BNF for Children 2011-2012

BNFC 2011–2012 10.1.1 Non-steroidal anti-inflammatory drugs 505Meloxicam (Non-proprietary) ATablets, meloxicam 7.5 mg, net price 30-tab pack =£1.36; 15 mg, 30-tab pack = £1.62Mobic c (Boehringer Ingelheim) ATablets, yellow, scored, meloxicam 7.5 mg, net price30-tab pack = £9.30; 15 mg, 30-tab pack = £12.93.Label: 21NAPROXENCautions see notes above; interactions: Appendix 1(NSAIDs)Contra-indications see notes aboveHepatic impairment see notes aboveRenal impairment avoid if estimated glomerular filtrationrate less than 30 mL/minute/1.73 m 2 ; see alsonotes abovePregnancy see notes aboveBreast-feeding amount too small to be harmful butmanufacturer advises avoid; see also notes aboveSide-effects see notes aboveLicensed use not licensed for use in children under 5years for juvenile idiopathic arthritis; not licensedfor use in children under 16 years for musculoskeletaldisorders or dysmenorrhoeaIndication and dosePain and inflammation in musculoskeletal disorders,dysmenorrhoea. By mouthChild 1 month–18 years 5 mg/kg twice daily(max. 1 g daily)Juvenile idiopathic arthritis. By mouthChild 2–18 years 5–7.5 mg/kg twice daily (max.1 g daily)1Naproxen (Non-proprietary) ATablets, naproxen 250 mg, net price 28-tab pack =£1.35; 500 mg, 28-tab pack = £1.72. Label: 21Brands include Arthroxen cTablets, e/c, naproxen 250 mg, net price 56-tab pack= £3.18; 375 mg, 56-tab pack = £26.82; 500 mg, 56-tabpack = £4.83. Label: 5, 25Suspension, naproxen 25 mg/mLAvailable from ‘special-order’ manufacturers or specialistimporting companies, see p. 8091. Can be sold to the public for the treatment of primarydysmenorrhoea in women aged 15–50 years subject to max.single dose of 500 mg, max. daily dose of 750 mg for max. 3days, and a max. pack size of 9 250 mg tablets; forexemptions see Medicines, Ethics and Practice, London,Pharmaceutical Press (always consult latest edition)Naprosyn c (Roche) ATablets, yellow, scored, naproxen 250 mg, net price56-tab pack = £4.29; 500 mg, 56-tab pack = £8.56.Label: 21Tablets, e/c, (Naprosyn EC c ), naproxen 250 mg, netprice 56-tab pack = £4.29; 375 mg, 56-tab pack =£6.42; 500 mg, 56-tab pack = £8.56. Label: 5, 25Synflex c (Roche) ATablets, blue, naproxen sodium 275 mg, net price 60-tab pack = £7.10. Label: 21Note 275 mg naproxen sodium : 250 mg naproxenPIROXICAM UCautions see notes above and CHMP advice belowContra-indications inflammatory bowel disease; seealso notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding amount too small to be harmful; seealso notes aboveSide-effects see notes aboveLicensed use not licensed for use in childrenIndication and doseRelief of pain and inflammation in juvenileidiopathic arthritis. By mouthChild 6–18 years and body-weight under 15 kg5 mg dailyChild 6–18 years and body-weight 16–25 kg10 mg dailyChild 6–18 years and body-weight 26–45 kg15 mg dailyChild 6–18 years and body-weight over 46 kg20 mg dailyCHMP advicePiroxicam (June 2007)The CHMP has recommended restrictions on the useof piroxicam because of the increased risk of gastrointestinalside effects and serious skin reactions. TheCHMP has advised that:. piroxicam should be initiated only by physicians experiencedin treating inflammatory or degenerative rheumaticdiseases. piroxicam should not be used as first-line treatment. in adults, use of piroxicam should be limited to the symptomaticrelief of osteoarthritis, rheumatoid arthritis, andankylosing spondylitis. piroxicam dose should not exceed 20 mg daily. piroxicam should no longer be used for the treatment ofacute painful and inflammatory conditions. treatment should be reviewed 2 weeks after initiatingpiroxicam, and periodically thereafter. concomitant administration of a gastro-protective agent(section 1.3) should be consideredNote Topical preparations containing piroxicam are notaffected by these restrictionsPiroxicam (Non-proprietary) AUCapsules, piroxicam 10 mg, net price 56-cap pack =£16.62; 20 mg, 28-cap pack = £22.45. Label: 21Dispersible tablets, piroxicam 10 mg, net price 56-tab pack = £9.96; 20 mg, 28-tab pack = £32.41.Label: 13, 21Brexidol c (Chiesi) AUTablets, yellow, scored, piroxicam (as betadex) 20 mg,net price 30-tab pack = £13.82. Label: 21Feldene c (Pfizer) AUCapsules, piroxicam 10 mg (red/blue), net price 30-cap pack = £3.86; 20 mg (white), 30-cap pack = £7.71.Label: 2110 Musculoskeletal and joint diseases