Round and Yellow M 66 Pill

M 66 Pill

This pill is round and yellow in color with an imprint of “M 66”. It has been identified as meloxicam 7.5 mg, which is used for the treatment of inflammatory conditions, fibromyalgia, osteoarthritis, rheumatoid arthritis, and tendonitis.

Under the Controlled Substances Act, meloxicam is not a controlled substance. Its strength is 7.5 mg and its size is 6 mm. It is only available by prescription. During pregnancy, risks cannot be ruled out and it has been put under category C. There is a positive evidence of its risk, especially starting at 30 weeks gestation. During this period, it is put under category D. It is supplied by Mylan Pharmaceuticals Inc. This drug contains the following inactive ingredients:

• Crospovidone
• Silicon dioxide
• Magnesium stearate
• Lactose monohydrate
• Microcrystalline cellulose
• Sodium lauryl sulfate

Uses

Meloxicam is a nonsteroidal anti-inflammatory drug used to reduce arthritis pain, joint stiffness, and swelling. It is available under the brand name Mobic. Its generic form is also available. It can be used for the treatment of osteoporosis, rheumatoid arthritis, and juvenile arthritis in individuals who are 2 years old and above. 

Meloxicam helps reduce inflammation, pain, and fever by inhibiting prostaglandin synthesis. Prostaglandin is a substance that contributes to joint inflammation. When there is an inflammatory component, meloxicam is used as an analgesic.

It can also be used to reduce the symptoms of primary dysmenorrhea. This medication is closely related to piroxicam and is marketed in Europe under the brand names Movalis, Recoxa, and Melox. In North America, it is marketed as Mobic. In Latin America, it is under the brand name Tenaron.

Pharmacodynamics

Meloxicam has analgesic and antipyretic properties. Meloxicam reduces inflammation by inhibiting the synthesis of prostaglandin. Prostaglandins are chemicals that are involved in inflammation of the joints.

Mechanism of Action

The inhibition of prostaglandin synthetase causes the inhibition of prostaglandin synthesis, which is said to contribute to the anti-inflammatory effect of meloxicam.

Due to the inhibition of prostaglandin, meloxicam is able to exhibit antipyretic and analgesic properties. Meloxicam is said to sensitize pain receptors.

Usage

Carefully read the medication guide provided by your pharmacist before taking this medication. If you have any questions, ask your doctor or pharmacist.

Take this medication by mouth as directed by your doctor. Drink a full glass of water when taking this medicine. After taking this pill, wait for at least 10 minutes before lying down. 

Take this medicine with food, antacid, or milk if stomach upset occurs. The lowest effective dose should be taken only for a prescribed length of time to avoid the risk of bleeding and stomach ulcers. The tablet and capsule forms provide a different amount of medications, so avoid switching other forms of meloxicam without your doctor's advice. It may take two weeks for the drug to show its effects. Take this medication at the same time every day.

Dosage

The lowest effective dose should be used for each patient. Daily meloxicam therapy is usually started at 7.5 mg. Some may need a daily dose of 15 mg. Large doses of this medication is usually prescribed by the doctor.

For juvenile rheumatoid arthritis, the dose is usually prescribed at 0.125 mg/kg a day to 7.5 mg. It can be taken with or without food.

Side Effects

The common side effects are stomach upset, diarrhea, nausea, dizziness, indigestion, headache, itching or skin rash, and heartburn. If the symptoms persist, inform your doctor or pharmacist. Many people taking this medication do not experience any serious symptoms. However, this medication may cause an increase in blood pressure levels. 

Seek immediate medical help if you experience any of the following serious side effects:

• Chest pain
• Bleeding or easy bruising
• Severe or persistent headache 
• Cold sweats
• Pain or discomfort in the back, shoulder, jaw, neck, arms, and the area above the stomach
• Unexplained weight gain
• Mental or mood changes
• Swelling of the hands
• Unexplained neck stiffness 
• Kidney problem
• Unusual tiredness

Although rare, this drug may also cause liver disease. Immediately inform your doctor if you experience any symptoms of liver damage such as persistent vomiting, nausea, yellowing of the eyes or skin, and stomach pain.  Allergic reactions may occur, but such instances are quite rare. Call your doctor if you experience hives, itching, rash, swelling, trouble breathing, or dizziness.

Meloxicam may also cause symptoms of stroke, which include:

• Weakness or numbness of the arm, face, or leg, especially on one side of the body
• Trouble speaking
• Sudden confusion
• Vision problems
• Loss of balance
• Dizziness
• Unexplained severe headache

Meloxicam may cause symptoms of stomach and intestinal bleeding, which includes vomiting blood, severe stomach pain, and black sticky or bloody stools.

Other side effects of meloxicam:

• Symptoms of increased blood pressure such as dizzy spells, nose bleeds, and a dull headache
• Rapid weight gain and swelling of the ankles, feet, and hands due to water retention
• Kidney damage
• Anemia

Considerations

The general side effects of meloxicam are abdominal pain, upset stomach, and nausea. Vomiting, pain, and diarrhea are the side effects that are more commonly seen in children than in adults. Within a couple of days or weeks, these side effects may disappear. However, speak with your doctor if they persist.

Precautions

Inform your doctor if you are allergic to meloxicam, aspirin, or any other NSAIDs. An allergic reaction can be caused by inactive ingredients present in this medication. If you have any other allergies, then inform your doctor.

Inform your doctor if you have a medical history of the following conditions:

• Liver disease
• Asthma and other lung problems after taking aspirin or any NSAIDs
• Esophagus disorders
• Gastrointestinal problems
• Heart disease
• Stroke
• High blood pressure
• Blood disorders such as clotting problems
• Anemia
• Nasal polyps

The use of nonsteroidal anti-inflammatory medications such as meloxicam can also cause kidney problems, especially for individuals who are dehydrated, have heart failure, kidney disease, and even those who are taking certain medications. Call your doctor right away if you notice a change in the amount of urine you pass. To prevent dehydration, drink an adequate amount of water and follow your doctor's advice.

Meloxicam may make you feel dizzy. Taking it along with alcohol or marijuana may increase the side effects. Avoid doing any task that requires mental alertness. Meloxicam may also cause stomach bleeding, especially when it is combined with alcohol and tobacco use.

While on this medication, limit your sun exposure since it may make you more sensitive to it. Avoid sunlamps and tanning booths. When outdoors, wear protective clothing and sunscreen. If you develop redness, sunburn, or skin blisters, inform your doctor immediately.

If you need to undergo surgery, inform your doctor about all the medications you are taking before the procedure. During pregnancy, this medicine should only be taken when needed. It is not recommended in the first and last trimesters of pregnancy since it may harm the unborn baby. It may also interfere with normal labor or delivery. Women of childbearing age should talk to the doctor about taking this medication since it may cause trouble in getting pregnant or may cause a miscarriage.

Interactions

Some drugs may interact with meloxicam. They include:

• Aliskiren
• ACE inhibitors (lisinopril, captopril)
• Cidofovir
• Methotrexate
• Lithium
• Angiotensin II receptor blockers (valsartan, losartan)
• Water pills (furosemide)
• Anticoagulants (warfarin, clopidogrel, dabigatran and enoxaparin)
• Pain relievers or NSAIDs (ibuprofen, celecoxib, and ketorolac)

The risk of side effects may increase due to the interaction of meloxicam with these medications. Consult and follow your doctor's instructions when taking other medications along with meloxicam.

• Sodium polystyrene sulfonate - Taking meloxicam along with sodium polystyrene sulfonate may cause severe damage to the intestines. This damage can even be fatal.

• Cyclosporine - Combining meloxicam with rheumatoid arthritis drugs such as cyclosporine may increase the side effects of cyclosporine on the kidneys. Dehydration increases the risk even further.

• Methotrexate - Combining meloxicam with methotrexate may cause methotrexate to accumulate in the body, thereby increasing the risk of side effects associated with methotrexate such as abdominal pain, liver damage, decreased red blood cells, nausea, and diarrhea.

• Anxiety Drugs - The risk of bleeding may also increase if meloxicam is combined with certain anxiety drugs such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs) and other antidepressants.

• Lithium - Combining meloxicam with lithium may cause increased refluxes, upset stomach, confusion, uncontrolled muscle movements, and other side effects.

Overdose

Immediately inform your doctor if you experience any symptoms of overdose such as shallow or slow breathing, severe stomach pain, extreme drowsiness, or vomiting.

Periodically, laboratory tests and other medical tests will be performed to check your liver and kidney function as well as your blood pressure level. Your doctor may approve certain nondrug treatments for arthritis to improve the range of motion, flexibility, and joint function.

Route of Elimination

Meloxicam is completely metabolized into four inactive metabolites. In the urine and feces, these metabolites are excreted up to an equal extent.

Missed Dose

Take the missed dose as soon as you remember. However, if it is already time for the next dose, then skip the missed dose and follow the usual schedule. 

Storage

Store this medication at room temperature and away from light and moisture. Keep it away from the reach of children. Properly dispose of any expired or unused medications. 

Bottom Line

Meloxicam is usually effective when it comes to treating short-term pain that is associated with arthritis. However, like other NSAIDs, it can affect the heart, stomach, and increases the risk of bleeding.

Inflammation associated with osteoarthritis can be treated using meloxicam. The first line option for treating pain associated with arthritis is NSAIDs since they are effective when given a correct dosage, they are readily available, and they do not cause dependence. However, the use of NSAIDs has been associated with a higher tendency of stroke and heart attack. This risk increases even further when a person has a pre-existing cardiovascular condition or uses NSAIDs at a higher dosage.