The 159 pill—specifically the tablet debossed with “CIPLA” on one side and “159” on the other – is Meloxicam 15 mg, manufactured by Cipla USA. Meloxicam is a prescription nonsteroidal anti-inflammatory drug (NSAID) widely prescribed to reduce pain, swelling, and joint stiffness caused by arthritis.
Pill Identification
When verifying the identity of a pill stamped with “159”, examine its color, shape, and full imprint lettering:
Visual Characteristic – Physical Description
- Imprint –
CIPLAon one side,159on the reverse - Active Ingredient – Meloxicam (15 mg)
- Color & Shape – Light yellow, round, flat-faced with beveled edges
- Size – ~10 mm
- Manufacturer – Cipla USA Inc.
- Drug Class – Nonsteroidal Anti-inflammatory Drug (NSAID)
- Alternative Identifications: While “CIPLA 159” refers to Meloxicam 15 mg, other medications carry a “159” imprint code in different shapes or colors:
- Fenofibrate 145 mg: White, oval tablet imprinted with
159. - Phentermine HCl 37.5 mg: White/blue speckled oval tablet imprinted with
A 159. - Omeprazole DR 40 mg: Purple/yellow capsule imprinted with
OMEPRAZOLE 40mg R159.
- Always confirm an unverified medication with a licensed pharmacist before consumption.
Mechanism of Action
Meloxicam provides analgesic (pain-relieving), anti-inflammatory, and antipyretic (fever-reducing) effects:
- Cyclooxygenase (COX) Inhibition: Meloxicam inhibits the cyclooxygenase enzymes (COX-1 and COX-2).
- Prostaglandin Suppression: COX enzymes are responsible for synthesizing prostaglandins – the hormone-like lipid compounds in the body that cause pain, localized inflammation, tissue swelling, and fever.
- COX-2 Preference: At lower doses, meloxicam exhibits relative selectivity for COX-2 (which controls inflammatory signaling) over COX-1 (which protects the mucosal lining of the stomach and regulates blood flow to the kidneys). However, at a full 15 mg dose, this COX-2 selectivity diminishes, making gastrointestinal and renal monitoring important.
Indications & Dosage
Approved Medical Uses
- Osteoarthritis (OA): Symptomatic treatment of chronic joint wear, pain, and stiffness.
- Rheumatoid Arthritis (RA): Reduction of joint inflammation, tenderness, and pain in adults.
- Juvenile Idiopathic Arthritis (JIA): Symptomatic relief in pediatric patients weighing $\ge 60\text{ kg}$ (132 lbs).
Typical Dosage Guidelines
- Adult Starting Dosage: Usually 7.5 mg taken orally once daily.
- Maximum Daily Dose: 15 mg once daily (one 159 tablet). Taking more than 15 mg per day does not increase therapeutic effectiveness but significantly increases the risk of severe side effects.
- Administration: May be taken with or without food. Taking it with food or milk helps reduce mild gastrointestinal upset.
- Duration Strategy: Guidelines advise prescribing the lowest effective dose for the shortest duration consistent with individual treatment goals.
Side Effects
Common Side Effects
- Dyspepsia (indigestion), heartburn, or upper stomach discomfort
- Nausea, diarrhea, abdominal pain, or flatulence
- Mild headaches or lightheadedness
- Mild skin itching or rash
Serious Side Effects (Require Immediate Medical Attention)
- Gastrointestinal Ulceration & Bleeding: Black, tarry stools, vomiting blood or material resembling coffee grounds, or persistent severe abdominal pain.
- Renal Toxicity: Abrupt decline in urination, fluid retention, or swelling in the legs, ankles, or feet.
- Hepatotoxicity: Yellowing of the skin or eyes (jaundice), dark urine, or upper-right quadrant stomach pain.
- Severe Allergic & Dermatologic Reactions: Unexplained fever, throat swelling, hives, or severe skin reactions featuring blistering and peeling (e.g., Stevens-Johnson syndrome).
Black Box Warnings & Precautions
The U.S. FDA requires a Boxed Warning on all prescription NSAIDs, including meloxicam:
FDA Boxed Warnings
Cardiovascular Risk:
- NSAIDs increase the risk of serious, potentially fatal cardiovascular thrombotic events, including myocardial infarction (heart attack) and stroke. Risk can occur early in treatment and increases with higher doses or prolonged use.
- Contraindication: Meloxicam is strictly contraindicated for perioperative pain management in patients undergoing Coronary Artery Bypass Graft (CABG) surgery.
Gastrointestinal Risk:
- NSAIDs cause an increased risk of serious gastrointestinal adverse events, including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Elderly patients and those with a prior history of peptic ulcer disease or GI bleeding are at greatest risk.
Key Precautions
- Pregnancy: Avoid use at 20 weeks of gestation or later. NSAID use in late pregnancy can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios.
- Hypertension & Heart Failure: Meloxicam can trigger new-onset hypertension or exacerbate existing high blood pressure and fluid retention.
- Renal Impairment: Avoid or closely monitor use in patients with advanced kidney disease or dehydration.
- Drug Interactions: Use caution when taking alongside anticoagulants (e.g., warfarin), antiplatelets (aspirin), corticosteroids, SSRIs, ACE inhibitors, or diuretics, as combination therapy increases bleeding or kidney risks.