What is meloxicam used for? When should you seek medical attention for meloxicam side effects? What are the warnings and drug interactions you should know about meloxicam?

Meloxicam 7.5mg: Who Is This Dose For?

Meloxicam tablets come in four dosages: 5 mg, 7.5 mg, 10 mg, and 15 mg. Healthcare providers typically prescribe the 5 mg dose when people with osteoarthritis (OA) or rheumatoid arthritis (RA) start treatment with meloxicam. However, the U.S. Food and Drug Administration (FDA) also approves meloxicam to manage the pain associated with juvenile rheumatoid arthritis (JRA) in children ages two and older. Children may be prescribed 7.5 mg of meloxicam if their symptoms are not controlled on lower doses.

What is Meloxicam Used For?

Meloxicam can be used to treat a wide range of pain and swelling, but it is frequently prescribed to alleviate specific types of joint pain in conditions like OA and RA. People can also use it off-label to treat a joint condition called gout. All of these conditions are characterized by inflammation in the joints. While there is no cure for these conditions, non-steroidal anti-inflammatory drugs (NSAIDs) such as meloxicam can manage the pain.

Osteoarthritis (OA) is a condition typically associated with wear and tear on the joints, causing swelling, redness, pain, and deformities that can make it hard to function on a day-to-day basis. OA becomes more common as we age, with signs of the disease present in more than 80% of people over 60.

Rheumatoid arthritis (RA) is caused by the immune system inappropriately attacking certain areas of the body, including the joints, the lungs, and other tissues. While rest often improves the symptoms of osteoarthritis, it exacerbates the pain and stiffness associated with rheumatoid arthritis. Treatment for rheumatoid arthritis involves the use of NSAIDs like meloxicam to quell the immune response and alleviate pain, as well as other immune-suppressing drugs like steroids.

Meloxicam can also be used off-label to manage the pain and swelling associated with gout flare-ups, a condition characterized by sudden pain, redness, and swelling of joints. Gout commonly affects one joint in the big toe but may affect any joint in the body. This condition often results from a buildup of uric acid in the body, but many behavioral factors can trigger flare-ups or attacks in susceptible individuals.

Additionally, meloxicam has been used off-label to help with the pain associated with ankylosing spondylitis (AS), a rare, chronic inflammatory condition that affects the spine.

Side Effects of Meloxicam

The most common side effects of meloxicam are diarrhea, indigestion (dyspepsia), and flu-like symptoms. Other possible side effects include headache, dizziness, skin rash, and other gastrointestinal issues such as heartburn, nausea, and gas.

The FDA has issued a “black box” warning about this medication’s serious potential side effects on the digestive system. Meloxicam can increase your risk of bleeding, ulceration, and perforations in the stomach or intestines. These conditions may occur without warning and may be fatal. Older people and those with a prior history of GI problems using meloxicam are at higher risk for these adverse effects.

When to Seek Medical Attention

If you experience any of the following symptoms while taking meloxicam, it’s important to seek medical attention immediately:

• Severe stomach pain or burning
• Vomiting blood or material that looks like coffee grounds
• Blood in the stool or black, tarry stools
• Unexplained weight loss
• Nausea or vomiting that persists
• Swelling or pain in the abdomen

Meloxicam Warnings

Meloxicam comes with several important warnings that patients should be aware of:

1. It can increase the risk of heart attack or stroke, especially in those with cardiovascular disease or risk factors.
2. It may worsen high blood pressure or cause new high blood pressure to develop.
3. It can increase the risk of serious and potentially fatal skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis.
4. It may cause serious and potentially fatal liver problems, including liver failure.
5. It can increase the risk of kidney problems, including kidney failure, especially in those with pre-existing kidney disease.

Meloxicam Drug Interactions

Meloxicam can interact with a number of other medications, including:

• Antidepressants (SSRIs, SNRIs)
• Blood thinners (warfarin, apixaban, rivaroxaban, etc.)
• Corticosteroids
• Diuretics (“water pills”)
• ACE inhibitors and ARBs for high blood pressure
• Methotrexate

It’s important to inform your healthcare provider of all medications you are taking, including over-the-counter drugs, supplements, and herbal products, to avoid potentially dangerous interactions.

Meloxicam Forms and Brand Names

Meloxicam is available in several formulations, including tablets, capsules, and an oral suspension. The brand names for meloxicam include Mobic, Vivlodex, Qmiiz ODT, and Anjeso.

Meloxicam 7.5 Mg: Who Is This Dose For?

1. What is meloxicam used for?
2. Side effects of meloxicam
3. When to seek medical attention
4. Meloxicam warnings
5. Meloxicam drug interactions
6. Meloxicam forms and brand names

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Meloxicam tablets come in four dosages: 5 mg, 7.5 mg, 10 mg, and 15 mg. Generally, healthcare providers prescribe 5 mg doses when people with osteoarthritis (OA) or rheumatoid arthritis (RA) start treatment with meloxicam. U.S. Food and Drug Administration (FDA) also approves meloxicam to manage the pain associated with juvenile rheumatoid arthritis (JRA) (RA in children ages two and older). Children may be prescribed 7.5 mg of meloxicam if their symptoms are not controlled on lower doses (DailyMed, 2018).

Though 7.5 mg is enough to manage pain in many patients, it may take time to feel the full effects of meloxicam. Research shows that those with RA may begin to feel relief as early as three weeks into treatment on either 7.5 mg or 15 mg dosages (Reginster, 1996). 

Individuals prescribed meloxicam for osteoarthritis may feel the effects even sooner. Researchers found evidence that meloxicam was working after just two weeks in patients given daily doses of either 7.5 mg or 15 mg of the prescription drug (Yocum, 2000).

Meloxicam can be used to treat a wide range of pain and swelling but is frequently prescribed to alleviate specific types of joint pain in conditions like OA and RA, which we’ll get into below. People can also use it off-label to treat a joint condition called gout. All of these conditions are characterized by inflammation in the joints. While there is no cure for these conditions, NSAIDs such as meloxicam can manage the pain.

• Osteoarthritis (OA) is a condition typically associated with wear and tear on the joints. It causes swelling, redness, pain, and deformities of the joints that can make it hard to function on a day-to-day basis. OA becomes more common as we age, with signs of the disease present in more than 80% of people over 60. Still, other factors contribute, including genetics, history of injury, increased body weight, and the presence of other underlying conditions. More than 43 million people around the world suffer from moderate-to-severe osteoarthritis (Sen, 2020). 

• Rheumatoid arthritis (RA) is caused by the immune system inappropriately attacking certain areas of the body, including the joints, the lungs, and other tissues. And while rest often improves the symptoms of osteoarthritis, it exacerbates the pain and stiffness associated with rheumatoid arthritis. Treatment for rheumatoid arthritis involves the use of NSAIDs like meloxicam to quell the immune response and alleviate pain and other immune-suppressing drugs like steroids.  

• Meloxicam can also be used off-label to manage the pain and swelling associated with gout flare-ups, a condition characterized by sudden pain, redness, and swelling of joints. Gout commonly affects one joint in the big toe but may affect any joint in the body. This condition often results from a buildup of uric acid in the body, but many behavioral factors can trigger flare-ups or attacks in susceptible individuals (Jin, 2012). These factors include certain foods, like shellfish and red meat, and drugs, like aspirin and certain diuretics (“water pills”), which increase the levels of uric acid in the body (ACR, 2019). Meloxicam can help manage gout symptoms (Gaffo, 2019).
• Meloxicam has also been used off-label to help with the pain associated with ankylosing spondylitis (AS), a rare, chronic inflammatory condition that affects the spine (Song, 2008). Like OA and RA, we do not have a cure for AS, but NSAIDs such as meloxicam can help manage the pain.

The most common side effects of meloxicam are diarrhea, indigestion (dyspepsia), and flu-like symptoms (FDA, 2012). Other possible side effects include headache, dizziness, skin rash, and other gastrointestinal issues such as heartburn, nausea, and gas (DailyMed, 2019).

The FDA issued a “black box” warning about this medication’s serious potential side effects on the digestive system. A black box warning is the FDA’s most serious advisory. Meloxicam can increase your risk of bleeding, ulceration, and perforations in the stomach or intestines. 

These conditions may occur without warning and may be fatal. Older people and those with a prior history of GI problems using meloxicam are at higher risk for these adverse effects (FDA, 2012). Meloxicam comes in different forms and does not need to be taken by mouth to cause digestive problems. It does the same when administered as an injection.

Non-steroidal anti-inflammatory drugs (NSAIDs) act on different parts of the inflammation pathway to decrease symptoms such as swelling. Meloxicam also increases the time it takes your blood to clot, which may increase your risk of bleeding (Rinder, 2002; Martini, 2014).  

If you’re taking meloxicam and experiencing sudden and severe stomach pain that won’t go away, black or bloody stool, dark urine, dizziness, or loss of consciousness, seek medical attention immediately.

Meloxicam may cause severe allergic (hypersensitivity) reactions. Signs of an allergic reaction include hives, trouble breathing, shortness of breath, or skin reactions such as a blistering skin rash. If you experience any of these symptoms, get medical help immediately (DailyMed, 2019).

One of the reasons that meloxicam is not available over the counter is that it can increase your risk of having a heart attack or stroke, especially if you have a history of heart disease or other risk factors. This risk may be higher if you use this prescription drug long-term (FDA, 2012). 

Meloxicam should not be used to treat pain right before or after heart surgery, like a coronary artery bypass graft (CABG) procedure (commonly referred to as “bypass”), because the use of NSAIDs increases the risk of heart attack or stroke following these procedures (Kulik, 2015).  

NSAIDs such as meloxicam should also not be taken during the third trimester of pregnancy. 

If you’re nursing, talk to a healthcare professional before using meloxicam. While we aren’t sure how much meloxicam reaches breast milk, your healthcare provider can help you weigh the risks and benefits of using this medication while breastfeeding (FDA, 2012). If you are pregnant, it’s important to know that you should not take this medication or any NSAIDs (like ibuprofen or naproxen) after the second trimester of pregnancy. 

These medications may interfere with the development of the fetus’s heart and redirect blood flow in its body, which may result in progressive heart problems later on (Bloor, 2013; Enzensberger, 2012). Research has also shown that NSAIDs like meloxicam may make it harder for the embryo to implant (Bermas, 2014). If you take meloxicam regularly, consult with a healthcare professional if you have been trying to conceive or plan to start trying.

Certain medications may increase the risk of bleeding if taken with meloxicam. Blood thinners (like warfarin) and antiplatelet agents (like aspirin) should not be taken with meloxicam for this reason (DailyMed, 2019). Smoking while taking meloxicam also increases your risk of bleeding problems (FDA, 2012).

Combining meloxicam with other NSAIDs such as naproxen increases the chance of developing gastrointestinal problems, like bleeding or stomach ulcers.

Meloxicam may affect how well blood pressure medications work. Drugs that lower blood pressure (antihypertensive drugs), like ACE inhibitors, angiotensin receptor blockers (ARBs), or beta-blockers may be less effective if taken with meloxicam (Fournier, 2012; Johnson, 1994). 

Meloxicam may have this effect on other medications such as diuretics (aka “water pills”), drugs that reduce fluid retention. Loop diuretics such as furosemide and thiazide diuretics such as hydrochlorothiazide (HCTZ) may not work as well if taken with meloxicam. These medications may also worsen kidney function if taken together, potentially causing kidney failure (DailyMed, 2019).

Meloxicam is available as a generic drug and sold under the brand names Mobic and Vivlodex. There are multiple forms of this medication: Meloxicam comes as an oral suspension (7.5 mg/5 ml), a disintegrating tablet (7.5 mg and 15 mg dosages), and an intravenous (IV) solution. IV meloxicam is used in a hospital setting.

Most people usually take one pill by mouth daily. If you miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and take your next dose as usual. Don’t take a double dose. Meloxicam tablets should be stored at room temperature and out of the reach of children.

A 30-day supply of meloxicam costs between $4 to over $400, and many insurance plans cover this prescription drug (GoodRx.com). The price depends on the strength and whether you purchase brand name or generic pills. 

1. American College of Rheumatology (ACR) (2019). Gout. Retrieved on 16 September 2020 from https://www. rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout
2. Bloor, M., & Paech, M. (2013). Nonsteroidal Anti-Inflammatory Drugs During Pregnancy and the Initiation of Lactation. Anesthesia & Analgesia, 116(5), 1063-1075. doi:10.1213/ane.0b013e31828a4b54. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23558845/
3. Bermas, B. L. (2014). Non-steroidal anti inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy. Current Opinion in Rheumatology, 26(3), 334-340. doi:10.1097/bor.0000000000000054. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24663106/
4. DailyMed (2019). Meloxicam tablet. Retrieved on 16 September 2020 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5e12448-1ca1-46a4-8de4-e8b94567e5a8
5. Enzensberger, C., Wienhard, J., Weichert, J., Kawecki, A., Degenhardt, J., Vogel, M., & Axt-Fliedner, R. (2012). Idiopathic Constriction of the Fetal Ductus Arteriosus. Journal of Ultrasound in Medicine, 31(8), 1285-1291. doi:10.7863/jum.2012.31.8.1285. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22837295/
6. Fenando A, Widrich J. Gout. [Updated 2020 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546606/
7. Food and Drug Administration (FDA) (2012). Mobic (meloxicam) tablets and oral suspension. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/012151s072lbl.pdf
8. Fournier, J. P., Sommet, A., Bourrel, R., Oustric, S., Pathak, A., Lapeyre-Mestre, M., & Montastruc, J. L. (2012). Non-steroidal anti-inflammatory drugs (NSAIDs) and hypertension treatment intensification: a population-based cohort study. European journal of clinical pharmacology, 68(11), 1533–1540. doi:10.1007/s00228-012-1283-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22527348/
9. Gaffo, A. L., MD, MsPH. (2019, December 4). Treatment of gout flares. Retrieved September 18, 2020, from https://www.uptodate.com/contents/treatment-of-gout-flares/
10. GoodRx.com (n.d.). Meloxicam. Retrieved 16 September 2020 from https://www.goodrx.com/meloxicam
11. Huskisson, E. C., Ghozlan, R., Kurthen, R., Degner, F. L., & Bluhmki, E. (1996). A Long-Term Study to Evaluate the Safety and Efficacy of Meloxicam Therapy in Patients with Rheumatoid Arthritis. Rheumatology, 35(Suppl 1), 29-34. doi:10.1093/rheumatology/35.suppl_1.29. Retrieved from https://academic.oup.com/rheumatology/article/35/suppl_1/29/1782379
12. Jin, M., Yang, F., Yang, I., Yin, Y., Luo, J. J., Wang, H., & Yang, X. F. (2012). Uric acid, hyperuricemia and vascular diseases. Frontiers in bioscience (Landmark edition), 17, 656–669. doi:10.2741/3950. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247913/
13. Johnson, A. G., Nguyen, T. V., & Day, R. O. (1994). Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Annals of internal medicine, 121(4), 289–300. doi:10.7326/0003-4819-121-4-199408150-00011. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8037411/
14. Kulik, A., Bykov, K., Choudhry, N. K., & Bateman, B. T. (2015). Non-steroidal anti-inflammatory drug administration after coronary artery bypass surgery: Utilization persists despite the boxed warning. Pharmacoepidemiology and Drug Safety, 24(6), 647-653. doi:10.1002/pds.3788. Retrieved from https://scholar.harvard.edu/files/nkc/files/2015_nsaids_after_cabg_pds.pdf
15. Martini, A. K., Rodriguez, C. M., Cap, A. P., Martini, W. Z., & Dubick, M. A. (2014). Acetaminophen and meloxicam inhibit platelet aggregation and coagulation in blood samples from humans. Blood Coagulation & Fibrinolysis, 25(8), 831-837. doi:10.1097/mbc.0000000000000162. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25004022/
16. Reginster, J. Y., Distel, M., & Bluhmki, E. (1996). A Double-Blind, Three-Week Study to Compare the Efficacy and Safety of Meloxicam 7.5 mg and Meloxicam 15 mg in Patients with Rheumatoid Arthritis. Rheumatology, 35(Suppl 1), 17-21. doi:10.1093/rheumatology/35.suppl_1.17. Retrieved from https://www.researchgate.net/profile/Erich_Bluhmki/publication/14569192_A_Double-Blind_Three-Week_Study_to_Compare_the_Efficacy_and_Safety_of_Meloxicam_75_mg_and_Meloxicam_15_mg_in_Patients_with_Rheumatoid_Arthritis/links/599d516745851574f4b258e4/A-Double-Blind-Three-Week-Study-to-Compare-the-Efficacy-and-Safety-of-Meloxicam-75-mg-and-Meloxicam-15-mg-in-Patients-with-Rheumatoid-Arthritis.pdf
17. Rinder, H. M., Tracey, J. B., Souhrada, M., Wang, C., Gagnier, R. P., & Wood, C. C. (2002). Effects of Meloxicam on Platelet Function in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Clinical Pharmacology, 42(8), 881-886. doi:10.1177/009127002401102795. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12162470/
18. Sen R, Hurley JA. Osteoarthritis. [Updated 2020 Mar 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Retrieved from: https://www. ncbi.nlm.nih.gov/books/NBK482326/
19. Song, I. H., Poddubnyy, D. A., Rudwaleit, M., & Sieper, J. (2008). Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs. Arthritis & Rheumatism, 58(4), 929-938. doi:10.1002/art.23275. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/art.23275
20. Yocum, D. (2000). Safety and Efficacy of Meloxicam in the Treatment of Osteoarthritis. Archives of Internal Medicine, 160(19), 2947-2954. doi:10.1001/archinte.160.19.2947. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485487

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

Auro-Meloxicam – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Meloxicam belongs to the family of medications known as COX-2 inhibiting nonsteroidal anti-inflammatory drugs (NSAIDs). It is used to treat rheumatoid arthritis and painful osteoarthritis in adults. It helps with these conditions by relieving pain and reducing swelling and inflammation.

NSAIDs work by blocking a response to injury in the body that leads to inflammation and pain.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do.  It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

7.5 mg
Each light yellow, round, biconvex uncoated tablet debossed with “Z” on one side and “45” on the other side contains 7.5 mg of meloxicam. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, sodium citrate, crospovidone, povidone, colloidal anhydrous silica, and magnesium stearate.

15 mg
Each light yellow, round, uncoated tablet with score line between “F” and “2” debossed on one side and plain on the other side contains 15 mg of meloxicam. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, sodium citrate, crospovidone, povidone, colloidal anhydrous silica, and magnesium stearate.

How should I use this medication?

Rheumatoid arthritis: The usual starting dose of meloxicam to treat the symptoms of rheumatoid arthritis is 15 mg once daily.  For some people who may respond well to the medication, their doctor can reduce the dose to 7.5 mg once daily, according to need.

Osteoarthritis: The recommended dose to relieve osteoarthritis pain is 7.5 mg once daily. The doctor may increase this to 15 mg taken once daily if necessary.

For both conditions, the maximum dose of meloxicam is 15 mg taken once daily.

This medication may be taken with or without food.

The use of this medication should be limited to the lowest effective dose for the shortest period of time needed.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule.  Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to meloxicam or any ingredients of the medication
• are about to have or have recently had coronary artery bypass graft (CABG) surgery
• are pregnant or breast-feeding
• are less than 18 years of age
• have active or recent stomach or intestinal ulcers or bleeding
• have bleeding of the brain or other bleeding disorders
• have experienced asthma, hives, nasal polyps, or allergic reactions after taking ASA or other NSAIDs
• have higher than normal levels of potassium in the blood
• have inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
• have severely reduced kidney function or worsening kidney function
• have severely reduced liver function or active liver disease
• have severe uncontrolled heart failure

What side effects are possible with this medication?

Many medications can cause side effects.  A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• dizziness or lightheadedness
• drowsiness
• flushing
• gas/flatulence
• headache
• indigestion
• mouth ulcers
• nausea
• sensitivity to sunlight
• sleepiness
• sore mouth
• uncomfortable feeling in the stomach
• weight changes

Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• confusion
• eye infection (e.g., swollen runny eyes, itching eyes, crusty eyelids)
• hearing problems
• high blood pressure
• pain while urinating or difficulty urinating
• pounding heart beat
• ringing in the ears
• signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don’t stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of infection (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)
• signs of kidney problems (e. g., increased urination at night, decreased urine production, blood in the urine, painful or difficult urination)
• signs of liver damage (e.g., yellow skin or eyes, abdominal pain, dark urine, clay-coloured stools, loss of appetite, nausea and vomiting, or itching)
• skin rash or itching
• small, red spots on skin
• swelling of the lower legs, ankles, or feet
• unexplained weight gain
• vision changes including blurred vision
• vomiting or persistent nausea, indigestion, stomach pain, or diarrhea

Stop taking the medication and seek immediate medical attention if any of the following occur:

• changes in the amount or colour of urine (such as red or brown urine)
• fainting
• rapid swelling of face, tongue, lips
• seizures
• severe stomach pain
• shortness of breath
• signs of bleeding in the stomach (e.g., bloody, black, or  tarry stools, spitting up of blood, vomiting blood or material that looks like coffee grounds)
• signs of breathing problems (e. g., shortness of breath, troubled breathing, wheezing, or tightness in chest, fast or irregular breathing)
• signs of meningitis not caused by infection (e.g., headache (severe), throbbing, or with stiff neck or back)
• signs of a severe allergic reaction (e.g., hives, difficulty breathing, swelling of the face, mouth, throat, or tongue)
• signs of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

June 8, 2021

Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada’s web site at www.hc-sc.gc.ca.

A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.

Alcohol: People taking this medication should not drink alcohol, as this can increase the risk of stomach problems with the medication.

Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., ibuprofen, ketoprofen, diclofenac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take this medication. If you experience symptoms of a severe allergic reaction (e.g., hives; difficulty breathing, wheezing; swelling of the face, tongue, or throat), get immediate medical attention.

Aseptic meningitis: This medication can rarely cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). If you have an autoimmune condition (e.g., systemic lupus erythematosus, mixed connective tissue disease), you are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking this medication and get immediate medical attention.

Bladder symptoms: This medication can cause bladder symptoms such as frequent or painful urination and blood in urine. If you develop these symptoms, stop taking this medication and contact your doctor immediately.

Blood counts: This medication can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. Contact your doctor immediately if you notice an increased occurrence of signs of infection (e.g., fever, chills, or sore throat), feel unusually tired, lack energy, or experience unusual bleeding or bruising.

Blood pressure: Like other NSAIDs, meloxicam can cause increased blood pressure, which may contribute to other heart conditions. If you have high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Meloxicam may reduce mental or physical abilities required for performance of hazardous tasks such as operating machinery or driving a motor vehicle. Avoid these and other hazardous tasks until you are sure that this medication does not affect your ability to do these safely.

Fertility: Fertility may be decreased in people taking this medication. This medication is not recommended for women who are trying to get pregnant.

Galactose intolerance/glucose malabsorption: Meloxicam medications are prepared with lactose. If you have lactose or galactose intolerance you should not take these medications.

Heart attack and stroke: The use of COX-2 NSAIDs, including meloxicam, is associated with an increased risk of heart attack and stroke. This risk is increased with higher total daily doses and taking the medication over long periods of time. If you have a history of heart disease, including heart attack and stroke, discuss with your doctor the benefits and risks of taking this medication. Ask your doctor about all available treatment options that may be right for you.

Heart conditions: This medication can cause fluid retention which will make symptoms of certain heart conditions worse. If you have heart failure, high blood pressure, or other medical conditions that increase your risk of fluid retention (e. g., kidney problems), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Infection: This medication may mask signs of infection such as fever or muscle aches. If you notice other symptoms of infection (e.g., painful or frequent urination, sore throat, cough) contact your doctor.

Informing health professionals: Be sure to tell any health professionals (including your doctor, nurse, pharmacist, and dentist) involved in your care that you are taking this medication, particularly if you are scheduled for heart surgery.

Kidney function: This medication can affect kidney function. You have a higher risk of developing kidney problems if you are a senior, take diuretics (water pills; e.g., hydrochlorothiazide, furosemide), or already have kidney disease or heart failure. Your doctor may monitor your kidney function with blood tests when you are taking this medication. Meloxicam is not recommended for people with severely reduced kidney function if they are not receiving dialysis.

Liver function: This medication may affect your liver function or cause liver problems. If you experience symptoms of liver problems (e.g., nausea, vomiting, feeling tired, yellowing of the skin or eyes) contact your doctor immediately. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely reduced liver function or have active liver disease should not take this medication.

Potassium levels: Meloxicam may cause high blood potassium levels. You are more at risk of high blood potassium if you are a senior, have diabetes or kidney failure, or are taking beta-blockers (e.g., metoprolol, atenolol), angiotensin converting enzyme (ACE) inhibitors (e. g., ramipril, enalapril), or some diuretics (e.g., triamterene, amiloride). Because extremely high blood potassium levels can contribute to other conditions, such as heart problems, your doctor will monitor your potassium level with blood tests while you are taking this medication.

Ulcers and bleeding in the stomach and intestines: This medication may cause stomach ulcers and bleeding from the stomach. These complications can occur at any time and are sometimes severe.

If you have had a stomach or intestinal ulcer, diverticulosis, Crohn’s disease or ulcerative colitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

If you experience symptoms of an ulcer or other stomach problems (e.g., stomach or abdominal pain, black stools, blood or coffee grind-like vomit, weakness), contact your doctor immediately or get immediate medical attention.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately. It must not be used during the last 3 months of pregnancy as it may cause heart and kidney problems for the developing baby and cause prolonged labour with excessive bleeding during delivery.

Breast-feeding: Many anti-inflammatory medications are known to pass into breast milk. If you are a breast-feeding mother and are taking meloxicam, it may affect your baby. Breast-feeding is not recommended while you are taking meloxicam.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may have a higher risk of side effects and should be closely monitored by their doctors while taking this medication.

What other drugs could interact with this medication?

There may be an interaction between meloxicam and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• aliskiren
• alteplase
• aminoglycoside antibiotics (e. g., amikacin, gentamicin, tobramycin)
• angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril, captopril, quinapril)
• angiotensin receptor blockers (ARBs; e.g., candesartan, irbesartan, losartan)
• apixaban
• “azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
• beta-adrenergic blockers (e.g., atenolol, propranolol, sotalol)
• bimatoprost
• bisphosphonates (e.g., alendronate, etidronate)
• bosentan
• carbamazepine
• celecoxib
• cholestyramine
• clopidogrel
• colestipol
• cyclosporine
• dabigatran
• dabrafenib
• dasatinib
• deferasirox
• desmopressin
• digoxin
• dipyridamole
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
• edoxaban
• eplerenone
• glucosamine
• haloperidol
• heparin
• herbal products that affect blood clotting (e. g., cat’s claw, chamomile, evening primrose, feverfew, fenugreek, garlic, ginger, ginseng, turmeric)
• hydralazine
• ibrutinib
• latanoprost
• lithium
• low-molecular-weight heparins (e.g., dalteparin, enoxaparin, tinzaparin)
• mesalamine
• methotrexate
• mifepristone
• milk thistle
• multivitamins (with vitamins A, E) with or without minerals
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, naproxen)
• obinutuzumab
• omega-3 fatty acids
• oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• pemetrexed
• pentoxifylline
• prasugrel
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
• rifampin
• rivaroxaban
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e. g., desvenlafaxine, duloxetine, venlafaxine)
• sodium phosphates
• sodium polystyrene sulfonate
• sulfasalazine
• tacrolimus
• tenofovir
• ticagrelor
• ticlopidine
• tipranavir
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• urokinase
• vancomycin
• vitamin E
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Auro-Meloxicam

Ecofuril capsules 200 mg instructions for use

Instructions for use Ecofuril® capsules 200 mg

Trade name of the drug: Ecofuril ^®

International non-proprietary name: nifuroxazide

Dosage form: capsules

Composition per capsule

for 200 mg dosage:

active ingredient: nifuroxazide 200. 0 mg.

excipients: lactitol – 300.0 mg, microcrystalline cellulose – 58.0 mg, potato starch – 18.0 mg, magnesium stearate – 6.0 mg, sucrose to obtain the mass of the contents of the capsule. 630.0 mg.

hard gelatin capsules No. 00 [gelatin (up to 100%), water (14-15%), cap:
body: quinoline yellow color (0.3497%), sunset color (0.0116%), titanium dioxide (0.8742%)].

Description

Yellow No. 0 hard gelatin capsules (for dosages of 100 and 200 mg) The contents of the capsules are yellow granular powder with white patches.

Pharmacotherapeutic group: antimicrobial agent – nitrofuran

ATX Code: A07AX03

Pharmacological properties

A broad-spectrum antimicrobial agent – a derivative of 5-nitrofuran. Used to treat infections of the gastrointestinal tract. Nifuroxazide blocks the activity of dehydrogenases and inhibits the respiratory chains, the tricarboxylic acid cycle and other biochemical reactions in the bacterial cell. Destroys the membranes of sensitive bacteria, reduces the production of toxins by microorganisms. Activates the immune system, increases the activity of phagocytes and complement titer.

Effective against gram-positive microorganisms:

• Staphylococcus spp.;
• Streptococcus spp.

and Gram-negative microorganisms:

• Salmonella spp.;
• Klebsiella spp.;
• Enterobacter spp.;
• Escherichia coli;
• Shigella spp.;
• Proteus spp.;
• Haemophilus influenzae;
• Campylobacter spp.;
• Edwarsiella spp.;
• Citrobacter spp.;
• Vibrio cholerae;
• Yersinia enterocolitica.

Nifuroxazide does not affect the state of the normal human intestinal microflora. In acute bacterial diarrhea restores intestinal eubiosis. When infected with enterotropic viruses, it prevents the development of bacterial superinfection.

Pharmacokinetics

After oral administration, nifuroxazide is practically not absorbed in the gastrointestinal tract and does not have a systemic effect. It exhibits antibacterial activity against sensitive bacterial species only in the intestinal lumen. It is excreted unchanged by the intestines. The rate of elimination depends on the dose of the drug and the motility of the gastrointestinal tract.

Indications for use

Acute and chronic diarrhea of ​​​​infectious genesis (without signs of helminthic invasion).

Chronic colitis and enterocolitis.

Contraindications

Hypersensitivity to nifuroxazide, other components of the drug, other derivatives of 5-nitrofuran. Sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.
Children’s age up to 3 years (for this lekform).

Use during pregnancy and lactation.

There are no data on adverse effects on the fetus during pregnancy. If necessary, with caution, the drug can be prescribed to pregnant women and women who are breastfeeding.

Dosage and administration

Take inside.

Adults and children over 7 years old: 2 capsules of 100 mg or 1 capsule of 200 mg 4 times a day (800 mg / day).

Children 3-7 years old: 2 capsules of 100 mg or 1 capsule of 200 mg 3 times a day (600 mg / day).

The duration of therapy with nifuroxazide is no more than 7 days.

Overdose

Specific symptoms of overdose are not described. Standard emergency measures are recommended.

Side effect

Allergic reactions.

Interaction with other drugs
Data on the interaction of nifuroxazide with other drugs has not been published.

Special instructions

In the treatment of diarrhea, concurrently with nifuroxazide therapy, it is necessary to carry out rehydration therapy (oral or intravenous) in accordance with the patient’s condition and the duration of diarrhea. During therapy with nifuroxazide, alcohol is not allowed.

Influence on the ability to drive vehicles and perform work that requires increased concentration of attention and speed of psychomotor reactions.

The drug does not adversely affect the ability to drive vehicles and / or other mechanisms.

Form

Capsules 100 mg and 200 mg. 10 capsules (with a dosage of 100 mg) or 5, 7, 8 capsules (with a dosage of 200 mg) are placed in a blister pack made of PVC film and printed lacquered aluminum foil. 30 capsules (100 mg dosage) or 16, 28 or 30 capsules (200 mg dosage) in a plastic bottle with a screw cap or a plastic jar with a screw cap. 3 blisters (for a dosage of 100 mg) or 2 blisters of 8 capsules, 4 blisters of 7 capsules or 6 blisters of 5 capsules (for a dosage of 200 mg) or 1 bottle or 1 jar together with instructions for use are placed in a pack of cardboard.

Storage conditions

In a place protected from moisture and light, at a temperature not exceeding 25 ° C. Keep out of the reach of children.

Expiration date :

5 years. Do not use after the expiration date.

Vacation conditions

Over the counter

Name and address of the legal entity in whose name the registration certificate was issued / organization accepting claims:

JSC “AVVA RUS”, Russia, 121614, Moscow, st.