Is Mobic a safe alternative to Vioxx, Celebrex, Bextra?

Since the recall of Vioxx (Related article: Vioxx sales may resume in the US), and doubts raised about safety of Celebrex and Bextra, arthritis patients have turned to alternatives like Mobic (meloxicam). No surprise then that Mobic sales in the US jumped 85% in 2004 from 2003. In the fourth quarter of 2004 (during which most of the shift to Mobic happened after Vioxx was recalled in September 2004), sales jumped as much as 175%. (Related article: FDA panel recommendations on Vioxx and Bextra questioned after conflicts of interest reported)

While consumers somehow feel that Mobic is not a Cox-2 inhibitor drugs like Vioxx, Celebrex, and Bextra, the reality is that this is the case only in the United States. In some countries like Australia and New Zealand, meloxicam (sold under brand names like Mobic, Movalis, etc.) is treated as a Cox-2 drug. The US FDA, that tends to be friendlier to drug companies rather than American people, has put Mobic in the same NSAID category as ibuprofen, naproxen (Aleve), etc. (Related articles: Australia limits/bans use of most Cox-2 drugs and New Zealand restricts Cox-2 prescriptions)

During the FDA panel hearings in February, almost all members agreed that Cox-2 drugs have a class effect. Or in other words, all drugs that use the Cox-2 mechanism to provide pain relief have varying degrees of side effects on the heart. Dr. David Graham, a highly respected expert at the FDA, has conducted a study on side effects of Mobic and called the drug a "bad actor." The data is still preliminary and is highly disputed by the drug manufacturer and the agency itself. "We found an increased risk," Dr. Graham said at the FDA panel hearings. "It's one study. It's the only study." (Related article: Dr. David Graham blasts Cox-2 drugs)

The FDA, an agency not known for keeping track of drugs on its own after they have been approved, does not provide any information on the side effects of Mobic on the heart. But FDA does say that "even short-term treatment is not without risk." It goes on to say that a doctor will need to decide if Mobic is right for you if you have heart failure.

Public Citizen, a consumer watchdog group, that focuses on drugs and has asked for recall of all Cox-2 drugs including Vioxx, Celebrex, and Bextra, also lists Mobic as a "Do Not Use" drug because it is no more effective than related drugs, has not been shown to have a lower rate of ulcers than related drugs, and has been shown to cause heart disease.

Recommended article: Vioxx recall makes health agencies worldwide more careful