Meloxicam

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Meloxicam
Systematic (IUPAC) name
(8E)-8-[hydroxy-[(5-methyl-1,3-thiazol-2-yl)amino]
methylidene]-9-methyl-10,10-dioxo-10λ6-thia-9-
azabicyclo[4.4.0]deca-1,3,5-trien-7-one
Identifiers
CAS number 71125-38-7
ATC code M01AC06
PubChem 5281106
DrugBank APRD00529
Chemical data
Formula C14H13N3O4S2 
Mol. mass 351.403 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability  ?
Protein binding 99.4%
Metabolism Hepatic
Half life 15 to 20 hours
Excretion Urine & Faeces equally
Therapeutic considerations
Pregnancy cat.

?

Legal status

POM

Routes Oral

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 UK and U.S. it is generally marketed under the brand name Mobic, in Canada as Mobicox. In Latin America, the drug is marketed as Tenaron. A veterinary formulation of the drug is marketed in the U.S. as Metacam by the Vetmedica division of Boehringer-Ingelheim.

Contents

[edit] 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.

[edit] 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.

Two Meloxicam pills, showing either side
Two Meloxicam pills, showing either side

[edit] 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 and is marketed in the under the name of Metacam by Boehringer Ingelheim Vetmedica.

[edit] Veterinary use

Under the brand name Metacam, meloxicam is also used in the veterinary field, most commonly in dogs and cattle, but also in other animals such as cats and exotics; in the U.S. is indicated for management of pain and inflammation associated with osteoarthritis in dogs (FDA.gov), and in Europe, where the product has been available since the early 1990s, it is also prescribed and licensed for other anti-inflammatory benefits including relief from both acute and chronic pain in dogs and cats. Side effects in animals are similar to those found in humans; the principal side effect is gastrointestinal irritation (vomiting, diarrhea and ulceration). Rarer but important side effects include liver and kidney toxicity.

For many years, both injectable and oral (liquid and tablet) formulations of meloxicam have been licensed for use in dogs, and injectable ones for use in cats. In June 2007, a new oral version of Metacam was licensed in Europe for the long-term relief of pain in cats. As of June 2008, Meloxicam is registered for long term use in cats in Australia, New Zealand, and throughout Europe.

[edit] References