Mobic

Mobic or Meloxicam is an NSAID just like Celebrex, ibuprofen and naproxen. Although it is classified as a non-specific inhibitor of the COX enzymes, at typical doses it basically blocks only the COX 2 enzyme. As such, Mobic should avoid many of the gastrointestinal, cardiovascular and thromboitc side effects of those aspirin relatives indiscriminately blocking both of the enzymes.

Mobic is the 38th most frequently prescribed medicine in America with more than 19 million prescriptions written each year. Mobic was patented in 1977 and was granted marketing approval by the FDA in 2000.

Primary indications are osteoarthritis, rheumatoid arthritis and juvenile rheumatoid arthritis. It is available as a tablet – either 7.5 mg or 15 mg - with advice to always begin with 7.5 mg once daily for a sufficient time to judge its impact on the underlying disease and the associated pain. It may be taken with or without food. A relatively new orally disintegrating tablet is available at a premium price for those unable to swallow a pill.

A new intravenous preparation for in office use or in ambulatory settings supposedly provides pain relief for 24 hours. Some recent investigations indicate relief only lasts for the first 18 hours with no better relief than placebo for the final 6 hours. Additionally some evidence indicates both Mobic and Celebrex provide less pain relief than full doses of other NSAIDS.

As with any drug, the side effect profile suggests the smallest practical dose for the shortest period of time. Important toxicity relates to the gastrointestinal system with bleeding, ulceration and perforation. Cardiovascular issues include the potential for heart attack and stroke. These issues occur in all of the NSAIDS in use today although the potential for harm might be lowest with Mobic.

Other problems include kidney injury when prostaglandins are important for maintaining renal blood flow. Especial caution is necessary in the elderly and those with dehydration from vomiting, diarrhea or inadequate fluid intake. Risks further increase with pre-existing renal or liver impairment and in those receiving ACE inhibitors or ARBs for control of blood pressure.