Overview
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) used to manage pain and inflammation associated with osteoarthritis and rheumatoid arthritis. It works by inhibiting cyclooxygenase enzymes, reducing prostaglandin synthesis. It carries boxed warnings for cardiovascular and gastrointestinal risks.
Mechanism of Action
Meloxicam selectively inhibits cyclooxygenase-2 (COX-2) more than COX-1, reducing the synthesis of prostaglandins that mediate pain, inflammation, and fever.
Indications
- Osteoarthritis
- Rheumatoid arthritis
Common Doses
- 7.5 mg
- 15 mg
Dosage
For osteoarthritis: 7.5 mg once daily; may increase to 15 mg once daily. For rheumatoid arthritis: 15 mg once daily. Maximum daily dose is 15 mg. Take with food to minimize gastrointestinal upset.
Contraindications
- Known hypersensitivity to meloxicam or any product components
- History of asthma, urticaria, or allergic reactions after taking aspirin or other NSAIDs
- In the setting of coronary artery bypass graft (CABG) surgery
Side Effects
- Common: nausea, dyspepsia, diarrhea, abdominal pain, edema
- Serious: gastrointestinal bleeding, cardiovascular events, renal impairment, hepatotoxicity, serious skin reactions
Interactions
- Anticoagulants (e.g., warfarin): increased risk of bleeding
- ACE inhibitors/ARBs: reduced antihypertensive effect and risk of renal impairment
- Diuretics: reduced diuretic efficacy and risk of renal impairment
- Lithium: increased lithium levels and toxicity risk
- Methotrexate: increased methotrexate toxicity
Counseling Points
- Take with food or milk to reduce stomach upset
- Report any signs of gastrointestinal bleeding (black/tarry stools, vomiting blood)
- Monitor for cardiovascular symptoms (chest pain, shortness of breath, weakness)
- Discontinue immediately and seek medical attention for skin rash or allergic reactions
- Avoid alcohol consumption while taking meloxicam
- Use lowest effective dose for shortest duration possible