NURUL NADIAH BINTI NOR SUKOR

C 111 11 857
NON-OPIOID DRUG

MOBIC
INDICATION
Meloxicam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints. Meloxicam is
known as a nonsteroidal anti-inflammatory drug (NSAID).

PHARMACODYNAMIC
The pharmacodynamic properties of NSAIDs can be recorded as inhibitory effects on COX enzymes.
Meloxicam preferentially inhibits COX-2, which is induced by inflammatory stimuli in pathophysiological
conditions. Meloxicam is an nonsteroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic
properties. Prostaglandins are substances that contribute to inflammation of joints. Meloxicam inhibits
prostaglandin synthetase (cylooxygenase 1 and 2) and leads to a decrease of the synthesis of
prostaglandins, therefore, inflammation is reduced. It has a high intrinsic activity combined with a low
ulcerogenic potential.

SIDE EFFECT
In general, the most common side effects with NSAIDs are related to the gastrointestinal tract (GI) and
include nausea, vomiting, abdominal pain, diarrhea, and gas. To prevent these common side effects, it is
recommended that most NSAIDs be taken with food or milk. NSAIDs may cause ulcers in the stomach
and or small intestine. A few NSAIDs are designed to be less damaging to the stomach and small
intestine, and, therefore, they may be taken with or without food. Meloxicam is an example of one of
these NSAIDs, but, nevertheless, it should be taken cautiously without food. NSAIDs have been
associated with an increased risk of blood clots that can cause strokes and heart attacks. NSAIDs also
may interfere with the function of the kidneys or injure the kidneys.
Nervous system
Nervous system side effects have included headache , dizziness, and insomnia. Nervous system side
effects reported in less than 2% of treated patients have included convulsions, paresthesia, tremor,
vertigo, abnormal vision, conjunctivitis, taste perversion, and tinnitus.
Cardiovascular
Cardiovascular side effects have included edema. Other cardiovascular side effects have included angina
pectoris, cardiac failure, hypertension, hypotension, myocardial infarction, vasculitis, arrhythmia,
dehydration or decreased intravascular volume, palpitations, and tachycardia.
Hypersensitivity
Hypersensitivity reactions have included anaphylactic shock, facial edema, fever, hot flashes, syncope,
fatigue, and malaise.
Respiratory
Respiratory system side effects have included cough and pharyngitis or upper respiratory infection.
Respiratory system side effects in less than 2% of patients have included asthma, bronchospasm, and
dyspnea.
Dermatologic
Dermatologic side effects have included rash and pruritus. Dermatologic side effects observed in less
than 2% of patients have included alopecia, angioedema, bullous eruption, erythema multiforme,
photosensitivity reaction, pruritus, Stevens-Johnson syndrome, increased sweating, toxic epidermal
necrolysis, and urticaria.
Hematologic
Hematologic side effects have included anemia (reported in more than 2% of patients, but only in some
studies.) The incidence has ranged from 0.1% to 4%. Stool sampling for blood loss was not reported in
these studies. Other hematologic side effects have included agranulocytosis, leukopenia, purpura, and
thrombocytopenia.
Musculoskeletal
Musculoskeletal side effects have included arthralgias in up to 5% and back pain in up to 3% of patients.
Genitourinary
Genitourinary side effects have included new urinary tract infections in up to 7% of patients (it has been
the only genitourinary complaint reported in at least 2% of patients.) Hematuria has been associated
with the use of meloxicam (the active ingredient contained in Mobic) in less than 2% of patients. Acute
urinary retention has been reported in less than 0.1% of patients in postmarketing experience.
Hepatic
Hepatic side effects have been rarely reported (2% or less). These have included, increased serum
enzymes (ALT, AST, and GGT), bilirubinemia, hepatitis, jaundice, and liver failure.
Psychiatric
Psychiatric side effects have included abnormal dreaming, anxiety, confusion, depression, nervousness,
and somnolence.
Renal
Renal side effects have included urinary frequency, albuminuria, increased BUN, increased serum
creatinine, hematuria, interstitial nephritis, and renal failure. New or worsened renal insufficiency has
been rarely associated with the use of meloxicam (the active ingredient contained in Mobic) (less than
2% of treated patients).
CONTRAINDICATION
Allergic Reactions
It is contraindicated in patients with known hypersensitivity (e.g., anaphylactoid reactions and serious
skin reactions) to meloxicam. It should not be given to patients who have experienced asthma, urticaria,
or allergic-type reactions after taking aspirin or other NSAIDs. Severe, rarely fatal, anaphylactic-like
reactions to NSAIDs have been reported in such patients
Coronary Surgery
This drug is contraindicated for the treatment of peri-operative pain in the setting of coronary artery
bypass graft (CABG) surgery

SPECIAL PRECAUTION
This drug may contain inactive ingredients, which can cause allergic reactions or other problems.
Special precaution need to be taken for patient with asthma (including a history of worsening breathing
after taking aspirin or other NSAIDs), liver disease, stomach/intestine/esophagus problems (such as
bleeding, ulcers, recurring heartburn), heart disease (such as history of heart attack), high blood
pressure, stroke, blood disorders (such as anemia, bleeding/clotting problems), growths in the nose
(nasal polyps). Kidney problems can sometimes occur with the use of NSAID medications, including
meloxicam. This medication may cause stomach bleeding. Daily use of alcohol and tobacco, especially
when combined with this medication, may increase risk for stomach bleeding. Limit alcohol and
smoking. This medication may make skin more sensitive to the sun. Avoid prolonged sun exposure,
tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.
During pregnancy, this medication should be used only when clearly needed. It is not recommended for
use during the first and last trimesters of pregnancy due to possible harm to the unborn baby and
interference with normal labor/delivery.

DOSAGE

Usual Adult Dose for Osteoarthritis
Initial dose: 7.5 mg orally once daily
Maintenance dose: 7.5 mg orally once daily
Maximum dose: 15 mg orally daily
Usual Adult Dose for Rheumatoid Arthritis
Initial dose: 7.5 mg orally once daily
Maintenance dose: 7.5 mg orally once daily
Maximum dose: 15 mg orally daily
Usual Pediatric Dose for Juvenile Rheumatoid Arthritis
Greater than or equal to 2 years: 0.125 mg/kg orally once daily
Maximum dose: 7.5 mg orally daily
There was no additional benefit demonstrated by increasing the dose above 0.125 mg/kg once
daily in clinical trials.