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Rheumatic or musculoskeletal conditions comprise over 150 diseases and syndromes, which are usually progressive and associated with pain. They can broadly be categorized as joint diseases, physical disability, spinal disorders, and conditions resulting from trauma. Musculoskeletal conditions are leading causes of morbidity and disability, giving rise to enormous healthcare expenditures and loss of work. Those conditions with the greatest impact on society include:


Rheumatoid Arthritis (RA)

Rheumatoid Arthritis is a chronic systemic disease that affects the joints, connective tissues, muscle, tendons, and fibrous tissue. It tends to strike during the most productive years of adulthood, between the ages of 20 and 40, and is a chronic disabling condition often causing pain and deformity.

  • The prevalence varies between 0.3% and 1% and is more common in women and in developed countries.
  • Within 10 years on onset, at least 50% of patients in developed countries are unable to hold down a full-time job.

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a chronic inflammatory disease of the Axial Skeleton, with variable involvement of peripheral joints and non-articular structures. AS is a member of the group of the spondyloarthropathies, with a strong genetic predisposition. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine. Complete fusion results in a complete rigidity of the spine, a condition known as “Bamboo Spine”. It usually begins in the second or third decade of life and has male preponderance.



Osteoarthritis is a degenerative joint disease, which mainly affects the articular cartilage. It is associated with ageing and will most likely affect the joints that have been continually stressed throughout the years including the knees, hips, fingers, and lower spine region.

  • Osteoarthritis is already one of the ten most disabling diseases in developed countries.
  • Farming 1-9 years increases the risk of osteoarthritis 4.5 times; farming 10 or more years increases the risk 9.3 times.
  • Worldwide estimates are that 9.6% of men and 18.0% of women aged over 60 years have symptomatic osteoarthritis.
  • 80% of those with osteoarthritis will have limitations in movement, and 25% cannot perform their major daily activities of life



Gout is a chronic arthritic disorder caused by an abnormality in uric acid metabolism or excretion, or both”. It is characterized by elevated serum uric acid (urate) levels (hyperuricemia) and recurrent attacks of acute inflammatory arthritis, which may become chronic and deforming.

Primary gout is apparently due to several unknown inborn errors of metabolism.

Secondary gout occurs as a complication of certain disorders, particularly proliferative (cancerous) blood disorders, or from the use of certain drugs.

The underlying pathologic process in gout is an excess accumulation of uric acid in body fluid - due to either overproduction or under excretion of uric acid, or both - which leads to the deposition of sodium urate crystals in the body.


Spinal Disorders

Spinal Disorders include trauma, mechanical injury, spinal cord injury, inflammation, infection, and tumor. About 80–85% of back pain episodes have no known cause.

  • Low back pain, the most common spinal disorder, affects over 80% of persons at some point in their life, and from 4–33% of a population at any one time.
  • Back pain is the most common cause of disability among young adults.
  • Many factors, physical, psychological and occupational, contribute to the occurrence of back pain


Headache & Migraine

These are actually referred pains (often a person feels pain in part of his/her body which is considerably away from the tissue causing pain) to the front of the head from the deep structure. The brain itself is almost totally insensitive to pain. The following diagram shows the areas of head demonstration pain due to one or the other reasons.

Migraine is a special type of headache that is thought to result from abnormal vascular phenomena, though the exact mechanism is unknown. Migraine headache often begins with various prodromal (symptoms indicative of and approaching disease) sensations such as nausea, loss of vision in a part of sensory hallucination (nightmares). Ordinarily these prodromal symptoms appear half an hour to an hour prior to the beginning of headache itself.



Liometacen® contains Meglumine Indomethacinate as active ingredient and belongs to a class of drugs named NSAIDs acting against pain, fever and inflammation.

Liometacen® is a preparation with a marked analgesic activity. Liometacen is a water-soluble indomethacin salt and is the only injectable form of indomethacin available. Liometacen® ensures two fold attack on pain transmission i.e. Central and Peripheral. Centrally it blocks the pain signals at spinothalamic level between 2nd to 3rd neuron and peripherally it inhibits the release of chemical mediators of pain and inflammation.


Dosage & Administration

An ampoule of Liometacen administered every 12 hours can be useful in the forms with painful and hyper-pyretic reactions of greater intensity.

The initial starting dose can be progressively reduced according clinical response.

In chronic cases, according to the course of the disease, one can administer an ampoule of Liometacen at intervals of two or more days. The intramuscular injections are to be given slowly and deeply into the higher external quarter of the gluteal region. Injections given in about 500 patients less than 1% have complained of local reactions. Intravenous drip infusions are particularly useful in hospital procedures; one or more ampoules of Liometacen diluted in 250ml physiological solution at a rate of thirty drops per minute should be administered. The application of Liometacen for intra-articular infiltration was usefully adopted using 2% procaine as a solvent (2ml per every vial of Liometacen).


Brexin® is a unique and innovative product in its class of non-steroidal anti-inflammatory (NSAID) drug. Brexin is the first NSAID based on State of the Art, Nobel Prize winning technology Host Guest complexation with improved pharmacokinetic properties. In this technology the Guest molecule of Piroxicam is encapsulated into the cavity of Host molecule of β-Cyclodextrin. In this way millions of free single molecules of are available for absorption offering high solubility, negligible contact time with G.I mucosa, rapid absorption and maximum bioavailability ultimately leading towards FAST ONSET of ACTION.

Brexin is a Non-steroidal oxicam derivative with anti-inflammatory, antipyretic and analgesic properties. As a nonsteroidal anti-inflammatory drug, Piroxicam binds and chelates both isoforms of cyclooxygenases (COX1 and COX2), thereby stalling phospholipase A2 activity and conversion of Arachidonic Acid into prostaglandin precursors. This results in inhibition of prostaglandin biosynthesis. As a second, independent effect, Piroxicam inhibits the activation of neutrophils thereby contributing to its overall anti-inflammatory effects.

Brexin is indicated for the symptomatic treatment of acute and chronic painful and inflammatory conditions such as rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, backache, headache dental pain.



The recommended daily dose is 20 mg, administered as one single daily dose, preferably with or after food.

Riacen® Cream

Riacen Cream contains 1gm Piroxicam (4-hydroxy-2-methyl-2H-1,2-benzothiazine-3-[N-(2-pyridyl)-carboxamide]-1,1-dioxide)

Riacen Cream (Piroxicam) possesses marked anti-inflammatory and antipyretic activity percutaneously.

Riacen Cream is the only topical formulation in creamy form among Oxicams and due to hi-tech cosmetic formulation, considering the rapid absorption as a prime concern, Riacen Cream complete its absorption within a few minutes after percutaneous application, by leaving a pleasant effect superficially. Piroxicam start accumulating directly at the site of inflammation. Localized action of Piroxicam inhibits the biosynthesis of prostaglandins (chemical mediators of inflammation and pain). In fact, Piroxicam prevents the further conversion of arachidonic acid into cyclooxygenase, precursors of prostaglandin bio-formation.



Apply gently on the pain site twice daily.

Riacen® Capsule

Riacen® capsules contains Piroxicam which is a non-steroidal anti-inflammatory (NSAID) drug indicated for the symptomatic treatment of painful and inflammatory conditions such as rheumatic disorders.



The recommended daily dose is 20 mg, administered as one single daily dose, preferably with or after food.