GENERIC NAME: meloxicam
BRAND NAME: Mobic
DRUG CLASS AND MECHANISM: Meloxicam is in a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) and are used to treat pain and/or inflammation. Prostaglandins are chemicals that contribute to inflammation within joints, and it is the inflammation that leads to the common symptoms of pain, tenderness and swelling associated with arthritis. Meloxicam blocks the enzymes that make prostaglandins (cyclooxygenase 1 and 2) and reduces the levels of prostaglandins. As a result, inflammation and its accompanying symptoms are reduced. Meloxicam was approved for use in April 2000.
GENERIC AVAILABLE: yes
PREPARATIONS: Meloxicam is available as a yellow, round, biconvex, uncoated tablet containing meloxicam 7.5 mg or as a yellow, oblong, biconvex, uncoated tablet containing meloxicam 15 mg.
STORAGE: Meloxicam should be stored in a dry place at room temperature, 15-30°C (59-86°F).
DOSING: The lowest effective dose should be used for each patient. Meloxicam therapy usually is started at 7.5 mg daily. Some patients require a dose of 15 mg daily, but this dose should be taken only under the direction of a physician. Meloxicam may be taken with or without food.
DRUG INTERACTIONS: In studies where meloxicam was administered with cimetidine (Tagamet), digoxin (Lanoxin), and methotrexate (Rheumatrex), there were no drug interactions. Meloxicam may interfere with a class of drugs called ACE inhibitors, e.g., captopril (Capoten) and ramipril (Altace) or the water pill, furosemide (Lasix), that are used for controlling high blood pressure,. This may lead to an increase in blood pressure, and as a result, the dose of ACE inhibitor or Lasix may need to be changed when starting or stopping meloxicam.
If aspirin is taken with meloxicam there may be an increased risk for developing an ulcer.
Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking meloxicam or other NSAIDs.
Lithium (Eskalith or Lithobid) blood levels may increase or decrease after meloxicam therapy starts or stops. Therefore, both the patient taking lithium and the blood level of lithium need to be evaluated when starting or stopping meloxicam.
Meloxicam should be used with caution in combination with blood thinning medications such as warfarin (Coumadin) because of an increased risk of bleeding.
PREGNANCY: There have been no studies of meloxicam therapy in pregnant women. Meloxicam generally should be avoided during the first and second trimester of pregnancy. Since meloxicam may cause a fetal birth defect called ductus arteriosus (early closure of two major blood vessels of the heart and lung) in the third trimester of pregnancy, meloxicam also should be avoided during this last part of pregnancy.
NURSING MOTHERS: There have been no studies in humans to determine if meloxicam is excreted in breast milk.
SIDE EFFECTS: In general, the most common side effects with NSAIDs are related to the gastrointestinal tract (GI) and include nausea, vomiting, abdominal pain, diarrhea and gas. To prevent these common side effects, it is recommended that most NSAIDs be taken with food or milk. NSAIDs may cause ulcers in the stomach and/or small intestine. A few NSAIDs are designed to be less damaging to the stomach and small intestine, and, therefore, they may be taken with or without food. Meloxicam is an example of one of these NSAIDs, but, nevertheless, it should be taken cautiously without food. NSAIDs have been associated with an increased risk of blood clots that can cause strokes and heart attacks. NSAIDs also may interfere with the function of the kidneys or injure the kidneys.
Other less common side effects of meloxicam are headache, fatigue related to anemia (low red blood cell count), joint pain, back pain, insomnia, itching, skin rash, bladder infection and upper respiratory tract infection.
Reference: FDA Prescribing Information
Last Editorial Review: 2/23/2007
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