What is the information about Mobic (Meloxicam)?

From the Guidelines

Mobic, also known as meloxicam, is a nonsteroidal anti-inflammatory drug (NSAID) that should be used at a dose of 7.5-15 mg daily for the treatment of pain and inflammation associated with osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis, with caution in patients with cardiovascular risk factors, as evidenced by studies such as 1.

Key Considerations

• The dosage of Mobic should be individualized, with a typical starting dose of 7.5 mg once daily, which can be increased to 15 mg daily if needed, as recommended in the management of inflammatory arthritis 1.
• Mobic works by inhibiting cyclooxygenase (COX) enzymes, particularly COX-2, which reduces the production of prostaglandins responsible for pain and inflammation.
• Common side effects include stomach upset, heartburn, dizziness, and headache, while more serious risks include gastrointestinal bleeding, cardiovascular events, and kidney problems, especially with long-term use.
• Patients with a history of heart attack, stroke, or severe heart failure should avoid Mobic, and caution is needed in those with hypertension, liver disease, or kidney disease, as highlighted in the American Heart Association's scientific statement on the use of NSAIDs 1.

Special Populations

• Elderly patients or those with renal impairment should start with the lowest effective dose, as recommended in the guidelines for the treatment of juvenile idiopathic arthritis 1.
• Pregnant women in their third trimester should not take Mobic, and it should not be taken with other NSAIDs.
• The American College of Rheumatology guideline for the treatment of juvenile idiopathic arthritis recommends the use of NSAIDs, including meloxicam, as part of the treatment plan 1.

Monitoring and Precautions

• Patients taking Mobic should be monitored for signs of gastrointestinal bleeding, cardiovascular events, and kidney problems, as well as for changes in blood pressure and renal function.
• The use of Mobic should be carefully considered in patients with cardiovascular risk factors, and alternative treatments should be explored if possible, as recommended in the scientific statement from the American Heart Association 1.

From the FDA Drug Label

NSAID medicines can cause ulcers and bleeding in the stomach and intestines at any time during treatment Ulcers and bleeding: can happen without warning symptoms may cause death The chance of a person getting an ulcer or bleeding increases with: taking medicines called "corticosteroids" and "anticoagulants" longer use smoking drinking alcohol older age having poor health Meloxicam Mobic® The Mobic drug label indicates that it is an NSAID medicine that can cause ulcers and bleeding in the stomach and intestines at any time during treatment.

• The label warns that ulcers and bleeding can happen without warning symptoms and may cause death.
• The risk of ulcers and bleeding increases with factors such as taking certain medicines, longer use, smoking, drinking alcohol, older age, and having poor health.
• Mobic should only be used exactly as prescribed, at the lowest dose possible, for the shortest time needed 2.

From the Research

Mobic Overview

• Mobic, also known as meloxicam, is a non-steroidal anti-inflammatory drug (NSAID) used to treat osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute 'rheumatic' pain 3.
• It is a COX-2 preferential inhibitor, which means it has less gastrointestinal toxicity than non-selective NSAIDs 3, 4.

Efficacy and Safety

• Meloxicam has been shown to be as effective as piroxicam, diclofenac, and naproxen in treating osteoarthritis, with fewer clinical gastrointestinal symptoms and less perforations, obstructions, and bleeds 3.
• In clinical trials, meloxicam was found to be safe and effective in treating osteoarthritis, with a lower incidence of gastrointestinal adverse events compared to diclofenac 5.
• The recommended dose of meloxicam is 7.5-15 mg daily, with gastrointestinal tolerability comparable to that of placebo 5, 4.

Side Effects and Interactions

• Common side effects of meloxicam include abdominal pain, anemia, and edema, as well as an increased risk of serious gastrointestinal adverse events, such as ulceration and bleeding 6.
• Meloxicam may interact with other medications, such as blood thinners, and should be used with caution in patients with a history of gastrointestinal problems or bleeding disorders 6, 7.

Comparison to Other NSAIDs

• Meloxicam has been compared to other NSAIDs, such as celecoxib, ibuprofen, and naproxen, in terms of safety and efficacy in patients with osteoarthritis and rheumatoid arthritis 7.
• Studies have shown that meloxicam may have a similar or lower risk of cardiovascular, gastrointestinal, and renal adverse events compared to other NSAIDs 7.