Meloxicam

Indications & Dose:

Exacerbation of osteoarthritis (short-term)

• BY MOUTH

Child 16–17 years: 7.5 mg once daily, then increased if necessary up to 15 mg once daily

Adult: 7.5 mg once daily, then increased if necessary up to 15 mg once daily

Pain and inflammation in rheumatic disease | Ankylosing spondylitis

• BY MOUTH

Child 16–17 years: 15 mg once daily, then reduced to 7.5 mg once daily if required

Adult: 15 mg once daily, then reduced to 7.5 mg once daily if required
Elderly: 7.5 mg once daily

Relief of pain and inflammation in juvenile idiopathic arthritis and other musculoskeletal disorders in children intolerant to other NSAIDs

• BY MOUTH

Child 12–17 years (body-weight up to 50 kg): 7.5 mg once daily

Child 12–17 years (body-weight 50 kg and above): 15 mg once daily 

Contraindications:

Hypersensitivity, aspirin allergy (asthma, urticaria, or allergic-type reactions) 

Side Effects:

CNS: Headache, dizziness, insomnia
CV. Edema (W. (25%) Abdominal pain ‘ diarrhea, dyspepsia. flatulence ‘ nausea. ulceration/bleed, elevated transaminases (evidence exists documenting less GI toxicity than other NSAIDs without COX-2 selectivity)
HEME: Anemia
SKIN- Rash, pruritus 

Cautions:

Precautions:

Renal disease (CrCl < 15 ml/min), history of GI Ulcer/bleed (increased risk of GI adverse reactions: extended course of high dose NSAID or corticosteroid therapy), smoker, alcoholics, bleeding disorders, hepatic dysfunction, dehydration, fluid retention, heart failure, hypertension, asthma, elderly, 3rd trimester pregnancy 

Interaction:

Drugs

Anticoagulants (heparin, low molecular weight heparin, warfarin, etc.): Increased risk of hematoma and major and minor bleeding

Aspirin: Increased risk of GI ulceration, especially with high dose.

ACE inhibitors, angiotensin 11 receptor blockers: Diminished antihypertensive effect

B-blockers: Diminished antihypertensive effect

Cholestyramine: Increases clearance of meloxicam (50%), ).

Corticosteroids: Additive effects; increased risk of GI bleeding, sodium/water retention

Cyclosporine: Additive nephrotoxicity

Diuretics: Reduced natriuretic effects

Lithium: Addition of meloxicam may result in increased lithium blood levels (2 1%)

Warfarin: Additive effects on coagulation; prothrombin times as INR have increased with the addition of meloxicam 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; animal studies document both teratogenic and nonteratongenic (premature PDA closure) in animals; no studies in humans: no human studies on breast milk excretion; in rats, milk concentrations are twice that of plasma 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: