mobic and Hypertension

Drug induced linear IgA bullous dermatosis (LABD) is a rare blistering disease that has been shown to be associated with the use of various medications. Although rarely seen together, some of the medications associated with LABD can lead to the syndrome drug reaction with eosinophilia and systemic symptoms (DRESS), which presents with fever, cutaneous eruption, and multi-organ involvement. We present a patient who developed fever and a generalized vesiculobullous eruption after recently starting amlodipine and meloxicam. Initial laboratory tests demonstrated elevated liver function tests, leukocystosis, and eosinophilia. Histopathologic examination of the punch biopsy revealed a bulla with sub-epidermal split and numerous neutrophils. Direct immunofluorescence demonstrated broad deposition of IgA along the dermal-epidermal junction. These findings were consistent with an overlap between LABD and DRESS. Drug induced LABD and DRESS are independently both rare diseases. It is even more uncommon to see the two concurrently in the same patient. In this patient, these two conditions were thought to be triggered by either amlodipine or meloxicam. Given the high mortality rate associated with DRESS, it is important to recognize the presentation and initiate the appropriate treatment plan as soon as possible.

Topics: Amlodipine; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Arthralgia; Drug Hypersensitivity Syndrome; Female; Humans; Hypertension; Linear IgA Bullous Dermatosis; Meloxicam; Middle Aged; Osteoarthritis

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Drug Interactions; Humans; Hypertension; Lisinopril; Male; Meloxicam; Middle Aged; Osteoarthritis, Knee; Pain Management; Renal Insufficiency; Thiazines; Thiazoles

Normotensive and hypertensive male Wistar rats were subjected to the 3 h bilateral carotid artery occlusion followed by 72 h of reperfusion. The selective cycloxygenase-2 inhibitor meloxicam was administered intramuscularly after the cerebral reperfusion at a daily dose of 15 mg/kg. Doppler ultrasound was used to evaluate the cerebral blood flow during the reperfusion phase. The level of malondialdehyde (MDA) within the brain tissue homogenate was determined using spectrophotometry. The presence of arterial hypertension caused the altered response of brain tissue to ischemia/reperfusion. The meloxicam treatment significantly decreased the MDA level in normotensive rats subjected to ischemia-reperfusion. The protective effect of meloxicam against cerebral ischemia/reperfusion injury was more pronounced in hypertensive rats as compared to normotensive animals.

Topics: Animals; Blood Pressure; Brain Ischemia; Cerebrovascular Circulation; Disease Models, Animal; Follow-Up Studies; Hypertension; Injections, Intramuscular; Male; Meloxicam; Middle Cerebral Artery; Rats; Rats, Wistar; Reperfusion Injury; Thiazines; Thiazoles; Treatment Outcome; Ultrasonography, Doppler, Transcranial

To obtain formally quantified data on the relation of meloxicam to newly diagnosed gastrointestinal problems, myocardial infarction, or treated hypertension.. Nested case-control study.. United Kingdom-based General Practice Research Database.. Patients who received prescriptions for meloxicam, diclofenac, naproxen, or piroxicam formed the study population. Cases were people who developed gastrointestinal problems, myocardial infarction, or hypertension.. Relative risk estimates for developing the study outcomes were provided for each study nonsteroidal antiinflammatory drug (NSAID), with diclofenac as the reference drug. In no instance was meloxicam associated with an increased risk for a study outcome.. Compared with the other NSAIDs, meloxicam was not materially associated with any study outcomes. This study provides reassurance to those prescribing this newer class of NSAIDs.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Case-Control Studies; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Databases, Factual; Diclofenac; Gastrointestinal Hemorrhage; Humans; Hypertension; Isoenzymes; Meloxicam; Membrane Proteins; Myocardial Infarction; Naproxen; Piroxicam; Prostaglandin-Endoperoxide Synthases; Risk Assessment; Thiazines; Thiazoles; United Kingdom