Meloxicam

Indications
Oral
Rheumatoid arthritis
Adult: 15 mg daily as a single dose. Patients with increased risk of adverse effects: Initially 7.5 mg.
Elderly: 7.5 mg daily for long-term treatment.
Oral
Ankylosing spondylitis
Adult: 15 mg daily as a single dose. Patients with increased risk of adverse effects: Initially 7.5 mg.
Elderly: 7.5 mg daily for long-term treatment.
Oral
Acute exacerbations of osteoarthritis
Adult: 7.5 mg daily up to a max of 15 mg as a single dose.
Elderly: 7.5 mg daily.
Oral
Juvenile rheumatoid arthritis
Child: ≥2 yr: 125 mcg/kg ocne daily. Max dose: 7.5 mg daily.
Rectal
Ankylosing spondylitis
Adult: 15 mg daily as a single dose. Patient with increased risk of adverse effects: Initially 7.5 mg. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.
Rectal
Rheumatoid arthritis
Adult: 15 mg daily as a single dose. Patient with increased risk of adverse effects: Initially 7.5 mg. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.
Rectal
Acute exacerbations of osteoarthritis
Adult: 7.5 mg daily up to a max of 15 mg daily as a single dose. Limit use to the shortest time possible.
Elderly: 7.5 mg daily. Limit use to the shortest time possible.

Special Populations: In patients with an increased risk of adverse reactions: Initially, 7.5 mg daily. Dialysis patients: Max daily dose of 7.5 mg.
Contraindications
Hypersensitivity to meloxicam, aspirin or other NSAIDs; severe hepatic impairment; bleeding disorders; renal failure without dialysis. Rectal admin in patients with proctitis, haemorrhoids or rectal bleeding.
Warnings / Precautions
History of GI disease, asthma, hypertension, CVD or risk factors, fluid retention or heart failure. Monitor patients with advanced renal disease. May impair ability to drive or operate machinery. Elderly. Pregnancy (avoid in the 3rd trimester) and lactation.
Adverse Reactions
Dyspepsia, headache, nausea, diarrhoea, upper respiratory tract infection, abdominal pain, dizziness, oedema, flatulence, influenza-like symptoms, back pain, muscle spasms, musculoskeletal pain, rash, anaemia. GI perforation, ulceration and/or bleeding. In children: Abdominal pain, vomiting, diarrhoea, headache, pyrexia.
Potentially Fatal: Stevens Johnson syndrome, thrombocytopenia, interstitial nephritis and idiosyncratic liver abnormality.
Overdose Reactions
Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain. Severe symptoms e.g. apnoea, metabolic acidosis, coma, nystagmus, seizures, leukocytosis, renal failure may occur. Management: Supportive and symptomatic. Multiple doses of charcoal may be needed; cholestyramine increases meloxicam clearance. Not dialysable.
Drug Interactions
May reduce effects of antihypertensives. Increased clearance with bile acid sequestrants e.g. colestyramine. Increased risk of renal failure with diuretics; may reduce natriuretic effects of furosemide and thiazides. May increase toxicity of methotrexate.
Potentially Fatal: May increase plasma concentrations and toxicity of lithium. Increased risk of severe GI effects with aspirin, warfarin.
See Below for More meloxicam Drug Interactions
Food Interactions
Avoid herbal preparations or food with antiplatelet activity e.g. alfalfa, anise, bilberry, bladderwrack, bromelain, cat's claw, celery, coleus, cordyceps, dong quai, evening primrose, feverfew, fenugreek, garlic, ginger, ginkgo biloba, red clover, horse chestnut, grapeseed, green tea, ginseng, guggul, horse chestnut seed, horseradish, licorice, prickly ash, red clover, reishi, sweet clover, turmeric, white willow.
Mechanism of Actions
Meloxicam inhibits prostaglandin synthesis by reducing cyclooxygenase enzyme activity. This results in decreased production of prostaglandin precursors.
Absorption: Well absorbed from the GI tract (oral).
Distribution: Protein-binding: 99%.
Metabolism: Extensively hepatic via oxidation pathway.
Excretion: Via urine and faeces (as inactive metabolites); 20 hr (elimination half-life).
Administration
May be taken with or without food. (May be taken w/ meals if GI discomfort occurs.)
Storage Conditions
Oral: Store at 25°C (77°F).
ATC Classification
M01AC06 - meloxicam ; Belongs to the class of non-steroidal antiinflammatory and antirheumatic products, oxicams.
Storage
Oral: Store at 25°C (77°F).
Available As
  • Meloxicam 15 mg
  • Meloxicam 5 mg
  • Meloxicam 7.5 mg
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