizziness or disturbances in vision.
SYNOPSIS
| Drug | : | Lornoxicam |
| Pharmacological Category | : | Non-steroidal anti-inflammatory drugs |
| Therapeutic Indication | : | Treats mild to moderate pain |
| Dosage Forms | : | Tablet, Injection |
MORE INFORMATION
- Keep FLEXILOR INJECTION out of reach of children
- Store at room temperature
FAQs ABOUT FLEXILOR INJECTION
What is FLEXILOR INJECTION used for?
FLEXILOR INJECTION is used for short-term treatment of acute mild to moderate pain and it treats symptoms such as pain and inflammation of joints associated with conditions such as rheumatoid arthritis (a chronic inflammatory condition affecting the joints) and osteoarthritis (a type of arthritis that occurs when flexible tissue at the end of bones wears down).
What if I forget to take a dose of FLEXILOR INJECTION?
If you forget to take a dose of FLEXILOR INJECTION, take it as soon as you remember. However, omit the missed dose if it is almost time for the next dose. Do not take FLEXILOR INJECTION twice to make up for a forgotten dose.
Can FLEXILOR INJECTION be used in elderly patients?
FLEXILOR INJECTION should be used with caution in elderly patients. Your doctor may monitor your laboratory tests frequently during treatment with this medicine. Consult your doctor before taking FLEXILOR INJECTION.
Is FLEXILOR INJECTION safe to use in patients with heart problems?
FLEXILOR INJECTION is not recommended for use in patients with severe heart failure. It should be used with caution in patients with a history of high blood pressure and heart failure. Consult your doctor before taking FLEXILOR INJECTION.
Can FLEXILOR INJECTION be used during pregnancy?
FLEXILOR INJECTION is not recommended for use in the first six months of pregnancy unless advised by the doctor and it is not recommended for use in the last three months of pregnancy. Also, it is not recommended for women attempting to become pregnant as it may impair fertility. Consult your doctor for advice before taking FLEXILOR INJECTION.
REFERENCES
1. KD. Tripathi. Nonsteroidal Antiinflammatory Drugs and Antipyretic-Analgesics. Essentials of medical pharmacology. 8th Edition. 2019. Page – 211 to 223.
2. Susanna Radhofer-Welte, Peter Dittrich, Marija Simin, Poul Erik Branebjerg. Comparative bioavailability of lornoxicam as single doses of quick-release tablet, standard tablet and intramuscular injection: a randomized, open-label, crossover phase I study in healthy volunteers. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov 2008. [Accessed on 27th June 2022] https://pubmed.ncbi.nlm.nih.gov/18479176/
3. Christian Hillstrom, Jan G Jakobsson. Lornoxicam: pharmacology and usefulness to treat acute postoperative and musculoskeletal pain a narrative review. NIH National Library of Medicine, National center for biotechnology information. Pubmed.gov August 2013. [Accessed on 27th June 2022] https://pubmed.ncbi.nlm.nih.gov/23713572/
4. Takeda GmbH. Health Products Regulatory Authority (HPRA). [Revised in January 2015] [Accessed on 27th June 2022] https://www.hpra.ie/img/uploaded/swedocuments/2161377.PA1547_005_004.8c107a5e-a8cd-4d47-bfce-2b57776096de.000001Xefo%20Rapid.150421.pdf
5. Takeda GmbH. Health Products Regulatory Authority (HPRA). [Revised in January 2015] [Accessed on 27th June 2022] https://www.hpra.ie/img/uploaded/swedocuments/2150393.PA1547_005_001.f21e4af8-22d9-44ef-af58-4b7065459e48.000001PIL4mg.150210.pdf
6. DM pharma. Lornoxicam Tablet. [Accessed on 27th June 2022] http://www.dmpharma.co.in/Lornoxicam.html
USEFUL DIAGNOSTIC TESTS
- Liver function test
- Kidney function test
AUTHOR DETAILS
Written By Dr. R. Dinesh John Rajkumar, Pharm.D
Last updated on 25 Nov 2022 | 06:16 PM(IST)
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