Tablets from pain in the knees

For the treatment of pain in the knees using a variety of means, but the tablets deserve special attention. Consider their types, names, medicinal properties and application features.

Knee joints are the most vulnerable joints, so have a complex structure and are under constant strain. Orthopedists and traumatologists often encounter complaints of pain in the knee during extension, walking or at rest. Before starting treatment, the patient is sent to X-ray studies and other diagnostic methods to identify the root cause of the pathological condition.

Tablets from pain in the knees are used for joint pathologies. Drugs can be prescribed by stages. Most often, medicines are prescribed for treatment:

1. Non-steroidal anti-inflammatory drugs

Assign to patients of adult age, as they have side effects on the duodenum and stomach. These organs are severely affected by prolonged use of NSAIDs. Effective not only with pain, but also pathological processes in the joint. Most commonly prescribed: Diclofenac, Paracetamol, Indomethacin, Ibuprofen, Nimesulide, Meloxicam, Celecoxib.

2. Non-narcotic analgesics

The use of these drugs will help to remove pain and minimal harm to other organs and systems. Moderate analgesic effect has: Analgin, Sulpirin. The drugs with the active component ketorolac have a more potent effect: Ketanov, Ketoprofen, Ketolong. For severe pain, tablets with dexketoprofen are used. Strong non-narcotic analgesics are prescribed to patients with pronounced pain, but such medications are of high cost: Xefokam, Larfix and other lornoxicam tablets.

3. Narcotic analgesics

If the drugs of other pharmacological groups are ineffective, the patient is prescribed analgesic drugs. To ensure that the treatment is not addictive, short-term therapy is performed, combining with non-narcotic analgesics and NSAIDs. Most of the drugs in this group are released in the form of injections, but there are also pills: Tramadol, Promedol.

4. Medication for opioid use

They act on opioid brain receptors, do not cause addiction and do not refer to psychotropic drugs. Their effectiveness is similar to that of narcotic analgesics. They are of high value and are only released on the basis of a prescription: Nalbuphine.

Medicines can be taken only for medical purposes. Independent use of drugs causes temporary anesthesia. But without proper treatment, discomfort quickly returns with renewed vigor.

Indications for use

The use of any medication to stop painful sensations in the joints is recommended only for medical use. The doctor conducts a number of diagnostic procedures and on their results gives indications for the use of certain medications.

The algorithm of using medicines to eliminate pain in the knees:

• Painkillers are prescribed according to the principle from weak to strong. Exceptions are possible with severe pain syndrome.
• To treat severe pain, blockade with injection or local anesthetics. Tablets should be taken before and after the above manipulations to achieve a more stable analgesic effect.
• For acute inflammatory or traumatic pain, NSAIDs are taken. With chronic - non-narcotic / narcotic analgesics, muscle relaxants, glucocorticoids. In addition, the periarticular and intraarticular blockades are shown.

Tablets are prescribed for mild lesions (bruises, meniscopathy, synovitis), and for more serious pathologies (osteoporosis, arthritis, bursitis, inflammatory diseases, joint blockade, penetrating infections).

Pharmacodynamics

Biochemical and physiological properties of drugs determine their effectiveness. Pharmacodynamics allows you to find out how the active components act on these or other harmful microorganisms, pathological processes. Consider the pharmacodynamics of popular groups of tablets from pain in the knees.

• NSAIDs

Ibuprofen - has analgesic, anti-inflammatory and antipyretic properties. Pain relief is due to the inhibition of biosynthesis of prostaglandins through inhibition of the enzyme cyclooxygenase.

• Non-narcotic analgesics

Xefokam - a drug with analgesic and anti-inflammatory action. Oppresses the synthesis of prostaglandins through inhibition of the activity of cyclooxygenase isoenzymes. Inhibits the release of leukocytes of the combined radicals. The analgesic effect is not related to the narcotic effect on the central nervous system. Does not affect respiratory function and opioid receptors, does not cause addiction and withdrawal syndrome.

• Narcotic analgesics

Morphine is an analgesic, an opioid receptor agonist. Reduces the emotional evaluation of pain due to the oppression of pain impulses in the central nervous system. It slows down the conditioned reflexes, the excitability of the cough cents. Increases the tone of the smooth muscles of the internal organs, increases the intestinal peristalsis.

• Opioid

Tramal is a synthetic analogue of opiates, a phenanthrene derivative. Has a mixed mechanism of action, since its active substance binds to opiate receptors in the central, middle and posterior regions of the spinal cord. Reduces the excitability of the pain center, minimizes the negative emotional color of discomfort. Blocking the flow of calcium ions into the cell, which causes a delay in the release of mediators of pain, norepinephrine.

• Chondroprotectors

Chondroitin - affects the phosphorus-calcium metabolism in the cartilaginous tissue. Suspends bone resorption and degeneration of cartilage. Prevents the compression of connective tissue, acts as a lubricant for the surfaces of the joints. It stimulates the regeneration of articular cartilage, restores the metabolism of hyaline tissue.

Pharmacokinetics

Since the tablets are intended for oral administration, the processes of absorption, absorption, metabolism and excretion are very important. Pharmacokinetics of drugs for the treatment of joints:

• NSAIDs

Ibuprofen - after ingestion quickly and completely absorbed from the digestive tract. The maximum concentration in the plasma occurs after 2 hours after admission, in synovial fluid after 3 hours. Metabolised in the liver, excreted by the kidneys in the form of conjugates, the half-life is 1.5-2 hours.

• Non-narcotic analgesics

Xefokam - absorbed from the gastrointestinal tract, the maximum concentration in the plasma comes in 1-2 hours. Bioavailability 90-100%, binding with albumin fraction of proteins 99%. The active substance has no pharmacological activity and is not metabolizable. In blood plasma, it is present in active form. The half-life time depends on the concentration of the drug and on average is 4 hours. It is excreted in urine and bile.

• Narcotic analgesics

Morphine - rapidly absorbed, binding to blood plasma proteins is low - 35%. Penetrates through the placental and GEB barriers, excreted in breast milk. At a metabolism forms sulphates and glucuronides. It is excreted by the kidneys, about 12% during the day in unchanged form and 80% in the form of glucuronides, the remaining 10% with bile.

• Opioid

Tramal - therapeutic dosages do not affect the circulatory process. The analgesic effect is 7.5 times weaker than that of Morphine. Has sedative properties, is addictive, excites the emetic center. Slightly affects the intestinal peristalsis. The effectiveness is maintained for 9 hours.

• Chondroprotectors

Chondroitin - the maximum concentration in the blood plasma is observed after 3-4 hours, and in the synovial fluid for 4-5 hours. Bioavailability at the level of 13%. Metabolized in the liver, excreted by the kidneys during the day.

Tablets from joint pain in the knees

Joint pain occurs for various reasons: trauma, disease. However, they do not always indicate the development of arthritis or arthrosis. Discomfort can cause any damage: infectious, endocrine, cold, inflammatory. If discomforts appear regularly and have an increasing character, then you need to seek medical help, take a test and discover the cause of the pathological condition.

In order to relieve joint pain, non-steroidal anti-inflammatory drugs and chondroprotectors, rather than analgesics, are most often used. Let's consider more detailed tablets from joint pain in knees:

1. Chondroprotectors

Protect the joints from damage due to the effects on the cartilaginous tissue. Their activity is based on restorative and barrier functions, nutritional and moisturizing action. Since the cartilage begins to deteriorate due to drying, the chondroprotectors give useful elements for its normal functioning, preventing articular pain.

Most often, patients are prescribed: Arthra, Structum, Teraflex. These drugs are well tolerated, have a minimum of contraindications and adverse reactions. But do not forget that oral forms of drugs have low efficiency, since some of the active components are lost in the process of metabolic transformations, unlike injections and topical agents.

2. Non-narcotic analgesics

Eliminate painful joint pain, regardless of their cause. They are the main group of painkillers for knee joint damage. As a rule, patients are prescribed: Metamizol, Ketorolac, Lornoxicam, Acetylsalicylic acid.

3. NSAIDs

They relieve articular pain in the knees, affect the pathogenetic links in many pathologies of the joint apparatus. The most common medicines are: Diclofenac, Meloxicam, Nimesulide. These drugs are most effective for pain of inflammatory origin.

4. Combination drugs

Pain in the joints can arise due to different pathogenetic reactions. Most often, it is inflammation, muscle spasms, destruction of bones and articular cartilage. To eliminate them, you have to use combined medicines from different medicinal groups:

• Tizalud, Midokalm, Sirdalud - relieve tension and muscle spasms.
• Medrol, Methylprednisolone - hormones glucocorticosteroids.
• Renalgan, Spazmalgon, Baralgetas - NSAIDs of combined action with myotropic antispasmodics.

The correct approach to choosing pain relievers speeds up the healing process and minimizes discomfort.

Names of tablets from pain in the knees

Pain in the knees is the most frequent reason for contacting traumatologists, surgeons and orthopedists. To eliminate discomfort, drugs of different release forms are used. Consider the popular names of tablets from pain in the knees and the features of their use:

Nonsteroidal anti-inflammatory drugs

Diclofenac

Has anti-inflammatory, antipyretic and analgesic effect. Its effectiveness is based on the inhibition of cyclooxygenase 1 and 2, a violation of the metabolism of arachidonic acid and a decrease in prostaglandins in the inflammatory focus. Has analgesic and anti-inflammatory effect in rheumatic pains, morning stiffness, swelling of the joints, during the postoperative period.

After oral administration, it is quickly and completely absorbed. The intake of food slows down the absorption process for 1-4 hours and reduces the concentration of active components by 40%. Bioavailability of 50%, binding to blood plasma proteins - 99%. It penetrates into the synovial fluid, it is metabolized at the first passage through the liver.

• Indications for use: pathology of the musculoskeletal system (arthritis, rheumatic tissue damage, osteoarthritis, bursitis, tenosynovitis), mild and moderate pain syndrome, post-traumatic and post-operative pain. Complex therapy of infectious and inflammatory diseases (throat, nose, ear) with severe pain syndrome, fever.
• Contraindications: acute stages of erosive and ulcerative gastrointestinal lesions, disorders of hematopoiesis and hemostasis, pregnancy and lactation, age of patients younger than 6 years, hypersensitivity to active substances. With extreme caution used for anemia, bronchial asthma, renal or hepatic insufficiency, in old age and with systemic lesions of connective tissue.
• Dosage is individual for each patient. Tablets are taken orally by washing with water. For children from 6 to 12 years of age appoint 1 pc. Per day, for patients 12 years and over 2 pcs. Per day. The duration of therapy depends on its results in the first days of treatment. In case of an overdose, unfavorable symptoms appear: vomiting, nausea, headaches and dizziness, convulsions, bleeding. To eliminate them, it is recommended to wash the stomach, forced diuresis.
• In some cases, there are side effects that manifest as: flatulence, nausea, constipation, abdominal pain, dry mucous membranes. Possible headaches, aseptic meningitis, seizures, disorientation, anxiety, general weakness. In 1% of patients there are violations of the genitourinary system, hematopoiesis and skin allergic reactions.

[6], [7], [8], [9], [10]

Indomethacin

One of the most active non-steroidal anti-inflammatory drugs. The inhibitor of biosynthesis of prostaglandins, has a pronounced analgesic effect. The medicine is prescribed for such pathologies: rheumatoid arthritis, periarthritis, osteoarthritis, inflammation of the connective tissue, thrombophlebitis, nephrotic syndrome.

It is effective not only for pain in the knees, but also for neuralgia, pain in the spine, rheumatism.

• Indomethacin is taken orally after meals. The initial dosage is 25 mg 2-3 times a day, the maximum dosage is 200 mg. Duration of treatment is 3-4 weeks with a gradual decrease in dosage to prevent withdrawal syndrome.
• Contraindications: ulcer of the duodenum and stomach, ulcerative processes in the esophagus and intestines. Bronchial asthma, the period of pregnancy and breastfeeding. With special care appoint to patients whose work is related to the management of vehicles and other mechanisms.
• Side effects: drowsiness, headaches and dizziness, nausea, vomiting, loss of appetite, flatulence. In rare cases, bleeding from the digestive tract, digestive disorders, allergic reactions to the skin.

Meloksikam

NSAIDs from the oxicam group suppresses the cyclooxygenase-2 isoenzyme, providing analgesic and anti-inflammatory effects. After oral administration, it is completely absorbed in the digestive tract. The maximum concentration is achieved in 5-6 hours.

With regular application for 5-6 days, an equilibrium state develops. Eating does not affect absorption and metabolism.

• Indications for use: symptomatic treatment of exacerbations of arthrosis, polyarthritis, ankylosing spondylitis, rheumatoid arthritis. Contraindicated in ulcerative lesions of the digestive system, intolerance of active components, gastrointestinal bleeding, during pregnancy and lactation, severe renal and hepatic insufficiency and for patients younger than 15 years.
• Tablets are taken once a day with food, washed down with water. The duration of treatment is determined by the attending physician. In case of an overdose, there are bouts of nausea and vomiting, drowsiness, and abdominal pain. Possible development of gastric bleeding, increased blood pressure, respiratory depression, convulsions, collapse. Symptomatic and maintenance therapy is indicated for the treatment of overdose.
• Side effects: leukopenia, anemia, decreased visual acuity, headaches, tinnitus, dizziness. From the side of the digestive tract there are pains in the epigastric region, nausea, vomiting, diarrhea, stomatitis, perforation of the walls of the digestive canal. It is also possible to violate breathing, skin allergic reactions, disorders of the genitourinary system.

Non-narcotic analgesics

Analgin

The drug with pronounced analgesic, antipyretic and anti-inflammatory properties. After oral administration, it is rapidly absorbed and has a medicinal effect.

It is used for relief of pain of different origin: articular, head, with fever, rheumatism, neuralgia.

• Tablets are taken after meals. For adults, the dosage is 250-500 mg 2-3 times a day, for children 5-10 mg / kg body 3-4 times a day.
• Contraindicated with intolerance of the active substance, hematopoiesis, bronchospasm.
• Side effects: prolonged therapy causes oppression of hematopoiesis, therefore, medical monitoring of the patient's condition and periodic blood tests are required.

[11], [12]

Ketanov

The drug with the active substance is ketorolac. Inhibits the biosynthesis of prostaglandins, affects the cyclooxygenase pathway of arachidic acid metabolism. Has anti-inflammatory and analgesic properties.

Inhibits the aggregation of platelets, does not affect the ATP induced platelet aggregation. Does not exert a depressant effect on the respiratory centers and does not cause an increase in RVC, does not affect the heart muscle, does not cause hemodynamic disturbances. Tablets do not affect psychomotor functions.

• Indications for use: elimination of moderate and severe pain of orthopedic, dental, otolaryngological, gynecological. Helps minimize discomfort in acute muscular injuries, bone and soft tissue injuries, sprains, fractures, dislocations.
• To achieve an analgesic effect, take 1 capsule every 4-6 hours. The duration of therapy should not exceed 7 days. For patients weighing less than 50 kg, over 65 years of age and with impaired renal function, minimum dosages are indicated.
• Contraindications: pregnancy, breastfeeding, nasal polyposis, bronchial asthma, stomach and duodenal ulcer, intolerance to ketorolac tromethamine, bleeding disorders, age of patients under 16 years.
• Symptoms of overdose and side effects are similar. Most often, patients face attacks of drowsiness, abdominal pain, nausea, diarrhea, headaches. Possible increased nervousness, dry mouth, increased sweating, heart palpitations, asthenia.

Xsefokam

Anesthetic with anti-inflammatory properties. Its effectiveness is due to the inhibition of the synthesis of prostaglandins through inhibition of the activity of cyclooxygenase isoenzymes. Does not affect the opioid receptors of the central nervous system, the analgesic effect is not associated with drug effects.

Does not cause addiction and withdrawal symptoms. When administered orally, it is almost completely absorbed from the digestive tract. The maximum concentration is observed after 1-2 hours, bioavailability at the level of 90-100%, binding to plasma proteins of 99%.

• Indications for use: moderate and mild pain syndrome, degenerative and inflammatory diseases of the musculoskeletal system, acute pain, trauma, postoperative period.
• Contraindications: intolerance to NSAIDs and lornoxicam, blood clotting and liver function disorders, acute duodenal ulcer and stomach ulcer, ulcerative colitis, heart failure, hearing loss, hemorrhagic stroke, bronchial asthma, patients under 18 years of age.
• Tablets are taken before meals, washed down with water. The average dosage is 8-20 mg for 2-3 doses per day. The duration of treatment depends on the severity of the pain syndrome. In case of an overdose, there are violations from many organs and systems that are similar to side effects: nausea, vomiting, drowsiness, dizziness, allergic reactions. To eliminate them use symptomatic therapy and enterosorbents.

Narcotic analgesics

Tramadol

A drug with a pronounced long-acting analgesic activity. Used for acute and chronic pain: with trauma, in the postoperative period, before surgery, with cancer.

• As a rule, take 50 mg, that is, up to 8 capsules a day with a break of 2 hours. Elevated dosages can trigger a number of side effects. More often than not, patients experience severe respiratory depression, gastrointestinal disorders, increased sweating, and headaches. To eliminate them, you need to see a doctor to adjust the dose.
• Contraindications: hypersensitivity to narcotic analgesics, alcohol intoxication, pregnancy and lactation, the patient's age is less than 14 years. Long-term use causes addiction and weakening of the therapeutic effect.

Promedol

A strong analgesic, affects the central nervous system, is close to morphine. It is prescribed to patients with diseases and injuries, which are accompanied by severe pain. Effective in the after and before the operation period, with malignant neoplasms, angina pectoris, for anesthesia of the birth process.

• Take 250 mg once a day (can be divided into several receptions). The maximum daily dose is 500 mg. Long-term use of the drug may lead to the development of drug addiction.
• Contraindications: senile and child age, severe exhaustion of the body.
• Side effects: respiratory depression, nausea, vomiting, diarrhea / constipation. To eliminate them, anticholinergics are prescribed.

Opioid

Nalbuphine

A narcotic analgesic from the pharmacological group of opioid receptor agonist-antagonists. Its action is based on the violation of the interneuronal transmission of pain impulses at different levels of the central nervous system. This is due to the effect on the brain. It inhibits conditioned reflexes, has a sedative effect, excites the vomiting center. The drug effect for oral administration develops within 1-2 hours and persists for 5-6 hours.

• Indications for use: treatment of patients with severe pain syndrome of different etiology. Can be used as an additional agent for anesthesia. Dosage and duration of treatment are selected by the doctor, individually for each patient.
• Side effects: changes in blood pressure, nausea, vomiting, digestive disorders, headaches, increased anxiety, a sense of euphoria, sleep and speech disorders. Also, skin allergic reactions are possible: urticaria, fever, skin itching, increased sweating, bronchospasm. Abrupt withdrawal of the drug causes withdrawal syndrome.
• Contraindications: intolerance of the active ingredient, treatment of patients of childhood, acute alcohol intoxication, craniocerebral trauma, severe kidney and liver diseases, increased intracranial pressure, depressed breathing.
• The use of elevated dosages leads to signs of an overdose. Patients are faced with depression of the central nervous system, attacks of drowsiness, dysphoria. For their elimination, symptomatic therapy is carried out, and in case of intoxication, administration of an antidote-naloxone hydrochloride.

Chondroprotectors

Structum

Chondroprotective oral drug. Contains the active substance - chondroitin sulfate sodium salt. This component is the structural basis of bone and cartilaginous tissue. Restores and maintains the normal structure of the cartilage matrix.

This is due to an increase in the anabolic activity of chondrocytes. Stimulates the synthesis of hyaluronic acid, normalizes the synovial environment of the joints due to the restoration of its viscosity.

• Indications for use: treatment of degenerative-dystrophic diseases of the joints and spine, osteoarthritis, intervertebral osteochondrosis. Tablets take whole, washed down with water, regardless of food intake. The recommended daily dosage is 1 piece, that is 1000 mg of chondroitin sodium sulfate. Duration of treatment is from 3-6 months. If necessary, the therapy is repeated after 2-5 months.
• Structurum is well tolerated, but in rare cases, side effects occur. As a rule, these are diarrheal phenomena, nausea, vomiting, erythema, allergic dermatitis, urticaria, and Quincke's edema. To eliminate them, you must stop taking the drug and contact your doctor.
• Contraindications: the reaction of intolerance to the active component in the history, pediatric practice, patients younger than 15 years.
• Overdosing occurs when using higher doses. It appears as an intensification of adverse reactions. With brightly expressed symptoms, hospitalization and symptomatic therapy are indicated.

Arthra

Combined chondroprotector with active substances - chondroitin sulfate and glucosamine hydrochloride. Restores cartilaginous tissue and improves joint mobility, relieves severe pain syndrome with degenerative-dystrophic joint lesions.

Stimulates the synthesis of proteoglycans and collagen, reduces the enzymatic cleavage of cartilaginous tissue.

• Indications for use: complex therapy of degenerative-dystrophic pathologies of the musculoskeletal system, osteoarthritis of the joints of the spine and peripheral joints. Tablets are taken regardless of food intake. Adults appoint 1 capsule 2 times a day for 3 weeks with a further transition to 1 pc. Per day. Duration of treatment from 4-6 months.
• Side effects: pain in the epigastric region, flatulence, stool, dizziness, allergies. As a rule, these reactions are poorly expressed, therefore, the drug is not withdrawn, but in any case it is necessary to consult a doctor. There is no information about an overdose. But when applying excessive doses, it is recommended to wash the stomach and conduct symptomatic therapy.
• Contraindications: individual intolerance of active ingredients Astra, renal dysfunction, bronchial asthma, diabetes mellitus, tendency to bleeding, pediatric practice.

[13], [14],

Teraflex

A combined agent with two active substances: glucosamine hydrochloride and sodium chondroitin sulfate (potentiates each other's activity). Slows down the processes of destruction of cartilaginous tissue, stimulates the regeneration of joint tissues, reduces pain sensations.

After oral intake quickly absorbed into the digestive tract, the maximum concentration in the blood plasma after 3-4 hours, in the synovial fluid after 4-5 hours. About 30% of the drug penetrates into the synovial membranes and cartilage. Biotransformiruetsya in the liver, excreted by the kidneys within 24 hours.

• Indications for use: complex treatment of musculoskeletal injuries with degenerative-dystrophic changes of articular tissue. It is prescribed for knee injuries, traumatic bone lesions, spine osteochondrosis, primary and secondary osteoarthritis. It is not used for intolerance of components, during pregnancy and breastfeeding, with phenylketonuria.
• Method of use: the drug is taken by all patients older than 12 years. The patients are prescribed 1 capsule 3 times a day from 1 to 21 days of therapy, and in the future 1 unit each. 2 times a day. The course of treatment should last at least 2 months. For a complete recovery, several courses are conducted at intervals of 3 months.
• Adverse reactions occur rarely, and, as a rule, it is dyspepsia or skin allergic soup. To date, there have been no cases of overdose, but with the use of elevated doses, symptomatic therapy is necessary. There is no specific antidote.

Method of administration and dosage of tablets against pain in the knees

To achieve the desired therapeutic result, the doctor selects not only the drug, but also the method of its application. Doses of tablets from pain in the knees depend on their cause, the severity of the pain syndrome, the age of the patient and the individual characteristics of his body.

As a rule, patients are prescribed 1-3 daily doses, the dosage can be calculated as mg / kg of body weight. Some medicines (narcotic analgesics, opioids) are taken in short courses to prevent addiction and withdrawal symptoms. The duration of therapy with chondroprotectors can be from 3-6 months with subsequent repeated courses. The duration of treatment with other drug groups depends on the results obtained in the first days of use.

Using tablets against knee pain during pregnancy

From injuries and joint pain, no one is immune. So, in the period of bearing a child because of the increased strain on the body, many women face pain in the knees. To eliminate them, various drugs are used in terms of effectiveness and form of production. The use of tablets against pain in the knees during pregnancy is possible only with the appropriate medical clearance.

The use of non-steroidal anti-inflammatory drugs such as Ibuprofen, Diclofenac, Indomethacin, or Paracetamol is only possible by the doctor's prescription. Prescription is given to non-narcotic analgesics, chondroprotectors and opioid. Narcotic painkillers are contraindicated, since, despite a strong analgesic effect, they penetrate into all biological fluids, which negatively affects the development of the fetus. Most often, women are prescribed local anesthetics - ointments, creams, gels.

Contraindications for use

Drugs for the removal of joint pain, like other medications, have certain contraindications to the use. Consider them on the example of popular tablets, prescribed for painful sensations in the knees:

• NSAIDs

Do not apply for erosive and ulcerative gastrointestinal lesions, hematopoietic disorders, hypersensitivity to the components of the drug, for patients younger than 6 years.

• Non-narcotic analgesics

Individual intolerance of active ingredients, allergy to NSAIDs, hemorrhagic diathesis, kidney and liver failure, hemorrhagic stroke, acute duodenal ulcer and stomach, bronchial asthma.

• Narcotic analgesics

Hypersensitivity, blood clotting disorders, intestinal obstruction, respiratory depression. The period of pregnancy and lactation, for patients of elderly and children.

• Opioid

Alcohol or narcotic intoxication, craniocerebral trauma, epilepsy, severe form of renal and hepatic insufficiency, intolerance to opiates, pregnancy and children's age of patients.

• Chondroprotectors

Inclination to bleeding, pregnancy, lactation, elderly patients.

[1], [2], [3], [4], [5]

Side effects of tablets against pain in the knees

Regardless of the pharmacological group, the side effects of tablets against knee pain have similar symptoms:

• Nausea, vomiting, diarrhea / constipation.
• Headaches and dizziness.
• Sleep disorders, increased excitability.
• Decreased visual acuity and hearing.
• Increased sweating.
• Disorders of the genitourinary system.
• Increased blood pressure and heart palpitations.
• Skin allergic reactions.
• Inhibition of the respiratory center, bronchospasm.

For their elimination, in most cases, symptomatic therapy and compulsory consultation with the attending physician is indicated.

Overdose

Exceeding the dosage prescribed by the doctor or prolonged use of the medication can cause adverse symptoms from many organs and systems. Overdose is similar to side effects. Most often, patients are confronted with:

• Stomach ache.
• Nausea, vomiting
• Drowsiness.
• Headache.
• Noise in ears.
• Tachycardia.
• Increased sweating.
• Confusion of consciousness.
• Convulsions.
• Lowering blood pressure and other symptoms.

Symptomatic therapy is indicated for their elimination. First of all, it is washing the stomach and taking activated charcoal to reduce the absorption of the active components of the drug. After this, you need to seek medical help to adjust the dose or prescription of another medication.

Interactions with other drugs

In the treatment of any disease, an integrated approach is applied. This implies interaction with other drugs to restore health. Consider the possibility of simultaneous application of different groups of drugs with pills for the treatment of knee injury:

• NSAIDs - Ibuprofen reduces the diuretic effect of Furosemide, enhances the effect of oral hypoglycemic agents, Diphenine and anticoagulants of the coumarin series.
• Non-narcotic analgesics - Xefokam increases the risk of bleeding when used with anticoagulants and aggregation inhibitors. Potentiates the action of sulfonylurea derivatives. In combination with NSAIDs, the risk of GI side effects increases.
• Narcotic analgesics - Morphine is enhanced by the action of sedative and topical anesthetics. The analgesic effect decreases with the systematic use of barbiturates, especially Phenobarbital.
• Opioid - the use of different drugs from this group increases the effectiveness of each. Psychostimulants and analeptics reduce the analgesic effect. When taking antidepressants, synergy is observed.

Storage conditions

To preserve the medicinal properties of tablets during their entire shelf life, storage conditions must be observed. Tablets should be kept in the original packaging, protected from light and moisture.

The storage location must be out of the reach of children and sunlight. The recommended temperature is not higher than 25 ° C. Non-compliance with these conditions leads to premature deterioration of the drug.

Shelf life

Tablets from pain in the knees have a shelf life, during which they must be used. For different pharmacological groups, it is different, usually from 3 to 5 years, provided that the storage rules are observed. At the end of this time, the drug must be disposed of. Take unpublished, but expired medication is contraindicated.