What are the approved uses of meloxicam 15mg. How does meloxicam work to reduce pain and inflammation. What are the common and serious side effects of meloxicam. Which medications can interact with meloxicam.

Understanding Meloxicam: A Powerful NSAID for Pain and Inflammation

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to treat various forms of arthritis and associated pain. Available as both a generic medication and under the brand name Mobic, meloxicam comes in three forms: oral tablets, injections, and oral capsules. This article focuses primarily on the oral tablet form of meloxicam, particularly the 15mg dosage.

What Conditions Does Meloxicam 15mg Treat?

Meloxicam 15mg is primarily prescribed for the following conditions:

• Osteoarthritis
• Rheumatoid arthritis
• Juvenile idiopathic arthritis (JIA) in children 2 years and older

These conditions are characterized by joint pain, stiffness, and inflammation, which meloxicam helps to alleviate.

The Mechanism of Action: How Meloxicam Fights Pain and Inflammation

Meloxicam works by inhibiting the production of prostaglandins, hormone-like substances that play a crucial role in inflammation and pain signaling. By reducing prostaglandin levels, meloxicam helps decrease swelling, pain, and fever associated with various forms of arthritis.

Is meloxicam’s exact mechanism of action fully understood?

While the general mechanism of NSAIDs like meloxicam is well-established, the precise details of how it decreases pain are not fully known. Research suggests that its primary action involves the inhibition of cyclooxygenase (COX) enzymes, particularly COX-2, which is responsible for producing inflammatory prostaglandins.

Common Side Effects of Meloxicam: What to Expect

Like all medications, meloxicam can cause side effects. Some of the more common side effects include:

• Abdominal pain
• Diarrhea
• Indigestion or heartburn
• Nausea
• Dizziness
• Headache
• Itching or rash

These side effects are typically mild and may resolve on their own within a few days to a couple of weeks. However, if they persist or become severe, it’s important to consult with a healthcare provider.

Are side effects more common in certain populations?

Some studies suggest that children may experience certain gastrointestinal side effects, such as pain, vomiting, and diarrhea, more frequently than adults when taking meloxicam. It’s crucial for parents and caregivers to monitor children closely when they’re prescribed this medication.

Serious Side Effects: Recognizing the Warning Signs

While less common, meloxicam can potentially cause serious side effects that require immediate medical attention. These include:

1. Heart attack symptoms (chest pain, trouble breathing, cold sweat)
2. Stroke symptoms (sudden weakness, confusion, vision problems)
3. Gastrointestinal bleeding or ulceration (severe stomach pain, bloody stools)
4. Liver damage (jaundice, dark urine, pale stools)
5. Kidney problems (changes in urination, pain while urinating)
6. Severe skin reactions (blistering, peeling, rash)
7. Anemia (unusual tiredness, pale skin)

If any of these symptoms occur, it’s crucial to seek medical help immediately.

Meloxicam Dosage: Finding the Right Balance

The typical starting dose of meloxicam for adults with osteoarthritis is 7.5 mg once daily. For rheumatoid arthritis, the recommended dose is 15 mg once daily. However, dosages may vary based on individual patient factors and response to treatment.

Can the meloxicam dosage be adjusted?

Yes, the dosage of meloxicam can be adjusted by a healthcare provider. For some patients, the dose may be increased to 15 mg daily if needed for osteoarthritis. It’s important to use the lowest effective dose for the shortest duration possible to minimize the risk of side effects.

Drug Interactions: Medications to Watch Out For

Meloxicam can interact with several other medications, potentially altering their effectiveness or increasing the risk of side effects. Some important drug interactions to be aware of include:

• Antidepressants (SSRIs, SNRIs) – may increase bleeding risk
• Blood thinners (warfarin, heparin) – may increase bleeding risk
• Other NSAIDs (aspirin, ibuprofen) – may increase gastrointestinal side effects
• ACE inhibitors and ARBs – may reduce effectiveness of blood pressure medications
• Diuretics – may increase risk of kidney problems
• Lithium – may increase lithium levels in the blood
• Methotrexate – may increase methotrexate levels and toxicity

It’s crucial to inform your healthcare provider about all medications, including over-the-counter drugs, supplements, and herbal products, to avoid potential interactions.

Special Precautions: Who Should Use Meloxicam with Caution?

Certain groups of people should use meloxicam with caution or may need to avoid it altogether. These include:

• People with a history of heart disease or stroke
• Individuals with gastrointestinal issues, such as ulcers or bleeding
• Patients with liver or kidney disease
• Pregnant women, especially in the third trimester
• Breastfeeding mothers
• People with a history of asthma or allergic reactions to aspirin or other NSAIDs

It’s essential to discuss your medical history and any concerns with your healthcare provider before starting meloxicam.

Is meloxicam safe for long-term use?

While meloxicam can be effective for managing chronic conditions like arthritis, long-term use of NSAIDs carries risks. Prolonged use may increase the likelihood of cardiovascular events, gastrointestinal problems, and kidney issues. Regular monitoring and follow-ups with a healthcare provider are crucial for those on long-term meloxicam therapy.

Alternatives to Meloxicam: Exploring Other Treatment Options

For those who cannot take meloxicam or experience intolerable side effects, several alternative treatments for arthritis and pain management exist:

• Other NSAIDs (e.g., ibuprofen, naproxen)
• Acetaminophen for pain relief
• Topical pain relievers
• Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis
• Corticosteroid injections
• Physical therapy and exercise
• Complementary therapies (e.g., acupuncture, massage)

The choice of treatment should be made in consultation with a healthcare provider, taking into account individual factors and the specific condition being treated.

Can lifestyle changes complement meloxicam treatment?

Yes, several lifestyle modifications can enhance the effectiveness of meloxicam and improve overall management of arthritis:

• Maintaining a healthy weight to reduce stress on joints
• Regular low-impact exercise to improve joint flexibility and strength
• Applying heat or cold therapy to affected joints
• Using assistive devices to reduce joint strain
• Following an anti-inflammatory diet rich in omega-3 fatty acids and antioxidants

These lifestyle changes, when combined with appropriate medication, can significantly improve quality of life for those with arthritis.

Side effects, dosage, uses, and more

1. Meloxicam oral tablet is available as both a generic and brand-name drug. Brand name: Mobic.
2. Meloxicam comes in three forms: an oral tablet, an injection, and an oral capsule.
3. Meloxicam oral tablets are nonsteroidal anti-inflammatory drugs (NSAIDs). They’re used to treat pain and inflammation caused by osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis.

Meloxicam is a prescription drug. It comes in three forms: an oral tablet, an injection, and an oral capsule.

Meloxicam oral tablet is available as the brand-name drug Mobic.

Meloxicam oral tablet is also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Meloxicam decreases inflammation and pain. It’s approved to treat:

• osteoarthritis
• rheumatoid arthritis
• juvenile idiopathic arthritis (JIA) in children ages 2 years and older

How it works

Meloxicam belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs help reduce pain, inflammation, and fever.

It isn’t known how this medication works to decrease pain. It may help reduce swelling by lowering levels of prostaglandin, a hormone-like substance that usually causes inflammation.

Meloxicam can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking meloxicam. This list does not include all possible side effects.

For more information on the possible side effects of meloxicam, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects that can occur with meloxicam include:

• abdominal pain
• diarrhea
• indigestion or heartburn
• nausea
• dizziness
• headache
• itching or rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain or discomfort
  • trouble breathing
  • cold sweat
  • pain or discomfort in one or both arms, your back, shoulders, neck, jaw, or area above your belly button
• Stroke. Symptoms can include:
  • numbness or weakness of your face, arm, or leg on one side of your body
  • sudden confusion
  • trouble speaking or understanding speech
  • vision problems in one or both eyes
  • trouble walking or loss of balance or coordination
  • dizziness
  • severe headache with no other cause
• Stomach and intestinal problems, such as bleeding, ulcers, or tearing. Symptoms can include:
  • severe stomach pain
  • vomiting blood
  • bloody stools
  • black, sticky stools
• Liver damage. Symptoms can include:
  • dark urine or pale stools
  • nausea
  • vomiting
  • not wanting to eat
  • pain in your stomach area
  • yellowing of your skin or whites of your eyes
• Increased blood pressure: Symptoms of extreme high blood pressure can include:
  • dull headache
  • dizzy spells
  • nosebleeds
• Water retention or swelling. Symptoms can include:
  • rapid weight gain
  • swelling in your hands, ankles, or feet
• Skin problems, such as blistering, peeling, or red skin rash
• Kidney damage. Symptoms can include:
  • changes in how much or how often you urinate
  • pain with urination
  • Decreased red blood cells (anemia)

GASTROINTESTINAL SIDE EFFECTS
Abdominal pain, diarrhea, upset stomach, and nausea occur very often with this drug. Pain, vomiting, and diarrhea may occur more often in children than adults. Sometimes these side effects can cause more serious stomach problems.

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If you or your child has these side effects and they bother you or don’t go away, talk to your doctor.

Meloxicam oral tablet can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with meloxicam. This list does not contain all drugs that may interact with meloxicam.

Before taking meloxicam, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Antidepressants and anxiety drugs

Taking meloxicam with certain antidepressant and anxiety medications raises your risk of bleeding. Examples of these drugs include:

• selective serotonin reuptake inhibitors, such as citalopram
• selective serotonin and norepinephrine reuptake inhibitors, such as venlafaxine

Corticosteroids

Taking meloxicam with corticosteroids can increase your risk of stomach ulcers or bleeding. Examples of these drugs include:

• prednisone
• dexamethasone

Cancer drug

Taking pemetrexed with meloxicam can increase your risk for infection, kidney problems, and stomach issues.

Transplant drug

Taking cyclosporine with meloxicam can increase the levels of cyclosporine in your body, causing kidney problems. If you take these drugs together, your doctor should monitor your kidney function.

Disease-modifying antirheumatic drug

Taking methotrexate with meloxicam can increase the levels of methotrexate in your body. This can result in kidney problems and an increased risk of infection.

Anticoagulant/blood thinner

Taking warfarin with meloxicam increases your risk of stomach bleeding.

Bipolar disorder medication

Taking lithium with meloxicam can cause amounts of lithium in your blood to increase to dangerous levels. Symptoms of lithium toxicity may include tremors, excessive thirst, or confusion. If you take these drugs together, your doctor may monitor your lithium levels.

Blood pressure drugs

Taking these medications with meloxicam may reduce the blood pressure-lowering effects of these drugs. Examples of these drugs include:

• angiotensin receptor blockers (ARBs), such as candesartan and valsartan
• angiotensin-converting enzyme (ACE) inhibitors, such as benazepril and captopril
• beta blockers, such as propranolol and atenolol

Diuretics (water pills)

Taking certain diuretics with meloxicam can decrease the effect of these drugs. Examples of these diuretics include:

• hydrochlorothiazide
• furosemide

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Meloxicam is an NSAID. Combining it with other NSAIDs may increase your risk of side effects, such as stomach bleeding or ulcers. Examples of NSAIDs include:

• aspirin
• ibuprofen
• naproxen
• etodolac
• diclofenac
• fenoprofen
• ketoprofen
• tolmetin
• indomethacin

The meloxicam dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using meloxicam to treat
• your age
• the form of meloxicam you take
• other medical conditions you may have, such as kidney damage

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Meloxicam

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Brand: Mobic

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Dosage for osteoarthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for rheumatoid arthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for juvenile idiopathic arthritis (JIA)

Child dosage (ages 2–17 years)

• Typical starting dosage (130 lbs/60 kg): 7.5 mg once daily.
• Maximum dosage: 7.5 mg per day.

Child dosage (ages 0–1 years)

Dosage for children younger than 2 years hasn’t been established. This drug has not been found to be safe and effective in this age group.

Special dosage considerations

For people receiving hemodialysis: This drug isn’t removed in dialysis. Taking a typical dosage of meloxicam while receiving hemodialysis may cause a buildup of the drug in your blood. This could cause worsened side effects. The maximum daily dose for people ages 18 years and older and receiving hemodialysis is 7. 5 mg per day.

FDA warnings

• This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
• Heart risk warning: This drug may increase your risk of developing a blood clot, heart attack, or stroke, which can be fatal. Your risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure. You shouldn’t take meloxicam for pain before, during, or after coronary artery bypass graft surgery. This can increase your risk for a heart attack or stroke.
• Stomach problems warning: This medication may increase your risk of developing stomach and intestinal problems. These include bleeding, ulcers, and holes in your stomach or intestines, which can be fatal. These effects can occur any time while you’re taking this drug. They may happen without any signs or symptoms. Adults ages 65 years and older are at higher risk of these stomach or intestinal problems.

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Allergy warning

Don’t take meloxicam if you’ve had itchy skin, symptoms of asthma, or an allergic reaction to aspirin or other NSAIDs. A second reaction could be much more severe.

Liver damage warning

This drug may affect your liver. Symptoms may include yellowing of your skin or whites of your eyes and liver inflammation, damage, or failure. Your doctor may check your liver function while you take this drug.

Blood pressure warning

This medication may increase or worsen your blood pressure. This can increase your risk of heart attack or stroke. Your doctor may check your blood pressure while you’re taking meloxicam. Some medicines for high blood pressure may not work as well as they should when you’re taking meloxicam.

Allergy warning

Meloxicam can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives

Don’t take meloxicam if you have asthma, runny nose, and nasal polyps (aspirin triad). Don’t take it if you’ve had itching, trouble breathing, or an allergic reaction to aspirin or other NSAIDs.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life threatening. Call your doctor right away if you have symptoms, such as a rash, a fever, or swollen lymph nodes.

Harm to developing fetus warning

You shouldn’t take meloxicam if you’re pregnant or planning to become pregnant. Meloxicam can cause harm to a developing fetus if taken at 20 weeks or later in pregnancy. If you are between 20 to 30 weeks of pregnancy, only take this drug if your doctor has told you to. Do not take this drug if you are more than 30 weeks pregnant.

Warnings for people with certain health conditions

For people with heart or blood vessel diseases: This medication increases your risk of blood clots, which can cause a heart attack or stroke. It may also cause fluid retention, which is common with heart failure.

For people with high blood pressure: This medication may make your blood pressure worse, which can increase your risk of having a heart attack or stroke.

For people with stomach ulcer or bleeding: Meloxicam can make these conditions worse. If you have a history of these conditions, you have a higher chance of having them again if you take this medicine.

For people with liver damage: Meloxicam can cause liver disease and changes in your liver function. It may make your liver damage worse.

For people with kidney disease: If you take meloxicam for a long time, it may decrease your kidney function, making your kidney disease worse. Stopping this drug could reverse kidney damage caused by the drug.

For people with asthma: Meloxicam can cause bronchial spasm and difficulty breathing, especially if your asthma gets worse if you take aspirin.

Warnings for other groups

For pregnant women: Using meloxicam during your third trimester of pregnancy increases the risk of negative effects to your pregnancy. You should not take meloxicam after 30 weeks of pregnancy. If you’re pregnant, talk to your doctor. Meloxicam should be used during pregnancy only if the potential benefit justifies the potential risk.

You should also talk to your doctor if you’re trying to get pregnant. Meloxicam can cause a reversible delay in ovulation. If you’re having a hard time getting pregnant or are getting tested for infertility, don’t take meloxicam.

For women who are breastfeeding: It isn’t known if meloxicam passes into breast milk. If it does, it could cause side effects in your child if you breastfeed and take meloxicam. You and your doctor may decide whether you’ll take meloxicam or breastfeed.

For seniors: If you’re age 65 years or older, you may have a higher risk of side effects from meloxicam.

For children: For the treatment of JIA, this drug has been found to be safe and effective for use in children 2 years and older. It should not be used in children younger than 2 years.

For the treatment of other conditions, this drug has not been found to be safe and effective for children of any age. It should not be used in people younger than 18 years.

Meloxicam oral tablet may be used for short-term or long-term treatment. It comes with risks if you don’t take it as prescribed by your doctor.

If you stop taking the drug or don’t take it at all: Your symptoms will remain and may worsen.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• nausea
• vomiting
• stomach pain
• stomach bleeding

Overdosing on meloxicam can cause organ failure or serious heart problems. If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you can, However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on time.

Never try to catch up by taking two doses at once. This could result in serious side effects.

How to tell if the drug is working: You should have less pain and inflammation.

Keep these considerations in mind if your doctor prescribes meloxicam oral tablet for you.

General

• You can take meloxicam with or without food. If it upsets your stomach, take it with food or milk.
• You can cut or crush the oral tablet.

Storage

• Store this medication at room temperature, 77°F (25°C). If needed, you can keep it for short periods at temperatures between 59°F and 86°F (15°C and 30°C).
• Keep this medication away from high temperatures.
• Keep your medications away from areas where they could get damp, such as bathrooms.

Refills

A prescription for this medication is refillable.You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They won’t damage your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with this drug, your doctor may check your:

• blood pressure
• liver function
• kidney function
• red blood cell count to check for anemia

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

What is Meloxicam? | Is It Addictive? | Is Meloxicam Safe?

Table of Contents

What is Meloxicam?

Meloxicam, or Mobic, is a drug that is used extensively in the treatment of symptoms associated with arthritis. The symptoms it’s used to control or treat include pain and inflammation without the use of opioid painkillers, like hydrocodone or oxycodone.

Boehringer Ingelheim developed meloxicam, and it received a patent in 1977. However, it was only in the year 2000 that the drug received clearances for medical use.  It’s generally considered as a safe alternative to opioid medication, reducing the chances of needing addiction treatment.

Legally, it is available as prescription medicine. It is produced in three basic forms, all for oral consumption only – in tablet, disintegrating tablet, and capsule forms.

In tablet form, the medication is available in both generic as well as brand variants. However, the orally disintegrating tablet is only available as a branded medication. Generic variants of Mobic cost less than the branded versions.

Treats Inflammation and Pain

As an effective remedy for inflammation and pain, Mobic is used to treat arthritic health conditions such as osteoarthritis and rheumatoid arthritis. The medication is also used in treating an arthritic condition in young children aged two and above, known as juvenile idiopathic arthritis (JIA).

Meloxicam is safe when used following a doctor’s prescription. But its misuse or abuse can lead to potentially dangerous side effects. Many people also worry about this drug’s ability to cause addiction. Since meloxicam is used as a pain killer, many people believe it could be a gateway to opioids.  In some cases, meloxicam addiction may necessitate treatment in a rehab facility.

Statistics

In 2017, a total of 19,793,507 meloxicam prescriptions were issued in the U.S.A.¹

In 2016, meloxicam was the 36th most frequently prescribed drug in America.¹

In 2006, a total of 48,928 meloxicam prescriptions were issued to active duty soldiers in the U.S. Army and in 2014, the number stood at 91,048.²

How Does Meloxicam Work?

Mobic belongs to the class of drugs that are known as non-steroidal anti-inflammatory drugs (NSAIDs). It received approval for use in April 2000.  The drug is primarily used in the treatment of conditions such as pain and inflammation that are associated with arthritis. These pains are caused by the inflammation induced by the presence of chemicals known as prostaglandins in the body.

By blocking the enzymes responsible for prostaglandin production and reducing their levels in the body, meloxicam reduces inflammation and associated symptoms of arthritis.

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Is Meloxicam Safe?

Mobic is viewed as a drug with the potential to replace opioid-class painkillers in the treatment of moderate- to severe-grades of physical pain. Compared to opioids, the risks of physical or psychological dependence is not severe in Mobic users. The fact that Mobic does not induce the kind of euphoria that opioids do is partly responsible for this. However, the risk of acquiring a Mobic dependence does exist and could occur when the drug continues to be taken even after it is no longer prescribed by a doctor.

Ironically, many instances of Mobic dependence and abuse occur on account of its reputation as a prescription painkiller. Some people mistakenly believe that because Mobic is a prescription pain killer, it must contain opioids, resulting in substance abuse.

USDA Guidance

The US Food and Drug Administration discourages medical practitioners from prescribing the drug, both – branded as well generic variants, for patients known to be at risk of acquiring psychological dependence through the use of psychoactive medications.

Although meloxicam is itself relatively harmless, it has the potential for misuse by being combined with substances such as alcohol. Its pain-alleviating properties mean that meloxicam is frequently used to treat hangovers after a binge-drinking session. Such practices could lead to long-term damage such as liver damage or heart disease.

How is Meloxicam Used?

Meloxicam is prescribed for patients who have arthritis, a medical condition wherein the joints experience pain and swelling. Mobic is primarily used in the treatment of symptoms related to osteoarthritis and rheumatoid arthritis — two of the common types of arthritis.

Medical practitioners also rely upon Mobic for use as an alternative to conventional opioid pain medications. To reduce the intensity of symptoms of opioid withdrawal, doctors often prescribe it before starting an opioid taper on their patients.

The method of Mobic use depends on the type of formulation a patient takes. Currently, three formulations are available in the market:

Oral tablets (immediate release action) available in 7.5mg and 15mg specifications. Brand name: Mobic tablets 7.5mg and 15mg.

Oral suspension in 7.5mg/5mL specifications.

Orally-disintegrating tablets in 7.5mg and 15mg specifications.

Although Mobic can be taken on an empty stomach, it is recommended to take it with food to reduce the chances of suffering an upset stomach.

The orally-disintegrating tablets must be placed on the tongue immediately after the pack is opened. Since the tablets are meant to dissolve on coming in touch with the tongue, water should not be consumed as long as the tablet is on the tongue. While in the mouth, care should be taken to see that the tablets are not crushed, broken, or chewed.

In the case of meloxicam in oral suspension form, the container has to be shaken well before use. The recommended dosage must be taken with the help of the measuring device included in the product packaging.

Effects of Meloxicam

Short-Term Effects

Some of the short-term side effects of meloxicam are:

Upset Stomach

An upset stomach is the most common side effect of meloxicam.  That is why taking it with food is recommended.

Allergic Reactions

Asthmatics are at a higher risk of experiencing serious allergic reactions to the drug. Similarly, people allergic to NSAIDS, are also susceptible to allergic reactions such as feeling shortness of breath.

Skin Reactions

Typical skin conditions arising from Mobic use include Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and exfoliative dermatitis. 

Dizziness

Dizziness, drowsiness, and blurred vision are some of the side effects on the central nervous system.

Long-Term Effects

Ulcers

Long term use of meloxicam can cause bleeding or ulcers in the stomach, which can turn fatal if left untreated. The intestines also face similar risks from long-term usage of Mobic.  People who are older, especially those who regularly consume significant quantities of alcohol or suffer from poor health, face a higher risk of developing such problems. These issues could appear without any warning signs, or they may appear in the form of symptoms such as heartburn, stomachache, bloody vomit, bloody stools, or tarry stools.

Hypertension

Meloxicam use can lead to the worsening of hypertension in patients with a history of hypertension. While, in others, Mobic could cause the onset of high blood pressure. That’s why it is important to monitor blood pressure when meloxicam is prescribed.

Fluid Retention

Fluid retention or edema (swelling) is another likely side effect of meloxicam usage, and therefore people with heart conditions are generally not prescribed the drug.

Stroke

Even people with no history of heart disease are in danger of suffering a stroke when prescribed the drug. Therefore, NSAIDs are not to be prescribed nor used for the treatment of pains arising due to coronary artery bypass graft (CABG) surgery.

Insomnia

Insomnia is another potential adverse effect of meloxicam use over the long-term.¹ Insomnia is a health condition where the person is unable to fall asleep and thus feels sleepy during the daytime, and a corresponding lack of energy.  Insomnia can also lead to feelings of depression, anxiety, or irritability, difficulty in focusing, learning, and remembering things.

Kidney Damage

While long-term usage can damage the kidneys, often, ending use results in reversal of such damage.

Liver Damage

Liver damage is among the major effects that long-term usage of meloxicam can cause. 

Can You Overdose on Meloxicam?

While meloxicam is considered a safe drug, it is possible to overdose, if more than the maximum recommended dosage is taken. 

The factors influencing the Mobic dosage that your doctor prescribes include the type, severity, and condition for which the medication is being used, the age of the patient, the form of meloxicam being taken, health, and medical conditions involved.

Meloxicam is available in tablet and orally disintegrating tablet form, both of which are produced in 7.5 grams specifications. Initial dosage usually begins at 7.5 g and could reach a maximum dosage of 15 g for adults. So, technically speaking, anything above 15 g is considered an overdose.

The symptoms of meloxicam overdose include drowsiness, nausea, lack of energy, vomiting, stomachache, bloody or tarry stool, breathlessness, seizures, and coma.

What is Withdrawal From Meloxicam Like?

Withdrawal from this medication is generally not difficult, and may be safely stopped without any tapering. However, there may be some symptoms that are unmasked by stopping the medication, and it may be wise for people to take precautions to avoid any discomfort. An awareness of meloxicam helps people anticipate any potential problems.  You should always discuss your medications with a healthcare provider before discontinuing any drug.

Detox Recommended

However, discontinuing the drug, all of a sudden, could cause uncomfortable symptoms to emerge.  It is advisable to consult a healthcare provider for necessary advice on keeping such problems at bay while undergoing detox.

Pain and Inflammation May Return

Typically, the withdrawal from meloxicam usage would lead to a return of the symptoms for which the medication was prescribed for in the first place – pain and inflammation. After discontinuing Mobic it’s possible to suffer from withdrawal symptoms such as stiffness, redness, swelling, and heat.

In actual terms, there are no withdrawal symptoms associated with meloxicam. But it takes the body between 15 and 20 hours to metabolize and expel half the drug out of the system. This is also the time frame for Mobic withdrawal. Since it is not an opioid class drug, meloxicam withdrawal does not result in the worsening of symptoms after stopping the drug intake. But the symptoms treated initially by the drug could resurface once use is discontinued.

Is Treatment for Meloxicam Dependence Needed?

Meloxicam withdrawal management usually does not require any kind of medical intervention or alternate drug therapy. This is because, unlike the case of alcohol or substance dependence, meloxicam withdrawal has no specific safety concerns associated with it.

The only medical intervention may be in terms of drugs, prescribed by the health provider, to address the problems that meloxicam was prescribed in the first place. In this case, alternative such medicines would be medicines prescribed for suppressing pains and inflammations related to arthritis. The alternatives include pain treatments involving physical therapy, acupuncture, ice-application, heat-application, and adequate rest.

Resources

1. https://clincalc.com/DrugStats/Drugs/Meloxicam
2. https://academic.oup.com/milmed/article/182/3-4/e1709/4099494

Additional Drug Education

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Hallucinogens

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Opiates

• Deadly Heroin Epidemic
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• Opiates vs. Opioids

Opioids

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• Opioid Deaths Increase
• Oxycodone
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Other Drugs

• Baclofen
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Stimulants

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Interaction Meloxicam – what it is combined with, the effect of the use with other drugs

Catalog :: Medicines :: Musculoskeletal system :: Anti-inflammatory drugs :: Meloxicam-Teva 15mg №20 tab.

Dosage form

One tablet contains

active substance – meloxicam 7.5 and 15 mg

excipients : sodium citrate, lactose monohydrate, microcrystalline cellulose (Avicel PH 102), povidone (PVP K-30), crospovidone, colloidal silicon anhydrous (Aerosil 200), magnesium stearate.

Description

Round, flat, marbled, yellow, bevelled tablets, scored on one side and engraved with “MLX 7.5” on the other side (for a dosage of 7.5 mg).

Yellow marbled oval tablets, scored on one side and engraved with “MLX 15” on the other side (for 15 mg dosage).

Pharmacotherapeutic group

Musculoskeletal system. Anti-inflammatory and antirheumatic drugs. Anti-inflammatory and antirheumatic drugs, non-steroidal. Oxycams. Meloxicam.

ATC code M01AC06

Pharmacological properties

Pharmacokinetics

The bioavailability of meloxicam after oral administration is about 89%. The maximum plasma concentration is reached approximately 5-6 hours after oral administration. Eating does not affect the rate and extent of absorption of meloxicam. Meloxicam binds to plasma proteins (99%). Meloxicam is excreted from the body mainly by hepatic metabolism. About 2/3 of the amount of the drug that is metabolized in the liver is destroyed by enzymes of the cytochrome P450 system (the main metabolic pathway is cytochrome 2C9, additional – cytochrome 3A4), about 1/3 is metabolized by other systems, for example, by peroxidation. When used in conjunction with meloxicam, drugs that have a known ability to inhibit CYP 2C9 and / or CYP 3A4 or are metabolized with the participation of these enzymes, the possibility of pharmacokinetic interaction should be taken into account. The mean half-life is about 20 hours. The total clearance in blood plasma is 8 ml / min.

Pharmacodynamics

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) from the oxicam group of substances with anti-inflammatory, analgesic and antipyretic properties. The mechanism of action is associated with a decrease in the biosynthesis of prostaglandins as a result of inhibition of the enzymatic activity of cyclooxygenase (COX-2).

Indications for use

• short-term symptomatic treatment of osteoarthritis exacerbations
• long-term symptomatic treatment of rheumatoid arthritis or ankylosing spondylitis.

Method of administration and dosage

Tablets should be taken with food, drinking water or other liquid.

Osteoarthritis: the dose is 7.5 mg per day. If sufficient improvement does not occur, the dose may be increased to 15 mg per day.

Rheumatoid arthritis, ankylosing spondylitis: The dose is 15 mg per day. Depending on the success of therapy, the dose may be reduced to 7.5 mg per day. In elderly patients, the recommended dose is 7.5 mg daily

With a slight or moderate decrease in kidney function (creatinine clearance is reduced by no more than 25 ml / min from the norm), a dose reduction is not required. It is contraindicated in patients with severely impaired renal function who are not on hemodialysis. In patients on dialysis with severe renal insufficiency, the dose should not exceed 7.5 mg per day

The duration of the drug is individual and is determined by the attending physician.

Side effects

Common

– headache

Very common

– nausea, vomiting, abdominal pain, diarrhea , constipation, flatulence, dyspepsia

Uncommon

– anemia

– allergic reactions, itching, rash, angioedema, anaphylactic shock

– dizziness, drowsiness, vertigo

– dyspepsia, gastritis, erosive and ulcerative lesions of the gastrointestinal

tract, colitis, perforation of the gastrointestinal tract, hidden or overt

gastrointestinal bleeding (gastrointestinal bleeding, ulcer and perforation can potentially be fatal)

– transient changes in liver function tests (increased activity of transaminases or bilirubin)

– sodium and water retention

– hyperkalemia

– changes in renal function (increased creatinine and/or urea levels)

Rare

– emotional lability

– leukopenia, thrombocytopenia

– conjunctivitis, visual disturbances, including blurred vision

– tinnitus

90 005 – palpitations

– acute development of bronchial asthma (in patients with allergies to acetylsalicylic acid or other NSAIDs), urticaria, severe skin adverse reactions (SCNR): Stevens-Johnson syndrome and toxic

epidermal necrolysis

– ulcerative stomatitis, esophagitis

Very rare

– hepatitis

– bullous dermatitis, erythema multiforme failure, in particular in patients with risk factors

Unknown

– confusion, disorientation, photosensitivity reaction

– pancreatitis

Contraindications

– hypersensitivity to meloxicam or to any component of the drug

– hypersensitivity to acetylsalicylic acid and other NSAIDs

– history of gastrointestinal bleeding or perforation associated with previous NSAID therapy, gastrointestinal bleeding, history of cerebrovascular bleeding or other bleeding cauldron persons with hereditary intolerance to fructose, Lapp-lactose, malabsorption of glucose-galactose

– recurrent peptic ulcer

– severe liver failure

• severe renal failure without dialysis
• severe heart failure
• children under 16 years of age
• pregnancy and lactation

90 005 Drug interactions

Other non-steroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid > 3 g / day:

Co-administration with other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid in anti-inflammatory doses (≥ 1 g as a single dose or ≥ 3 g as a total daily dose) is not recommended.

Corticosteroids (eg glucocorticoids):

Caution should be exercised when co-administered with corticosteroids due to an increased risk of bleeding or gastrointestinal ulceration.

Oral anticoagulants, heparin, thrombolytics: increased risk of bleeding due to delayed platelet function and damage to the gastric and intestinal mucosa. NSAIDs may enhance the effects of anticoagulants such as warfarin. The simultaneous use of NSAIDs and anticoagulants or heparin is not recommended. In other cases, when using heparin, care must be taken due to the increased risk of bleeding. If this combination cannot be avoided, careful monitoring of the INR is recommended.

Selective serotonin reuptake inhibitors (SSRIs):

Increased risk of gastrointestinal bleeding.

Diuretics, ACE inhibitors and angiotensin II antagonists:

NSAIDs may reduce the effect of diuretics and other antihypertensive drugs. In some patients with impaired renal function (for example, patients with dehydration or elderly patients with impaired renal function), the co-administration of an ACE inhibitor or angiotensin II antagonists and agents that inhibit cyclooxygenase may lead to further deterioration of renal function, including possible acute renal failure, which is usually reversible. This combination should be used with caution, especially in elderly patients. The patient needs to drink enough liquid, it is advisable to check the kidney function before starting treatment

Other antihypertensive drugs (eg beta-blockers):

Reduces the antihypertensive effect of beta-blockers (by inhibiting the synthesis of prostaglandins with a vasodilating effect).

Calcineurin inhibitors (eg cyclosporine, tacrolimus): NSAIDs may increase the nephrotoxicity of cyclosporins indirectly via renal prostaglandins. During the co-administration of these drugs, it is necessary to monitor kidney function

Contraception:

There are reports that NSAIDs reduce the effectiveness of intrauterine contraceptives.

Lithium:

NSAIDs increase the concentration of lithium in the blood (through a decrease in renal excretion of lithium), which can reach toxic values. The simultaneous use of lithium and NSAIDs is not recommended. If co-administration cannot be avoided, it is necessary to determine the level of lithium in plasma at the beginning and end of treatment, as well as after changing the dose of meloxicam.

Methotrexate:

NSAIDs reduce tubular secretion of methotrexate, thereby increasing plasma concentrations of methotrexate. For this reason, for patients taking high doses of methotrexate (more than 15 mg/week), the concomitant use of NSAIDs is not recommended. The risk of interaction between NSAIDs and methotrexate must be considered in patients receiving low doses of methotrexate, especially in patients with impaired renal function. In the case of combined treatment, blood tests and kidney function should be monitored. Be careful if NSAIDs and methotrexate are received within 3 days, because in these cases, the plasma level of methotrexate may increase and lead to increased toxicity. Concomitant treatment with meloxicam does not affect the pharmacokinetics of methotrexate (15 mg/week), but the haematological toxicity of methotrexate should be considered to be aggravated by NSAIDs.

Cholestyramine:

Cholestyramine accelerates the elimination of meloxicam by interrupting the enterohepatic circulation so that the clearance of meloxicam is increased by 50% and the elimination half-life is reduced to 13 ± 3 hours. This interaction is of clinical importance.

Clinically significant pharmacokinetic interactions have not been identified when co-administered with antacids, cimetidine and digoxin.

Special instructions:

Use the lowest effective dose for the minimum period necessary to control symptoms.

The maximum daily dose should not be exceeded if there is insufficient therapeutic effect, and NSAIDs should not be added as this may increase toxicity. Meloxicam-Teva is not suitable for the treatment of acute pain.

Meloxicam-Teva should not be prescribed to patients who have a history of asthma symptoms, nasal mucosal polyps, angioedema, urticaria after the appointment of acetylsalicylic acid or other NSAIDs.

Use with caution in elderly patients.

As with other NSAIDs, Meloxicam should be used with caution in patients with a history of upper gastrointestinal disease and in patients receiving anticoagulant therapy. In the event of a peptic ulcer or gastrointestinal bleeding, Meloxicam-Teva should be discontinued.

Serious skin reactions such as exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and even death have been reported rarely with the use of NSAIDs. Adverse events from the skin and mucous membranes in patients at risk of developing these reactions are observed during the first month of treatment. If a skin rash or mucosal damage occurs, you should immediately stop taking Meloxicam-Teva.

NSAIDs inhibit the synthesis of renal prostaglandins, which are involved in maintaining a sufficient level of renal blood flow. The administration of NSAIDs to patients with reduced renal blood flow and circulating blood volume may accelerate renal decompensation, however, after discontinuation of NSAID therapy, renal function is usually restored to its previous level. The risk of developing such reactions is especially high in patients with symptoms of dehydration, patients with congestive heart failure, cirrhosis of the liver, nephrotic syndrome and severe kidney disease, in patients receiving diuretics, as well as in those who have undergone significant surgery that led to hypovolemia. In such patients, diuresis and renal function should be carefully monitored from the very beginning of treatment.

Rarely, NSAIDs can cause interstitial nephritis, glomerulonephritis, renal medulla necrosis, or nephrotic syndrome.

In patients with end-stage renal disease and on hemodialysis, Meloxicam-Teva should not be administered at a dose of more than 7.5 mg / day. Dose reduction is not required in patients with mild or moderately severe renal insufficiency (creatinine clearance more than 25 ml / min).

As with most NSAIDs, in rare cases, an increase in serum transaminases or changes in other parameters characterizing liver function have been reported. In most cases, deviations from the norm were minor and transient.

If deviations from the norm are expressed or are of a permanent nature, Meloxicam-Teva should be discontinued and control laboratory tests should be carried out.

Dose reduction is not required in patients with clinically non-progressive cirrhosis.

Debilitated and debilitated patients may tolerate side effects more severely and should be closely monitored. Like other NSAIDs, Meloxicam should be used with caution in elderly patients who are more likely to have impaired renal, hepatic, or cardiac function.

Meloxicam, like any other NSAID, may mask the symptoms of an infectious disease.

Meloxicam-Teva 7.5 mg and 15 mg tablets contain lactose and therefore should not be taken by patients with congenital galactose intolerance (eg, galactosemia), lactase deficiency, or glucose-galactose malabsorption syndrome.

Fertility

The use of Meloxicam-Teva, as well as any other drug that inhibits COX or prostaglandin synthesis, may impair fertility and is not recommended for women who intend to become pregnant. Meloxicam may delay ovulation. In this regard, in women with impaired fertility or who are being examined for these disorders, meloxicam should be discontinued.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous machinery other potentially dangerous mechanisms.

Overdose

Symptoms: drowsiness, nausea, vomiting, stomach pain, bleeding in the gastrointestinal tract, increased blood pressure, renal failure, impaired liver function, respiratory depression, coma convulsions, cardiovascular collapse, anaphylactoid reactions.

Treatment: symptomatic therapy, taking cholestyramine 4 g 3 times a day accelerates the elimination of meloxicam.

Presentation and packaging

10 tablets each in a blister pack made of PVC/PE/PVDC film and aluminum foil.

2 blister packs, together with instructions for medical use in the state and Russian languages, are put into a cardboard box.