What is mobic tablets used for. Mobic (Meloxicam): Uses, Side Effects, and Dosage for Arthritis Treatment

28.05.197427.09.2021 by alexxlab

What is Mobic used for. How does meloxicam work to relieve arthritis symptoms. What are the common side effects of Mobic. How does Mobic compare to other arthritis medications. What precautions should be taken when using meloxicam.

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Understanding Mobic: A Powerful NSAID for Arthritis Relief

Mobic, also known by its generic name meloxicam, is a potent nonsteroidal anti-inflammatory drug (NSAID) primarily used to treat various forms of arthritis. As a prescription medication, Mobic offers relief from pain, stiffness, and inflammation associated with joint conditions. But how exactly does this drug work, and what should patients know before taking it?

What is Mobic?

Mobic is the brand name for meloxicam, a medication belonging to the NSAID class. It’s available in several forms, including tablets, disintegrating tablets, capsules, and oral suspension. Manufactured by Boehringer Ingelheim Pharmaceuticals, Mobic is also available as generic meloxicam from various manufacturers.

How does Mobic work?

Mobic works by inhibiting the enzymes cyclooxygenase 1 and 2, which are responsible for producing prostaglandins – hormones that cause inflammation. By reducing prostaglandin levels, Mobic effectively decreases pain, swelling, and stiffness in the joints.

The Primary Uses of Mobic in Treating Arthritis

Mobic is primarily prescribed for the treatment of arthritis-related conditions. Its effectiveness in managing joint pain and inflammation makes it a valuable option for many patients struggling with chronic arthritis symptoms.

Which types of arthritis does Mobic treat?

Mobic is FDA-approved for treating several forms of arthritis:

Rheumatoid arthritis in adults
Osteoarthritis in adults
Juvenile rheumatoid arthritis in children 2 years and older

Additionally, some healthcare providers may prescribe Mobic off-label for ankylosing spondylitis, a type of arthritis affecting the spine.

Can Mobic be used for other conditions?

While Mobic is primarily used for arthritis, its pain-relieving and anti-inflammatory properties may make it useful for other conditions. However, it’s crucial to only use Mobic as prescribed by a healthcare professional, as it can have serious side effects if used improperly.

Dosage and Administration of Mobic

The correct dosage of Mobic varies depending on the condition being treated, the patient’s age, and other individual factors. It’s essential to follow the prescribing physician’s instructions carefully.

What are the typical dosages for Mobic?

For adults with osteoarthritis, the usual recommended dose is 7.5 mg once daily, which may be increased to 15 mg if necessary. For rheumatoid arthritis, the starting dose is often 7.5 mg once daily, which can be increased to a maximum of 15 mg daily. Children with juvenile rheumatoid arthritis typically receive 0.125 mg/kg once daily, up to a maximum of 7.5 mg per day.

How should Mobic be taken?

Mobic should be taken orally, with or without food. The tablets should be swallowed whole with water. For patients using the oral suspension, it’s important to shake the bottle well before each use and measure the dose carefully using the provided measuring device.

Common Side Effects and Precautions of Mobic

Like all medications, Mobic can cause side effects. While not everyone experiences side effects, it’s important to be aware of potential reactions and know when to seek medical attention.

What are the most common side effects of Mobic?

The most frequently reported side effects of Mobic include:

Diarrhea
Abdominal pain
Indigestion
Nausea
Headache
Dizziness
Flu-like symptoms

While these side effects are generally mild, patients should inform their healthcare provider if they persist or worsen.

Are there any serious side effects to be aware of?

Mobic can potentially cause more serious side effects, including:

Cardiovascular events (heart attack, stroke)
Gastrointestinal bleeding or ulceration
Liver or kidney problems
Severe allergic reactions
High blood pressure

Patients should seek immediate medical attention if they experience symptoms such as chest pain, shortness of breath, sudden weakness on one side of the body, black or bloody stools, or signs of an allergic reaction like rash, itching, or swelling of the face, tongue, or throat.

Mobic vs. Other Arthritis Medications: A Comparison

While Mobic is an effective treatment for arthritis, it’s not the only option available. Understanding how it compares to other medications can help patients and healthcare providers make informed decisions about treatment.

How does Mobic compare to over-the-counter NSAIDs?

Mobic is generally considered more potent than over-the-counter NSAIDs like ibuprofen or naproxen. In one study, patients with osteoarthritis of the knee reported greater pain relief with meloxicam compared to ibuprofen. However, this increased potency also comes with a potentially higher risk of side effects.

What are the advantages of Mobic over other prescription arthritis medications?

Compared to some other prescription arthritis medications, Mobic has the advantage of once-daily dosing, which can improve patient compliance. It may also have a lower risk of gastrointestinal side effects compared to some other NSAIDs. However, the choice of medication depends on individual patient factors and should be made in consultation with a healthcare provider.

Special Considerations and Precautions for Mobic Use

While Mobic can be an effective treatment for arthritis, there are certain situations where its use may be contraindicated or require special precautions.

Who should not take Mobic?

Mobic is not suitable for everyone. It should not be used by patients who:

Have had an asthma attack, hives, or other allergic reaction to aspirin or other NSAIDs
Have recently had or are about to have heart bypass surgery
Are in the last trimester of pregnancy
Have severe liver disease
Have a history of stomach ulcers or bleeding

What precautions should be taken when using Mobic?

Patients taking Mobic should be aware of the following precautions:

Avoid alcohol, as it can increase the risk of stomach bleeding
Use caution when driving or operating machinery, as Mobic can cause dizziness
Inform all healthcare providers about Mobic use before any surgery or medical procedure
Monitor blood pressure regularly, as Mobic can cause hypertension
Be cautious about sun exposure, as Mobic can increase skin sensitivity to sunlight

Long-Term Use of Mobic: Benefits and Risks

For many patients with chronic arthritis, long-term use of Mobic may be necessary to manage symptoms effectively. However, it’s important to understand both the benefits and potential risks associated with prolonged use.

What are the benefits of long-term Mobic use?

Long-term use of Mobic can provide continued relief from arthritis symptoms, improving quality of life and maintaining mobility. For many patients, the consistent anti-inflammatory effect of Mobic can help slow the progression of joint damage associated with some forms of arthritis.

Are there risks associated with long-term Mobic use?

While Mobic can be effective for long-term symptom management, prolonged use does carry some risks. These may include:

Increased risk of cardiovascular events
Potential for gastrointestinal complications
Possible kidney function impairment
Liver function abnormalities

Regular check-ups and monitoring by a healthcare provider are essential for patients on long-term Mobic therapy to manage these risks effectively.

Interactions and Contraindications of Mobic

Understanding potential drug interactions and contraindications is crucial for safe and effective use of Mobic. Patients should always inform their healthcare providers about all medications, supplements, and herbal products they are taking.

What medications interact with Mobic?

Mobic can interact with several medications, potentially altering their effectiveness or increasing the risk of side effects. Some notable interactions include:

Other NSAIDs or aspirin (increased risk of bleeding)
Blood thinners like warfarin (increased risk of bleeding)
ACE inhibitors or ARBs (may reduce effectiveness of blood pressure medication)
Diuretics (may increase risk of kidney problems)
Lithium (may increase lithium levels in the blood)
Methotrexate (may increase methotrexate levels and toxicity)

Are there any dietary considerations when taking Mobic?

While Mobic can be taken with or without food, patients should be aware of certain dietary considerations:

Limit alcohol consumption to reduce the risk of stomach bleeding
Maintain adequate hydration to support kidney function
Some patients may benefit from taking Mobic with food to reduce stomach upset

As always, patients should consult their healthcare provider for personalized advice on diet and medication use.

In conclusion, Mobic (meloxicam) is a powerful tool in the treatment of arthritis, offering effective relief from pain and inflammation. However, like all medications, it comes with potential risks and side effects. Patients considering Mobic should work closely with their healthcare providers to determine if it’s the right choice for their individual needs and to ensure safe and effective use. Regular monitoring and open communication about any side effects or concerns are key to maximizing the benefits of Mobic while minimizing potential risks.

Common and Rare Side Effects for Mobic oral

COMMON side effects

If experienced, these tend to have a Severe expression i

Sorry, we have no data available. Please contact your doctor or pharmacist.

If experienced, these tend to have a Less Severe expression i

diarrhea
intense abdominal pain

INFREQUENT side effects

If experienced, these tend to have a Severe expression i

a skin rash
visible water retention

If experienced, these tend to have a Less Severe expression i

a common cold
indigestion
constipation
urinary tract infection
dizziness
flu-like symptoms
pain
headache
nausea
gas

RARE side effects

If experienced, these tend to have a Severe expression i

water retention
high levels of potassium in the blood
anemia
large purple or brown skin blotches
decreased blood platelets
very low levels of granulocytes, a type of white blood cell
low levels of white blood cells
high blood pressure
a heart attack
angina, a type of chest pain
a stroke
inflammation of the blood vessels
low blood pressure
throat irritation
asthma
bronchospasm
canker sores
a stomach ulcer
stomach or intestinal ulcer
inflammation of the large intestine
liver failure
damage to the liver and inflammation
bleeding of the stomach or intestines
a type of kidney inflammation called interstitial nephritis
damage to the kidneys
kidney failure
renal papillary necrosis
inflammation of the skin with blisters
erythema multiforme, a type of allergic skin reaction
a skin disorder with blistering and peeling skin called toxic epidermal necrolysis
a skin disorder with blistering and peeling skin called Stevens-Johnson syndrome
skin rash with sloughing
hives
puffy face from water retention
wheezing
trouble breathing
chest tightness
an inability to completely empty the bladder
abnormal liver function tests
a significant type of allergic reaction called anaphylaxis
a type of allergic reaction called angioedema
a rupture in the wall of the stomach or intestine
a yellowing of the eyes or skin from buildup of bilirubin called jaundice
pancreatitis
worsening of chronic heart failure
a type of significant allergic skin reaction called DRESS syndrome
fast heartbeat
an abnormally fast heartbeat

If experienced, these tend to have a Less Severe expression i

confusion
mood changes
a change in vision
ringing in the ears
dry mouth
inflammation of the esophagus
gastroesophageal reflux disease
black tarry stools
increased sensitivity of the skin to the sun
itching
hair loss
drowsiness
fainting
sensation of spinning or whirling
low energy
excessive sweating
muscle tremors
taste impairment
temporary redness of face and neck
weight gain
weight loss
cough
vomiting
burping
an increased need to urinate often
nervousness
a feeling of pins and needles on skin
a feeling of general discomfort called malaise
anxious feelings

What is meloxicam and what is it used for?

Living with arthritis and the associated pain and swelling can be difficult, but there are treatment options. Meloxicam is a prescription drug that helps relieve pain and inflammation from arthritis. Here we discuss what meloxicam is, why it’s prescribed, common dosage and side effects, and how it compares to other medications used for arthritis.

What is meloxicam?

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat arthritis. It helps treat pain, stiffness, inflammation, and swelling of the joints. Meloxicam is used to treat rheumatoid and osteoarthritis in adults, and juvenile rheumatoid arthritis in children who are at least 2 years old.

Meloxicam is a strong painkiller that must be prescribed by a doctor. It can come as a tablet, disintegrating tablet, capsule, or oral suspension liquid. Some popular brand names of meloxicam include Mobic, Vivlodex, and Meloxicam Comfort Pac. Boehringer Ingelheim Pharmaceuticals manufactures brand-name Mobic, and numerous other manufacturers make generic meloxicam.

What is meloxicam used for?

Meloxicam is used to treat the pain and inflammation that results from having rheumatoid arthritis, osteoarthritis, and juvenile rheumatoid arthritis. It works by blocking the enzymes cyclooxygenase 1 and 2, which lower levels of the inflammation-causing hormone, a prostaglandin. Meloxicam is sometimes used to treat a condition called ankylosing spondylitis, which is arthritis that affects the spine.

The main symptoms that meloxicam treats are pain, stiffness, swelling, and tenderness. Many people use ibuprofen to try and treat their arthritis symptoms as they arise, and even though both ibuprofen and meloxicam are nonsteroidal anti-inflammatory drugs, meloxicam is stronger. In one study, patients with osteoarthritis in the knee and hip showed significant improvement after 12 weeks in comparison to a placebo.

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Meloxicam dosages

Meloxicam is available as a tablet, disintegrating tablet, oral capsule, and as an oral suspension liquid. For osteoarthritis and rheumatoid arthritis, the standard dosage of meloxicam is 7. 5 mg taken once per day, with a maximum daily dosage of 15 mg. For children with juvenile rheumatoid arthritis, the standard dosage is 0.125 mg/kg per day, with a maximum dosage of 7.5 mg per day.

Meloxicam can take up to two weeks to start working in full effect. Some changes to pain, swelling, tenderness, or stiffness may be noticeable within 24 to 72 hours, but it might take longer to notice a large difference in pain levels.

“Meloxicam treats pain, swelling, and inflammation, especially associated with arthritis,” says Nonye Uddoh, Pharm.D., a clinical pharmacist with UnitedHealth Group. “It starts working within 30 minutes, but peaks in efficacy at four hours when taken by mouth. Its half life is 15-20 hours, meaning it takes 15 hours to eliminate half of it from your body.”

Dr. Uddoh also explains that meloxicam shouldn’t be used for people with asthma, aspirin sensitivity, known stomach disease, or by anyone with a medical history of ulcers or bleeding. Meloxicam shouldn’t be taken by anyone who has an allergy to nonsteroidal anti-inflammatory drugs. Anyone with a heart problem or heart disease should avoid taking this drug because it’s associated with a heightened risk of heart attacks. If you are about to have a coronary artery bypass graft (CABG), meloxicam shouldn’t be taken right before or after surgery.

If you are pregnant, planning to become pregnant, or breastfeeding you should avoid taking meloxicam. It’s possible that meloxicam could cause infertility or negatively affect your unborn baby. Research on whether or not meloxicam transfers to babies from their mother via breast milk is unclear.

Meloxicam shouldn’t be taken with the following drugs because it reacts negatively with them:

ACE-inhibitors
Aspirin
Diuretics
Lithium
Methotrexate
Cyclosporine

In the case of aspirin, taking it at the same time as meloxicam could result in an increased risk of ulcers. Keeping a list of all the medications you take, including any herbal products, can help doctors determine whether or not meloxicam is the right medication for you.

Taking ibuprofen and meloxicam at the same time shouldn’t be done without prior approval from a medical professional. Both medications are nonsteroidal anti-inflammatory drugs, and if they’re combined they can increase the risk of more serious side effects like stomach ulcers or bleeding.

Meloxicam is safe to take daily, and it’s typically longer-lasting than other over-the-counter medications like ibuprofen. Meloxicam is non-addictive and is easy to stop taking if wanted or required. Sometimes, serious side effects such as allergic reaction, nausea, or vomiting may occur. You should stop taking meloxicam immediately and seek medical advice if you experience any negative side effects.

What are the side effects of meloxicam?

As with any medication, there is always the potential for adverse effects. Here is a list of some of the common side effects associated with meloxicam:

Headache
Blurred vision
Dizziness
Diarrhea
Constipation
Stomach pain, nausea, or vomiting
Dark urine
Skin rash
Heartburn
Bleeding
Elevated potassium levels

Meloxicam has more serious side effects that are related to an increased risk of high blood pressure, stroke, and heart attacks. It may cause allergic reactions that can be life-threatening. An allergic reaction could cause a shortness of breath, sore throat, hives, or swelling of the lips, tongue, and face. If you believe you are having an allergic reaction, seek medical help immediately.

Meloxicam should not be taken if you are pregnant, planning to become pregnant, or breastfeeding. Anyone who has had ulcers, kidney or liver disease or problems, or stomach bleeding should not take this medication. It should be taken with extreme caution for people with fluid retention and heart failure. Older adults, those who are in poor health, and those who have been taking NSAIDs for a long time are more likely to experience these side effects.

Meloxicam is not addictive, but it interacts poorly with blood thinners and could lead to bleeding. Alcohol should be avoided as much as possible while taking meloxicam because it increases the risk of getting stomach ulcers.

More serious risk factors associated with taking meloxicam include chest pain, infrequent urination or not urinating at all, coughing up blood or vomit that looks like coffee grounds, and black, bloody, or tarry stools. You should stop taking meloxicam and call your doctor immediately if you experience any of these side effects. This list of side effects is not comprehensive. Ask a healthcare professional for more details regarding the possible side effects of meloxicam.

This medication guide is a great resource that lists FDA warnings, adverse reactions, drug interactions, and general drug information as it relates to meloxicam.

Are there alternatives to meloxicam?

There are multiple drug alternatives to meloxicam that function in a similar way. Any medication that’s classified as a nonsteroidal anti-inflammatory drug will be similar in nature to meloxicam. Some medications like Aleve and Tylenol are available over-the-counter. Speaking with a medical professional can help you determine which medication is best for treating your individual arthritis pain.

Aleve (naproxen): Aleve is long-lasting and treats mild to moderate pain, inflammation, and fever. It’s available over-the-counter or by prescription.
Cambia (diclofenac): Cambia helps with muscle aches and pain that are a result of inflammation. It often needs to be taken several times a day and is not for long-term use because of its side effects. See diclofenac vs. ibuprofen to learn more about diclofenac and how it compares to ibuprofen.
Celebrex (celecoxib): Celebrex treats arthritis pain but should not be used if you have a heart condition. It causes fewer stomach problems and has a lower risk of causing heart attacks than other NSAIDs. Check out meloxicam vs. Celebrex for more information on the differences between meloxicam and Celebrex. However, it has shown to increase risk for heart disease.
Feldene (piroxicam): Feldene can help with joint stiffness, pain, and swelling due to rheumatoid and osteoarthritis.
Lodine (etodolac): Lodine relieves pain from arthritis and other conditions. It may take up to two weeks to see therapeutic results, and Lodine is associated with some serious side effects like heart attacks and strokes. It’s important to speak with a medical professional if you are thinking of taking NSAIDs and have a heart condition.
Relafen (nabumetone): Relafen helps with pain and inflammation and is typically taken only once per day in comparison to other NSAIDs. It may take up to a week or more to feel a difference in pain levels if taking Relafen.
Tylenol Regular Strength (acetaminophen): Tylenol helps relieve pain and reduce fevers, but it doesn’t reduce swelling and inflammation. Tylenol is easier on the stomach and causes less bleeding than other pain medications. It’s available over-the-counter.

RELATED: Cambia details | Celebrex details | Feldene details | Lodine details | Nabumetone details

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Natural remedies for arthritis

Many natural and home remedies can help treat arthritis symptoms and may be an alternative to meloxicam for some people. Certain herbal supplements have anti-inflammatory properties, and natural treatments like massage therapy, acupuncture, or chiropractic adjustments can help manage pain symptoms. Here’s a list of some of the most popular natural and home remedies that people use to treat the stiffness, pain, aching, and swelling that come from having arthritis:

Anti-inflammatory diet. Foods that contain omega-3s, sulfur, antioxidants, and collagen will help lower inflammation and pain. Types of foods that contain these nutrients include wild-caught fish, walnuts, garlic, onions, bone broth, and fresh fruits and vegetables.
Staying active. Even though exercising might be more painful for people with arthritis, being active actually helps strengthen muscles that surround joints, which gives them more support. Exercising regularly lowers inflammation levels in the body. Stretching, walking, strength training, biking, and swimming are all activities that someone with arthritis could benefit from.
Ginger and turmeric. Even though the use of herbal supplements like ginger and turmeric aren’t approved by the FDA, many people still use them and benefit from their anti-inflammatory properties. Ginger acts as an anti-inflammatory for the body, and also as an analgesic that helps reduce pain. The most active ingredient in turmeric is curcumin, which is a powerful anti-inflammatory that can help with joint inflammation and swelling.
Getting chiropractic care. Chiropractic adjustments may help relieve pain that comes from having osteoarthritis. Treatment varies on a case-by-case basis, but most chiropractic manipulations are done on the neck, back, and spine. Many chiropractic offices offer massage therapy as well, which also helps with pain.
Using boswellia essential oil. Also known as frankincense oil, boswellia essential oil is known for its ability to reduce arthritis pain. It can be combined with a carrier oil and applied topically over painful areas several times per day.

A Safer Alternative to Opioid Painkillers?

Although the dangers of opioid painkillers are well-known and documented, there are few alternative options that provide effective relief from chronic or severe pain. For those who are in recovery from substance use disorder, managing pain without opioid drugs may sometimes be difficult. Meloxicam is one drug that has been considered as a possible alternative to opioids and it shows promise. However, meloxicam and other NSAIDs also come with their own set of risks.

What is Meloxicam?

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is used to treat pain and inflammation.¹ It is sold under the brand name Mobic, which is used to treat arthritis. It is recommended that the lowest possible effective dose is used for patients taking meloxicam, as higher doses can cause significant health problems. The average dose is 7.5 mg daily and Mobic is administered in tablet, liquid, or capsule form.

How Does Meloxicam Work?

Meloxicam works to reduce pain by decreasing the production of prostaglandins, which are chemicals that contribute to inflammation, especially within the joints of the body. Other NSAIDs like Ibuprofen (Motrin), Indomethacin (Indocin), and Nabumetone (Relafen) work the same way.

Is Meloxicam a Strong Painkiller?

Yes, meloxicam is a strong painkiller that is only legally available with a prescription. Although NSAIDs are available in an over-the-counter or prescription form, meloxicam is more potent than other over-the-counter NSAIDs that are used to treat pain. Examples of less potent NSAIDs include ibuprofen (Motrin, Advil), naproxen (Aleve, Naprosyn), and diclofenac gel.

Is Meloxicam Stronger than Ibuprofen?

Yes, meloxicam is a stronger drug than ibuprofen. Both drugs are available in prescription form but ibuprofen is also available in over-the-counter form. Although both ibuprofen and meloxicam are nonsteroidal anti-inflammatory drugs (NSAIDs), meloxicam is a long-acting drug that can relieve pain for up to 24 hours and it is not prescribed in combination with other drugs. Comparatively, ibuprofen is generally taken three to four times a day (although longer-lasting forms of the drug can be prescribed) and it is available in combination with other medications.²

Is Meloxicam Like Tramadol?

Meloxicam and tramadol are both used to treat pain, so they are similar but not the same. Meloxicam and tramadol belong to different classes of drugs. Meloxicam is an NSAID and tramadol is a narcotic painkiller. Both drugs may also interact with alcohol, antidepressants, heart medication, or blood pressure medication. Meloxicam and tramadol share some side effects, including nausea, drowsiness, stomach upset, dizziness, diarrhea, headache, nervousness, and skin rash.

How Long Does Meloxicam Stay in Your System?

The elimination half-life of meloxicam (or the duration of time it takes your body to metabolize and get rid of half of the drug in your system) is about 20 hours.³ However, this varies from person to person. Meloxicam can also be detected by a urine drug test for up to five days after the last dose.

What is Meloxicam Used For?

Meloxicam is approved by the FDA to treat pain and inflammation caused by arthritis.⁴ Other NSAIDs like meloxicam are used to treat mild to moderate pain and fever. Specifically, NSAIDs may be used to treat a variety of medical conditions and ailments such as:

Headaches
Arthritis
Menstrual cramps
Sports injuries
Ankylosing spondylitis (a form of arthritis that causes chronic inflammation of the spine)

NSAIDs are also found in many cold and allergy medications.

Is Meloxicam a Narcotic?

No, meloxicam is not a narcotic. It is classified as a nonsteroidal anti-inflammatory drug (NSAID). Unlike narcotics, these types of drugs work by reducing the production of certain hormones that cause pain and inflammation.

Is Meloxicam a Controlled Substance?

No, meloxicam is not a controlled substance in the U. S. However, there is still a risk that it will be misused and it can cause psychological addiction even though it won’t get you high.

Does Meloxicam Help with Back Pain?

Although meloxicam may help relieve back pain, the FDA has only approved it for treating symptoms of juvenile rheumatoid arthritis, osteoarthritis, and rheumatoid arthritis, such as inflammation, swelling, stiffness, and joint pain.⁵

What are the Side Effects of Meloxicam?

Although meloxicam is effective in relieving pain, swelling, and tenderness caused by arthritis conditions, it does have some side effects that users should be aware of. Common side effects of meloxicam include:

Stomachache
Nausea
Dizziness
Drowsiness
Blurred vision
Diarrhea
Increased blood pressure
Shortness of breath
Fluid retention/swelling
Liver damage/liver disease²

Some people are also highly allergic to NSAIDs, which can lead to serious reactions. Additionally, people who are at risk of heart disease may also face an increased risk of stroke or deadly heart attacks and people with kidney problems are at risk for kidney failure and should avoid taking meloxicam.⁴

Meloxicam vs. Opioids: Which is Safer?

According to the CDC, more than 191 million opioid prescriptions were dispensed to American patients in 2017 and between July 2016 and September 2017, emergency department visits for opioid overdoses rose 30 percent in all parts of the U.S.^6,7 More than 130 people die every day from opioid-related overdoses and in 2017 alone, 2 million people misused prescription opioid drugs for the first time.⁶

Due to the clear dangers and risks of prescription opioid painkillers, medical experts and scientists are searching for alternatives that are just as effective for pain relief, without the risk for dependence and addiction. Unfortunately, this process isn’t as easy as it sounds. Every person has a different threshold for pain so certain drugs may work well for some, but not others. Additionally, some alternative drugs work to relieve pain, but they cause serious side effects.

Although opioid drugs like hydrocodone, morphine, fentanyl, oxycodone and others are touted as the most potent prescription painkillers available, one 2018 study published in JAMA found that they were no more effective than non-opioid drugs in treating moderate to severe chronic back pain or hip or knee osteoarthritis over a 12-month span.⁷

Since some scientific studies have shown meloxicam to be just as effective for certain types of pain relief, there is a possibility that it may be a better treatment method than opioid medication. Although a person could still abuse meloxicam and become psychologically dependent, the risk of dependence is less severe than that of opioids.

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Will Meloxicam Get You High?

While it is possible to abuse meloxicam by taking larger doses or taking it without a medical need for it, it will not produce a euphoric high as prescription opioids do. There is, however, a risk for overdose if a person takes too much meloxicam or takes it too quickly.⁴

Is Meloxicam Addictive?

Meloxicam is not considered physically addictive, although a person may become psychologically addicted to the pain relief it provides. Regardless, the FDA discourages doctors from prescribing meloxicam to people with a history of substance use disorder or to those who have previously abused prescription opioid painkillers.³

Meloxicam Abuse

Although meloxicam will not produce a euphoric high, some people still abuse it in the hopes of achieving a high that is similar to that of opioid painkillers. This is due to the common misconception that meloxicam is a narcotic when it is really an NSAID.

Unfortunately, if a person is not experiencing physical pain and they take meloxicam, they may suffer damage to the liver and kidneys. The medication may also cause their blood to thin. The risk of overdose is also much higher if a person abuses meloxicam with other NSAIDs like ibuprofen.¹⁰

The combination of meloxicam and alcohol is also highly dangerous and may result in jaundice, internal bleeding of the stomach, or liver failure.¹⁰ As a result, there is no benefit to abusing meloxicam recreationally.

Meloxicam comes with its own set of risks and side effects, but it may be a safer alternative to opioid painkillers without as much potential for abuse and addiction.

Treatment for Meloxicam Abuse

Abusing meloxicam recreationally might be a sign of a deeper problem, as the drug does not provide any euphoric side effects. A drug rehab program can provide life skills, peer support, and behavioral therapy to address co-occurring disorders and the root causes of your addiction, so you can learn how to live sober without relying on drugs to cope with life circumstances.

If you or a loved one is struggling with meloxicam abuse or is addicted to prescription medication, Nova Recovery Center can help. Call today to speak with a Nova admissions representative. We have immediate openings and accept several different health insurance providers.

References:

https://www.medicinenet.com/meloxicam/article.htm#what_are_the_uses_for_meloxicam
https://www.drugs.com/medical-answers/difference-between-meloxicam-ibuprofen-3504403/
https://www.ncbi.nlm.nih.gov/pubmed/8630630
https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020938s022lbl.pdf
https://www.mayoclinic.org/drugs-supplements/meloxicam-oral-route/side-effects/drg-20066928?p=1
https://www.cdc.gov/drugoverdose/opioids/prescribed.html
https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html
https://www.hhs.gov/opioids/about-the-epidemic/index.html
https://jamanetwork.com/journals/jama/article-abstract/2673971
http://www.safetymedical.net/meloxicam-abuse

Mobic | healthdirect

What it is used for

MOBIC tablets and capsules are indicated for the symptomatic treatment of osteoarthritis and rheumatoid arthritis.

How to take it

The way to take this medicine is: Oral.
This medicine is taken by mouth.

Store below 25 degrees Celsius
Protect from direct sunlight
Shelf lifetime is 3 Years.

You should seek medical advice in relation to medicines and use only as directed by a healthcare professional.

Always read the label. If symptoms persist see your healthcare professional.

Visual appearance

Pastel-yellow, round tablet in “SNAP-A-TAB” form, one face is convex with the Boehringer Ingelheim logo, the other face is concave and marked ’59D’ and has a broad break bar.

Images are the copyright of the Pharmacy Guild of Australia

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All medicines and poisons in Australia are categorised by how they are made available to the public. Medicines with a low safety risk are usually less tightly controlled than medicines with a higher safety risk. This system is called ‘scheduling’.

You can read more about the scheduling of medicines as well as the different scheduling categories on our Scheduling of medicines and poisons information page.

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This medicine is available from a pharmacist and requires a prescription. It is
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Background
Meloxicam (Mobic; Boehringer Ingelheim, Ridgefield, Conn) is an enolic acid derivative of the oxicam group of nonsteroidal anti-inflammatory drugs (NSAIDs) whose mechanism of action may be related to prostaglandin (cyclooxygenase) synthetase inhibition. In previous studies, meloxicam has been found to be safe and effective in the treatment of osteoarthritis (OA) at doses of 7.5 to 15 mg daily. To evaluate a lower dose and a different patient population, we evaluated the efficacy and safety of 3 doses of meloxicam vs placebo and diclofenac for the treatment of OA among patients with symptom exacerbations.

Methods
In this double-blind, double-dummy, parallel-group, multicenter study, 774 patients with confirmed OA of the hip or knee and a flare were randomized and treated with daily oral administration of meloxicam tablets (at dosages of 3.75, 7.5, or 15 mg/d), diclofenac (100 mg [50 mg twice daily]), or placebo. Treatment was for 12 weeks, with regular assessments for drug safety and efficacy. Safety was assessed by evaluation of adverse events, vital signs, and laboratory data. Primary efficacy variables included the Western Ontario and McMaster University Osteoarthritis (WOMAC) index, the patient’s overall assessment of pain, and the patient’s and investigator’s overall assessment of disease activity.

Results
The incidence of all adverse events was lower at each dosage of meloxicam than for diclofenac but greater than for placebo. However, the incidence of gastrointestinal adverse events and dropout rates because of such events was the same for meloxicam as for placebo and lower than for diclofenac. Meloxicam, at 7.5 and 15 mg/d, and diclofenac were statistically significantly more effective than placebo for all end points, while the 3.75-mg/d dosage of meloxicam did not always reach statistical significance for all end points. Efficacy was evident after 2 weeks of treatment, improved with increasing doses, and was maintained until the end of the trial.

OSTEOARTHRITIS (OA) is a chronic degenerative joint disease that, although radiologically detectable in a broad population, typically becomes symptomatic in the elderly. The prevalence of OA increases with age, resulting not only in considerable pain and disability, but also in substantial medical costs.¹^,2 In addition, the increases in indirect and nonmedical costs attributable to OA can approach those of rheumatoid arthritis, usually considered a more severe disease.³

Osteoarthritis is characterized by pain both on motion and at rest, stiffness after inactivity, impaired mobility, and inflammation, especially in the early stages. No specific cause has been identified and no cures are available; treatment is aimed at alleviation of symptoms. Symptomatic treatment may consist of nonpharmacologic as well as pharmacologic interventions, including the use of nonsteroidal anti-inflammatory drugs (NSAIDs).⁴^,5

Use of NSAIDs has been associated with a risk of serious and life-threatening gastrointestinal (GI) adverse events, such as perforation and bleeding.⁶^,7 Although these events are of great concern, they are uncommon. One study estimated the annual rate of hospitalizations for upper GI adverse events in OA patients taking NSAIDs to be 0.4%.⁷ Much more common are adverse effects such as dyspepsia, nausea, and vomiting. While these adverse effects do not correlate with GI bleeding, they do impact the performance of daily functions and contribute to increased medical costs resulting from the need for additional physician visits and changes in medication.⁸

Meloxicam is an enolic acid derivative of the oxicam group of NSAIDs. It has been approved for use in more than 80 countries for the treatment of OA, rheumatoid arthritis, and ankylosing spondylitis. In vitro and in vivo tests have shown that meloxicam is a cyclooxygenase (COX) inhibitor that demonstrates more COX-2 inhibition than COX-1 inhibition at therapeutic concentrations.⁹^,10 Its pharmacokinetic profile suggests good bioavailability with once-daily dosing.¹¹ The drug is readily absorbed and widely distributed with no accumulation in any tissue. Steady-state plasma concentrations are reached after 3 to 5 days with administration of 7.5 and 15 mg/d, with a plasma elimination half-life of 20 hours. Meloxicam is extensively protein bound (99%) and is metabolized in the liver, with equal excretion of inactive metabolites in the urine and feces. In 6-month, double-blind trials, meloxicam, 15 mg/d, is comparable to piroxicam, 20 mg/d, and diclofenac, 100 mg/d.¹²^,13

Patients enrolled in this study met the following criteria: current NSAID user at least 40 years of age, at least a 3-month history of OA of the knee or hip confirmed by x-ray and by clinical signs and symptoms, and pain on movement in the target joint. Main exclusionary criteria included, but were not limited to, prior intolerance of any NSAID, analgesic, or antipyretic; presence of aspirin hypersensitivity or any disease that, in the opinion of the investigator, could interfere with the evaluation of efficacy or safety; abnormal renal, hematologic, or hepatic function; history of a bleeding disorder or current therapy with an anticoagulant; recent (within 2 months) use of corticosteroids; treatment with intra-articular injections of hyaluronic acid in the prior 3 months; long-term use of GI medications (H₂-blockers, misoprostol, proton pump inhibitors) that could not be discontinued prior to participation; and history of narcotic and/or alcohol abuse. Patients with a history of upper GI perforations, ulcers, or peptic ulcer bleeding were not excluded unless the event had occurred within the 6 months prior to enrollment.

Subsequent to enrollment, an NSAID-free period of at least 3 days was initiated, during which demonstration of a flare was required. A flare was defined as a worsening of disease activity from initial screening that met the following criteria: at least 1 grade deterioration in the investigator’s global assessment of disease activity; an increase of 10 mm or greater on a 100-mm visual analog scale (VAS) for the patient’s global assessment of disease activity; and an increase greater than 35 mm (on a 100-mm VAS) in the patient’s overall assessment of pain. Upon flare, the patient was scheduled for baseline evaluation and initiation of treatment. Once treatment was initiated, efficacy and safety evaluations were performed at 2, 4, 8, and 12 weeks or at early termination.

Diclofenac was chosen as an active comparator to establish sensitivity of the efficacy end points based on its’ known efficacy and frequent clinical use. Diclofenac is considered to be well tolerated and has a favorable GI safety profile compared with other standard NSAIDs.⁷^,14^,15 A dosage of 100 mg/d (50 mg twice daily) was used since it is the recommended starting dosage for the treatment of OA. Meloxicam and placebo were given once in the morning after food, and diclofenac was administered in the morning and in the evening after food.

Tolerability was assessed by recording the incidence, duration, and intensity of all adverse events and patient withdrawals due to adverse events. For each adverse event, the investigator assessed whether or not the event was drug related. The need for treatment of the adverse event and the action taken with the study drug subsequent to the adverse event also were recorded. Safety was further assessed by vital signs, physical examinations, and clinical laboratory tests, including hematologic analysis and standard chemistry tests (uric acid, phosphorus, and calcium), serum creatinine levels, serum urea nitrogen levels, and both aspartate and alanine aminotransferase levels, to identify any effects on renal or hepatic function. In addition, a 24-hour urine collection was done prior to administering the first study medication and at the trial conclusion to determine the patient’s creatinine clearance.

The WOMAC index is based on Likert scales that allow the patient to self-evaluate the status of his or her condition.¹⁶ The assessment consists of 3 subscales (for pain, stiffness, and physical function), as well as a total score (ranging from 0 [best] to 96 [worst]). In addition to the WOMAC subscale for pain, the patient’s overall pain for the prior 24 hours was assessed using a 100-mm VAS (0, no pain; 100, worst pain).

Secondary efficacy variables included assessment of pain both at rest and on movement for the previous 24 hours in the target joint. As in the primary efficacy end point for pain, a 100-mm VAS was used. Use of rescue medication (acetaminophen) was permitted, and the rate of consumption on treatment was included as a secondary efficacy variable. At 12 weeks or with early termination, a final global assessment of efficacy was performed by the patient and the investigator using a 4-point verbal rating scale (good, satisfactory, not satisfactory, and poor). In addition, the patient’s status with regard to the change in arthritic condition was determined by asking the patient to rate his or her current condition compared with the condition at the start of the trial as improved, unchanged, or deteriorated.

To establish the superiority of meloxicam over placebo, a type I error was maintained by comparing meloxicam, 15 mg/d, with placebo, and subsequently comparing meloxicam, 7.5 and 3.75 mg/d, with placebo if, and only if, the next highest dose was significantly better than placebo (P≤.05). It was determined that, to demonstrate efficacy differences between placebo and meloxicam at a significance level of P≤.05 with an overall power of 80%, a sample size of 700 patients (140 per treatment arm) would be required.

Primary efficacy analyses were performed based on the intent-to-treat principle, including all treated patients with at least one on-treatment evaluation. Both the patient’s last visit assessment (last observation carried forward) and the weighted mean of all on-trial assessments were analyzed. Analysis of variance models, including treatment, target joint, and center, were used for all variables assessed by VAS, as well as for the WOMAC index (for pain, stiffness, physical function, and total score). These variables were analyzed as change from baseline (intensity of flare). Pairwise differences between the adjusted means for treatments were calculated along with P values and 2-sided 95% confidence intervals for these differences.

Secondary efficacy variables were also analyzed applying the intent-to-treat principle. For those variables assessed by VAS (pain on movement and pain at rest), analyses were performed using analysis of variance on data for change from baseline in a manner similar to that for the primary analyses. For rescue medication use, analysis of covariance was performed, with weekly average use as the dependent variable and use during flare as a covariate. The patients’ and investigators’ final global assessment of efficacy and the patients’ assessment of change in arthritic condition were analyzed using stratified rank sum test procedures, stratified by center. Time to early discontinuation (overall, for adverse events, and for lack of efficacy) was analyzed with log-rank tests and Kaplan-Meier estimates. Time to first GI adverse event was analyzed with adjustment for exposure by applying log-rank tests and the Kaplan-Meier algorithm.

Among a total of 1091 patients enrolled and screened by 61 study centers, 779 patients were randomized into the trial, and 774 patients initiated treatment. The demographic and disease characteristics were similar across the treatment groups (Table 1). The ratio of women to men was 2:1, and the mean ± SD age of the patient population was 62.9 ± 10.3 years; approximately 25% of the patients were at least 70 years of age. Duration of OA was greater than 5 years in more than 50% of the patients. Osteoarthritis of the knee was more prevalent as the target joint (82% of patients) than OA of the hip. Almost 90% of patients had OA in more than 1 joint. The mean total duration of prior NSAID use ranged from 3.8 to 4.1 years.

The incidence of all adverse events was comparable among the 3 meloxicam groups (58.4%, 55.8% and 57.7% for 3.75, 7.5, and 15 mg/d, respectively) and was higher than in the placebo group (47.8%) and lower than in the diclofenac group (66.0%). Meloxicam did not demonstrate any dose-dependent increase in total adverse events or adverse events grouped by preferred terms (Table 2) based on the World Health Organization adverse event coding thesaurus (World Health Organization Adverse Event Dictionary, September 1995).

Gastrointestinal adverse events were the most frequently reported events by system organ class (Table 2). There were no significant differences in the incidence of GI adverse events between the placebo and meloxicam groups, including the pooled meloxicam group, which differed from the placebo group by less than 2% (χ², P>.70). There were significantly more patients with GI adverse events in the diclofenac group than in the placebo group (χ², P = .02). After Kaplan-Meier adjustments for dropout rates, estimated 12-week GI adverse event rates were 18% for meloxicam, 15 mg/d; 21% for placebo and meloxicam, 3.75 and 7.5 mg/d; and 30% for diclofenac (Figure 1). Log-rank tests indicated that meloxicam was significantly different from diclofenac (P = .02) but not from placebo (P = .95). Other adverse effects, such as headache, rash, and edema, were not significantly different between any of the meloxicam, placebo, and diclofenac groups (P>.05 for all events; data not shown).

Withdrawals due to adverse events over the 12-week period were similar among the meloxicam and diclofenac groups (7% to 9%) and were not significantly different than for the placebo group (3.8%) (P>.50) (Table 3). Kaplan-Meier estimates of withdrawal due to adverse events are 8% to 10% for the active drugs and 7% for placebo (Table 4). Likewise, the percentage of withdrawals as a result of GI adverse events was similar among the meloxicam groups (3.2%, 3.2%, and 3.8%, respectively, for 3.75, 7.5, and 15 mg/d) and the diclofenac group (4.6%) and not significantly different from the placebo group (1.3%).

The incidence of serious adverse events was similar among the meloxicam and diclofenac groups (<3%) and was slightly higher than for patients receiving placebo (1.3%; P>.05). A serious adverse event was defined as any fatal or immediately life-threatening clinical experience or disabling event, or one that required prolonged inpatient hospitalization, whether or not it was judged to be related to treatment. Only 1 GI event was considered to be a serious adverse event and also thought to be related to study medication. A patient receiving meloxicam, 15 mg/d, with a history of intermittent diverticulitis experienced GI bleeding 17 days after beginning therapy that was believed to be because of active diverticulosis as diagnosed by colonoscopy. There was 1 death in this trial, in the 3.75-mg/d meloxicam group, that was a result of coronary insufficiency and was deemed by the treating physician not to be related to treatment. There were no reported occurrences of upper GI tract perforations, ulcerations, or peptic ulcer bleedings in any of the treatment groups.

Baseline values (flare) were similar across all treatment groups for each efficacy end point and demonstrated worsening from the values recorded at screening during prior NSAID use. At the end of treatment, all treatment groups had improved from their flare disease state, demonstrating significant improvement (P<.001) from baseline. Efficacy of meloxicam and diclofenac became evident early in treatment (2 weeks) (Figure 2). Efficacy is evident by 28 days in comparing the withdrawals due to lack of efficacy in the placebo group with the withdrawals in the meloxicam and diclofenac treatment groups (Table 4). The difference between the 3.75-mg/d meloxicam dosage and the higher dosages of meloxicam is also clear, with a withdrawal rate of 18% in the 3.75-mg/d group and a 9% withdrawal rate in the 7.5- and 15-mg/d groups. Overall, patients in the meloxicam and diclofenac groups had statistically significantly lower rates of withdrawal for lack of efficacy than the placebo group (41%): 18%, 17%, and 12% for meloxicam, 7.5 and 15 mg/d, and diclofenac, respectively (P<.001), and 31% for meloxicam, 3.75 mg/d (P<.01). Withdrawal rates due to lack of efficacy were also significantly lower for meloxicam, 7.5 and 15 mg/d, and for diclofenac than for meloxicam, 3.75 mg/d (P<.01). Both meloxicam and diclofenac produce symptomatic reductions to below pre-flare levels, while placebo patients are less successful in recovering from NSAID withdrawal (Figure 2).

The WOMAC index consists of a total score and 3 subscales for pain, physical function, and stiffness. At the final visit (Figure 3 and Table 5) and for on-treatment weighted means (data not shown), meloxicam, 7.5 and 15 mg/d, and diclofenac were significantly superior to placebo for all WOMAC efficacy parameters. Meloxicam exhibited dose-dependent efficacy that was most pronounced for the WOMAC pain and stiffness subscales and was reflected in the total WOMAC score (Figure 3). The 3.75-mg/d dosage of meloxicam proved superior to placebo only for the WOMAC stiffness subscale at the final assessment.

Similar results were obtained for the patient’s overall assessment of pain and the patient’s global assessment of disease activity. Meloxicam, 7.5 and 15 mg/d, and diclofenac demonstrated significant improvement over placebo (P<.005) for patient’s overall assessment of pain, and all active treatment groups were statistically significantly better than placebo in the patient’s overall assessment of disease activity (P<.05 for meloxicam, 3.75 mg/d, and P<.001 for diclofenac and meloxicam, 7.5 and 15 mg/d) (Table 5).

At baseline, 60% of patients were rated as having severe or very severe disease activity by the investigator’s assessment of disease activity. At the final visit, the proportion of patients with severe or very severe disease activity in the meloxicam, 7.5- and 15-mg/d, groups (12% and 13%, respectively) and in the diclofenac group (15%) was approximately half that in the placebo group (30%) (P<.01 for all comparisons with placebo).

Results for secondary efficacy variables were consistent with those observed for the primary variables. For pain on movement, both meloxicam at 7.5 mg and 15 mg/d and diclofenac demonstrated significantly better efficacy than placebo (P<.01), and for pain at rest, all 3 meloxicam dosages were significantly better than placebo (P≤.001 for meloxicam, 7.5 and 15 mg/d, and diclofenac; and P<.05 for meloxicam, 3.75 mg/d.

For both patient’s and investigator’s final global assessment of efficacy, the 7.5- and 15-mg/d dosages of meloxicam and diclofenac were statistically significantly superior to placebo for all comparisons (data not shown). The mean rate of consumption of rescue medication on treatment was significantly lower (P<.05) in all the meloxicam groups compared with placebo (12.0 tablets per week for placebo and 9.7, 8.5, and 8.4 tablets per week for meloxicam 3.75, 7.5, and 15 mg/d, respectively). When patients were asked to evaluate their change in disease status with respect to the start of the trial, the percentage of patients reporting improvement increased as the dosage of meloxicam increased (29.7%, 37.9%, 47.7%, 55.8%, and 57.9% for placebo; meloxicam, 3.75, 7.5, and 15 mg/d; and diclofenac, respectively). The greatest percentage of patients reporting unchanged or deteriorated arthritic activity was in the placebo and 3.75-mg/d meloxicam groups. However, the 3.75-mg/d meloxicam group was still statistically significantly superior to placebo for this end point (P<.05), as were the 2 higher dosages of meloxicam (P<.001). A comparison of the end point values with the values at screening (prior to previous NSAID washout) for the efficacy variables shows that the magnitude of patient improvement with meloxicam is at least equal to that of the observed flare. Figure 2 shows the patient’s overall assessment of pain at screening, at baseline (flare), and during the course of treatment until the end of the trial (last observation carried forward). Similar results were obtained for other efficacy variables.

Among patients taking NSAIDs, GI adverse events, such as dyspepsia, nausea, and vomiting, can add considerably to the cost of treatment.¹⁷^,18 These adverse effects, though not predictive of more serious GI injury,¹⁹^-21 lead to treatment interruptions and drug switching²²^-24 and add to treatment costs when additional physician visits or concomitant medications are required.⁹ In one study, the incidence of dyspepsia was approximately 16% in NSAID users,²² and it has been suggested that the incidence may be as high as 50% to 60%²⁵^,26 depending upon other factors.

The safety and tolerability of meloxicam in this 12-week trial are consistent with the results of 2 European trials that directly compared the safety and tolerability of meloxicam, 7.5 mg/d, with diclofenac, 100 mg/d, and piroxicam, 20 mg/d, in 17,979 patients during a 1-month course of treatment, the standard of care for OA in Europe.²⁷^,28 In those 2 studies, meloxicam demonstrated significantly better tolerability than these NSAIDs. Other comparative European trials have demonstrated both of these meloxicam doses to be effective in comparison with diclofenac and piroxicam for the treatment of OA, in some trials for as long as 6 months.¹²^,13,29^,30

The WOMAC index was designed as a self-administered health status instrument and has been validated specifically for assessment of OA.¹⁶ This tool is especially useful since it is very effective at differentiating treatment effects. A meloxicam dose-response relationship was observed for all 4 WOMAC end points and was especially apparent for the pain and stiffness subscales, as pain and stiffness are the 2 symptoms that most affect and limit functionality. There was a corresponding improvement in the patient’s overall assessment of pain; as the meloxicam dosage increased, however, a clear dose response was not observed as in the WOMAC pain subscale.

Meloxicam Osteoarthritis Investigators: Roy Altman, MD, Miami, Fla; Andrew Baldassare, MD, St Louis, Mo; Richard Bath, MD, Cincinnati, Ohio; Scott Baumgartner, MD, Spokane, Wash; Charles Birbara, MD, Worcester, Mass; Bruce Blatt, MD, Philadelphia, Pa; Joel Block, MD, Chicago, Ill; Robert Boyd, MD, Columbia, SC; Robert Brewer, MD, Little Rock, Ark; Jacques Caldwell, MD, Gainesville, Fla; Walter Chase, MD, Austin, Tex; Andrew Chubick, MD, Dallas, Tex; Chris Codding, MD, Oklahoma City, Okla; Julian Colton, MD, St Petersburg, Fla; Paul Dalgin, MD, Stamford, Conn; Frederick Dietz, MD, Rockford, Ill; Margarita Nunez, MD, St Petersburg, Fla; Roy Fleischmann, MD, Dallas, Tex; Charles Franklin, MD, Willow Grove, Pa; Larry Gilderman, DO, Pembroke Pines, Fla; Edward Gillie, MD, Fort Myers, Fla; Oscar Gluck, MD, Phoenix, Ariz; Allan Goldman, MD, Milwaukee, Wis; Richard Gordon, MD, Mercerville, NJ; Maria Greenwald, MD, Rancho Mirage, Calif; Brian Grimmett, MD, Cherry Hill, NJ; Maria Guttierrez, MD, Boynton Beach, Fla; Edward Harris, MD, Whittier, Calif; Scott Heatley, MD, PhD, Redwood, Calif; Lynn Hopkins, MD, Winter Park, Fla; Maria Jurado, MD, Boynton Beach, Fla; Jeffrey Kaine, MD, Sarasota, Fla; Alastair Kennedy, MD, Melborne, Fla; Brian Keroack, MD, Portland, Me; Alan Kivitz, MD, Altoona, Pa; Karen Kolba, MD, Santa Maria, Calif; Theodore Lefton, MD, Winter Park, Fla; Charles Ludivico, MD, Bethlehem, Pa; James McKay, DO, Tulsa, Okla; George McLaughlin, MD, Norristown, Pa; Kenneth Miller, MD, Danbury, Conn; Brent Mohr, MD, South Bend, Ind; Carter Multz, MD, San Jose, Calif; Thomas O’Barr, MD, Marietta, Ga; Howard Offenberg, MD, Daytona Beach, Fla; Theodore Pincus, MD, Nashville, Tenn; Malin Prupas, MD, Reno, Nev; Joseph Ragno, MD, Maitland, Fla; Peter Ripley, MD, South Yarmouth, Mass; Sanford Roth, MD, Phoenix, Ariz; Joel Rutstein, MD, San Antonio, Tex; Thomas Schnitzer, MD, PhD, Chicago, Ill; Douglas Schumacher, MD, Columbus, Ohio; Yvonne Sherrer, MD, Boca Raton, Fla; David Silver, MD, Beverly Hills, Calif; Joel Silverfield, MD, Tampa, Fla; Michael Strachan, MD, Richmond, Va; Nina Stuccio-White, MD, Marlton, NJ; Martin Throne, MD, Atlanta, Ga; Daniel Wallace, MD, Los Angeles, Calif; Louise Taber, MD, Peoria, Ariz; David Yocum, MD, Tucson, Ariz; Muhammad Yunus, MD, Peoria, Ill; Steven Zeig, MD, Ft Lauderdale, Fla.

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Meloxicam blocks an enzyme that plays a key role in the synthesis of prostaglandins – substances that trigger the inflammatory process and reduce the threshold of pain sensitivity.Prostaglandins also protect the stomach and intestinal mucosa from ulcerative processes. Meloxicam selectively acts on the formation of prostaglandins, which appear only during inflammation, and therefore causes fewer side effects from the digestive system compared to the so-called “traditional” or non-selective NSAIDs.

Meloxicam has been used in medical practice since the end of the 20th century. At the same time, it is worth mentioning separately that the profile of its efficacy and safety was established taking into account the requirements of modern evidence-based medicine in numerous clinical studies, in which tens of thousands of patients took part.Of all the non-steroidal anti-inflammatory drugs that suppress the mechanisms of formation of inflammatory mediators, it is meloxicam that is often recommended for the treatment of osteoarthritis (osteoarthritis) and other joint diseases. Since its inception, this substance has been used in most countries of the world, and wide clinical practice has confirmed the effectiveness of pain therapy with a minimal risk of adverse reactions for this group of drugs.

It is produced in different dosage forms: tablets, solution for intramuscular injections, rectal suppositories, cream and gel for external use.All of them have the same indications – the doctor chooses the most suitable option, based on the characteristics of the patient’s illness, the presence of other diseases. Creams and gels are one of the most optimal options for local anesthesia, since such use does not cause pain and practically does not have systemic side effects from the gastrointestinal tract, as, for example, when taking oral anti-inflammatory drugs in the form of capsules or tablets.

The main area of application of meloxicam is joint diseases: all types of arthritis, including rheumatoid and gout, ankylosing spondylitis, as well as myalgia, neuralgia, osteochondrosis. Due to its pronounced anti-inflammatory effect, it relieves pain well, relieves swelling, restoring joint mobility.At the same time, meloxicam, unlike some anti-inflammatory drugs, is chondroneutral: it does not destroy cartilage and does not suppress the activity of chondrocytes, substances that ensure its renewal.

Meloxicam stops the development of inflammation, improves the patient’s well-being: pain disappears, swelling subsides, movement in the joint is restored, but this is only symptomatic treatment. At the same time, it does not affect the main cause of the disease, therefore, it usually cannot be the main and only component of therapy.For example, it is impossible to treat osteoarthritis without repairing damaged cartilage or gout without drugs that lower the amount of uric acid in the blood.

Often, in the treatment of joint diseases, general (tablets, injections, suppositories) and local therapy with meloxicam are used sequentially. Creams and gels applied to the damaged area ensure the delivery of the active substance to the inflammation focus, while it practically does not enter the systemic circulation, that is, it does not cause side effects.However, for full therapy, higher and constant concentrations of the drug in the body are needed, for this it is prescribed by mouth or in injections.

Acceptability	Criteria: Inclusion criteria: – non-smoking men or women with a minimum age of 18 years (i.e.E. Non-smokers or non-smokers). tobacco smoker at least 90 days prior to the pre-test medical examination). – Body mass index (BMI = weight / height²) is greater than or equal to 18.5 kg / m² and less than 29.9 kg / m². – The presence of the subject for the entire period of study and the willingness to adhere to the protocol requirements, as evidenced by the signed informed consent form. – Normal physical examination results, 12-lead ECG and vital signs (blood pressure 100-140 / 60-90 mmHg)Art., pulse rate 50-99 beats / min, temperature from 35.8 ° C to 37.5 ° C). – Negative for drugs, nicotine, alcohol, hepatitis B surface antigen, hepatitis C and HIV, and for women – pregnancy (serum ß-CG). – There are no clinical laboratory values outside the acceptable range defined by the BCR, unless the Principal Investigator determines they are not clinically relevant. – Female subjects who have been sterile surgically for at least six months or are postmenopausal.for at least one year, or who will avoid pregnancy before the study, during the study, and for up to one month after the end of the study. Exclusion criterion: – Known history of hypersensitivity to meloxicam (eg Mobic®) or related drugs such as any other nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (eg Excedrin®, Aspirin®), ibuprofen (eg Motrin®) , celecoxib (e.g. Celebrex®), Feldene®, Indocin®, Naprosyn®, Vioxx®, Toradol®, Clinoril®, Tolectin® or Lodin®.- Known history or presence of cardiac, pulmonary, gastrointestinal, endocrine, musculoskeletal, neurologic, hematologic or liver disease, unless otherwise determined to be clinically relevant to the principal investigator or appointed physician. – Any history or presence of peptic ulcer disease, gastrointestinal bleeding, or kidney disease. disease. – A history or presence of food allergies or any condition known to interfere with the absorption, distribution, metabolism or excretion of drugs.- Any clinically significant illness within the last four weeks prior to enrollment in the study. – The presence of any significant physical or internal abnormalities. – Any subject with a history of drug abuse. – Any mental or psychological illness (including depression) that is not considered clinically relevant to the principal investigator or designated physician. – Use of any prescription medication within 14 days prior to enrollment in this study. – Use of over-the-counter medications within seven days of enrollment (excluding spermicidal / barrier contraceptives).- Women: use of oral contraceptives or contraceptive implants (for example, Norplant®) within 30 days before the administration of the drug or depot injection of the progestogen drug (for example, Depo-Provera®) for one year before taking the drug. – Women: being pregnant or breastfeeding. – Women at risk of becoming pregnant must consent to the use of two medically acceptable methods of contraception throughout the study, including the washout period and within one month after completion of the study.barrier methods of contraception that can be used by the subject and / or partner include a diaphragm with a spermicide, an IUD, a foam condom, and a vaginal spermicide suppository. Complete abstinence can be used as a method of contraception. – Any subject from whom blood was drawn within 56 days prior to this study during any clinical study conducted at a facility other than BCR, or within the lockout period specified in a previous study conducted at BCR.- Participation in a clinical trial of an investigational drug within 30 days prior to that study. – Any subject who donated blood within the 56 days prior to this study. – Any subject who has participated as a plasma donor in a plasmapheresis program in the seven days prior to this study. – Any subject with a recent history of (less than one year) abuse of alcohol. – Significant or recent history of asthma (after 12 years) or family history of asthma or asthma sensitive to aspirin, severe bronchospasm, nasal polyps, or chronic sinusitis.- Intolerance to venipuncture. … Floor: All Minimum age: 18 years old Maximum age: N / A Healthy volunteers: Accepts healthy volunteers

Acceptability

Criteria:

Inclusion criteria: – non-smoking men or women with a minimum age of 18 years (i.e.E. Non-smokers or non-smokers). tobacco smoker at least 90 days prior to the pre-test medical examination). – Body mass index (BMI = weight / height²) is greater than or equal to 18.5 kg / m² and less than 29.9 kg / m². – The presence of the subject for the entire period of study and the willingness to adhere to the protocol requirements, as evidenced by the signed informed consent form. – Normal physical examination results, 12-lead ECG and vital signs (blood pressure 100-140 / 60-90 mmHg)Art., pulse rate 50-99 beats / min, temperature from 35.8 ° C to 37.5 ° C). – Negative for drugs, nicotine, alcohol, hepatitis B surface antigen, hepatitis C and HIV, and for women – pregnancy (serum ß-CG). – There are no clinical laboratory values outside the acceptable range defined by the BCR, unless the Principal Investigator determines they are not clinically relevant. – Female subjects who have been sterile surgically for at least six months or are postmenopausal.for at least one year, or who will avoid pregnancy before the study, during the study, and for up to one month after the end of the study. Exclusion criterion: – Known history of hypersensitivity to meloxicam (eg Mobic®) or related drugs such as any other nonsteroidal anti-inflammatory drugs (NSAIDs) such as acetylsalicylic acid (eg Excedrin®, Aspirin®), ibuprofen (eg Motrin®) , celecoxib (e.g. Celebrex®), Feldene®, Indocin®, Naprosyn®, Vioxx®, Toradol®, Clinoril®, Tolectin® or Lodin®.- Known history or presence of cardiac, pulmonary, gastrointestinal, endocrine, musculoskeletal, neurologic, hematologic or liver disease, unless otherwise determined to be clinically relevant to the principal investigator or appointed physician. – Any history or presence of peptic ulcer disease, gastrointestinal bleeding, or kidney disease. disease. – A history or presence of food allergies or any condition known to interfere with the absorption, distribution, metabolism or excretion of drugs.- Any clinically significant illness within the last four weeks prior to enrollment in the study. – The presence of any significant physical or internal abnormalities. – Any subject with a history of drug abuse. – Any mental or psychological illness (including depression) that is not considered clinically relevant to the principal investigator or designated physician. – Use of any prescription medication within 14 days prior to enrollment in this study. – Use of over-the-counter medications within seven days of enrollment (excluding spermicidal / barrier contraceptives).- Women: use of oral contraceptives or contraceptive implants (for example, Norplant®) within 30 days before the administration of the drug or depot injection of the progestogen drug (for example, Depo-Provera®) for one year before taking the drug. – Women: being pregnant or breastfeeding. – Women at risk of becoming pregnant must consent to the use of two medically acceptable methods of contraception throughout the study, including the washout period and within one month after completion of the study.barrier methods of contraception that can be used by the subject and / or partner include a diaphragm with a spermicide, an IUD, a foam condom, and a vaginal spermicide suppository. Complete abstinence can be used as a method of contraception. – Any subject from whom blood was drawn within 56 days prior to this study during any clinical study conducted at a facility other than BCR, or within the lockout period specified in a previous study conducted at BCR.- Participation in a clinical trial of an investigational drug within 30 days prior to that study. – Any subject who donated blood within the 56 days prior to this study. – Any subject who has participated as a plasma donor in a plasmapheresis program in the seven days prior to this study. – Any subject with a recent history of (less than one year) abuse of alcohol. – Significant or recent history of asthma (after 12 years) or family history of asthma or asthma sensitive to aspirin, severe bronchospasm, nasal polyps, or chronic sinusitis.- Intolerance to venipuncture. …

Floor:

All

Minimum age:

18 years old

Maximum age:

N / A

Healthy volunteers:

Accepts healthy volunteers

Inside, tablets are taken with water 1 time per day, with meals.The drug should be prescribed in the shortest possible courses and in the smallest effective doses. With osteoarthritis – 7.5 mg / day. If ineffective, the dose may be increased to 15 mg / day. With rheumatoid arthritis, ankylosing spondylitis – 15 mg / day. After achieving a therapeutic effect, the dose can be reduced to 7.5 mg / day. The maximum daily dose should not exceed 15 mg. The recommended dose for elderly patients is 7.5 mg per day. In patients with an increased risk of side effects, as well as in patients with severe renal failure on hemodialysis, the dose should not exceed 7.5 mg / day.

May cause severe allergic reactions: facial edema, asthma, shock, skin redness, rash, blisters; especially in people who are allergic to aspirin.In this case, you should stop taking the drug. Use with caution in patients with phenylketonuria, cardiovascular diseases, gastrointestinal diseases (risk of inflammation, bleeding, ulceration and perforation of the stomach or intestines). Consult a specialist before use. Do not use before or after heart surgery.

Nausea, vomiting, abdominal pain, diarrhea, constipation, flatulence, bleeding of the gastrointestinal tract (latent or overt), hepatitis, colitis, stomatitis, dry mouth, belching; tachycardia, increased blood pressure; exacerbation of bronchial asthma, cough; headache, dizziness, tinnitus; sleep disturbance, vertigo; swelling, urinary tract infection, kidney failure; conjunctivitis, blurred vision; itching, skin rash, urticaria; anemia; allergic reactions; fever.

Indications for use : Meloxicam is used for myositis, arthritis, bursitis, tendinitis, tendovaginitis, neuritis, articular and muscular rheumatism, as well as for pain caused by damage to peripheral nerves in cattle, calves, goats, sheep and pigs.The drug is used as an analgesic for postpartum complications (paresis), in combination with general therapeutic agents. The use of meloxicam is highly effective in inflammatory processes of the udder, especially in the late stages of development of mastitis (catarrhal, fibrinous, purulent), in parallel, the cause that caused the mastitis should be eliminated, and in the presence of pathogenic microflora, antibiotic therapy should be prescribed. The drug is used in the treatment of inflammatory processes of various etiology and localization, as a non-steroidal anti-inflammatory agent.

Since the beginning of its activity on the Ukrainian pharmaceutical market, the German pharmaceutical company “Boehringer Ingelheim” has been offering specialists high-quality drugs for use in various fields of medicine: rheumatology, pulmonology, gastroenterology, cardiology, etc.The company’s drugs have become brands and deservedly won the trust of consumers, since they fully meet their purpose – to improve the health of the population. Not stopping at what has been achieved, the Ukrainian representative office of Boehringer Ingelheim is constantly replenishing the portfolio of presented drugs, introducing new drugs (drugs) to the domestic pharmaceutical market. This autumn was no exception: the company delighted specialists working in the field of rheumatology by adding a dosage form of MOVALIS for intramuscular administration to the arsenal of doctors.

In order to answer this question, it is enough to study the data on the incidence of rheumatoid arthritis and osteoarthritis. According to experts, this problem is faced by 10 to 30% of the adult population worldwide. Among people aged 60 years, this pathology is even more common.Almost 50% of the population is diagnosed with joint diseases. And with such acute conditions as sciatica and lumbago, almost every person encounters during life.

With exacerbation of rheumatoid arthritis, acute lumbago and sciatica, severe pain appears, which requires the appointment of drugs that quickly eliminate pain and alleviate the patient’s condition. Such properties are inherent in non-steroidal anti-inflammatory drugs (NSAIDs), which quickly eliminate pain and have an anti-inflammatory effect.Moreover, during the first days of the disease, it is preferable to prescribe parenteral dosage forms of NSAIDs, which have not only a relatively rapid onset of action, but also have a certain psychotherapeutic effect.

Until recently, on the pharmaceutical market of Ukraine, NSAIDs for parenteral administration were represented only by non-selective COX inhibitors – diclofenac, piroxicam, etc. Meloxicam for intramuscular administration is the first and only drug of a selective COX-2 inhibitor on the world pharmaceutical market intended for parenteral administration.Due to the peculiarities of the mechanism of action, selective COX-2 inhibitors are less likely to cause the development of side effects from the digestive tract. The results of the studies carried out indicate that the overall tolerance of meloxicam is better compared to piroxicam and diclofenac [10, 11]. However, for intramuscular administration, such an indicator as the local tolerance of the drug is also important.

The reason for the increase in the level of CPK with intramuscular injections is chemotoxicity, stimulation of the release of histamine and muscle injury [1]. After intramuscular administration of some traditionally used NSAIDs, a significant increase in the level of CPK was revealed [2, 8].It was reported an increase in the level of CPK compared with the baseline by an average of 147% when using piroxicam and 922% – diclofenac [2]. Local tolerance of meloxicam, injected intramuscularly, was good both in healthy volunteers and in patients, local reactions and significant fluctuations in the level of CPK in the blood were not observed. These data confirm the results of experimental studies, during which in rabbits receiving intramuscular injections of diclofenac and piroxicam, there were cases of muscle tissue necrosis at the injection site, while the introduction of meloxicam was not accompanied by the development of necrosis [3].

Analysis of the results of a comparative study of meloxicam and piroxicam, conducted with the participation of volunteers, indicates that in patients receiving piroxicam intramuscularly, there was a significant increase in the level of CPK in the blood by 59% compared with the initial values, and with the same route of administration of meloxicam, the level KFK remained unchanged [8].These data confirm the results of evaluating the local tolerance of intramuscular injections of meloxicam in other clinical studies, which were characterized as very good. Moreover, according to the assessment of doctors and patients in a comparative study with piroxicam with intramuscular administration of meloxicam, in general, significantly less local hyperemia and better local tolerance were noted (Fig. 2) [8].

In two comparative studies with intramuscular administration of piroxicam at a dose of 20 mg, the overall tolerance of intramuscular administration of meloxicam (at a dose of 15 mg) (as assessed by doctors and patients) in most patients was characterized as “very good” [4, 8].There were no significant differences in the incidence of side effects between the two studies. The incidence of side effects from the digestive tract was low, with no significant differences between patients receiving piroxicam and meloxicam [7, 8].

The appearance on the Ukrainian pharmaceutical market of MOVALIS for intramuscular injection did not coincide with the autumn season – a period of exacerbations of chronic diseases of the musculoskeletal system and rheumatic diseases.Indeed, it was at this time that drugs intended for the quick and effective relief of pain syndrome are in special demand among the population. MOVALIS for intramuscular administration is especially indicated for patients with acute rheumatic fever, sciatica and lumbago. Intramuscular administration of MOVALIS is an alternative to the traditional use of non-selective NSAIDs, since the drug not only quickly eliminates pain syndrome, but also, due to selective inhibition of COX-2, is well tolerated.

REFERENCES

1. Cacace L. (1972) Elevated serum CPK after drug injections. N. Engl. J. Med. 287: 309-10.

2. Vaccarino V., Sirtoni R., Bufalino L. (1989) Local and systemic tolerability of piroxicam after intramuscular administration in healthy volunteers.Curr. Ther. Res. 45: 1-13.

3. Stei P., Kruss B., Wiegleb J., Trach V. (1996) Local tissue tolerability of meloxicam, a new NSAID: indications for parenteral, dermal and mucosal administration. Br. J. Rheumatol. 35 (Suppl. 1): 44-50.

4. Narjes H., Turck D., Busch U., Heinzel G., Nehmiz G. (1996) Pharmaco-kinetics and tolerability of meloxicam after im administration. Br. J. Clin. Pharmacol. 41: 135-9.

5. Auvinet B., Ziller R., Appelboom T., Velicitat P.(1995) Comparison of the onset and Intensity of action of intramuscular meloxicam and oral meloxicam in patients with acute sciatica. Clin. Ther., 17: 1078–90.

6. Combe B., Velicitat P., Garzon N., Koneke N., Bluhmki E. Comparison of intramuscular and oral meloxicam in rheumatoid arthritis patients [This supplement].

7. Bosch H.-C., Sigmund R., Hettich M. (1997) Efficacy and tolerability of intramuscular and oral meloxicam in patients with acute lumbago: a comparison with intramuscular and oral piroxicam.Curr. Med. Res. Opin., 14: 29–38.

8. Ghozlan P.O.R., Bemhardt M., Velicitat P., Bluhmki E. (1996) Tolerability of multiple administration of intramuscular meloxicam: a comparison with intramuscular piroxicam in patients with rheumatoid arthritis and osteoarthritis. Br. J. Rheumatol. 35 (Suppl. 1): 51-5.

9. Baturone M., Euller-Ziegler L., Kneer W., Bluhmki E., Morene J. The intramuscular formulation of the COX-2 inhibitor meloxicam is effective and safe in osteoarthritis.Presented at 3rd APLAR congress, The Philippines, January 1998.

10. Dequeker J, Hawkey C, et al. (1998 Sep.) 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. Br. J. Rheumatol., 37 (9): 946-951.

11. Hawkey C, Kahan A, et al. (1998 Sep.) Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients.International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment. Br. J. Rheumatol., 37 (9): 937-945.

If you experience drowsiness, dizziness, hypotension, or headache while taking Mobic Tablet / Mobic Tablet, you may need to stop driving and heavy industrial equipment.You should stop driving if taking the drug makes you drowsy, dizzy, or hypotensive. Doctors recommend to stop drinking alcohol with such drugs, because alcohol significantly increases side effects and drowsiness. Please check your body’s response while taking Mobic Tablet / Mobic Tablet. Be sure to contact your healthcare professional for advice based on your body and overall health.

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