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Meloxicam has been shown, especially at low therapeutic doses, to selectively inhibit COX-2 over COX-1. [9] Meloxicam concentrations in synovial fluid range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid compared to plasma.
Studies of meloxicam 7.5 mg per day for 23 days find a level of gastric injury similar to that of a placebo, and for meloxicam 15 mg per day a level of injury lower than that of other NSAIDs; however, in clinical practice meloxicam can still cause some ulcer complications.
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An equianalgesic chart can be a useful tool, but the user must take care to correct for all relevant variables such as route of administration, cross tolerance, half-life and the bioavailability of a drug. [5] For example, the narcotic levorphanol is 4–8 times stronger than morphine, but also has a much longer half-life. Simply switching the ...
The goals of treatment are to minimize symptoms such as pain and swelling, to prevent bone deformity (for example, bone erosions visible in X-rays), and to maintain day-to-day functioning. [109] This is primarily addressed with disease-modifying antirheumatic drugs (DMARDs); dosed physical activity; analgesics and physical therapy may be used ...
More aggressive treatments such as synovectomy, achieved using intra-articular agents (chemical or radioactive) can provide good results, with efficacy reported for at least 1 year. [10] Reducing acute joint swelling: Arthrocentesis (or drainage of joint) may be useful to relieve joint swelling and improve range of motion. Local steroid ...
The exception is meloxicam with a slight (10:1) preference for COX-2, which, however, is only clinically relevant at low doses. [3] The most popular drug of the oxicam class is piroxicam. [1] Other examples include: ampiroxicam, droxicam, pivoxicam, tenoxicam, lornoxicam, [1] and meloxicam. Isoxicam has been suspended as a result of fatal skin ...