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Meloxicam

 
Drug Info:

Meloxicam

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Brand names: Mobic®

Chemical formula:



Meloxicam tablets

What are meloxicam tablets?

MELOXICAM (Mobic®) is used for osteoarthritis or rheumatoid arthritis to reduce pain and inflammation. Meloxicam has also been used to treat mild to moderate pain due to other conditions. Generic meloxicam is available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
• asthma, especially aspirin sensitive asthma
• bleeding problems or taking medicines that make you bleed more easily such as anticoagulants ('blood thinners')
• cigarette smoker
• coronary artery bypass graft (CABG) surgery within the past 2 weeks
• dental disease
• diabetes
• drink more than 3 alcohol-containing beverages a day
• heart disease or circulation problems such as heart failure or leg edema (fluid retention)
• high blood pressure
• kidney disease
• liver disease
• stomach or duodenal ulcers
• systemic lupus erythematosus
• ulcerative colitis
• an unusual or allergic reaction to aspirin, other salicylates, meloxicam, piroxicam, other NSAIDs, other medicines, foods, dyes or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take meloxicam tablets by mouth. Follow the directions on the prescription label. Swallow tablets whole with a full glass of water; take tablets in an upright or sitting position. Taking a sip of water first, before taking the tablets, may help you swallow them. If possible take bedtime doses at least 10 minutes before lying down. If meloxicam upsets your stomach, take it with food or milk. Take your doses at regular intervals. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction to this medicine and need smaller doses.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What drug(s) may interact with meloxicam?

• alcohol
• alendronate
• aspirin and aspirin-like medicines
• cidofovir
• cyclosporine
• drospirenone; ethinyl estradiol (Yasmin®)
• entecavir
• herbal products that contain feverfew, garlic, ginger, or ginkgo biloba
• lithium
• medicines for high blood pressure
• medicines that affect platelets
• medicines that treat or prevent blood clots such as warfarin and other 'blood thinners'
• methotrexate
• other antiinflammatory drugs (such as ibuprofen or prednisone)
• pemetrexed
• water pills (diuretics)

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking meloxicam?

Let your prescriber or health care professional know if your pain continues; do not take with other pain-killers without advice. If you get flu-like symptoms (fever, chills, muscle aches and pains), call your prescriber or health care professional; do not treat yourself.

To reduce unpleasant effects on your stomach, take meloxicam with a full glass of water and never just before lying down. You may also take this medicine with food to decrease stomach upset. If you notice black, tarry stools or experience severe stomach pain and/or vomit blood or what looks like coffee grounds, notify your health care prescriber immediately.

Meloxicam cannot take the place of aspirin for the prevention of heart attack or stroke. If you are taking medicines that affect the clotting of your blood, such as aspirin or blood thinners such as Coumadin®, talk to your health care provider or prescriber before taking this medicine. If you are currently taking aspirin for this purpose, you should not discontinue taking aspirin without checking with your prescriber or health care professional.

Do not smoke cigarettes or drink alcohol; these increase irritation to your stomach and can make it more susceptible to damage from meloxicam.

It is especially important not to use meloxicam during the last 3 months of pregnancy unless specifically directed to do so by your health care provider. Meloxicam may cause problems in the unborn child or complications during delivery.

Avoid taking other prescription or over-the-counter non steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®) or naproxen (Aleve®) while taking meloxicam. Side effects including stomach upset, heartburn, nausea, vomiting, or serious side effects such as ulcers are more likely if meloxicam is given with other NSAIDs. Many non-prescription products contain NSAIDs; closely read labels before taking any medicines with meloxicam.

What side effects may I notice from taking meloxicam?

Long-term, continuous use may increase the risk of heart attack or stroke. Patients should seek immediate emergency help in the case of a serious allergic reaction.

Side effects that you should report to your prescriber or health care professional as soon as possible:
• signs of bleeding - bruising, pinpoint red spots on the skin, black tarry stools, blood in the urine, unusual tiredness or weakness, vomiting blood or vomit that looks like coffee grounds
• signs of an allergic reaction - difficulty breathing or wheezing, skin rash, redness, blistering or peeling skin, hives, or itching, swelling of eyelids, throat, lips
• blurred vision
• chest pain
• decrease in the amount of urine passed
• difficulty swallowing, severe heartburn or burning, pain in throat
• nausea or vomiting
• slurred speech or weakness on one side of the body
• stomach pain or cramps
• swelling of feet or ankles
• unexplained weight gain or edema
• yellowing of eyes or skin

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• constipation or diarrhea
• difficulty swallowing
• dizziness
• gas or heartburn
• minor upset stomach

Where can I keep my medicine?

Keep out of the reach of children in a container that small children cannot open.

Store at room temperature 15—30 degrees C (59—86 degrees F). Protect from moisture. Keep container tightly closed. Throw away any unused medicine after the expiration date.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

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Oxford A-Z of Medicinal Drugs:

meloxicam

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Home > Library > Health > Drugs Directory

An non-steroidal anti-inflammatory drug used for the short-term treatment of acute osteoarthritis and for the long-term treatment of rheumatoid arthritis and ankylosing spondylitis (a type of arthritis of the spine). It is available as tablets or suppositories on prescription only.

Side effects and interactions with other drugs:
see non-steroidal anti-inflammatory drugs.

Precautions:
see non-steroidal anti-inflammatory drugs. The suppositories should not be used in people with haemorrhoids.

Proprietary preparation:
Mobic.

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Saunders Veterinary Dictionary:

meloxicam

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Home > Library > Animal Life > Veterinary Dictionary

A nonsteroidal anti-inflammatory drug used in dogs for management of pain.

Wikipedia on Answers.com:

Meloxicam

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Home > Library > Miscellaneous > Wikipedia
Meloxicam
Systematic (IUPAC) name
4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide.
Clinical data
Trade names Mobic
AHFS/Drugs.com monograph
MedlinePlus a601242
Pregnancy cat. C(US) D in third trimester
Legal status POM (UK) ℞-only (US)
Routes Oral
Pharmacokinetic data
Bioavailability 89%
Protein binding 99.4%
Metabolism Hepatic (CYP2C9 and 3A4-mediated)
Half-life 15 to 20 hours
Excretion Urine and faeces equally
Identifiers
CAS number 71125-38-7 YesY
ATC code M01AC06
PubChem CID 5281106
DrugBank APRD00529
ChemSpider 10442740 YesY
UNII VG2QF83CGL YesY
KEGG D00969 YesY
ChEMBL CHEMBL599 YesY
Chemical data
Formula C14H13N3O4S2 
Mol. mass 351.403 g/mol
SMILES eMolecules & PubChem
 N(what is this?)  (verify)

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic and fever reducer effects. It is a derivative of oxicam, closely related to piroxicam, and falls in the enolic acid group of NSAIDs.[1] It was developed by Boehringer-Ingelheim.

Contents

Mechanism of action

Main article: Non-steroidal anti-inflammatory drug

Meloxicam inhibits cyclooxygenase (COX), the enzyme responsible for converting arachidonic acid into prostaglandin H2—the first step in the synthesis of prostaglandins, which are mediators of inflammation. Meloxicam has been shown, especially at its low therapeutic dose, selectively to inhibit COX-2 over COX-1.[2]

Meloxicam concentrations in synovial fluid range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid as compared to plasma. The significance of this penetration is unknown,[1] but it may account for the fact that it performs exceptionally well in treatment of arthritis in animal models.[3]

Adverse effects

Meloxicam use can result in gastrointestinal toxicity and bleeding, tinnitus, blinding headaches, rash, and very dark or black stool (a sign of intestinal bleeding). It has fewer gastrointestinal side effects than diclofenac,[4] piroxicam,[5] naproxen,[6] and perhaps all other NSAIDs which are not COX-2 selective.[4] Although meloxicam does inhibit thromboxane A, it does not appear to do so at levels that would interfere with platelet function.

Veterinary use

Meloxicam is also used in the veterinary field, most commonly in dogs, but also sees off-label use in other animals such as cattle, cats and exotics.[7][8] The U.S. Food and Drug Administration sent a Notice of Violation to the manufacturer for its promotional materials which included promotion of the drug for off-label use.[9] In the U.S. the drug is indicated for management of pain and inflammation associated with osteoarthritis in dogs only. In Europe, where the product has been available since the early 1990s, it is also prescribed and licensed for other anti-inflammatory benefits including relief from both acute and chronic pain in dogs. Side effects in animals are similar to those found in humans; the principal side effect is gastrointestinal irritation (vomiting, diarrhea and ulceration). Rarer but important side effects include liver and kidney toxicity.

Since 2003, the oral (liquid) formulations of meloxicam have been licensed in the U.S for use in dogs only,[10] with the January 2005 product insert specifically warning in bold-face type: "Do not use in cats."[11] An injectable formulation for use in dogs was approved by the FDA November 2003,[12] with a formulation for cats, for surgical use only, approved in October, 2004.[13]

In the U.S., per the manufacturer's clinical instructions as of July 2010, injectable meloxicam is indicated in operative use with felines as a single, one-time dose only, with specific and repeated warnings not to administer a second dose.[14] In June 2007, a new oral version of meloxicam was licensed in Europe for the long-term relief of pain in cats. As of June 2008, meloxicam is registered for long term use in cats in Australia, New Zealand, and throughout Europe.

Consumer confidence

As issues arise with any drug used off-label, the off-label use of meloxicam in cats has led to many reports of irreversible renal damage and death.[15] A peer-reviewed journal article cites feline overdose of NSAIDs, including meloxicam, as being a cause of severe kidney damage in cats.[16]

Brands

Box and strip of Meloxicam (Mobic) 7.5 mg

In Europe, meloxicam is marketed under the brand names Movalis, Melox, and Recoxa. In the UK, U.S., Middle East, Argentina, Paraguay, Uruguay and Australia it is marketed under the brand name Mobic, in Germany as Mobec, and in Canada as Mobicox. In Latin America, the drug is marketed as Tenaron, Ilacox, Mavicam, Melocam, Niflamin (Colombia) or Artriflam. A veterinary formulation of the drug is marketed as Metacam, Meloxidyl, Meloxoral, Meloxidolor or Petcam. In the Philippines, it is generally marketed under the brand name Moxen. In India, it is marketed as Melonex (मेलोनेक्स). In Greece, it is manufactured under licence from aVianex S.A under the name Loxitan.[17]

References

  1. ^ a b "Meloxicam official FDA information, side effects, and uses". Drugs.com. March 2010. http://www.drugs.com/pro/meloxicam.html. Retrieved 17 March 2010. 
  2. ^ Noble, S; Balfour, JA (Mar 1996). "Meloxicam". Drugs 51 (3): 424–30; discussion 431–32. doi:10.2165/00003495-199651030-00007. PMID 8882380. 
  3. ^ Engelhardt, G; Homma, D; Schlegel, K; Utzmann, R; Schnitzler, C (Oct 1995). "Anti-inflammatory, analgesic, antipyretic and related properties of meloxicam, a new non-steroidal anti-inflammatory agent with favourable gastrointestinal tolerance". Inflammation Research 44 (10): 423–433. doi:10.1007/BF01757699. PMID 8564518. 
  4. ^ a b Hawkey, C; Kahan, A; Steinbrü, K; Alegre, C; Baumelou, E; Bégaud, B; Dequeker, J; Isomäki, H et al (Sept 1998). "Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients". Rheumatology 37 (9): 937–945(9). doi:10.1093/rheumatology/37.9.937. 
  5. ^ Dequeker, J; Hawkey, C; Kahan, A; Steinbruck, K; Alegre, C; Baumelou, E; Begaud, B; Isomaki, H et al (1998). "Improvement in gastrointestinal tolerability of the selective cyclooxygenase (COX)-2 inhibitor, meloxicam, compared with piroxicam: results of the Safety and Efficacy Large-scale Evaluation of COX- inhibiting Therapies (SELECT) trial in osteoarthritis". The British Journal of Rheumatology 37 (9): 946–51. doi:10.1093/rheumatology/37.9.946. PMID 9783758. 
  6. ^ Wojtulewski, JA; Schattenkirchner, M; Barceló, P; Le Loët, X; Bevis, PJR; Bluhmki, E; Distel, M. "A Six-Month Double-Blind Trial to Compare the Efficacy and Safety of Meloxicam 7.5 mg Daily and Naproxen 750 mg Daily in Patients with Rheumatoid Arthritis". Rheumatology 35, Supplement 1: 22–8. 
  7. ^ Off-label use discussed in: Arnold Plotnick MS, DVM, ACVIM, ABVP, Pain Management using Metacam, and Stein, Robert, Perioperative Pain Managemment Part IV, Looking Beyond Butorphanol, Sep 2006.
  8. ^ For off-label use example in rabbits, see Krempels, Dana, Hind Limb Paresis and Paralysis in Rabbits, University of Miami Biology Department.
  9. ^ US FDA Notice of Violation for off-label use promotion, April 2005.
  10. ^ "NADA 141-213: New Animal Drug Application Approval (for Metacam (meloxicam) 0.5 mg/mL and 1.5 mg/mL Oral Suspension)". US Food and Drug Administration. April 15, 2003. http://www.fda.gov/downloads/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/FOIADrugSummaries/ucm118006.pdf. Retrieved 24 July 2010. 
  11. ^ Metacam Client Information Sheet, product description: "Non-steroidal anti-inflammatory drug for oral use in dogs only", and in the "What Is Metacam" section in bold-face type: "Do not use in cats.", January 2005.
  12. ^ Metacam 5 mg/mL Solution for Injection
  13. ^ Metacam 5 mg/mL Solution for Injection, Supplemental Approval October 28, 2004.
  14. ^ See the manufacturer's FAQ on its website, and its clinical dosing instructions for cats.
  15. ^ Discussion of Metacam use at persiancats.org in Metacam Risks In Cats, and at the consumer site metacamkills.com.
  16. ^ Merola, Valentina, DVM, DABT, and Dunayer Eric, MS, VMD, DABT, The 10 most common toxicoses in cats, Toxicology Brief, Veterinary Medicine, pp. 340–342, June, 2006.
  17. ^ Εθνικό συνταγολόγιο, Greece's National subscription list, entry on Meloxicam entry on Meloxicam .

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This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

 

Copyrights:

Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
 Oxford A-Z of Medicinal Drugs. Market University Press. © 2000, 2003, 2010 An A-Z of Medicinal Drugs. All rights reserved.  Read more
Saunders Veterinary Dictionary. Saunders Comprehensive Veterinary Dictionary 3rd Edition. Copyright © 2007 by D.C. Blood, V.P. Studdert and C.C. Gay, Elsevier. All rights reserved.  Read more
Wikipedia on Answers.com. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article Meloxicam.  Read more

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