Micam

Description

Micam 15mg tablets contain meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) used in Pakistan for managing pain, fever, and inflammation from conditions like arthritis. Bosch Pharmaceuticals produces it as an anti-rheumatic option for systemic relief, available in packs of 10 tablets for around Rs. 90-100, often prescribed for joint issues common in older adults or those with physically demanding jobs in cities like Faisalabad or rural Punjab. DRAP registers it for short-term use to minimize risks, stocked widely in pharmacies.

How It Functions

Meloxicam inhibits cyclooxygenase-2 (COX-2) enzymes more than COX-1, reducing prostaglandin production that drives inflammation, pain, and fever. This selective action provides relief for joint swelling and stiffness with potentially fewer stomach effects than older NSAIDs. Chemically, it’s 4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide. Effects build over days, peaking in 4-5 hours after a dose, with a half-life of 20 hours allowing once-daily use.

Dosage Information

Standard adult dose: 7.5mg or 15mg once daily, taken orally with food or milk to protect the stomach. For osteoarthritis or rheumatoid arthritis, start at 7.5mg and increase if needed, up to 15mg max daily. In juvenile rheumatoid arthritis (children 2+), weight-based at 0.125mg/kg daily. Not for long-term without monitoring; adjustments for elderly or kidney issues. DRAP guidelines limit to shortest duration for lowest effective dose.

Side Effects

• Very Common (>1 in 10): Stomach upset, indigestion, headache.
• Common (up to 1 in 10): Nausea, diarrhea, dizziness, rash, itching, swelling (angioedema), photosensitivity, fatigue.
• Rare: Severe skin reactions (erythema multiforme, Stevens-Johnson syndrome), blood disorders (anemia, low platelets), liver enzyme changes, heart issues (high blood pressure, palpitations), kidney problems, vision changes, tinnitus.

Drug Interactions

Meloxicam may interact with:

• Other NSAIDs or aspirin: Heightens bleeding or stomach ulcer risk.
• Anticoagulants (e.g., warfarin): Increases bleeding potential.
• Diuretics or ACE inhibitors: Reduces kidney function.
• Lithium or methotrexate: Raises toxicity levels.
• SSRIs (e.g., fluoxetine): Boosts bleeding risk.
• Alcohol: Worsens stomach irritation.

Indications

Approved for relieving pain, tenderness, swelling, and stiffness in osteoarthritis, rheumatoid arthritis (including juvenile form in children 2+), ankylosing spondylitis, and acute gout flares. Also used for fever and inflammation in musculoskeletal disorders.

When Not to Use

Avoid in:

• Hypersensitivity to meloxicam, other NSAIDs, or aspirin.
• Active stomach/duodenal ulcers or bleeding.
• Severe liver or kidney disease.
• Recent heart surgery (CABG) or uncontrolled heart failure.
• Third trimester pregnancy or known fetal risks.

Precautions

• Use cautiously in congestive heart failure, liver cirrhosis, kidney damage (nephrotic syndrome, renal failure), low blood volume (hypovolemia), or asthma.
• Monitor blood pressure, kidney function, and liver tests regularly, especially in elderly patients common in Pakistan’s aging population.
• Weigh weekly if edema develops; avoid dehydration in hot weather or during fasting.
• Not for lactating women; small amounts pass into milk.
• Shake suspension form if used; take with meals to ease stomach strain.

Warnings

• Cardiovascular: Raises risk of heart attack, stroke, or blood clots, especially with long use or in those with heart disease—higher in smokers or diabetics.
• Gastrointestinal: Can cause bleeding, ulcers, or perforation without warning; risk amps with alcohol, steroids, or history of ulcers.
• Pregnancy: Consult physician; avoid in last trimester due to fetal heart/kidney risks.
• Alcohol: Skip entirely—worsens bleeding and liver strain.
• Driving: May cause dizziness; wait until effects clear.
• Coffee/energy drinks: Limit caffeine, as it can heighten stomach irritation.

Additional Notes

• Pregnancy Category: Consult physician; category C early, D late—effects unknown but caution advised.
• Availability: Common in urban and rural pharmacies; Bosch brand or generics like Mobic available, with occasional shortages during monsoon fevers.
• Reporting: Note batch for side effects; report to DRAP hotline for tracking counterfeits.

Doctor Review

Rheumatologists in Pakistan value Micam’s once-daily dosing for arthritis control in patients with busy lives, like factory workers in Sialkot, noting quicker relief than paracetamol for inflammation. DRAP reports highlight its COX-2 preference for fewer GI issues, but stress heart monitoring in hypertensives prevalent here.

Disclaimer

This is general product information, not a prescription or medical advice. Consult your doctor or pharmacist for personal guidance.