Molecular structure of meloxicam
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Meloxicam

Meloxicam is a nonsteroidal anti-inflammatory drug used to relieve the symptoms of arthritis, primary dysmenorrhoea, pyrexia; and as an analgesic, especially where there is an inflammatory component. It is closely related to piroxicam. more...

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In Europe it is marketed under the names of Movalis, Melox, and Recoxa.

Mechanism of action

Meloxicam is an NSAID and, as such is a cyclooxygenase (COX) inhibitor. It is generally marketed under the name MOBIC. Meloxicam has been shown, especially at its low therapeutic dose, to selectively inhibit COX-2 over COX-1.

Adverse effects

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

Approval status

Meloxicam is quite popular in Europe for treatment of rheumatoid arthritis. It has recently (as of 2004) been approved for use in treating osteoarthritis in the United States.


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New Arthritis Drug Offers No Advantage
From Healthfacts, 7/1/00 by Maryann Napoli

Yet another painkiller for osteoarthritis has been approved recently by the Food and Drug Administration (FDA). One can only wonder why. It is no more effective than currently available drugs; it involves the same level of risk; and it is more expensive. The new drug is meloxicam (brand name: Mobic), a non-steroidal, anti-inflammatory drug of the same drug class that includes, aspirin, ibuprofen (Motrin), naproxen (Naprosyn), and celecoxib (Celebrex).

The FDA Web site states that Mobic showed "significant improvement compared to placebo," but gave no details. The two unpublished studies, required by the FDA, involved people with osteoarthritis of the knee or hip. One lasted 12 weeks, and the other lasted one to six months. Efficacy was judged to be comparable to two other non-steroid, anti-inflammatory drugs, piroxicam (Feldene) and diclofenac (Voltaren). Whether the new drug is more effective than the newer, widely promoted Celebrex or Vioxx remains to be determined.

All non-steroidal, anti-inflammatory drugs, including aspirin, are associated with severe gastrointestinal bleeding, which kills about 10-15,000 Americans yearly and hospitalizes an estimated 70,000 more. According to the FDA, "the serious gastrointestinal toxicity, inflammation, bleeding, ulceration, and perforation of the stomach can occur at any time with and without warning symptoms. Even short-term therapy is not without risk. Only one in five patients who develop a serious upper gastrointestinal adverse event on non-steroidal, anti- inflammatory therapy is symptomatic."

The cost of a one month supply of Mobic is $59.40, compared to $10.48 for the generic version of ibuprofen. At $72 for a one-month supply, Celebrex Vioxx are the most expensive non-steroidal, anti-inflammatory drugs. Though neither has been proven more effective than other drugs in this class, both drugs reduce--but do not eliminate--the risk of gastric hemorrhage.

COPYRIGHT 2000 Center for Medical Consumers, Inc.
COPYRIGHT 2003 Gale Group

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