What it's for (Indications)
- Meloxicam is used in the management of pain, inflammation, and fever associated with rheumatoid arthritis, ankylosing spondylitis, and acute osteoarthritis.
- It is also indicated for Juvenile rheumatoid arthritis (JRA) in children above two years of age.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Administer the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. **Adults (Osteoarthritis & Rheumatoid Arthritis):** The starting dose is typically 7.5 mg orally once daily. The dose may be increased to a maximum of 15 mg orally once daily based on patient response and tolerability. The maximum recommended daily oral dose for adults is 15 mg, regardless of formulation. **Pediatric Patients (Juvenile Rheumatoid Arthritis - JRA):** This medicine can be used for Juvenile rheumatoid arthritis in children above two years of age. For children weighing ≥60 kg, a typical dose is 7.5 mg once daily (consistent with a maximum daily dose of 0.125 mg/kg/day). **Patients with Hemodialysis:** A lower dose is required for patients undergoing hemodialysis, with a maximum recommended daily dose of 7.5 mg once daily due to the risk of drug accumulation. **Formulation Interchangability:** Meloxicam tablets are not interchangeable with approved formulations of oral meloxicam even if the total milligram strength is the same. |
Safety & Warnings
Common Side Effects
- Common side effects may include gastrointestinal disturbances such as diarrhea, upper respiratory tract infections, and dyspnea.
- More serious adverse reactions can involve stomach problems (e.
- g.
- , GI bleeding, ulceration, perforation), skin reactions (e.
- g.
- , pruritus, rash, itching, angioedema, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)), brain and cardiac effects (e.
- g.
- , cardiovascular thrombotic events, hypertension, heart failure, edema), liver problems (e.
- g.
- , hepatotoxicity, disturbed liver tests), kidney problems (e.
- g.
- , renal toxicity, hyperkalemia), blood disorders (e.
- g.
- , hematologic toxicity), and anaphylactic reactions.
- Patients might also experience dizziness or drowsiness.
Serious Warnings
- Black Box Warning: WARNING: RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS. **Cardiovascular Thrombotic Events:** Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Meloxicam is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. **GI Bleeding, Ulceration, and Perforation:** NSAIDs cause an increased risk of serious gastrointestinal (GI) 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 without warning symptoms. Elderly patients and those with a history of peptic ulcer disease and/or GI bleeding are at greater risk.
- Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
- **Cardiovascular Risks:** NSAIDs, including meloxicam, can cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal.
- This risk may occur early in treatment and may increase with duration of use.
- Caution is advised in patients with congestive heart failure.
- **Gastrointestinal Risks:** NSAIDs increase the 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 without warning symptoms.
- Elderly patients and those with a history of peptic ulcer disease and/or GI bleeding are at greater risk.
- **Hepatic Risks:** Caution is advised in patients with liver cirrhosis or other hepatic impairment; consult a doctor before use, as hepatotoxicity and disturbed liver tests can occur.
- **Renal Risks:** Caution is advised in patients with kidney damage (e.
- g.
- , nephrotic syndrome, renal failure) or hypovolemia.
- Renal toxicity and hyperkalemia can occur.
- Dialysis patients can use this medicine but in a lower dose (maximum 7.
- 5 mg once daily) because typical dosage will cause drug buildup.
- **Pregnancy:** Meloxicam is considered unsafe during pregnancy and is contraindicated, particularly in the third trimester due to risks of fetal toxicity (e.
- g.
- , premature closure of the ductus arteriosus).
- Consult a doctor immediately if pregnant or planning pregnancy.
- **Lactation:** This medicine is not recommended and is contraindicated during breastfeeding.
- **Alcohol:** It is unsafe to consume alcohol when using this medicine due to an increased risk of gastrointestinal bleeding and other adverse effects.
- **Neurological Effects:** This medicine might cause dizziness and drowsiness.
- Avoid driving or operating heavy machinery if you experience these symptoms.
- **Pediatric Use:** The safety and effectiveness in osteoarthritis and rheumatoid arthritis patients younger than 18 years of age are undetermined.
- However, it can be used for Juvenile rheumatoid arthritis in children above two years of age.
How it Works (Mechanism of Action)
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic, anti-inflammatory, and antipyretic properties. Its mechanism of action involves the inhibition of cyclooxygenase (COX-1 and COX-2) enzymes. By blocking COX, meloxicam reduces the synthesis of prostaglandins, which are natural chemicals responsible for sensitizing afferent nerves, mediating inflammation, and inducing pain in the body. This reduction in prostaglandin production leads to decreased pain and inflammation.