Meloxicam (Mobic, Xobix) – Uses, Side effects, Interactions, & Warnings

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meloxicam uses and indications

Meloxicam is a strong pain-relieving medicine that is available by the brand name of Xobix and Mobic. It is classified as selective Cox-2 inhibitor NSAID (non-steroidal anti-inflammatory drug) that is used for pain relief, tenderness, swelling, and stiffness in various conditions.

Meloxicam, a powerful pain-relieving medicine. It must be prescribed only by a doctor. You can get it as a tablet or capsule. Boehringer Ingelheim Pharmaceuticals makes the brand-name Mobic. Many other manufacturers also make generic meloxicam.

What is meloxicam used to treat?

Meloxicam is used for the treatment of pain and inflammation caused by rheumatoid, osteoarthritis, and juvenile rheumatoid. Meloxicam works by blocking enzymes cyclooxygenase 1, 2, and 3, which reduces inflammation. Meloxicam can also be used to treat Ankylosing Spondylitis. 

Meloxicam treats the following symptoms:

  • Pain,
  • Stiffness,
  • Swelling, and
  • Tenderness;

It is stronger than ibuprofen. One study found that patients suffering from osteoarthritis in their hip and knee showed significant improvements after 12 weeks compared to those who received a placebo.

Chronic arthritis is often treated with Meloxicam (Mobic). It was approved by the Food and Drug Administration (FDA), for use in the United States in 2000. Meloxicam is not available without a prescription from a doctor, unlike ibuprofen.

Meloxicam is also known as a COX inhibitor. Meloxicam and other NSAID drugs work by interfering in cyclooxygenase enzymes. They temporarily decrease the production certain prostaglandin molecules. These molecules play a crucial role in our normal inflammatory reaction to injury and infection, but also make us more sensitive to pain.

How to take Meloxicam?

Meloxicam is usually taken once daily, however, you should follow your doctor’s advice. Drink a full glass (8 ounces/240 ml) of water with it. After taking this drug, you should not lay down for more than 10 minutes.

Take the liquid form of the medication and shake it gently before you take each dose. Use a spoon or special measuring device to measure the dose. You may not receive the right dose if you use a household spoon.

Remove the tablet out of the packaging only at the time of use. Use dry hands to peel off the foil and carefully remove the tablet. If the tablet is forced out of the packaging, it may get damaged. Once removed from the packaging, place it on your tongue and let it dissolve. You can also take a glass of water after it has melted.

If a stomach upset occurs while taking this medication, take it with food, milk, or an antacid. Your medical condition and response to treatment will determine the dosage. Always use the lowest effective dose and for the prescribed time. Avoid taking higher doses than prescribed as the chances of GI bleeding may increase.

Meloxicam can come in many forms, including tablets, capsules, liquid, and disintegrating tablets. You should not change between forms without talking to your doctor.

This drug may take up to two weeks to fully work. To get the best results, you should use this medication frequently. Use it daily at the same time.

You can take Mobic with food or even without food once a day, however, it is better to take it with food. You should take meloxicam every day at the same time. You should not take more than the prescribed dose or use it more frequently than your doctor has instructed.

Mix the medication evenly, shake the suspension before each use. One tablet per day is the usual dosage. Either 7.5 mg or 15 mg tablets will be prescribed.

Take the tablet in its entirety and drink some water. Each dose should be taken with a snack, or shortly after eating. You can also drink lots of water while taking meloxicam.

If your are taking the oro-dispersible, tablets:

  • Make sure to moisten your mouth and take a sip of water, if necessary.
  • Take the tablet out of the package and dry it.
  • Allow the tablet to dissolve slowly on your tongue. It should take approximately five minutes.
  • After five minutes, drink a large glass water and then swallow the tablet.
  • Before the tablet has dissolved, do not chew or swallow it.

What precautions should you take?

Before you take meloxicam, tell your doctor and pharmacist if you are allergic to meloxicam, sorbitol or aspirin.

Tell your doctor and pharmacist about any prescription or nonprescription medications, vitamins, supplements, or herbal products that you are currently taking. Be sure to mention the medications listed below:

  • angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers
  • beta blockers 
  • diuretics
  • cholestyramine 
  • cyclosporine
  • lithium
  • methotrexate, and
  • pemetrexed.

Your doctor might need to adjust the dosage of your medication or watch for side effects.

Asthma:

  • Tell your doctor if you have asthma or allergies, particularly if it’s frequent, stuffed, runny, or have nasal polyps. NSAIDs, like meloxicam might make your condition worse. If you get short of breath, develop whistling sounds in your chest, or cough, stop meloxicam and consult your doctor.

Pregnancy:

  • Tell your doctor if, if possible, you plan to become pregnant or breast-feed. If you take meloxicam around 20 weeks of pregnancy, it may cause harm to the fetus or complications with delivery. If you are not told by your doctor to, do not take meloxicam after 20 weeks.
  • Meloxicam and other NSAIDs can cause the premature closure of ductus arteriosus that can be very serious to the baby.
  • In the late pregnancy, acetaminophen is safe when taken in the usual recommended doses. You may also try other non-medical techniques such as yoga and acupuncture.

Surgery:

  • If you have surgery, such as dental surgery, inform your doctor that you are taking meloxicam. NSAIDs may cause the platelets to become less sticky and result in excessive bleeding during the surgery. It is best to stop most NSAIDs at least 12 hours before the surgery.

Fructose Intolerance:

  • If you have fructose intolerance, a condition where the body doesn’t have the protein necessary to break down fructose (a fruit sugar found in some sweeteners like sorbitol), it is important that you know that oral suspensions are sweetened with sorbitol. If you are suffering from fructose intolerance, avoid taking meloxicam and consult your doctor.
  • Aspartame may be found in disintegrating tablets. Aspartame may be found in disintegrating tablets if you have phenylketonuria or another condition that makes it difficult or impossible to eat aspartame or phenylalanine. Consult your doctor or pharmacist to learn how to safely use this medication.

Side effects of Meloxicam:

GI Side effects:

  • Although meloxicam is safer than most other NSAIDs as far as the gastrointestinal side effects are concerned, you might still experience nausea, vomiting, stomach upset, or dizziness. These symptoms can be more common if you take the drug on an empty stomach.
  • In severe cases, it may cause gastric ulcers which can bleed. You may experience bloody stools or black stool, vomiting, bloody bowel movements, or stomach (abdominal), pains. These symptoms warrant urgent medical consultations. 
  • How to manage the gastrointestinal symptoms of meloxicam?
    • To avoid the gastrointestinal side effects of meloxicam, it is best to take the drug with milk or after a meal.
    • If you still have upset stomach, take an antacid like calcium carbonate, famotidine, or omeprazole daily until the symptoms have resolved.

Effect on Blood pressure:

  • Your blood pressure may rise if you take this medication. It is recommended to check your blood pressure regularly especially if you have pre-existing hypertension.
  • How to avoid changes in blood pressure when taking meloxicam?
    • If you observe changes in blood pressure or the blood pressure readings are above the ranges, you need to monitor it frequently.
    • Reduce salt intake as meloxicam may cause fluid and salt retention resulting in a rise in the blood pressure. Start graded exercises and eat a Mediterranean diet which is rich in fruits and low in salt.

Effect on heart and brain:

  • Meloxicam can cause thrombosis and result in myocardial infarction and stroke. It can fluid retention and worsen the symptoms of heart failure. Patients who have recently undergone cardiac bypass surgery, or a myocardial infarction, avoid meloxicam and other NSAIDs.
  • It can also cause dizziness and drowsiness especially when co-administered with medications that cause drowsiness and when taken with alcohol. Avoid driving or any such activity that requires mental alertness.

Bleeding Disorders:

  • You should immediately inform your doctor if you experience bleeding or bruising. This is more common if you have a bleeding disorder such as hemophilia or you are on blood thinners like Xarelto, Eliquis, or warfarin.
  • Inform your doctor about the medications you are on or any inherent condition that can result in bleeding.

Kidney Disease:

  • NSAIDs including meloxicam can cause kidney failure. This is a serious side effect and should be identified earlier to avoid complications later. Symptoms of kidney failure may include body swelling, weight gain, headaches, mental/mood issues, changes in urine volume and unexplained stiffness, swelling at the ankles and feet, and unusual tiredness.
  • What to do if you suspect kidney failure?
  • Stop the medicine and immediately consult your doctor who may ask you to do a panel of kidney tests and an ultrasound. You might need hospitalization and intravenous fluids. Some patients may also require a short course of corticosteroids.
  • Some patients can avoid developing kidney dysfunction by taking plenty of water while taking meloxicam and avoid concomitant medications that can cause kidney disease.

Liver disease:

  • Rarely, this drug can cause severe (possibly fatal!) liver disease. It is crucial to immediately seek medical attention if you notice signs of liver damage, such as dark urine or nausea/vomiting/loss of appetite, stomach/abdominal discomfort, yellowing of eyes/skin, or other symptoms like dark urine.
  • What to do if you develop signs of liver disease?
    • Stop meloxicam and Immediately inform your doctor.

Effect on skin:

  • Meloxicam can cause skin rashes including serious skin disorders such as exfoliative dermatitis and Steven-Johnson syndrome. If you notice a rash, discontinue the treatment and consult your doctor.

Allergic Reactions:

  • It is very rare for this drug to cause a severe allergic reaction. You should seek immediate medical attention if you experience symptoms like rash, swelling, dizziness, trouble breathing, or swelling of the face/tongue/throat.
  • If you have breathing problems such as wheezes or breathlessness, you should immediately seek medical attention. If you experience symptoms such as swelling or itching around your face or mouth, don’t hesitate to visit your doctor before you start getting short of breath.

Important: If you have any of these unusual but potentially serious symptoms, discontinue taking meloxicam immediately and consult your doctor.

Meloxicam can cause more severe side effects, including strokes, high blood pressure, and heart attacks. Other serious side effects of meloxicam use include chest pain, frequent urination, not urinating at any time, coughing up blood, vomit that looks like coffee grounds and black, bloody or tarry stool. If you have any of these side effects, it is best to stop using meloxicam immediately and consult your doctor. This list does not include all side effects.

Meloxicam does not result in drug addiction. It can interact with blood thinners in a way that could cause bleeding. Meloxicam can cause stomach ulcers so it is important to avoid alcohol as much as you can.

Meloxicam Interactions with other commonly used drugs:

Drug interactions can alter the way your medication works or increase your chance of side effects. Before using meloxicam, tell your doctor about any prescription or non-prescription medicines that you are taking including herbal medicines.

This drug can interact with ACE inhibitors (such as lisinopril and captopril), angiotensin II blocking agents (such Losartan or Valsartan), cidofovir(high-dose treatment), methotrexate (high-dose therapy), lithium, cidofovir. cidofovir), water tablets (diuretics such as furosemide).

When taken with other drugs that can cause bleeding, this medication could increase your risk of bleeding. Examples include anti-platelet drugs such as clopidogrel, “blood thinners” such as dabigatran/ enoxaparin/ warfarin, among others.

Avoid Blood thinners!

It is important to read all labels on prescription and non-prescription medications. Many medications include pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib or ibuprofen) or both. These drugs can be very similar to meloxicam and may increase the chance of side effects if taken together especially gastrointestinal bleeding.

If you are on a low dose aspirin to prevent strokes or heart attacks (normally between 8 and 325 mg daily), you should continue taking aspirin unless your doctor says otherwise.

Severe interactions include:

  • sodium polystyrene sulfonate
  • apixaban
  • benazepril
  • Captopril
  • Enalapril
  • fosinopril
  • ketorolac
  • ketorolac intranasal
  • lisinopril
  • methotrexate
  • moexipril
  • pemetrexed
  • perindopril
  • quinapril
  • Ramipril
  • tacrolimus
  • Trandolapril

Is Meloxicam addictive?

Meloxicam does not cause psychological or physical dependence, it is still something that doctors should be concerned about in patients who have shown signs of substance abuse risk.

If a patient experiences persistent fatigue, vomiting, or breathing problems while taking meloxicam, they may have overdosed and need immediate medical attention. High doses of meloxicam or excessive use of the drug can cause damage to the gastrointestinal tract and lead to internal bleeding.

Meloxicam is not addictive!

The addictive potential of meloxicam may be virtually negligible, but the Food and Drug Administration warns doctors not to prescribe it or any generic brand names or generics to patients who have shown a tendency for psychological dependence on psychoactive drugs.

Although meloxicam is not addictive by itself, there are some dangers associated with using it in combination with other drugs. Unnecessary use of meloxicam can still cause liver damage. It is dangerous to misuse, but not addictive

Meloxicam is not addictive because it does not affect the brain’s reward systems in the same way that other drugs do. People who are suffering from chronic pain or have severe cases of arthritis and inflammation, who use meloxicam to treat their pain, may experience an increase in their symptoms if they stop taking meloxicam. These patients should consult their primary care physician immediately to discuss how to reduce their dependence on meloxicam.

Read: Methocarbamol (Robaxin) for Pain and Muscle Relaxation