The yellow/pale yellow oblong pill debossed with “U L” on one side and “15” on the other is Meloxicam 15 mg, manufactured by Unichem Pharmaceuticals (USA) Inc. It is a generic formulation of the prescription drug Mobic, belonging to the nonsteroidal anti-inflammatory drug (NSAID) class and primarily used to treat inflammatory joint conditions.
Pill Identification
Attribute – Specification
- Imprint – U L on one side / 15 on the reverse
- Active Ingredient – Meloxicam (15 mg)
- Color – Pastel yellow to light yellow (sometimes described as off-white/yellow)
- Shape – Capsule / Oblong
- Manufacturer / Distributor – Unichem Laboratories Ltd. / Unichem Pharmaceuticals (USA) Inc.
- Drug Class – Nonsteroidal Anti-inflammatory Drug (NSAID) / Oxicam derivative
- Prescription Status – Rx-only (Non-controlled substance)
Mechanism of Action
Meloxicam belongs to the oxicam class of NSAIDs and exerts its therapeutic anti-inflammatory, analgesic, and antipyretic properties by inhibiting prostaglandin synthesis:
- Cyclooxygenase (COX) Inhibition: Meloxicam inhibits the cyclooxygenase enzymes (both COX-1 and COX-2). At lower therapeutic doses, it displays preferential inhibition for COX-2 over COX-1.
- Reduction of Inflammatory Mediators: COX-2 inducible enzyme converts arachidonic acid to pro-inflammatory prostaglandins responsible for pain, edema, and joint inflammation. By blunting COX-2 activity, meloxicam relieves chronic joint stiffness, swelling, and arthritic pain.
- Pharmacokinetics: Meloxicam is slowly absorbed, reaching peak plasma concentrations within 4 to 5 hours. It has a long elimination half-life of approximately 15 to 20 hours, allowing for once-daily dosing.
Indications and Dosage
Meloxicam 15 mg is indicated for the relief of the signs and symptoms of:
- Osteoarthritis (OA)
- Rheumatoid Arthritis (RA)
- Juvenile Rheumatoid Arthritis (JRA) / Pauciarticular or Polyarticular JIA
Dosing Guidelines (Adults)
- Osteoarthritis & Rheumatoid Arthritis:
- Standard Starting Dose: 7.5 mg once daily.
- Maximum Dose: If symptom control is insufficient, the dose may be increased to 15 mg once daily (1 tablet of “U L 15”). The maximum recommended daily oral dose is 15 mg/day.
- Administration:
- Take once daily with a full glass of water.
- It may be taken with or without food, though taking it with meals or milk is recommended if gastrointestinal upset occurs.
Side Effects
Common Side Effects
- Gastrointestinal: Dyspepsia (heartburn), nausea, abdominal pain, diarrhea, constipation, and flatulence.
- Central Nervous System: Dizziness, lightheadedness, and headache.
- Respiratory: Upper respiratory tract infection symptoms, pharyngitis.
- Dermatologic / General: Mild rash, pruritus, and peripheral edema (fluid retention).
Serious Adverse Reactions
- Gastrointestinal Bleeding, Ulceration, and Perforation: Life-threatening stomach or intestinal tears, ulcerations, or internal bleeding (symptoms include black/tarry stools, vomiting blood or “coffee-ground” emesis).
- Cardiovascular Events: Increased risk of serious thrombotic events, myocardial infarction (heart attack), and stroke.
- Renal Impairment & Toxicity: Acute kidney injury (AKI), interstitial nephritis, or renal papillary necrosis, especially in dehydrated patients or those with pre-existing renal compromise.
- Hepatotoxicity: Elevated liver enzymes (ALT/AST), severe hepatic injury, or jaundice.
- Severe Skin Reactions: Exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and Toxic Epidermal Necrolysis (TEN).
Precautions and Drug Interactions
- Anticoagulants and Antiplatelets: Co-administration with warfarin, DOACs (e.g., apixaban), or aspirin significantly increases the risk of major gastrointestinal and systemic bleeding.
- ACE Inhibitors, ARBs, and Diuretics: Meloxicam can diminish the antihypertensive effect of blood pressure medications and increase the risk of acute renal failure and hyperkalemia.
- Lithium: NSAIDs reduce the renal clearance of lithium, leading to increased lithium plasma levels and potential lithium toxicity.
- Methotrexate: Concomitant use can decrease methotrexate clearance and heighten the risk of methotrexate-induced bone marrow suppression or nephrotoxicity.
- Pregnancy Warning: Avoid use in pregnant women starting at 20 weeks of gestation (risk of fetal renal dysfunction resulting in oligohydramnios) and strictly avoid at or after 30 weeks due to premature closure of the fetal ductus arteriosus.
Critical Warnings (FDA Boxed Warnings)
- Cardiovascular Thrombotic Risk: NSAIDs increase the risk of serious and potentially fatal cardiovascular thrombotic events, including myocardial infarction and stroke. The risk can occur early in treatment and increases with duration of use. Meloxicam is contraindicated for the treatment of peri-operative pain in the setting of 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. These events can occur at any time during use and without warning symptoms; elderly patients are at greater risk.