Meloxicam

Meloxicam is a nonsteroidal anti-inflammatory drug used to relieve the symptoms of arthritis, primary dysmenorrhea, fever; and as an analgesic, especially where there is an inflammatory component. It has been developed by Boehringer-Ingelheim. It is closely related to piroxicam.

In Europe it is marketed under the brand names Movalis, Melox, and Recoxa. In the U.S. it is generally marketed under the brand name Mobic, in Canada as Mobicox. In Latin America, the drug is marketed as Tenaron.

Mechanism of action
Meloxicam is an NSAID and belongs to the class of drugs called enolic acid group, structurally related to piroxicam. Meloxicam significantly decreased symptoms of pain, function, and stiffness in patients, with a low incidence of gastrointestinal side effects. In models, it exhibits anti-inflammatory, analgesic, and antipyretic activities. Its mechanism of action may be related to prostaglandin synthetase (cyclooxygenase) (COX) inhibition.

Meloxicam has been shown, especially at its low therapeutic dose, to selectively inhibit COX-2 over COX-1.

A primary advantage of the Oxicam family of drugs is their long half-life which permits once-day dosing.

Adverse effects
Meloxicam use can result in gastrointestinal toxicity and bleeding, tinnitus, headache, rash, very dark or black stool (sign of intestinal bleeding). The risk of adverse side effects is lower than with piroxicam, diclofenac, or naproxen. Although meloxicam does inhibit thromboxane A, it does not appear to do so at levels that would interfere with platelet function.

In rare situations, it could cause serious liver disease. If there is a sensation of fatigue and/or liver pain, intake must be ceased.

Approval status
Meloxicam is licensed in Europe for treatment of rheumatoid arthritis, for short term use in osteoarthritis and for ankylosing spondylitis. As of 2004 it has been approved for use in treating osteoarthritis in the United States of America.

Veterinary use
Meloxicam is also used in the veterinary field, most commonly in dogs and cattle, but also in other animals such as cats and exotics. It is marketed under the brand name Metacam. It has similar side effects in animals as humans, but principal side effects are gastrointestinal irritation (vomiting, diarrhea and ulceration). Rarer but important side effects include liver and kidney toxicity. The safety of using Meloxicam in cats over longer periods has not been established.