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(meloxicam, Boehringer Ingelheim)

A nonsteroidal anti-inflammatory drug for osteoarthritis.

* Recommended Dosage: Starting at 7.5 mg daily up to 15 mg daily if necessary.

* Special Considerations: GI side-effect rates in Mobic-treated patients in a 12-week study were 17%-20% similar to placebo, according to package labeling.

* Comment: In this study patients on 7.5 mg or 15 mg daily had significant improvements over those on placebo in various measures of osteoarthritis signs and symptoms. Dr. Roy Altman, chief of the arthritis division at the University of Miami, said that Mobic is "somewhat selective" but not a specific inhibitor of cyclooxygenase (COX)-2, which produces pain-mediating prostaglandins. This means that at the higher 15-mg dose, "you're getting into COX-1 inhibition as well," which is in contrast to Celebrex (celecoxib) and Vioxx (rofecoxib), which do not inhibit COX- 1 at therapeutic doses, he said. COX-1 produces protective gastric prostaglandins.

Still, he believes there is room for a drug with less specific COX-2 inhibition, since not everybody responds to or tolerates Celebrex and Vioxx, added Dr. Altman, who has done studies of all three drugs and has lectured for all three manufacturers.
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Author:Mechcatie, Elizabeth
Publication:OB GYN News
Date:May 15, 2000
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