Meloxicam

Meloxicam Uses, Dosage, Side Effects, Food Interaction and all others data.

Meloxicam is an oxicam derivative which exhibits analgesic, antipyretic and anti-inflammatory actions. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors.

Meloxicam is an anti-inflammatory, analgesic analgesic with antipyretic effects in fever. Prostaglandins are substances that contribute to inflammation. This drug also exerts preferential actions against COX-2, which may reduce the possible gastrointestinal effects of this drug.

In humans, meloxicam has demonstrated the ability to decrease erythrocyte sedimentation rate(ESR) in patients with rheumatoid arthritis, and to decrease ESR, C-reactive protein (CRP), as well as aquaporin-1 expression. As with other NSAIDS, prolonged use of meloxicum can result in renal or cardiovascular impairment or thrombotic cardiovascular events.

A note on gastrointestinal effects

Trade Name Meloxicam
Availability Prescription only
Generic Meloxicam
Meloxicam Other Names Méloxicam, Meloxicam, Meloxicamum
Related Drugs Humira, Buprenex, aspirin, prednisone, ibuprofen, acetaminophen, tramadol, duloxetine, naproxen, Tylenol
Weight 15mg, , 7.5mg
Type Intravenous, Suppository, Tablet
Formula C14H13N3O4S2
Weight Average: 351.401
Monoisotopic: 351.034747299
Protein binding

Meloxicam is about 99.4% protein bound, primarily to albumin.

Groups Approved, Vet approved
Therapeutic Class Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)
Manufacturer Fontus Health Ltd, Dexa Medica, Mediwin Pharmaceuticals
Available Country United Kingdom, United States, Indonesia, Netherlands, Portugal, India, Nigeria
Last Updated: September 19, 2023 at 7:00 am
Meloxicam
Meloxicam

Uses

Meloxicam is used for Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis

Meloxicam is also used to associated treatment for these conditions: Dental Pain, Neuropathic Pain, Osteoarthritis (OA), Pain, Inflammatory, Pauciarticular juvenile rheumatoid arthritis, Polyarticular juvenile rheumatoid arthritis, chronic or unspecified, Postoperative pain, Rheumatoid Arthritis

How Meloxicam works

Meloxicam inhibits prostaglandin synthetase (cylooxygenase 1 and 2) enzymes leading to a decreased synthesis of prostaglandins, which normally mediate painful inflammatory symptoms. As prostaglandins sensitize neuronal pain receptors, inhibition of their synthesis leads to analgesic and inflammatory effects. Meloxicam preferentially inhibits COX-2, but also exerts some activity against COX-1, causing gastrointestinal irritation.

Dosage

Meloxicam dosage

For Adults:

  • Osteoarthritis: 7.5 mg/day. If necessary, in the absence of improvement, the dose may be increased to 15 mg/day.
  • Rheumatoid arthritis: 15 mg/day. In elderly patients the recommended dose for long term treatment is 7.5 mg/day.
  • Ankylosing spondylitis: 15 mg/day. In elderly patients the recommended dose is 7.5 mg/day.

Do not exceed the dose of 15 mg/day. The total daily amount should be taken as a single dose. Patients with increased risks for adverse reactions should start treatment with 7.5 mg/day. In dialysis patients with severe renal failure the dose should not exceed 7.5 mg/day

For Children: The pharmacokinetics of Meloxicam in paediatric patients under 18 years of age have not been investigated.

Side Effects

Nausea, vomiting, abdominal pain, dyspepsia, constipation or diarrhoea may occur. Ulcers or gastrointestinal bleeding may rarely occur. Skin rash, or urticaria may occur in some individuals. Oedema of the lower limbs may occur during treatment. Onset of an asthma attack has been reported in certain individuals allergic to aspirin or to other NSAIDs. Headache, vertigo or drowsiness may occur.

Toxicity

The oral LD50 in rats is 98 mg/kg. Signs and symptoms of overdose with meloxicam may include shallow breathing, seizure, decreased urine output, gastrointestinal irritation, nausea, vomiting, gastrointestinal bleeding, and black tarry stools. In the case of an overdose, offer supportive treatment and attempt to remove gastrointestinal contents. Cholestyramine has been shown to enhance the elimination of meloxicam.

Precaution

Patient with known CV disease or risk factors for CV disease, fluid retention or heart failure, history of GI bleeding or ulceration. Hepatic and renal impairment. Elderly. Pregnancy and lactation.

Interaction

Other NSAIDs, including high doses of salicylates: Administration of several NSAIDs together may increase the risk of ulcers and of gastrointestinal bleeding, via a synergistic effect.

Oral anticoagulants, heparin and ticlopidine: Increased risk of bleeding via inhibition of platelet function and damage to the gastroduodenal mucosa. Careful monitoring of the effects of anticoagulants is thus essential if it proves impossible to avoid such combined prescription.

Lithium: NSAIDs increase blood lithium levels, which may then reach toxic values.

Methotrexate: NSAIDs may accentuate the haematologic toxicity of methotrexate.

Intrauterine contraceptive devices: NSAIDs appear to decrease the efficacy of intrauterine contraceptive devices.

Food Interaction

  • Avoid alcohol. The risk of gastrointestinal bleeding may be increased.
  • Take with or without food. The absorption is unaffected by food.

Meloxicam Alcohol interaction

[Moderate] GENERALLY AVOID:

The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss.

The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining.



Patients should be counseled on this potential interaction and advised to refrain from alcohol consumption while taking aspirin or NSAIDs.

Meloxicam Hypertension interaction

[Major] Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure.

Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.

Hypertension interaction

[Moderate] Nonsteroidal anti-inflammatory drugs (NSAIDs), including topicals, can lead to new onset of hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events.

NSAIDs should be used with caution in patients with hypertension.

Blood pressure should be monitored closely during the initiation of NSAID therapy and throughout the course of therapy.

Volume of Distribution

The volume of distribution of meloxicam is 10-15L. Because of its high binding to albumin, it is likely to be distributed in highly perfused tissues, such as the liver and kidney. Meloxicam concentrations in synovial fluid, measured after an oral dose, is estimated at 40% to 50% of the concentrations measured in the plasma. This drug is known to cross the placenta in humans.

Elimination Route

The absolute bioavailability oral capsules after a dose was 89% in one pharmacokinetic study. Cmax was reached 5–6 hours after administration of a single dose given after the first meal of the day. The Cmax doubled when the drug was administered in the fasting state. Despite this, meloxicam can be taken without regard to food, unlike many other NSAIDS.

Meloxicam formulated for instillation with bupivacaine produced varied systemic measures following a single dose of varying strength. In patients undergoing bunionectomy, 1.8 mg of meloxicam produced a Cmax of 26 ± 14 ng/mL, a median Tmax of 18 h, and an AUC of 2079 ± 1631 ng*h/mL. For a 9 mg dose used in herniorrhaphy, the corresponding values were 225 ± 96 ng/mL, 54 h, and the AUC was not reported. Lastly, a 12 mg dose used in total knee arthroplasty produced values of 275 ± 134 ng/mL, 36 h, and 25,673 ± 17,666 ng*h/mL.

Half Life

The half-life of meloxicam is approximately 20 hours, which is considerably longer than most other NSAIDS. It can therefore be dosed without the need for slow-release formulations.

Meloxicam applied together with bupivacaine for postsurgical analgesia had a median half-life of 33-42 hours, depending on dose and application site.

Clearance

After an oral dose, the total clearance of meloxicam is 0.42–0.48 L/h. The FDA label indicates a plasma clearance from 7 to 9 mL/min. No dose changes are required in mild to moderate renal or hepatic impairment. The use of meloxicam in patients with severe renal or hepatic impairment has not been studied. FDA prescribing information advises against it.

Elimination Route

Meloxicam is mainly eliminated through metabolism. Its metabolites are cleared through renal and fecal elimination. Less than 10 About 1.6% of the parent drug is excreted in the feces.

Pregnancy & Breastfeeding use

Pregnancy: It is advisable to avoid the administration of Meloxicam during pregnancy.

Lactation: It is unknown whether Meloxicam passes into mother’s milk. Meloxicam should not be given to nursing mothers.

Contraindication

Meloxicam is contraindicated to patients hypersensitive to this drug. Meloxicam should not be given to patients who have developed signs of asthma, nasal polyps, angioneurotic oedema or urticaria following the administration of aspirin or NSAIDs. Meloxicam is contraindicated to patients with active peptic ulcer during the last six months or a history of recurrent peptic ulcer disease, severe hepatic failure, non-dialysed severe renal failure, gastrointestinal bleeding, cerebrovascular bleeding or other bleeding disorders.

Acute Overdose

Symptoms: Lethargy, drowsiness, nausea, vomiting, epigastric pain, GI bleeding; severe symptoms (e.g. HTN, hepatic dysfunction, resp depression, convulsions, CV collapse, cardiac arrest, coma, acute renal failure).

Management: Supportive and symptomatic treatment. Admin of activated charcoal 1-2 hr after ingestion.

Storage Condition

Store Meloxicam tablet in a cool & dry place and away from light. Store Meloxicam suppository below 25˚C protected from light and moisture.

Innovators Monograph

You find simplified version here Meloxicam

Meloxicam contains Meloxicam see full prescribing information from innovator Meloxicam Monograph, Meloxicam MSDS, Meloxicam FDA label

FAQ

What is Meloxicam used for?

Meloxicam is used to treat the symptoms of osteoarthritis and rheumatoid arthritis. Both diseases mainly affect the joints causing pain and swelling. Although MOXICAM can relieve symptoms such as pain and inflammation, it will not cure your condition.

What does Meloxicam do for the body?

Meloxicam is in a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). It works by stopping the body's production of a substance that causes pain, fever, and inflammation.

How long does Meloxicam stay in my system?

The elimination half-life of Meloxicam (or the duration of time it takes your body to metabolize and get rid of half of the drug in your system) is about 20 hours. However, this varies from person to person. Meloxicam can also be detected by a urine drug test for up to five days after the last dose.

Does Meloxicam make me sleepy?

The side effects for Meloxicam don't mention drowsiness (actually Meloxicam can cause insomnia) but does mention dizziness. But headache is a common, less serious side effect of Meloxicam.

What is the best time to take Meloxicam?

Take each dose with a snack or just after eating a meal and drink plenty of water whilst on Meloxicam. If your doctor has prescribed melt-in-the-mouth (orodispersible) tablets: Moisten your mouth first, taking a sip of water if needed. Remove the tablet from the packaging, taking care not to moisten it.

Is Meloxicam good for pain?

Meloxicam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints. Meloxicam is known as a nonsteroidal anti-inflammatory drug (NSAID).

How long does it take for Meloxicam to relieve pain?

Meloxicam can take up to two weeks to start working in full effect. Some changes to pain, swelling, tenderness, or stiffness may be noticeable within 24 to 72 hours, but it might take longer to notice a large difference in pain levels.

Who should not take Meloxicam?

If you have the following condition you should not take Meloxicam:

  • systemic mastocytosis
  • anemia
  • increased risk of bleeding due to clotting disorder
  • an increased risk of bleeding
  • alcoholism
  • high blood pressure
  • a heart attack
  • chronic heart failure
  • abnormal bleeding in the brain resulting in damage to brain tissue, called a hemorrhagic stroke
  • a blood clot
  • stomach or intestinal ulcer
  • bleeding of the stomach or intestines
  • kidney transplant
  • visible water retention
  • abnormal liver function tests
  • pregnancy
  • a rupture in the wall of the stomach or intestine
  • tobacco smoking
  • increased cardiovascular event risk
  • time immediately after coronary bypass surgery
  • chronic kidney disease
  • kidney disease with likely reduction in kidney function
  • aspirin exacerbated respiratory disease
  • history of gastric bypass surgery
  • history of kidney donation

Is Meloxicam a muscle relaxer?

Meloxicam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints.

Does Meloxicam cause high blood pressure?

Meloxicam may increase or worsen your blood pressure. This can increase your risk of heart attack or stroke. Your doctor may check your blood pressure while you're taking Meloxicam.

Can you take vitamins with Meloxicam?

No interactions were found between Meloxicam and Vitamin D3. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

Why is Meloxicam bad for me?

Meloxicam can increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease. Even people without heart disease or risk factors could have a stroke or heart attack while taking this medicine.

Can Meloxicam hurt kidneys?

It is possible to develop kidney damage from taking Meloxicam. However, drug-induced kidney damage is often reversible if the drug causing it is stopped. Meloxicam use can also lead to liver damage.

Is Meloxicam bad for heart?

Meloxicam can increase your risk of fatal heart attack or stroke, even if you don't have any risk factors. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Meloxicam may also cause stomach or intestinal bleeding, which can be fatal.

How does Meloxicam work?

Meloxicam works by blocking the effects of the enzymes cyclooxygenase (COX)-1 and COX-2 which prevents prostaglandin synthesis. Prostaglandins elevate body temperature and make nerve endings more sensitive to pain transmission.

Is it OK to stop taking Meloxicam suddenly?

Although Meloxicam does not cause a withdrawal syndrome, because Meloxicam is used for the treatment of pain and inflammation anyone who suddenly stops taking the medication may experience the return of their pain or inflammation.

What are the side effects of Meloxicam?

The more common side effects that can occur with Meloxicam include:

  • abdominal pain.
  • diarrhea.
  • indigestion or heartburn.
  • nausea.
  • dizziness.
  • headache.
  • itching or rash.


What are the side effects of long term use of Meloxicam?

Meloxicam can cause long-term harm. All medications have potential side effects. Long-term use of NSAIDs may increase the risk of stomach or intestinal bleeding, ulcers, or holes. Long-term use of non-aspirin NSAIDs may increase the risk of heart attack or stroke.

Is Meloxicam safe in pregnancy?

Use of Meloxicam during pregnancy is not advised unless prescribed by your doctor, especially if you are 30 or more weeks pregnant. Paracetamol is usually recommended to control pain or fever during pregnancy.

Is Meloxicam safe during breastfeeding?

It isn't known if Meloxicam passes into breast milk. Because no information is available on the use of Meloxicam during breastfeeding, other agents may be preferred, especially while nursing a newborn or preterm infant.

Can I lay down after taking Meloxicam?

Do not lie down for at least 10 minutes after taking Meloxicam. If you are taking the liquid form of this medication, shake the bottle gently before each dose.

*** Taking medicines without doctor's advice can cause long-term problems.
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