Formulary
Meloxicam: Indications, Dosing, Side Effects and Interactions
Meloxicam clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Meloxicam: Indications, Dosing, Side Effects and Interactions
Meloxicam clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Exacerbation of osteoarthritis (short-term)**
- **Child** (By Mouth): 16-17 years 7.5 mg once daily, then increased if necessary up to 15 mg once daily.
- **Adult** (By Mouth): 7.5 mg once daily, then increased if necessary up to 15 mg once daily.
**Pain and inflammation in rheumatic disease,Ankylosing spondylitis**
- **Child** (By Mouth): 16-17 years 15 mg once daily, then reduced to 7.5 mg once daily if required.
- **Adult** (By Mouth): 15 mg once daily, then reduced to 7.5 mg once daily if required.
- **Elderly** (By Mouth): 7.5 mg once daily.
**Relief of pain and inflammation in juvenile idiopathic arthritis and other musculoskeletal disorders in children intolerant to other NSAIDs**
- **Child** (By Mouth): 12-17 years (body-weight 50 kg and above) 15 mg once daily.
**Exacerbation of osteoarthritis (short-term) for meloxicam**
- **Child 16-17 years** (By mouth): 7.5 mg once daily, then increased if necessary up to 15 mg once daily.
**Pain and inflammation in rheumatic disease, Ankylosing spondylitis for meloxicam**
- **Child 16-17 years** (By mouth): 15 mg once daily, then reduced to 7.5 mg once daily if required.
**Relief of pain and inflammation in juvenile idiopathic arthritis and other musculoskeletal disorders in children intolerant to other NSAIDs for meloxicam**
- **Child 12-17 years (body-weight up to 50 kg)** (By mouth): 7.5 mg once daily.
- **Child 12-17 years (body-weight 50 kg and above)** (By mouth): 15 mg once daily.
Cautions
Allergic disorders; cardiac impairment (NSAIDs may impair renal function); cerebrovascular disease; coagulation defects; connective-tissue disorders; dehydration (risk of renal impairment); elderly (risk of serious side-effects and fatalities) (in adults); heart failure; history of gastro-intestinal disorders (e.g. ulcerative colitis, Crohn's disease); ischaemic heart disease; may mask symptoms of infection; peripheral arterial disease; risk factors for cardiovascular events; uncontrolled hypertension
Contraindications
Active gastro-intestinal bleeding; active gastro-intestinal ulceration; following coronary artery bypass graft surgery; history of gastro-intestinal bleeding related to previous NSAID therapy; history of gastro-intestinal perforation related to previous NSAID therapy; history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes); history of recurrent gastro-intestinal ulceration (two or more distinct episodes); severe heart failure
Side effects
Common or very common Constipation; diarrhoea; gastrointestinal discomfort; gastrointestinal disorders; headache; nausea; vomiting Uncommon Anaemia; angioedema; burping; dizziness; drowsiness; electrolyte imbalance; fluid retention; flushing; haemorrhage; hepatic disorders; hypersensitivity; oedema; skin reactions; stomatitis; vertigo Rare or very rare Acute kidney injury; asthma; conjunctivitis; leucopenia; mood altered; nightmare; palpitations; severe cutaneous adverse reactions (SCARs); thrombocytopenia; tinnitus; vision disorders Frequency not known Agranulocytosis; confusion; fertility decreased female; heart failure; increased risk of arterial thromboembolism; nephritis tubulointerstitial; nephrotic syndrome; photosensitivity reaction; renal necrosis Side-effects, further information For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non-steroidal anti-inflammatory drugs
Interactions
**Severe interactions:**
- In patients with severe renal impairment (creatinine clearance less than 45 ml/min), the concomitant administration of meloxicam and pemetrexed is not recommended.
**Other interactions (35):**
- Risks related to hyperkalemia Certain medicinal products or therapeutic groups may promote hyperkalemia: potassium salts, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors,...
- This risk is increased when the above-mentioned medicinal products are co-administered with meloxicam.
- Pharmacodynamic Interactions: Other NSAIDs (including cyclooxygenase-2 selective inhibitors) and Aspirin > 3g/d: The combination (see section 4.4) with other non steroidal anti-inflammatory drugs,...
- Anticoagulants or heparin administered in geriatrics or at curative doses: Considerably increased risk of bleeding, via inhibition of platelet function and damage to the gastroduodenal mucosa.
- NSAIDs may enhance the effects of anti-coagulants, such as warfarin (see section 4.4).
- The concomitant use of NSAIDs and anticoagulants or heparin administered in geriatrics or at curative dose is not recommended (see section 4.4).
Pregnancy
Important safety information For meloxicam MHRA/CHM advice: NSAIDs: potential risks following prolonged use after 20 weeks of pregnancy (June 2023) See Non-steroidal anti-inflammatory drugs .
Breast feeding
Use with caution during breast-feeding. Present in milk in animal studies-manufacturer advises avoid.
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.
Renal impairment
In general, for NSAIDs the MHRA advises to avoid where possible; if necessary, use with caution (risk of fluid retention and further renal impairment, including renal failure). For meloxicam , avoid if creatinine clearance less than 25 mL/minute; M see Prescribing in renal impairment .
Medicinal forms
Suspension,Tablet,Tablet
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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