A Comprehensive Review of Meloxicam
Arthritis is a condition that does not get much attention but is, in fact, the leading cause of disability among U.S. adults. Approximately 54 million adults live with arthritis while arthritis or a rheumatic condition affects 300,000 babies and children. With statistics like that there needs to be a reliable treatment. That is where meloxicam comes into play.
Pain and Inflammation is a natural part of the immune response, but when the immune system is overactive as in the case of arthritis, it can lead to pain, swelling, and stiffness of the joints; meloxicam works to reduce that.
What is Meloxicam?
Meloxicam is a medication commonly prescribed by a doctor to treat pain associated with inflammation related to arthritis. It is sold by the name brand, Mobic through pharmacies by prescription only. Meloxicam was approved by the Food and Drug Administration in April 2000 as an effective treatment of arthritis pain including pain, stiffness, and swelling in the joints.
Meloxicam is a Type of NSAID
Non-steroidal anti-inflammatory drugs (NSAIDs) work by decreasing or blocking the production of prostaglandins. They do so by blocking the COX-1 and COX-2 enzymes that stimulate the production of prostaglandins. Prostaglandins are chemicals that occur naturally in the body and have a hormone-like effect.
When the body experiences injury, illness, or infection that results in inflammation a large number of prostaglandins are produced. Prostaglandins are what causes the redness, swelling, fever, and pain commonly associated with inflammation and autoimmune responses. Therefore, prostaglandins do not cause the inflammation they cause the symptoms associated with inflammation.
NSAIDS work to reduce the production of these chemicals in an inflammation and autoimmune response. A common type of NSAID, ibuprofen, works the same way. However, ibuprofen and meloxicam differ in their focus of treatment.
Ibuprofen and other low-dose aspirin are called on more often to treat mild and moderate pain and inflammation associated with more common and diverse illnesses. Whereas meloxicam is used solely in the treatment of arthritis conditions due to its responsive nature.
Corticosteroids are a class of steroidal drug treatment and are commonly used for the same conditions as meloxicam. Common names for corticosteroids are prednisone, cortisone, and methylprednisolone.
NSAIDs and corticosteroids both work to reduce prostaglandin production related to inflammation. There are three primary types of NSAIDs; selective, nonselective and partially selective. Their classification depends on their response to COX enzymes.
The Many Meloxicam Uses
Meloxicam is prescribed by a doctor to treat three specific types of arthritis; osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis. As mentioned previously, meloxicam works to reduce the painful side effects associated with inflammation which leads to the overproduction of prostaglandins. These side effects include pain, swelling, redness, and stiffness surrounding the joints. Meloxicam can be used to treat these symptoms in patients that are at least two years of age or older.
This form of arthritis is also known as degenerative joint disease or degenerative arthritis. Osteoarthritis (OA) is the most common type of chronic condition affecting the joints and can occur at any age. While OA is not age discriminate it occurs most frequently in individuals over the age of 65. OA can affect any joint in the body but is most commonly seen in the hips, lower back, knees, neck, and fingers.
In OA patients the cartilage, a protective cushion for the joints, breaks down leading to inflammation. This inflammation then leads to pain and swelling as prostaglandins react.
Spurs, areas where bones have broken down and become damaged, may develop as OA continues without treatment. The disease state ends with cartilage completely worn away and bones rubbing against bones resulting in more pain and joint damage. Meloxicam has been shown to be a very safe and effective treatment for osteoarthritis. Treatment for OA includes managing symptoms, improving mobility and flexibility, obtaining a healthy weight, and getting exercise.
Meloxicam is part of OA treatment as a method of managing symptoms.
This form of arthritis, known as RA for short, is classified as an autoimmune disease. With this disease state, the body’s immune system mistakenly attacks healthy joints seeing them as foreign and potentially dangerous. This attack ultimately leads to inflammation, which is meant to be protective and sends a host of immune mediators to the sight. These mediators include T cells, B cells, macrophages, cytokines, and of course prostaglandins. As a result, pain, swelling, and stiffness ensue in the affected joint.
A multifaceted approach should be taken in the treatment of RA. This generally includes easing the symptoms, slowing disease activity, and in extreme cases surgery. Meloxicam works to ease symptoms by reducing the production of these prostaglandins in response to inflammation in RA patients. If inflammation is allowed to continue unchecked will cause a degradation of the cartilage and joints themselves.
The joints that are most commonly affected in RA are the hands, elbows, knees, feet, wrists, and ankles. A unique fact regarding the manifestation of RA is its symmetrical nature. Meaning, if the left hand is affected then the right hand will be affected as well, and so forth with the knees, and other joints.
Juvenile Rheumatoid Arthritis
Affecting nearly 300,000 children ranging from infancy to teenage years, juvenile rheumatoid arthritis (JRA), also known as juvenile idiopathic arthritis contains six types of the disease. They are all considered autoimmune except for systemic JRA which is autoinflammatory.
Research is still quite unclear as to the cause of JRA, but there may be a genetic factor leading to its development. While there is no cure for JRA treatment options exist that focus on reducing symptoms and preventing damage to affected areas of the body. Meloxicam works in the treatment of JRA to reduce symptoms associated with inflammation.
Meloxicam vs. Ibuprofen and other NSAIDs
While all NSAIDS work the same in the treatment of acute or chronic pain associated with inflammatory joint diseases they are not all equal. The most widely known over the counter NSAID, ibuprofen, is a nonselective NSAID while meloxicam is known as a partially selective NSAID.
The enzymes that stimulate prostaglandins are COX-1 and COX-2. Whether or not an NSAID is categorized as selective, nonselective, or partially selective depends on its relationship with these enzymes. Selective enzymes block COX-2 and not COX-1, nonselective block both, and partially selective primarily block COX-2. By blocking box COX-1 and COX-2 there comes the risk of GI bleed and ulcers because COX-1 is important in platelet aggregation in the gut. Therefore, COX-2 inhibitors were developed.
How to Determine Meloxicam Dosage
The prescribing physician will work with the patient to determine the best dose and a case by case basis. Generally, the patient should be started on the lowest possible dose as a set point. From there the dose can be increased if they continue to be symptomatic.
The lowest dose of meloxicam that is still effective for adults is around 7.5 mg a day. In the case of JRA, a dose equation is used which is 0.125 mg/kg a day, up to and not exceeding 7.5 mg a day. For adults, the max dose of meloxicam as an oral suspension and tablet is 15 mg a day at one time while oral capsule’s max dosage is 10 mg a day at once. These doses to treat adults are for RA and OA patients.
Missing a dose is not a major concern, but if it happens the individual should try to take it as soon as they remember. However, if it is not remembered until the next day then the dose should be skipped altogether and continue as normal. Otherwise, overdose becomes a risk. Symptoms of overdose are asthma-like, vomiting, nausea, abdominal pain, and gastrointestinal discomfort.
The Meloxicam Side Effects
As with any medication, there are risks and side effects, and meloxicam is no different. All signs and symptoms of a negative reaction should be taken seriously. Allergic reactions may occur among people allergic to NSAIDS, but this type of reaction is rare. Look for itching, rash, dizziness, swelling of the throat or tongue, and trouble breathing.
Common Meloxicam side effects that are not life-threatening unless they persist include nausea, diarrhea, dizziness, and upset stomach. It may take time for the body to adjust to meloxicam, but if any of these symptoms persists medical attention should be sought.
Meloxicam can have a blood pressure raising effect making it important that anyone taking this medication keep a check on their blood pressure regularly. A desirable blood pressure reading is less than 120/80 mm Hg. Along with side effects, there are the common supplement and drug interactions that should be considered as well. There is the potential for lithium toxicity as meloxicam increases blood lithium levels. Meloxicam is not safe to take with oral blood thinners as it thins the blood itself and can lead to excess bleeding.
Sensitivity to the sun may develop from meloxicam causing it to be necessary to avoid prolonged exposure. Tanning booths and sunlamps will have the same impact and sensitivity. Sunscreen and protective UV clothing should be worn when in the sun. Individuals taking blood pressure reducing medications should also avoid taking meloxicam as it reduces the effects of such drugs. Anyone with liver or kidney disease, a history of ulcers, blood disorders, or chronic bleeding should make this information known to their prescribing physician prior to taking meloxicam.
Meloxicam is not advised for women who are pregnant. This becomes even truer as the pregnancy progresses. If a woman is pregnant or planning to become pregnant it is important to release this information to her prescribing physician as meloxicam can impact both fertility and the unborn baby. The impact of meloxicam on breastmilk is unknown and breastfeeding should be avoided while taking meloxicam, or vice versa.
Interactions of Meloxicam and Alcohol
Those who drink alcohol should do so with caution. Drinking more than three alcoholic beverages a day may increase the risk of stomach ulcers when taking meloxicam. Because meloxicam can cause dizziness as well as alcohol it is imperative not to operate a vehicle after either use and to use them separately.
Symptoms of intestinal bleeding, which may result from the use of alcohol and meloxicam, are black, tarry, or bloody stools. Coughing or vomiting material that resembles coffee grounds is also a signal that there is intestinal or stomach bleeding. If these are observed medical attention must be sought immediately.
The individual suffering from arthritis pain and flares will agree that meloxicam can be a life-changing medication. The physiologic approach to reducing pain, redness, and stiffness associated with arthritis induced inflammation is revolutionary. While there are risks associated with meloxicam, as with any medication, the risks and benefits should be fully discussed with a prescribing physician.
Where to Buy Meloxicam
Meloxicam can only be obtained through a prescription. It generally prescribed by a rheumatologist or primary healthcare provider to people who have been diagnosed with rheumatoid arthritis, osteoarthritis, or juvenile rheumatoid arthritis. It is important to purchase prescription medications through a licensed drug store by way of prescription only.
Obtaining prescription medication through any other method poses serious dangers and risks. Doses are based on the individual suffering from symptoms and each person should be assessed for their need and dosage.
Meloxicam can be ordered online through online pharmacies; however, a prescription is still required to obtain the medication. It is important to check whether the source is reputable. Buying through an online pharmacy may also slow down the delivery of the product and may cause the purchaser to have trouble obtaining their medication if there is an issue with shipping.
Final Thoughts on Meloxicam
It is important to understand that meloxicam is not a cure. It is a necessary and effective treatment for the symptoms associated with arthritis caused by inflammation. Living with arthritis can be life-altering and any means of easing symptoms can greatly improve the quality of life for an arthritis patient. If you suffer from pain as a result of arthritis speak to your healthcare provider to see if meloxicam can work for you. It is safe and effective and is a great first step towards the control of painful arthritis symptoms.