Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) used to treat pain and inflammation from rheumatoid arthritis and osteoarthritis. It is more COX-2 selective, with lower gastrointestinal risk than other NSAIDs.
Also known as: mobic, aeirox
COX-2 selective NSAID + anticoagulant: increased bleeding risk, but lower than non-selective NSAIDs.
Meloxicam has COX-2 preference with less effect on platelet aggregation. However, GI bleeding risk remains significant with concomitant use.
INR, signs of bleeding.
Significant bleeding.
Monitor INR during the first weeks. Consider low-dose meloxicam (7.5 mg/day).
DailyMed/FDA — approved Meloxicam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58dbce26-b2ac-2ce4-e063-6294a90a5727
Food does not significantly affect meloxicam absorption. May be taken with or without food.
Take with or without food. Food may reduce GI discomfort.
Partial renal excretion. Accumulation in moderate-severe renal impairment.
eGFR 30-50: max dose 7.5 mg/day. eGFR <30: avoid.
DailyMed/FDA — approved Meloxicam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58dbce26-b2ac-2ce4-e063-6294a90a5727
CONTRAINDICATED in 3rd trimester. Risk of ductus arteriosus closure.
3rd trimester: CONTRAINDICATED. 1st-2nd trimester: avoid.
Limited data. Avoid during breastfeeding.
May affect fertility. Use reliable contraception.
DailyMed/FDA — approved Meloxicam label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58dbce26-b2ac-2ce4-e063-6294a90a5727
Clinical and educational support tool. The information does not replace a medical prescription or the opinion of a qualified healthcare professional.
NSAID with COX-2 preference (relative selectivity ~10:1 at low doses). Anti-inflammatory and analgesic activity with lower GI toxicity than non-selective NSAIDs.
Preferential COX-2 inhibition at low doses (7.5 mg). At higher doses (15 mg), loses selectivity and also inhibits COX-1.
Complete but slow oral absorption. Bioavailability: 89%. Food does not affect absorption. Peak: 5-6 h.
Metabolised in the liver by CYP2C9 and CYP3A4. Inactive metabolites. Excretion equally divided between urine and faeces.
15-20 h. Allows once-daily dosing.
Medicines from the same therapeutic group (ATC classification) or the same pharmacological class.
