Mobic (Meloxicam). Dosage, Side Effects, Interactions
Mobic (Meloxicam) is one of the non-steroidal anti-inflammatory drugs (NSAIDs) and is used, among other things, to treat osteoarthritis, chronic polyarthritis and Bechterew’s disease.
Meloxicam can be used for the symptomatic short-term treatment of activated osteoarthritis and the symptomatic long-term treatment of rheumatoid arthritis (chronic polyarthritis) or ankylans spondylitis ( Bechterew’s disease ).
How Mobic (Meloxicam) works
Meloxicam is one of the non-steroidal anti-inflammatory drugs (NSAIDs) and belongs to the group of active ingredients called oxicams with anti-inflammatory, analgesic and antipyretic effects. The mechanism of action is based on inhibition of cyclooxygenases (COX) 1 and 2, with meloxicam showing a slight preference over COX-2.
The absolute bioavailability of the active ingredient is 89%. Tablets, capsules and suspension are bioequivalent.
Peak plasma levels are reached within 2 hours (suspension) or 5-6 hours (tablets, capsules). Steady-state conditions are reached after 3-5 days with repeated dosing. Under steady-state conditions, peak plasma levels are reached after 5-6 hours (suspension, capsules and tablets).
Meloxicam is highly bound to plasma proteins, mainly to albumin (99%).
The active substance is mainly metabolised in the liver. Excretion, primarily in the form of metabolites, occurs in equal parts in urine and faeces. The mean elimination half-life is approximately 20 hours.
Dosage of Mobic (Meloxicam)
The film-coated tablet can be divided into equal doses. The film-coated tablet should be taken as a single dose during a meal with a glass of water or other liquid. The dosage of meloxicam depends on the clinical picture. It should be noted that the daily dose of 15 mg meloxicam must not be exceeded.
The recommended active ingredient dose for activated osteoarthritis is 7.5 mg per day. If the effect is not sufficient, the dose can be increased to 15 mg per day.
Rheumatoid arthritis/ankylanal spondylitis
The dosage for the treatment of rheumatoid arthritis/ankylosing spondylitis is 15 mg per day. Depending on the success of the therapy, the dose can also be reduced to 7.5 mg per day if this dose is already sufficiently effective.
Elderly patients and those at increased risk of side effects
For older patients or patients with an increased risk of side effects, the dose for long-term therapy in rheumatoid arthritis/ankylans spondylitis should be 7.5 mg per day.
Children and young people
The drug is contraindicated in children and adolescents under 16 years of age.
Impaired kidney function
In patients with severe renal impairment, the maximum daily dose of meloxicam is 7.5 mg. No dose reduction is necessary in patients with mild to moderate renal impairment (creatinine clearance >25 ml/min).
Side effects of Mobic (Meloxicam)
Various side effects can occur during therapy with meloxicam. According to clinical studies, it has been observed that the use of NSAIDs (especially at high doses and long-term treatment) can cause a slightly increased risk of arterial thrombotic events (e.g. myocardial infarction or stroke ). In addition, heart failure has been reported in connection with NSAID therapy .
However, most side effects are gastrointestinal in nature. These can be fatal, especially in older patients.
The following is an example list according to the information for healthcare professionals:
Very common (>1/10):
- nausea, vomiting
- stomach pain
Common (>1/100, <1/10):
- Edema including lower leg edema.
Uncommon (>1/1,000, <1/100):
- Allergic reactions (other than anaphylactic/anaphylactoid reactions)
- Elevated blood pressure
- Reddening of the skin with a feeling of heat (flush)
- Gastrointestinal bleeding (occult or macroscopic)
- Hepatic dysfunction (eg, transaminase or bilirubin elevation)
- skin rash
- Sodium and water retention
Rare (>1/10,000, <1/1,000):
- Blood count changes (including leukocytopenia, thrombocytopenia)
- mood swings
- Visual disturbances including blurred vision
- Asthma in patients with allergic reactions to ASA or other NSAIDs
- Gastroduodenal Ulcers
- Severe skin reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis) and urticaria .
Other non-steroidal anti-inflammatory drugs (NSAIDs and acetylsalicylic acid)
Concomitant use of meloxicam with other NSAIDs is not recommended due to the synergistic effect and the associated increased risk of gastrointestinal side effects (e.g. ulcers, bleeding).
Concomitant use of meloxicam and corticosteroids increases the risk of bleeding or gastrointestinal ulceration. So caution is advised here.
Anticoagulants or heparin in geriatric patients or in curative doses
The risk of bleeding increases significantly if meloxicam and anticoagulants or heparin are used at the same time.
Concomitant use is therefore not recommended in geriatric patients or in curative doses. Caution is advised in the other use cases. If use is unavoidable, the INR (International Normalized Ratio) must be carefully monitored.
Thrombolytics and antiplatelet agents
There is also an increased risk of bleeding with the simultaneous use of meloxicam and thrombolytics/platelet aggregation inhibitors.
Selective serotonin reuptake inhibitors
If selective serotonin reuptake inhibitors and meloxicam are used concomitantly, the risk of gastrointestinal bleeding is increased.
Diuretics, ACE inhibitors and angiotensin II antagonists
With the simultaneous use of meloxicam and diuretics , ACE inhibitors , angiotensin II antagonists , the effectiveness of the latter is reduced. In addition, there may be a further reduction in renal function in patients with impaired renal function. This particularly affects geriatric patients with impaired renal function and dehydrated patients.
The impairment of kidney function can lead to acute kidney failure. Renal function should therefore be closely monitored and patients should be ensured adequate hydration.
Since meloxicam also inhibits the synthesis of vasodilating prostaglandins, the antihypertensive effect may be reduced.
The use of calcineurin inhibitors (e.g. ciclosporin , tacrolimus ) and NSAIDs can damage kidney function. Renal function must be carefully monitored. This is especially true in elderly patients.
The effectiveness of intrauterine devices seems to be reduced by NSAIDs. However, further studies have not yet confirmed this.
Meloxicam can increase serum lithium concentrations into the toxic range by reducing renal lithium excretion. Should concomitant therapy be necessary, lithium levels should be carefully monitored at initiation, during dose adjustments, and after cessation of concomitant therapy.
The methotrexate concentration can be increased by simultaneous therapy with meloxicam and methotrexate . Therefore, methotrexate doses of more than 15 mg/week should not be used concomitantly with meloxicam. A gap of less than 3 days between taking methotrexate and meloxicam should also be evaluated critically, since in these cases the methotrexate level can reach increased toxicity. Even with lower doses, the possible increase in methotrexate levels must be considered, especially in the presence of renal dysfunction. Renal function and blood count must be monitored during concomitant therapy.
Colestyramine leads to a clinically relevant lower concentration of meloxicam due to accelerated elimination of the active substance.
If there is hypersensitivity to the active ingredient or a component of the drug, meloxicam should not be used.
In addition, it must not be used if there is hypersensitivity to drugs with a similar mode of action (e.g. other non-steroidal anti-inflammatory drugs, acetylsalicylic acid). Also, if the patient has a history of NSAID-related gastrointestinal bleeding, perforation and/or active or previous recurrent peptic ulcer/bleeding, meloxicam should not be used.
Furthermore, meloxicam is contraindicated in severe liver dysfunction and severe non-dialyzed renal insufficiency. Patients with severe heart failure should not receive meloxicam. If there is a history of gastrointestinal and/or cerebrovascular bleeding, the drug should not be taken.
The drug is also contraindicated in the third trimester of pregnancy. It must also not be used in children and adolescents under 16 years of age.
Meloxicam can adversely affect pregnancy and/or embryo-foetal development by inhibiting prostaglandin synthesis. In particular, there is an increased risk of miscarriage as well as cardiac malformations and gastroschisis. The risk presumably increases with dose and duration of therapy. In the first and second trimester of pregnancy, the drug should be used only if absolutely necessary. The dose should be kept as low as possible and the duration of therapy as short as possible. During the third trimester of pregnancy, the drug is contraindicated.
The use of meloxicam is not recommended in breastfeeding women.
There are no studies on the ability to drive and use machines with meloxicam. Based on the pharmacodynamic profile and the possible side effects of the active substance, it can be assumed that meloxicam has no or negligible effect on these abilities. However, if you experience visual disturbances, tiredness or dizziness, you should refrain from driving vehicles or operating machines.
Further information can be found in the respective specialist information.
Looking where to buy Mobic (Meloxicam) online without a prescription? Order now on our website! We deliver orders all over United States. The best drug prices are only available in our authorized online pharmacy