Meloxicam is a member of the non-steroidal anti-inflammatory (NSAID) group of drugs. Meloxicam reduces pain, stiffness, and inflammation and is used to relieve the symptoms of rheumatoid arthritis, ankylosing spondylitis, and acute episodes of ostheoarthritis. It does not cure the underlying condition, however. Meloxicam does not affect the stomach as severely as some other NSAIDs and is therefore less likely to cause gastrointestinal bleeding, ulceration, and perforation. Because elederly people are more sensitive to the drug’s effect, they are usually prescribed only half of the normal adult dose.

• Brand name: Mobic.
• Used in the following combined preparations: None.

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• Drug group: Non-steroidal anti-inflammatory drug.
• Overdose danger rating: Medium.
• Dependence rating: Low.
• Prescription needed: Yes.
• Available as generic: No.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor. Meloxicam can be taken in tablets or suppositories.

• Frequency and timing of doses: Once daily with food.
• Adult dosage range: 7.5-15mg.
• Onset of effect: 1 hour. Full of anti-inflammatory effect may not be felt for up to 2 weeks.
• Duration of action: 24 hours.
• Diet advice: None.
• Storage: Keep in original container at room temperature out of the reach of children.
• Missed dose: Take as soon as you remember. If your next dose is due within 8 hours, take a single dose now and skip the next.
• Stopping the drug: The drug can be safely stopped as soon as you no longer need it (short-term). Do not stop taking the drug without consulting your doctor (long-term).
• Exceeding the dose: An occasional unintentional extra dose is unlikely to be a cause for concern. Large overdoses can cause stomach and intestinal pain and damage. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

Gastrointestinal disturbance, skin rash, and headache are common adverse effects. Black or bloodstained faeces and wheezing should be reported to your doctor without delay.

Symptoms:

• Abdominal pain/indigestion: frequency of this symptom is common; discuss with doctor only if severe.
• Headache: frequency of this symptom is common; discuss with doctor only if severe.
• Diarrhoea or constipation: frequency of this symptom is common; discuss with doctor only if severe.
• Lightheadedness/drowsiness: frequency of this symptom is common; discuss with doctor only if severe.
• Skin rash/itching: frequency of this symptom is common; discuss with doctor only if severe and stop immediately taking the drug.
• Vertigo/ringing in the ears: it’s rare; discuss with doctor in all cases.
• Persistent sore throat: it’s rare; discuss with doctor in all cases and stop taking the drug.
• Palpitations: call immediately your doctor and stop taking the drug.
• Wheezing/breath difficulties: call immediately your doctor and stop taking the drug.
• Black/bloodstained faeces: call immediately your doctor and stop taking the drug.

SPECIAL PRECAUTIONS

Be sure to consult your doctor or pharmacist before taking this drug if:

• You have asthma.
• You are allergic to aspirin or other NSAIDs.
• You have a peptic ulcer, oesophagitis, or acid indigestion.
• You have liver or kidney problems.
• You have a bleeding disorder, proctitis or haemorrhoids.
• You have a heart problem or high blood pressure.
• You are taking other medicines.

Other particular conditions:

• Pregnancy: Safety in pregnancy not established. May affect the developing foetus. Discuss with your doctor.
• Breast-feeding: Safety not established. Discuss with your doctor.
• Infants and children: Not recommended.
• Over 60: Increased likelihood of adverse effects. Reduced dose necessary.
• Driving and hazardous work: Avoid such activities until you have learned how Meloxicam affects you because the drug can cause vertigo and drowsiness.
• Alcohol: Keep consumption low. Alcohol may increase the risk of stomach irritation with Meloxicam.
• Surgery and general anaesthetics: Meloxicam may prolong bleeding. Discuss the possibility of stopping treatment temporarily with your doctor or dentist.

INTERACTIONS

Meloxicam interacts with a wide range of drugs to increase the risk of bleeding and/or peptic ulcers. Such drugs include other NSAIDs, aspirin and also oral anticoagulants, and corticosteroids.

• Lithium, digoxin, and methotrexate: Meloxicam may raise blood levels of these drugs to an undesirable extent.
• Ciclosporin and tacrolimus: There is an increased risk of kidney damage when meloxicam is taken with these drugs.
• Antibacterials: Meloxicam may increase the risk of convulsions with ciprofloxacin and similar drugs.

PROLONGED USE

There is an increased risk of bleeding from peptic ulcers and in the bowel with prolonged use of Meloxicam. The lowest effective dose is given for the shortest duration. Periodic tests on kidney function may be performed.

Source: New Guide to Medicines & Drugs by BMA

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