How Genes Influence The Breakdown Of Meloxicam?

What Is Meloxicam?

Meloxicam is a long-acting non-steroidal anti-inflammatory drug (NSAID) used to reduce inflammation in the body.

It is primarily used to treat moderate to severe pain in conditions like rheumatoid arthritis and osteoarthritis in adults and juvenile rheumatoid arthritis in children above two years of age.

Meloxicam is available as a tablet, suspension or liquid form, and disintegrating tablet form, all of which can be taken orally.

Is Meloxicam A Narcotic?

Meloxicam is not a narcotic and belongs to the NSAID group of drugs.

It works by reducing the hormones responsible for pain and inflammation in the body.

What Is Meloxicam Used For?

Meloxicam is primarily used to relieve pain, inflammation, tenderness, swelling, and stiffness of joints observed in conditions like osteoarthritis and rheumatoid arthritis.

Sometimes, meloxicam is also prescribed for treating ankylosing spondylitis (arthritis of the spine).

Is Meloxicam A Strong Painkiller?

Meloxicam is a long-acting NSAID and is a stronger painkiller than ibuprofen.

How Does Meloxicam Work?

Cyclo-oxygenase or COX enzymes produce prostaglandins, a chemical substance, at injury or tissue damage sites.

These prostaglandins trigger pain and inflammation.

When NSAIDs like meloxicam are taken, they block the effect of COX enzymes, and subsequently, fewer prostaglandins are produced.

As a result of reduced prostaglandins, pain and inflammation are eased and relieved.

Side Effects Of Meloxicam

Though meloxicam is routinely used to treat inflammation and pain and is considered safe, it may cause moderate to severe side effects in some individuals.

Common side effects of meloxicam are:

Diarrhea
Abdominal pain
Indigestions
Heartburn
Nausea
Dizziness
Headache
Itching or rash

Usually, these symptoms subside in a few days. However, if they worsen, contact your doctor immediately.

Some serious side effects of meloxicam that require immediate medical attention are:

Increased blood pressure
Stomach or intestinal ulcers, tears or bleeding
Liver damage
Heart attack
Stroke
Water retention and swelling
Skin issues like blistering, peeling, or red rash
Kidney damage

Does Meloxicam Make You Sleepy?

Meloxicam does not make you drowsy or sleepy.

However, dizziness and headaches are relatively common.

Does Meloxicam Cause Weight Gain?

Taking meloxicam may increase water retention in the body and subsequent swelling.

Due to this, rapid weight gain is a side effect of this drug.

How Long Does Meloxicam Stay In Your System?

Meloxicam stays in the bloodstream for nearly 80 hours.

The drug’s half-life (time taken for the drug to reduce to half its original concentration) is around 15 to 20 hours.

Is Meloxicam Addictive?

Meloxicam does not cause euphoria and is not addictive like opioids.

Can You Overdose On Meloxicam?

It is possible to overdose on meloxicam.

Symptoms of meloxicam overdose include:

Nausea and vomiting
Stomach pain
Stomach bleeding.

In some cases, meloxicam overdose may result in severe heart problems and organ failure.

Interactions With Other Drugs

Though meloxicam is largely safe, it may interact with other drugs.

For this reason, it is important to tell your doctor about all the medicines and supplements that you are currently taking.

Some significant interactions of meloxicam with other drugs are:

Antidepressants and anti-anxiety drugs

Taking meloxicam with antidepressants and anti-anxiety drugs like citalopram and venlafaxine may increase your risk of bleeding.

Corticosteroids

Taking meloxicam with corticosteroids like prednisone and dexamethasone may increase your risk of stomach ulcers and bleed.

Pemetrexed

Taking pemetrexed, an anti-cancer drug, with meloxicam may increase your risk for infection, stomach and kidney problems.

Cyclosporine

Cyclosporine is an immunosuppressant drug used to reduce the risk of transplant rejection.

Taking cyclosporine with meloxicam may increase the level of cyclosporine in the body, increasing the risk of kidney problems.

Methotrexate

Methotrexate is an immunosuppressant medication (suppresses the body’s immune response) used commonly as an antirheumatic drug.

Taking meloxicam with methotrexate may increase the level of methotrexate in the body.

This can increase the risk of kidney problems and infection.

Blood thinners (anticoagulants)

Meloxicam increases the risk of bleeding and, therefore, should not be taken with blood thinners like warfarin, enoxaparin, and antiplatelet drugs like clopidogrel.

Lithium

Lithium-based medications are used to treat conditions like bipolar disorder.

Taking lithium with meloxicam may raise the level of lithium in the blood to dangerous levels and cause toxicity.

Symptoms of lithium toxicity include tremors, excessive thirst, and confusion.

To avoid these symptoms, your doctor may reduce the dosage of the lithium drug before prescribing meloxicam.

Diuretics

Diuretics or water pills help your body get rid of excess salt and water.

They are used to reduce blood pressure and edema (fluid accumulation) in the body.

Taking diuretics like hydrochlorothiazide and furosemide with meloxicam can decrease the effect of both drugs.

Anti-hypertensive drugs

Taking meloxicam with anti-hypertensive drugs can reduce the blood pressure-lowering effect of these drugs.

NSAIDs

Meloxicam and NSAIDs like aspirin, ibuprofen, naproxen, etc., are known to increase the risk of stomach ulcers and bleeding.

Taking them together will further increase the risk of these side effects and, therefore, must be avoided.

Can You Take Painkillers With Meloxicam?

It is best to avoid taking meloxicam with other NSAID drugs to reduce your risk of aggravated side effects due to both drugs.

However, when only NSAIDs are insufficient to relieve pain, meloxicam may be taken with Tylenol (acetaminophen), a non-NSAID pain reliever.

Can I Take Ibuprofen With Meloxicam?

Ibuprofen and meloxicam are both NSAIDs, and taking them together may aggravate the side effects of one or both drugs, especially gastrointestinal problems.

If you have to take both ibuprofen and meloxicam, it is best to wait for the effect of ibuprofen to wear off (it takes about 6 hours) before taking meloxicam.

Can I Take Tylenol With Meloxicam?

Since meloxicam (NSAID) and Tylenol (acetaminophen) belong to different classes of pain-relieving drugs, they do not interact with each other and, therefore, can be safely taken together.

However, always consult your doctor before taking these two drugs together.

Can You Take Advil With Meloxicam?

Advil is one of the many brand names for ibuprofen, an NSAID drug. Since meloxicam is also an NSAID, taking it with Advil is not recommended.

Taking Advil with meloxicam may increase your risk for gastrointestinal side effects like inflammation, bleeding, ulceration, and sometimes, perforation.

Meloxicam: Gene-Drug Interactions

The CYP2C9 Gene

Cytochrome P450 family 2 subfamily member 9 or the CYP2C9 gene gives instructions for producing an enzyme that plays a role in metabolizing or breaking down compounds like fatty acids and steroid hormones.

The CYP2C9 gene also plays a significant role in the metabolism of warfarin (a blood thinner) and ibuprofen.

Individuals having the haplotype *1/*13 of the CYP2C9 gene show decreased metabolism of meloxicam, resulting in increased effects of the drug.

A haplotype is a group of gene changes that are inherited together.

The *1, *13, etc., are star alleles.

Star alleles are used to name different haplotypes.

Recommendations To Use Meloxicam

Medical history

It is recommended to inform your doctor about medical conditions you currently suffer from or have a history of to avoid serious side effects of meloxicam.

Inform your doctor if you have any of the following conditions:

Allergy to meloxicam, aspirin, sorbitol, or other NSAIDs
Stomach ulcers or bleeding
Asthma
Fructose intolerance
Skin peeling, blistering, or loosening
Severe acne or skin ulcers
Bleeding disorders
Ulcerative colitis
Gastritis
Systemic lupus erythematosus
Liver impairment
Impending surgery

If you are undergoing or have recently undergone a coronary artery bypass graft ( a type of heart surgery), do not take meloxicam right before and after the surgery to avoid complications due to bleeding.

Pregnancy and breastfeeding

Taking meloxicam during the later stages of pregnancy may harm the unborn child. So, if you are pregnant or planning to conceive, inform your doctor about the same before taking the drug.

Genetic testing

Undergoing a genetic test helps your doctor determine how a particular drug will affect you.

It also helps them determine the appropriate meloxicam dosage based on their genotype.

Analyze Your Genetic Response to Meloxicam

Should I Take Meloxicam At Night Or In The Morning?

A recent study published in the Journal Scientific Reports stated that it is better to take NSAIDs like meloxicam during the day than to take them at night.

Why Can't I Drink Coffee With Meloxicam?

There are no known interactions between caffeine (in coffee) and meloxicam.

Can You Drink Alcohol With Meloxicam?

You must avoid drinking alcohol with meloxicam as the combination may increase your risk for stomach ulcers, bleeding, or perforation of the stomach and intestine.

Summary

Meloxicam is a long-acting NSAID drug used to reduce pain and inflammation in the body associated with rheumatoid and osteoarthritis.
Apart from rheumatoid and osteoarthritis, meloxicam may also be used to relieve symptoms in juvenile rheumatoid arthritis in children above 2 years.
Like other NSAIDs, meloxicam works by blocking the effect of COX enzymes, which reduces prostaglandin production.
Though safe to use, meloxicam may cause moderate to severe side effects in some individuals.
Meloxicam is known to interact with some classes of drugs like antidepressants, corticosteroids, blood thinners, diuretics, etc.
People with the *1/*13 variant of the CYP2C9 gene have a decreased metabolism of meloxicam.
It is essential to inform your doctor about your medical history and the medications you are currently taking to avoid the risk of side effects.

References

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