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Meloxicam information from DrugsUpdate  

See Available Brands of Meloxicam in India

P - Caution when used during pregnancy
L - Caution when used during lactation
FI - Food *

Meloxicam is a nonsteroidal anti-inflammatory drug of the oxicam class, used to relieve the symptoms of arthritis, primary dysmenorrhea, fever; and as an analgesic, especially where there is an inflammatory component. It has been developed by Boehringer-Ingelheim. It is closely related to piroxicam.

In Europe it is marketed under the brand names Movalis, Melox, and Recoxa. In the Philippines it is generally marketed as the brand name Moxen. In the UK, U.S., Middle East and Australia it is generally marketed under the brand name Mobic, in Germany as Mobec, and in Canada as Mobicox. In Latin America, the drug is marketed as Tenaron, Ilacox or Melocam. A veterinary formulation of the drug is marketed in the U.S. and in France as Metacam by the Vetmedica division of Boehringer-Ingelheim.

Pharmacodynamics

Pharmacokinetics

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 hours (elimination half-life).

Meloxicam Indications / Meloxicam Uses

Information Not Available

Meloxicam Adverse Reactions / Meloxicam Side Effects

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.

Precautions

Meloxicam tablets cannot be expected to substitute for corticosteroids or to treat corticosteroid insufficiency. Abrupt discontinuation of corticosteroids may lead to disease exacerbation. Patients on prolonged corticosteroid therapy should have their therapy tapered slowly if a decision is made to discontinue corticosteroids.

The pharmacological activity of Meloxicam tablets in reducing fever and inflammation may diminish the utility of these diagnostic signs in detecting complications of presumed noninfectious, painful conditions.

Overdosage

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.

Special 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.

Other 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.

Other Interactions

Food Interaction
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.

Dosage

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 years: 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.

Food(before/after)

May be taken with or without food. (May be taken w/ meals if GI discomfort occurs.)

List of Contraindications

Meloxicam and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

In 3rd trimester or near term.
                   
Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Meloxicam and Lactation

Caution when used during lactation

Meloxicam and Children

Safety and efficacy not established for JRA patients younger than 2 years of age

Meloxicam and Geriatic

Use with caution in patients 65 years of age and older

Meloxicam and Other 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.

Storage

Oral
Store at 25°C (77°F)

Lab interference

Oral
Store at 25°C (77°F)

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