meloxicam 15 mg

Meloxicam

Generic Mobic

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Meloxicam 7.5 mg / Meloxicam 15 mg
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Brand Name Mobic
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What is Meloxicam and how it works

meloxicamMeloxicam (US trade name – Mobic) is the non-steroidal anti-inflammatory drug (NSAID). It is enolic acid derivative with anti-inflammatory, analgesic and antipyretic action. It is a preferential inhibitor of the inducible cyclooxygenase-2 (COX-2), responsible for the synthesis of pro-inflammatory prostaglandins. To a small extent inhibits constitutive cyclooxygenase-1 (COX-1), responsible for the synthesis of prostaglandins meet physiological functions. In the gastrointestinal tract is absorbed almost completely (90%). Plasma concentrations are in linear dependence on the dose. t1/2 in blood is 20 hours. In the synovial fluid concentration of 50% is achieved in the blood. In more than 99% bound to plasma proteins, primarily albumin. 95% metabolized in the liver – inactive metabolites are excreted in the urine of 50% and 50% in the faeces; 5% of the drug is excreted unchanged in the feces and trace amounts in the urine. Very slightly inhibits platelet aggregation, preferentially acts on COX-2.

Indications

Meloxicam is used for short-term symptomatic treatment of exacerbations of osteoarthritis and long-term symptomatic treatment of rheumatoid arthritis and ankylosing spondylitis.

Meloxicam is also used as a painkiller

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Side effects

Common side effects

The most common side effects of meloxicam affect gastrointestinal tract: nausea, vomiting, dyspepsia, abdominal pain, bloating, diarrhea, constipation, gastritis, inflammation of the lining of the mouth or esophagus, gastrointestinal bleeding (including tarry stools, bloody vomiting) and gastrointestinal ulceration sometimes with bleeding and perforation (including fatal, especially in elderly patients), inflammation of the lining of the colon, exacerbation of colitis, exacerbation of Crohn’s disease, increased liver enzymes, rarely hepatitis, liver failure, jaundice, pancreatitis.

Possible side effects

Possible: headache, dizziness, fatigue, drowsiness, mood disorders, insomnia, nightmares, confusion, nervousness, depression, anxiety, visual disturbances (including blurred vision), conjunctivitis, tinnitus. Possible heart failure, palpitations, coronary heart disease (angina pectoris), edema, hypertension, vasculitis, flushing, fainting, hematologic disorders, including anemia, agranulocytosis, leukopenia, thrombocytopenia (if you develop symptoms such as fever, sore throat, flu-like symptoms, superficial ulceration of the mouth, fatigue, epistaxis, bruising, petechiae or purpura should immediately consult a doctor, as this may be the first signs of haematological disorders).

Rare side effects

Possible impairment of renal function, sodium and water retention, renal failure, increased blood urea and creatinine in the blood. Hypersensitivity reactions (rash, hives, itching, sensitivity to light) and anaphylactic reactions, including forming life-threatening anaphylactic shock, angioedema (swelling of the face, larynx, tongue, and throat that may cause difficulty breathing), bronchospasm, asthma attack and severe skin reactions: toxic epidermal necrolysis, Stevens-Johnson syndrome, erythema multiforme. Long-term use of meloxicam in high doses may increase the risk of heart attack or stroke.

Drug Interaction

Tell your doctor about all the medicines you take, also those available without a prescription.

Meloxicam is not recommended for use with:

  • Aspirin or other nonsteroidal anti-inflammatory drugs, including selective COX-2 inhibitors (increased risk of side effects, especially ulcers and gastrointestinal bleeding);
  • Diuretics, such as furosemide and antihypertensive drugs, including ACE inhibitors, angiotensin antagonists (possibly reducing their effectiveness; increased risk of renal dysfunction and the development of acute renal failure, especially in patients dehydrated or elderly, should ensure adequate hydration of the patient and to monitor renal function);
  • Oral anticoagulants, such as warfarin (possible enhancement of their effects and increase the risk of bleeding, and if you can not avoid the parallel use of these preparations should be closely monitored for blood clotting);
  • Drugs inhibiting platelet aggregation, such as ticlopidine, clopidogrel (increased risk of bleeding);
  • Thrombolytics (increased risk of bleeding);
  • Corticosteroids or serotonin reuptake inhibitors (increased risk of side effects, especially gastrointestinal bleeding);
  • Medicines called beta-blockers (possibly reducing their effectiveness);
  • Cyclosporine and tacrolimus (increased risk of nephrotoxicity, renal function should be monitored, especially in elderly patients);
  • Lithium (possible to increase the concentration of lithium and severity of the toxic effects, in case of necessity parallel application is recommended to control the concentration of lithium in the blood);
  • Methotrexate in doses greater than 15 mg per week (possible to increase the concentration of methotrexate and the severity of its toxic effects, sometimes severe poisoning, as in the case of methotrexate in doses lower than 15 mg per week is possible intensification of its toxic effects on the hematopoietic system and should be checked frequently complete blood count and renal function, caution should be exercised in patients with impaired renal function, and in the case if the interval between preparation and administration of methotrexate does not exceed 3 days);
  • cholestyramine (cholestyramine significantly accelerates the elimination of meloxicam).
  • Women with uterine inserts before using meloxicam, should consult a doctor.
  • You cannot exclude the interaction between meloxicam and oral antidiabetic drugs.

Contraindications

Unfortunately, even if there are indications for use of the preparation, you can not always use it. You can not use the product if you are allergic (hypersensitivity) to any component of this product or to other NSAIDs, including aspirin. It is contraindicated if you have ever occurred in the symptoms of allergy to acetylsalicylic acid (commonly known as aspirin) or other NSAIDs (eg, ibuprofen, ketoprofen). Sensitization it could manifest itself in the form of hypersensitivity reactions such as asthma attack, bronchospasm, allergic rhinitis, nasal polyps, angioneurotic edema or skin reactions, including urticaria, rash, erythema. Use of the product is contraindicated in patients: with active or recurrent peptic and / or duodenal bleeding or perforation, in that after use of NSAIDs – With severe hepatic impairment with severe renal failure and dialysis from gastrointestinal bleeding, cerebrovascular bleeding or other – With severe heart failure and · Pregnant women and breast-feeding. Should not be used in children and adolescents under 15 years of age.

Precautions

Some diseases and other circumstances may contraindicate the use or indication for dosage adjustment. In some situations it may be necessary to carry out specific examinations. The use of the lowest effective dose for the shortest possible period reduces the risk of side effects.

Avoid parallel use of other nonsteroidal anti-inflammatory drugs (including selective COX-2 inhibitors).

If symptoms persist after a few days of treatment, consult your doctor. Do not increase the dose prescribed or enable other NSAIDs because it increases the risk of side effects. If you have ever occurred in inflammation of the lining of the esophagus or stomach and / or ulceration of the stomach, inform the physician prescribing prescription for this drug. It is a complete cure of these disorders before starting the drug. If you have a history of these inflammation or ulcer treatment may contribute to their relapse. It should be under the supervision of a physician and report to him any irregularities or suspicions concerning the activities of the gastrointestinal tract.

Treatment may be associated with increased liver enzymes and changes in other parameters of liver function and kidney function. These changes are usually transient. In such an event, it should be immediately consult your doctor, who may recommend discontinuation of treatment. Alcohol consumption during the use of the drug may increase the risk of gastrointestinal bleeding and peptic ulcer disease.

Debilitated patients and / or low-weight side effects may be more severe; Patients in this group should remain under close medical supervision. Increased caution is also required in the case of the elderly, who are more likely to have impaired renal function, liver or heart. In elderly patients the risk of adverse effects (especially gastrointestinal bleeding, which can cause death) is increased. The use of non-steroidal anti-inflammatory drugs is associated with the risk of gastrointestinal bleeding, ulceration or perforation, which can be fatal and may not necessarily be preceded by warning signs. These symptoms can occur at any time during treatment, even in patients without previous gastrointestinal dysfunction. These complications are particularly dangerous in the elderly. Always tell your doctor about any unusual symptoms from the gastrointestinal tract (especially of bleeding). If there is bleeding from the gastrointestinal tract require immediate discontinuation of treatment. In the case of people with diseases of the gastrointestinal tract, with a history of ulcer bleeding or perforation, the preparation is possible only under medical supervision. In these patients should use the lowest effective dose. Large doses and older age increase the risk of gastrointestinal bleeding. Your doctor may prescribe medications curtain, such as proton pump inhibitors or misoprostol.

Drugs shielding may also be indicated in patients taking drugs that increase the risk of adverse effects from the gastrointestinal tract, including peptic ulcer or bleeding (eg, systemic corticosteroids, anticoagulants such as warfarin, drugs that inhibit platelet aggregation, including even small dose acetylsalicylic acid [commonly referred to as aspirin] class of drugs selective serotonin reuptake inhibitors). Caution should be exercised.

Because of the potential for exacerbation of the disease, the formulation may be used only under strict medical supervision and with caution in patients with ulcerative colitis or Crohn’s disease. Particular caution should be exercised if the preparation is used in patients with hypertension, congestive heart failure, fluid retention, with edema (NSAIDs may cause fluid retention and edema). Patients should remain under medical supervision. It is recommended that monitoring of cardiac and renal function.

Long-term use of NSAIDs in high doses may increase the risk of heart attack or stroke. Particular care and close medical supervision is required for its use in patients with hypertension, congestive heart failure, ischemic heart disease, peripheral arterial disease or cerebrovascular disease and in patients with risk factors for diseases of the cardiovascular system (diabetes, smoking, hyperlipidemia). If you belong to any of the above groups, before the administration consult your doctor.

The drug, like other NSAIDs, can cause serious skin reactions, sometimes leading to death, such as Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis. These reactions are very rare and usually occur in the first month of preparation. In the case of the first signs of skin changes (rash, lesions of the mucous membranes) or any symptoms, immediately discontinue using the drug and consult a doctor. If you experience severe skin reactions associated with the use of meloxicam is not allowed to return to its use.

The drug should be used with caution by people with reduced blood flow through the kidneys and the volume depletion. In these patients may experience impaired renal function, which usually resolve after discontinuation of the drug. Group increased risk of these disorders include patients with congestive heart failure, cirrhosis, nephrotic syndrome, renal failure, with nephritis, using diuretics or antihypertensive significantly dehydrated and after major surgical procedures as well as the elderly. In these patients, careful monitoring of renal function and urine output during the period of application of the drug.

The use of non-steroidal anti-inflammatory drugs (NSAIDs) may cause retention of sodium, potassium and water and cause swelling, or worsening of hypertension and cardiac dysfunction. The close clinical supervision and clinical control from the start of treatment is required for the use of patients with hypertension or heart failure. Possibly reduces the efficacy of antihypertensive therapy.

Patients with diabetes and applying medications that may increase serum potassium is recommended regular monitoring of serum potassium due to the risk of hyperkalemia. The drug, like other NSAIDs, may mask signs of infection. If you suspect an infection, consult a doctor because you may need to apply the appropriate treatment. The drug does not work antimicrobial.

Use of the drug may cause impaired fertility in women and is not recommended for women who intend to become pregnant.

Additional information about the other components of the preparation:

  • Preparation contains lactose; people with problems of galactose intolerance, the Lapp lactase deficiency or malabsorption of glucose-galactose should not take this medicine.

Dosing and Administration

meloxicam tabletThe drug is made in the form of tablets. It is intended for oral use. Apply the preparation according to the doctor instructions. Do not exceed the recommended dose because it does not increase the efficacy of the drug and can harm your health and life. If you have any questions concerning the preparation, consult your physician.

Exacerbation of osteoarthritis:

the recommended dose is 7.5-15 mg 1 time a day.

Rheumatoid arthritis, ankylosing spondylitis:

15 mg 1 time per day; doctor may reduce the dose to 7.5 mg per day for a satisfactory therapeutic response.

Do not exceed the maximum daily dose, which is 15 mg.

In elderly patients or with an increased risk of side effects dose adjustment is required by a doctor. Typically, in this group of patients, the recommended dose is 7.5 mg daily.

In patients undergoing dialysis with severe renal impairment, the dose should not exceed 7.5 mg daily.

In patients with mild or moderate renal impairment (creatinine clearance greater than 25 mL / min) or hepatic no dose adjustment is required.

Meloxicam is contraindicated In patients with severe renal impairment who are not undergoing hemodialysis and in patients with severe hepatic impairment.

Meloxicam should not be used in children and adolescents under 15 years of age.

Method of application:

It is intended for oral use. Tablets should be taken with a meal, with water or another liquid. The daily dose should be taken as a single dose (ie, 1 time a day).