Nonsteroidal anti-inflammatory drugs for migraine

How to make teething easier for children.

December 15, 2022
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Content

• Symptoms of teething in children
• Top 7 pain-relieving gels for teething
• Kamistad Baby
• Dentinale
• Holisal
• Baby Doctor First teeth
• Kalgel
• Pansoral
• Dentinox

A baby’s first teeth are always a great joy for parents, but often this is accompanied by a deterioration in the child’s well-being, fever, moodiness and bad mood. Only 30% of young children do not have any negative symptoms when teething. In pharmacies you can buy various drugs to improve the condition of a child during teething: both drugs for oral administration and for external use. Today we’ll talk about gels for gums.

Many parents buy such products on the advice of friends or based on reviews from moms on forums. But it is better to consult a pediatrician before purchasing a painkiller, because only a doctor can take into account all the individual characteristics of your baby’s body and choose a truly effective and safe remedy.

Read also Top 10 best hypoallergenic formulas for children 10 best infant formulas for children with allergies.

MUSCLE PAIN

The causes of muscle pain can be very different: inflammation, injuries (sprains, tears), autoimmune processes, etc. It is not recommended to endure muscle pain for a long time, as it can lead to further dysfunction of the musculoskeletal system.

The painkiller SPAZMALIN® will help you cope with muscle pain.

Directions for use and doses

The drug is taken orally after meals, 1-2 tablets 2-3 times a day. The maximum daily dose is 6 tablets. The break between doses of the drug should be at least 4 hours. To reduce the irritating effect on the gastrointestinal tract, the drug should be taken after meals with water, milk, or alkaline mineral water. Before using the drug SPAZMALIN®, read the instructions.

Symptoms of teething in children

Typically, when teething, the following symptoms are observed:

• excessive salivation, which can cause the baby to cough, possible hoarseness, a rash around the mouth and on the chin;
• soreness and swelling of the gums;
• itching of the gums (the child puts various objects in his mouth to “scratch” the gums);
• deterioration of appetite or its complete absence;
• increased body temperature;
• sleep problems;
• increased excitability, tearfulness;
• runny nose;
• stool disorder.

It is important to note that not all children have all the symptoms on this list. These may be several symptoms of teething, or even none at all. Everything is very individual.

How children cut teeth

Kamistad Baby

This German gel contains two main components: chamomile (disinfects, soothes and relieves inflammation) and polidocanol (a local anesthetic that is as safe as possible for the child’s body). “Kamistad Baby” has a sweetish-honey taste, so the baby will definitely not spit it out. The product is packaged in a convenient tube with a thin dispenser spout, so the gel is easy to apply to children's gums. Literally immediately after application, the drug begins to work, relieving pain, and the effect lasts for several hours. In addition to teething in babies, Kamistad Baby is prescribed for stomatitis and gingivitis in adults, for healing erosions in the oral cavity, after surgical procedures.

Kamistad Baby

STADA CIS, Russia

Kamistad® Baby is recommended at the first signs of teething in children.
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JOINT PAIN

Everyone is familiar with the terms “arthritis” and “arthrosis”.

“Arthritis” is an inflammatory disease of the joints.

“Arthrosis” is a disease of the joints of a degenerative-dystrophic nature.

With these two pathological conditions, sooner or later joint pain occurs.

This pain constrains the joints, prevents normal movement, and disrupts the natural and habitual rhythm of life.

The drug SPAZMALIN® is intended for reliable relief of joint pain of various locations and origins. The components of the drug can quickly relieve pain.

Directions for use and doses

The drug is taken orally after meals, 1-2 tablets 2-3 times a day. The maximum daily dose is 6 tablets. The break between doses of the drug should be at least 4 hours. To reduce the irritating effect on the gastrointestinal tract, the drug should be taken after meals with water, milk, or alkaline mineral water. Before using the drug SPAZMALIN®, read the instructions.

Dentinale

This teething gel helps babies get through the difficult period easier. Dentinale contains only safe ingredients, no chemical painkillers. The drug contains chamomile extract, aloe vera juice and boswellia. Dentinale reduces gum sensitivity, relieves inflammation and provides excellent pain relief. After applying the gel, a protective film is formed on the gums, so the child calms down and falls asleep. The drug can be applied many times, and the effect lasts for several hours. Dentinale does not contain sugar, parabens, or lidocaine. The gel has a sweetish, pleasant taste that your baby will definitely like. Dentinale can be used even by children prone to allergies.

Holisal

This Polish gel has a wide range of dental indications. It is suitable for both adults and children. You can use "Cholisal" when teething in babies from 6 months of age. The active ingredient of the drug is choline salicylate. The product has antimicrobial, anti-inflammatory, soothing and analgesic effects. “Cholisal” instantly relieves gum irritation and also reduces their bleeding (which is important for various oral problems in adults). The drug is sold in a convenient small tube; it should be used with caution in children under one year of age. The downside is the high cost.

Holisal

Pharmaceutical plant Elfa A.O., Poland

For local use on the mucous membranes of the oral cavity as an analgesic and anti-inflammatory agent in the treatment of periodontal diseases, damage to the mucous membrane, diseases that occur with an inflammatory reaction and pain: - stomatitis of various etiologies;
- gingivitis; - periodontitis; - damage to the oral mucosa when wearing dentures; - trauma to the oral mucosa; - pain during teething in children; - cheilitis; — candidiasis of the oral mucosa; — minor surgical interventions in the oral cavity; - lichen planus when localized on the oral mucosa; — damage to the oral mucosa in Stevens-Johnson syndrome (as part of complex therapy). from 204

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Cholisal for pain relief

The medication has anti-inflammatory and antibacterial effects. It quickly penetrates the tissue and reaches the site of inflammation, which reduces pain within the first few minutes after application. Due to its non-hormonal nature, it can be used at any age. Apply the ointment only topically, and it is advisable to do this immediately before meals. For treatment, first squeeze a 0.5-2 cm long strip of Cholisal onto your finger. The substance is gently rubbed around the diseased tooth into the gum and over its surface. Repeat such manipulations no more than three times a day.

Cholisal has anti-inflammatory and antibacterial effects

Attention! The medicine contains anise oil, which can provoke an allergic reaction. Before use, it will be useful to apply a small amount of ointment to any part of the body. If after an hour there are no particular unpleasant sensations, you can relieve toothache with Cholisal.

Baby Doctor First teeth

This Israeli teething gel contains plantain, marshmallow root, chamomile, calendula, and echinacea. This is an ideal drug for both infants and older children. “Baby Doctor First Teeth” quickly relieves inflammation of the gums, the drug is completely natural and hypoallergenic. The gel contains no anesthetics, so it is suitable for children. The product provides long-term relief from pain, itching and inflammation. It is also important that you can use “Baby Doctor First Teeth” as much as necessary per day. Many pediatricians and parents speak only positively about the drug.

Baby Doctor First teeth

Baby Doctor gel for gums First teeth is a transparent pinkish gel, tasteless and odorless.
The gel instantly soothes the gums and eliminates inflammation. With regular use of the gel, the teething period of an infant is greatly facilitated and the occurrence of complications is eliminated. from 279

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Teething by age

How to soothe an aching tooth?

If aching pain inside a tooth or after the removal of a wisdom tooth prevents you from sleeping peacefully or generally thinking about anything else, you need to take care to reduce it to a minimum. And at the first opportunity, be sure to consult a dentist, because pain relief does not mean that the problem has been eliminated, and there is no need for treatment. You can eliminate pain as follows:

• First of all, thoroughly brush your teeth and remove any remaining food from the interdental spaces.
• Rinse your mouth with a soda-salt solution (a teaspoon of soda and salt per glass of warm boiled water). You can use only saline solution or just warm water if nothing else is available.
• Take a pain reliever (analgin, paracetamol, ibuprofen) if possible.
• If there are no medications at hand, you can relieve pain with folk remedies. Rinsing with decoctions of chamomile, calendula, sage, and calamus root helps to cope well with toothache. You can also use tampons soaked in clove, sea buckthorn or mint oil, which should be applied to the affected area. Rinsing with alcohol-containing liquids - propolis tincture, regular vodka or cognac (sweetened alcohol-containing drinks cannot be used for this purpose!) can help get rid of pain.

It is strictly not recommended to use warming procedures in this case - rinsing should be at approximately room temperature, warm compresses and heating pads should not be applied to the sore area. Heat only accelerates and intensifies the inflammatory process, which can provoke the rapid development of a purulent abscess and the spread of inflammation to nearby tissues.

Kalgel

You can buy "Kalgel" only with a doctor's prescription, since this drug contains a powerful anesthetic - lidocaine, and it should be used with caution in small children, an overdose is dangerous. "Kalgel" is prescribed in difficult cases of teething in children, when weaker drugs do not have an effect. The gel also contains cetylpyridinium chloride - it disinfects and relieves inflammation due to bacterial infection. Kalgel has a powerful and long-lasting effect, but it is very important to observe the frequency of use and dosage.

Kalgel

GlaxoSmithKline, France

- for quick relief of pain during teething and reduce the severity of gum irritation.
The drug Kalgel also has a weak antiseptic effect. from 260

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SPASM OF SMOOTH MUSCLE OF INTERNAL ORGANS

This is a common cause of abdominal pain, especially in people with chronic diseases of the gastrointestinal tract.
Spasm of smooth muscles provokes intestinal, biliary and renal colic. Occurs with biliary dyskinesia, after surgery to remove the gallbladder and with chronic colitis. The antispasmodic drug SPAZMALIN® is effective for relieving spasms. Directions for use and doses

The drug is taken orally after meals, 1-2 tablets 2-3 times a day. The maximum daily dose is 6 tablets. The break between doses of the drug should be at least 4 hours. To reduce the irritating effect on the gastrointestinal tract, the drug should be taken after meals with water, milk, or alkaline mineral water. Before using the drug SPAZMALIN®, read the instructions.

Pansoral

This is a French phytogel for children's gums, the quality and safety of which are confirmed by international certificates. "Pansoral" relieves inflammation and slightly numbs the baby's gums. Thanks to the rapid penetration of active substances into the mucous membrane, the pain subsides in just two minutes. The preparation contains chamomile and saffron flowers, an extract from marshmallow roots. These components are excellent antiseptics; they heal and disinfect well. Gel "Pansoral" can be used in children from 3 months of age, it is completely natural. The drug is also indicated for the healing of ulcers on the mucous membrane, stomatitis, and bacterial rashes in the oral cavity. It is advisable to consult a pediatrician before using the drug. Among the disadvantages of the product is that it is not available in all pharmacies, it can cause an allergic reaction.

Pansoral

Pierre Fabre Medicament, France

Pansoral is a natural herbal remedy that is used to ease teething in children.
The plant extracts included in the preparation have a calming and softening effect on the gum mucosa. The plant extracts included in the preparation have a calming and softening effect on the mucous membrane of the gums and help the child endure this period easier. from 280

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HEADACHE AND MIGRAINE

The most common type of pain is headache. More than 70% of the population of developed countries in Europe and America complain of episodic or chronic headaches.

Main reasons:

• psycho-emotional or physical stress tension headache (50-70% of all headache cases)
• spasm or decrease in cerebral vascular tone, incl. with hypotension and changes in atmospheric pressure (vasodilation - cluster headache)
• migraine (10–15% of the world's population)

Directions for use and doses

The drug is taken orally after meals, 1-2 tablets 2-3 times a day. The maximum daily dose is 6 tablets. The break between doses of the drug should be at least 4 hours. To reduce the irritating effect on the gastrointestinal tract, the drug should be taken after meals with water, milk, or alkaline mineral water. Before using the drug SPAZMALIN®, read the instructions.

Dentinox

This German gel contains chamomile flowers and lidocaine. This drug should be prescribed exclusively by a pediatrician, given the presence of a strong anesthetic in the composition. Dentinox effectively relieves inflammation and pain during teething in babies. The drug is indicated for children from 4 months of age if weaker drugs do not help reduce inflammation and pain. Among the disadvantages of Dentinox are the risks of allergic reactions, fructose in the composition and a contraindication for use in case of damage to the oral mucosa.

Dentinox

Dentinox, Germany

It is used to prevent and relieve pain and inflammation during the eruption of milk and permanent teeth.
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Pain under professional control

Magazine "Remedium" No. 1-3, 2022

DOI:

10.21518/1561-5936-2020-1-2-3-42-46

Irina Shirokova

,
Yulia Prozherina
, Ph.D.,
Remedium
In Russia, the bulk of outpatient visits are for patients diagnosed with pathologies of the spine and joints, the main manifestation of which is pain [1]. The leading place in the treatment of pain is occupied by non-steroidal anti-inflammatory drugs (NSAIDs), among which are meloxicam, which is well known to Russians under the brand name Amelotex®.

Pain kept at bay by skilled practitioners

Irina Shirokova

,
Julia Prozherina
, PhD in biology,
Remedium
In Russia, the main part of outpatient care is provided to the patients diagnosed with disorders affecting the spine and joints, which manifest themselves as pain [1]. Non-steroidal anti-inflammatory drugs (NSAIDs) play a major role in pain syndrome management. Meloxicam, which is well known to Russians under Amelotex® brand, stands out from the rest of NSAIDs.

Pain is the most common reason for a patient to see a doctor. It is associated with about 90% of all diseases [2]. Pain not only reduces performance, affects emotional well-being and quality of life, but can also become unbearable, causing severe depression and thoughts of suicide. In clinical practice, there are 4 main types of pain: transient, associated with activation of nociceptors in the absence of tissue damage (and often not the reason for seeking medical attention); acute, resulting from tissue damage and activation of nociceptors; chronic – oncological and non-oncological [3]. Non-oncological pain that accompanies diseases of the musculoskeletal system - osteoarthritis and pain in the lower back - deserves special attention.

Pain is the main manifestation of these very common nosological forms, rational pathogenetic therapy for which has not yet been developed [4]. Its treatment is based on the use of NSAIDs, the most important and most popular class of analgesics in our country. More than 30 million people worldwide take NSAIDs daily, with 40% of these patients over the age of 60 years. According to forecasts, this number will only increase with the general aging of the population of developed countries and, accordingly, the increase in the prevalence of pathologies such as degenerative diseases of the musculoskeletal system and rheumatic lesions of soft tissues [5]. The main effect of NSAIDs is closely related to the blockade of the enzyme cyclooxygenase (COX-2), which is responsible for the active synthesis of prostaglandins (PGs), the main mediators of pain. Depending on their selectivity towards COX-2, all NSAIDs are divided into three groups: non-selective COX-1 and COX-2 inhibitors (n-NSAIDs), selective COX-2 inhibitors and highly selective COX-2 inhibitors (coxibs) ( Table 1

).

Table 1. Classification of NSAIDs by degree of selectivity [6]

According to GRLS: https://grls.rosminzdrav.ru/
Thanks to selectivity, it is possible to avoid suppression of the activity of the COX-1 enzyme, which is necessary to maintain the protective properties of the mucous membrane of the gastrointestinal tract (GIT). Selective COX-2 inhibitors, which include meloxicam, lornoxicam, nabumetone, nimesulide and tenoxicam, are characterized by a lower risk of gastrointestinal complications compared to non-selective drugs and do not cause complications from the cardiovascular system, which means they can be recommended to many patients [ 6]. It would be logical to believe that highly selective COX-2 inhibitors (coxibs) should have an even higher safety profile than selective COX-2 inhibitors.

However, in studies by D. Layton et al. (2003) found that the risk of complications from the cardiovascular system, in particular thromboembolic events, is significantly higher during the use of coxibs than during treatment with meloxicam. This is explained by the fact that coxibs, which have the ability to inhibit exclusively COX-2 (the ratio of COX-2/COX-1 inhibition is approximately 200/1), inhibit the synthesis of prostacyclin (antithrombogenic PG). However, they do not affect the synthesis of thromboxane A2 (thrombogenic PG), the formation of which is regulated by COX-1. As a consequence, the ratio of anti- and prothrombogenic factors significantly shifts towards the latter [6].

An illustrative example is the more than 20-year use in world clinical practice of the selective COX-2 inhibitor meloxicam, which to this day remains a very popular drug among the group of NSAIDs. In terms of its analgesic effect, it is comparable to other NSAIDs prescribed for the treatment of back pain, lumbosacral radiculopathy, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, etc., but has a higher safety profile. Meloxicam is well tolerated and has a significantly lower number of gastrointestinal complications compared to n-NSAIDs. This is confirmed by the results of numerous randomized clinical trials [7].

According to clinical recommendations for the diagnosis and treatment of osteoarthritis, selective NSAIDs are preferred among all groups of drugs. Note that this group of drugs, due to its high safety profile, is recommended, including for people over 65 years of age and with concomitant diseases [8]. According to Comcon Prindex, for diseases of the musculoskeletal system, doctors most often prescribe selective NSAIDs. At the same time, the first place in the number of medical prescriptions is occupied by meloxicam ( Table 2

).

Table 2. Top 5 INNs prescribed for diseases of the musculoskeletal system, based on the results of the third quarter. 2022

Source: PrIndex, Synovate Comcon

Meloxicam is available in different forms, including topical forms. By the way, the first monocomponent product based on meloxicam for topical use registered in Russia was the drug Amelotex® gel, which appeared on the market in 2014. Until that time, the global range of meloxicam drugs included solutions for injections, tablets and rectal suppositories, while meloxicam gels for cutaneous use it did not contain. Publications on a comparative assessment of the analgesic and anti-inflammatory effects of meloxicam gel (Amelotex® gel) and diclofenac and piroxicam gels indicate that meloxicam, having large molecular sizes, is stable in biological media, has a deeper penetration into the underlying tissues and can be retained in soft tissues for a long time, providing a long-lasting effect, which is facilitated by a longer half-life [7]. As noted by Andrey Evgenievich Karateev, head of the laboratory of pathophysiology of pain and clinical polymorphism of musculoskeletal diseases of the Federal State Budgetary Scientific Institution NIIR named after. V.A. Nasonova, in recent years, interest in local forms of NSAIDs has increased markedly.

The close attention of the medical community to the problem of complications associated with the use of this drug group determines the need to find approaches to their safer use. It is obvious that in a significant proportion of patients with severe comorbid pathology (for example, in persons with coronary artery disease who have suffered cardiovascular accidents), systemic administration of NSAIDs can pose a serious and very real threat to life. The only method of safe use of NSAIDs in these patients can only be considered the use of local forms. That is why Amelotex® gel has received wide recognition among doctors and is one of the leaders among drugs recommended by pharmacists. This is evidenced by the rapid growth of its sales.

At the end of 2022, meloxicam demonstrated the highest sales growth in value terms (+45% in rubles, 2022 to 2018) among the top 7 most popular single-component topical drugs used for joint and muscle pain ( Fig. 1

).

Figure 1. Rating of sales growth in 2022 by 2022 among the top 7 single-component topical drugs for topical use for joint and muscle pain, % rub.

Source: IQVIA retail audit

One of the key drivers in the meloxicam segment is the drug Amelotex® gel. Since 2014, its sales volume has been growing rapidly. Thus, at the end of 2022, about 1.6 million packages of this drug were sold for an amount of about 414 million rubles. By the way, the total sales volume of Amelotex in all forms of release is also steadily increasing.

The brand's total sales volume across all market segments in 2019 amounted to 4.4 million packages, or RUB 1.3 billion. in final consumption prices, which is significantly higher than in previous years ( Fig. 2

).

Figure 2. Sales dynamics of the drug Amelotex® gel in Russia

Source: IQVIA retail audit

The appearance of the drug Amelotex® gel significantly expands the possibilities of analgesic therapy, control of acute and chronic pain. Depending on the patient’s condition, doctors choose different dosage forms in their prescriptions - tablets for oral administration, injection solutions, local forms (gels, creams, ointments), etc. The Amelotex® brand line includes different release forms (tablets, suppositories, injection solutions, gel), which allows you to find the optimal solution for each patient. Local forms of the drug occupy a special place. Amelotex® gel may be indicated to “intensify” systemic treatment and/or in cases where systemic administration is not possible due to the presence of strict contraindications to oral NSAIDs.

List of literature / References

1. Diseases of the musculoskeletal system: treatment tactics. 2017. Access mode: https://www.provrach.ru/article/546-qqess7-zabolevaniya-oporno-dvigatelnogo-apparata.
2. Denisov I.N., Kuznetsova O.Yu., Moiseeva I.E. and others. Pain syndrome. Clinical guidelines for general practitioners (family doctors). M.; St. Petersburg; Rostov n/a; 2014. 26 p. Access mode: link.
3. Samoilova N.V., Zagorulko O.I., Gnezdilov A.V., Medvedeva L.A. Possibilities of treatment and rehabilitation of patients with pain syndrome in a multidisciplinary surgical clinic. Surgery. 2013;(3):75–78. Access mode: Link. / Samoĭlova NV, Zagorul'ko OI, Gnezdilov AV, Medvedeva LA Treatment and rehabilitation of patients with pain syndrome in surgical clinic. Khirurgiya = Khirurgiia. 2013;(3):75–78. (In Russ.) Available at: Link.
4. Karateev A.E. Analgesic therapy for diseases of the musculoskeletal system: the place of meloxicam. Difficult patient. 2014;12(11):42–49. Access mode: https://t-pacient.ru/articles/8491/ / Karateev AE Analgesic Therapy for the Diseases of Musculoskeletal System: Position of Meloxicam. Trudnyy patsient = Difficult patient. 2014;12(11):42–49. (In Russ.) Available at: https://t-pacient.ru/articles/8491/.
5. Zhuravleva M.V., Kukes V.G., Prokofiev A.B., Serebrova S.Yu., Gorodetskaya G.I., Berdnikova N.G. Rational use of NSAIDs – balance of effectiveness and safety (Literature review). International Journal of Applied and Basic Research. 2016;(6–4):687–696. Access mode: https://applied-research.ru/ru/article/view?id=9677.
6. Mishchenko N. Movalis in clinical practice: the optimal balance of effectiveness and safety. Health of Ukraine. 2011;(1):34–35. Access mode: https://www.health-ua.com/pics/pdf/ZU_2011_Nevro_1/34-35.pdf.
7. Denisov L.N. Rational therapy of pain syndrome in diseases of the musculoskeletal system. Medical advice. 2017;(17):132–136. doi.org/10.21518/2079-701X-2017-17-132-136. Denisov LN Reasonable therapy of pain syndromes of diseases of the musculoskeletal system. Meditsinskiy sovet = Medical Council. 2017;(17):132–136. (In Russ.) doi.org/10.21518/2079-701X-2017-17-132-136.
8. Denisov I.N., Lesnyak O.M., Popov A.A., Maksimov D.M., Solodovnikov A.G. and others. Clinical recommendations: diagnosis, treatment and prevention of osteoarthritis (osteoarthritis) in general medical practice. M.; St. Petersburg; Kazan; 2013. 29 p. Access mode: https://gpfm.ru/assets/image%20for%20events/osteoartroz.PDF.