Melsikam
Melsikam Uses, Dosage, Side Effects, Food Interaction and all others data.
Melsikam is an oxicam derivative which exhibits analgesic, antipyretic and anti-inflammatory actions. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors.
Melsikam is an anti-inflammatory, analgesic analgesic with antipyretic effects in fever. Prostaglandins are substances that contribute to inflammation. This drug also exerts preferential actions against COX-2, which may reduce the possible gastrointestinal effects of this drug.
In humans, meloxicam has demonstrated the ability to decrease erythrocyte sedimentation rate(ESR) in patients with rheumatoid arthritis, and to decrease ESR, C-reactive protein (CRP), as well as aquaporin-1 expression. As with other NSAIDS, prolonged use of meloxicum can result in renal or cardiovascular impairment or thrombotic cardiovascular events.
A note on gastrointestinal effects
Trade Name | Melsikam |
Availability | Prescription only |
Generic | Meloxicam |
Meloxicam Other Names | Méloxicam, Meloxicam, Meloxicamum |
Related Drugs | Humira, Buprenex, aspirin, prednisone, ibuprofen, acetaminophen, tramadol, duloxetine, naproxen, Tylenol |
Type | |
Formula | C14H13N3O4S2 |
Weight | Average: 351.401 Monoisotopic: 351.034747299 |
Protein binding | Meloxicam is about 99.4% protein bound, primarily to albumin. |
Groups | Approved, Vet approved |
Therapeutic Class | Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs) |
Manufacturer | |
Available Country | Georgia |
Last Updated: | September 19, 2023 at 7:00 am |
![Melsikam Melsikam](https://www.medicinesfaq.com/media/png/melsikam.png)
Uses
Melsikam is used for Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis
Melsikam is also used to associated treatment for these conditions: Dental Pain, Neuropathic Pain, Osteoarthritis (OA), Pain, Inflammatory, Pauciarticular juvenile rheumatoid arthritis, Polyarticular juvenile rheumatoid arthritis, chronic or unspecified, Postoperative pain, Rheumatoid Arthritis
How Melsikam works
Melsikam inhibits prostaglandin synthetase (cylooxygenase 1 and 2) enzymes leading to a decreased synthesis of prostaglandins, which normally mediate painful inflammatory symptoms. As prostaglandins sensitize neuronal pain receptors, inhibition of their synthesis leads to analgesic and inflammatory effects. Melsikam preferentially inhibits COX-2, but also exerts some activity against COX-1, causing gastrointestinal irritation.
Dosage
Melsikam dosage
For Adults:
- Osteoarthritis: 7.5 mg/day. If necessary, in the absence of improvement, the dose may be increased to 15 mg/day.
- Rheumatoid arthritis: 15 mg/day. In elderly patients the recommended dose for long term treatment is 7.5 mg/day.
- Ankylosing spondylitis: 15 mg/day. In elderly patients the recommended dose is 7.5 mg/day.
Do not exceed the dose of 15 mg/day. The total daily amount should be taken as a single dose. Patients with increased risks for adverse reactions should start treatment with 7.5 mg/day. In dialysis patients with severe renal failure the dose should not exceed 7.5 mg/day
For Children: The pharmacokinetics of Melsikam in paediatric patients under 18 years of age have not been investigated.
Side Effects
Nausea, vomiting, abdominal pain, dyspepsia, constipation or diarrhoea may occur. Ulcers or gastrointestinal bleeding may rarely occur. Skin rash, or urticaria may occur in some individuals. Oedema of the lower limbs may occur during treatment. Onset of an asthma attack has been reported in certain individuals allergic to aspirin or to other NSAIDs. Headache, vertigo or drowsiness may occur.
Toxicity
The oral LD50 in rats is 98 mg/kg. Signs and symptoms of overdose with meloxicam may include shallow breathing, seizure, decreased urine output, gastrointestinal irritation, nausea, vomiting, gastrointestinal bleeding, and black tarry stools. In the case of an overdose, offer supportive treatment and attempt to remove gastrointestinal contents. Cholestyramine has been shown to enhance the elimination of meloxicam.
Precaution
Patient with known CV disease or risk factors for CV disease, fluid retention or heart failure, history of GI bleeding or ulceration. Hepatic and renal impairment. Elderly. Pregnancy and lactation.
Interaction
Other NSAIDs, including high doses of salicylates: Administration of several NSAIDs together may increase the risk of ulcers and of gastrointestinal bleeding, via a synergistic effect.
Oral anticoagulants, heparin and ticlopidine: Increased risk of bleeding via inhibition of platelet function and damage to the gastroduodenal mucosa. Careful monitoring of the effects of anticoagulants is thus essential if it proves impossible to avoid such combined prescription.
Lithium: NSAIDs increase blood lithium levels, which may then reach toxic values.
Methotrexate: NSAIDs may accentuate the haematologic toxicity of methotrexate.
Intrauterine contraceptive devices: NSAIDs appear to decrease the efficacy of intrauterine contraceptive devices.
Food Interaction
- Avoid alcohol. The risk of gastrointestinal bleeding may be increased.
- Take with or without food. The absorption is unaffected by food.
Melsikam Alcohol interaction
[Moderate] GENERALLY AVOID:
The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss.
The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.
Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.
Melsikam Hypertension interaction
[Major] Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure.
Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.
Hypertension interaction[Moderate] Nonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events.
NSAIDs should be used with caution in patients with hypertension.
Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.
Melsikam Drug Interaction
Moderate: aspirin, duloxetine, omega-3 polyunsaturated fatty acids, escitalopram, metoprolol, sertralineUnknown: diphenhydramine, cyclobenzaprine, pregabalin, esomeprazole, acetaminophen / hydrocodone, montelukast, levothyroxine, acetaminophen, cyanocobalamin, ascorbic acid, ergocalciferol, cholecalciferol, alprazolam, cetirizine
Melsikam Disease Interaction
Major: asthma, fluid retention, GI toxicity, rash, renal toxicities, thrombosisModerate: anemia, heart failure, hepatotoxicity, hyperkalemia, hypertension, platelet aggregation inhibition
Volume of Distribution
The volume of distribution of meloxicam is 10-15L. Because of its high binding to albumin, it is likely to be distributed in highly perfused tissues, such as the liver and kidney. Melsikam concentrations in synovial fluid, measured after an oral dose, is estimated at 40% to 50% of the concentrations measured in the plasma. This drug is known to cross the placenta in humans.
Elimination Route
The absolute bioavailability oral capsules after a dose was 89% in one pharmacokinetic study. Cmax was reached 5–6 hours after administration of a single dose given after the first meal of the day. The Cmax doubled when the drug was administered in the fasting state. Despite this, meloxicam can be taken without regard to food, unlike many other NSAIDS.
Melsikam formulated for instillation with bupivacaine produced varied systemic measures following a single dose of varying strength. In patients undergoing bunionectomy, 1.8 mg of meloxicam produced a Cmax of 26 ± 14 ng/mL, a median Tmax of 18 h, and an AUC∞ of 2079 ± 1631 ng*h/mL. For a 9 mg dose used in herniorrhaphy, the corresponding values were 225 ± 96 ng/mL, 54 h, and the AUC∞ was not reported. Lastly, a 12 mg dose used in total knee arthroplasty produced values of 275 ± 134 ng/mL, 36 h, and 25,673 ± 17,666 ng*h/mL.
Half Life
The half-life of meloxicam is approximately 20 hours, which is considerably longer than most other NSAIDS. It can therefore be dosed without the need for slow-release formulations.
Melsikam applied together with bupivacaine for postsurgical analgesia had a median half-life of 33-42 hours, depending on dose and application site.
Clearance
After an oral dose, the total clearance of meloxicam is 0.42–0.48 L/h. The FDA label indicates a plasma clearance from 7 to 9 mL/min. No dose changes are required in mild to moderate renal or hepatic impairment. The use of meloxicam in patients with severe renal or hepatic impairment has not been studied. FDA prescribing information advises against it.
Elimination Route
Melsikam is mainly eliminated through metabolism. Its metabolites are cleared through renal and fecal elimination. Less than 10 About 1.6% of the parent drug is excreted in the feces.
Pregnancy & Breastfeeding use
Pregnancy: It is advisable to avoid the administration of Melsikam during pregnancy.
Lactation: It is unknown whether Melsikam passes into mother’s milk. Melsikam should not be given to nursing mothers.
Contraindication
Melsikam is contraindicated to patients hypersensitive to this drug. Melsikam should not be given to patients who have developed signs of asthma, nasal polyps, angioneurotic oedema or urticaria following the administration of aspirin or NSAIDs. Melsikam is contraindicated to patients with active peptic ulcer during the last six months or a history of recurrent peptic ulcer disease, severe hepatic failure, non-dialysed severe renal failure, gastrointestinal bleeding, cerebrovascular bleeding or other bleeding disorders.
Acute Overdose
Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding; severe symptoms (e.g. HTN, hepatic dysfunction, resp depression, convulsions, CV collapse, cardiac arrest, coma, acute renal failure).
Management: Supportive and symptomatic treatment. Admin of activated charcoal 1-2 hr after ingestion.
Storage Condition
Store Melsikam tablet in a cool & dry place and away from light. Store Melsikam suppository below 25˚C protected from light and moisture.
Innovators Monograph
You find simplified version here Melsikam
Melsikam contains Meloxicam see full prescribing information from innovator Melsikam Monograph, Melsikam MSDS, Melsikam FDA label
FAQ
What is Melsikam used for?
Melsikam is used to treat the symptoms of osteoarthritis and rheumatoid arthritis. Both diseases mainly affect the joints causing pain and swelling. Although MOXICAM can relieve symptoms such as pain and inflammation, it will not cure your condition.
What does Melsikam do for the body?
Melsikam is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain, fever, and inflammation.
How long does Melsikam stay in my system?
The elimination half-life of Melsikam (or the duration of time it takes your body to metabolize and get rid of half of the drug in your system) is about 20 hours. However, this varies from person to person. Melsikam can also be detected by a urine drug test for up to five days after the last dose.
Does Melsikam make me sleepy?
The side effects for Melsikam don't mention drowsiness (actually Melsikam can cause insomnia) but does mention dizziness. But headache is a common, less serious side effect of Melsikam.
What is the best time to take Melsikam?
Take each dose with a snack or just after eating a meal and drink plenty of water whilst on Melsikam. If your doctor has prescribed melt-in-the-mouth (orodispersible) tablets: Moisten your mouth first, taking a sip of water if needed. Remove the tablet from the packaging, taking care not to moisten it.
Is Melsikam good for pain?
Melsikam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints. Melsikam is known as a nonsteroidal anti-inflammatory drug (NSAID).
How long does it take for Melsikam to relieve pain?
Melsikam can take up to two weeks to start working in full effect. Some changes to pain, swelling, tenderness, or stiffness may be noticeable within 24 to 72 hours, but it might take longer to notice a large difference in pain levels.
Who should not take Melsikam?
If you have the following condition you should not take Melsikam:
- systemic mastocytosis
- anemia
- increased risk of bleeding due to clotting disorder
- an increased risk of bleeding
- alcoholism
- high blood pressure
- a heart attack
- chronic heart failure
- abnormal bleeding in the brain resulting in damage to brain tissue, called a hemorrhagic stroke
- a blood clot
- stomach or intestinal ulcer
- bleeding of the stomach or intestines
- kidney transplant
- visible water retention
- abnormal liver function tests
- pregnancy
- a rupture in the wall of the stomach or intestine
- tobacco smoking
- increased cardiovascular event risk
- time immediately after coronary bypass surgery
- chronic kidney disease
- kidney disease with likely reduction in kidney function
- aspirin exacerbated respiratory disease
- history of gastric bypass surgery
- history of kidney donation
Is Melsikam a muscle relaxer?
Melsikam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints.
Does Melsikam cause high blood pressure?
Melsikam may increase or worsen your blood pressure. This can increase your risk of heart attack or stroke. Your doctor may check your blood pressure while you're taking Melsikam.
Can you take vitamins with Melsikam?
No interactions were found between Melsikam and Vitamin D3. This does not necessarily mean no interactions exist. Always consult your healthcare provider.
Why is Melsikam bad for me?
Melsikam can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.
Can Melsikam hurt kidneys?
It is possible to develop kidney damage from taking Melsikam. However, drug-induced kidney damage is often reversible if the drug causing it is stopped. Melsikam use can also lead to liver damage.
Is Melsikam bad for heart?
Melsikam can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Melsikam may also cause stomach or intestinal bleeding, which can be fatal.
How does Melsikam work?
Melsikam works by blocking the effects of the enzymes cyclooxygenase (COX)-1 and COX-2 which prevents prostaglandin synthesis. Prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission.
Is it OK to stop taking Melsikam suddenly?
Although Melsikam does not cause a withdrawal syndrome, because Melsikam is used for the treatment of pain and inflammation anyone who suddenly stops taking the medication may experience the return of their pain or inflammation.
What are the side effects of Melsikam?
The more common side effects that can occur with Melsikam include:
- abdominal pain.
- diarrhea.
- indigestion or heartburn.
- nausea.
- dizziness.
- headache.
- itching or rash.
What are the side effects of long term use of Melsikam?
Melsikam can cause long-term harm. All medications have potential side effects. Long-term use of NSAIDs may increase the risk of stomach or intestinal bleeding, ulcers, or holes. Long-term use of non-aspirin NSAIDs may increase the risk of heart attack or stroke.
Is Melsikam safe in pregnancy?
Use of Melsikam during pregnancy is not advised unless prescribed by your doctor, especially if you are 30 or more weeks pregnant. Paracetamol is usually recommended to control pain or fever during pregnancy.
Is Melsikam safe during breastfeeding?
It isn't known if Melsikam passes into breast milk. Because no information is available on the use of Melsikam during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.
Can I lay down after taking Melsikam?
Do not lie down for at least 10 minutes after taking Melsikam. If you are taking the liquid form of this medication, shake the bottle gently before each dose.