How does meloxicam impact platelet function in healthy adults. What are the differences between meloxicam and traditional NSAIDs in terms of bleeding risk. Can meloxicam be considered a safer alternative for patients with bleeding concerns.

Understanding Meloxicam: A Selective COX-2 Inhibitor

Meloxicam belongs to a class of medications known as nonsteroidal anti-inflammatory drugs (NSAIDs). Unlike traditional NSAIDs, meloxicam is designed to selectively inhibit cyclooxygenase-2 (COX-2), the enzyme responsible for mediating inflammatory responses. This selectivity aims to reduce the risk of side effects associated with inhibition of cyclooxygenase-1 (COX-1), which is involved in maintaining the protective lining of the stomach and regulating platelet function.

The Mechanism of Action

To understand how meloxicam affects platelet function, it’s crucial to examine its mechanism of action:

• COX-2 Inhibition: Meloxicam primarily targets COX-2, reducing inflammation and pain.
• Partial COX-1 Inhibition: While less potent, meloxicam still exhibits some effect on COX-1, which may influence platelet function.
• Thromboxane A2 (TxA2) Production: By partially inhibiting COX-1, meloxicam can reduce TxA2 formation, a key factor in platelet aggregation.

Meloxicam’s Impact on Platelet Function: Key Findings

A randomized, double-blind, placebo-controlled trial conducted by Henry M. Rinder and colleagues provides valuable insights into meloxicam’s effects on platelet function. The study involved 79 healthy adults and compared various doses of meloxicam with extended-release indomethacin (Indo-ER) and placebo.

Dose-Dependent TxB2 Inhibition

How does meloxicam affect thromboxane B2 (TxB2) production? The study revealed that meloxicam significantly decreased TxB2 production compared to placebo in a dose-dependent manner:

• Peak inhibition of 77% was observed 6 hours after administering 30 mg of meloxicam (supratherapeutic dose).
• Indo-ER, a traditional NSAID, blocked TxB2 formation by 96% at the same time point.

Bleeding Time and Platelet Aggregation

Despite the reduction in TxB2 production, meloxicam demonstrated minimal impact on bleeding time and platelet aggregation:

• No significant increase in bleeding time was observed with meloxicam at any dose.
• Platelet aggregation remained unaffected in response to both COX-1-dependent (ADP, arachidonate) and COX-1-independent (high-dose collagen) agonists.
• In contrast, Indo-ER significantly increased bleeding time and inhibited platelet aggregation to COX-1-dependent agonists.

Comparing Meloxicam to Traditional NSAIDs

The study’s findings highlight important distinctions between meloxicam and traditional NSAIDs like indomethacin:

Platelet Function Preservation

How does meloxicam differ from traditional NSAIDs in terms of platelet function? Unlike nonselective NSAIDs, meloxicam’s inhibition of TxA2 formation does not reach levels that significantly impair in vivo platelet function, even at supratherapeutic doses. This suggests that meloxicam may have a lower risk of bleeding complications compared to traditional NSAIDs.

Hemostasis

The study concluded that meloxicam did not interfere with platelet-mediated hemostasis in healthy subjects. This finding is particularly relevant for patients who may be at increased risk of bleeding or those undergoing surgical procedures.

Clinical Implications of Meloxicam’s Platelet-Sparing Effect

The platelet-sparing properties of meloxicam have several potential clinical implications:

Perioperative Use

Can meloxicam be used safely in the perioperative period? The minimal impact on platelet function suggests that meloxicam may be a safer option for pain management before and after surgery, potentially reducing the risk of excessive bleeding.

Patients with Bleeding Disorders

For patients with underlying bleeding disorders or those taking anticoagulant medications, meloxicam’s platelet-sparing effect may offer a safer alternative for managing pain and inflammation compared to traditional NSAIDs.

Limitations and Considerations

While the study provides valuable insights, it’s important to consider its limitations:

• Healthy Subjects: The study was conducted on healthy adults, and results may differ in patients with pre-existing conditions or those taking other medications.
• Short-term Use: The study evaluated the effects of meloxicam over 8 days. Long-term use may yield different results.
• Dosage Range: Although supratherapeutic doses were tested, extreme doses beyond 30 mg were not evaluated.

Future Research Directions

The findings of this study open up several avenues for future research:

Long-term Effects

Does prolonged use of meloxicam alter its impact on platelet function? Studies examining the effects of long-term meloxicam use on platelet function and bleeding risk are needed.

Special Populations

How does meloxicam affect platelet function in patients with cardiovascular disease, bleeding disorders, or those taking anticoagulants? Research focusing on these special populations could provide valuable clinical insights.

Comparative Studies

Further studies comparing meloxicam to other selective COX-2 inhibitors and traditional NSAIDs could help establish a more comprehensive understanding of its relative safety profile.

Practical Considerations for Healthcare Providers

When considering meloxicam as a treatment option, healthcare providers should keep the following points in mind:

• Individual Risk Assessment: Evaluate each patient’s bleeding risk and consider meloxicam’s platelet-sparing properties in the context of their overall health status.
• Dose Optimization: Use the lowest effective dose of meloxicam to minimize potential side effects while maintaining therapeutic benefits.
• Monitoring: Regular monitoring of patients on long-term meloxicam therapy is essential to detect any changes in bleeding risk or other adverse effects.
• Patient Education: Inform patients about the potential benefits and risks of meloxicam, including its effects on platelet function compared to traditional NSAIDs.

The Role of Meloxicam in Modern Pain Management

As our understanding of meloxicam’s effects on platelet function evolves, its role in modern pain management continues to be refined:

Balancing Efficacy and Safety

How can healthcare providers strike a balance between pain relief and bleeding risk? Meloxicam’s unique profile offers an opportunity to provide effective pain management while potentially reducing the risk of bleeding complications associated with traditional NSAIDs.

Personalized Medicine Approach

The platelet-sparing properties of meloxicam underscore the importance of a personalized approach to pain management. Factors such as a patient’s medical history, concurrent medications, and individual risk factors should guide the selection of the most appropriate NSAID or alternative pain management strategy.

Integration with Multimodal Pain Management

Meloxicam’s favorable platelet function profile may make it a valuable component of multimodal pain management strategies, particularly in perioperative settings or for patients with chronic pain conditions who require long-term NSAID therapy.

In conclusion, the study by Rinder et al. provides compelling evidence that meloxicam, even at supratherapeutic doses, does not significantly impair platelet function in healthy adults. This finding distinguishes meloxicam from traditional NSAIDs and suggests it may be a safer option for patients with bleeding concerns. However, as with any medication, the decision to use meloxicam should be based on a careful assessment of individual patient factors and potential risks. Ongoing research will continue to refine our understanding of meloxicam’s role in pain management and its long-term effects on platelet function.

Effects of meloxicam on platelet function in healthy adults: a randomized, double-blind, placebo-controlled trial

Clinical Trial

. 2002 Aug;42(8):881-6.

doi: 10.1177/009127002401102795.

Henry M Rinder 
¹
, Jayne B Tracey, Magdalena Souhrada, Chao Wang, R Paul Gagnier, Chester C Wood

Affiliations

Affiliation

• ¹ Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8035, USA.

• PMID:

  12162470

• DOI:

  10.1177/009127002401102795

Clinical Trial

Henry M Rinder et al.

J Clin Pharmacol.

2002 Aug.

. 2002 Aug;42(8):881-6.

doi: 10.1177/009127002401102795.

Authors

Henry M Rinder 
¹
, Jayne B Tracey, Magdalena Souhrada, Chao Wang, R Paul Gagnier, Chester C Wood

Affiliation

• ¹ Department of Laboratory Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-8035, USA.

• PMID:

  12162470

• DOI:

  10.1177/009127002401102795

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase-1 (COX-1), thereby inhibiting platelet function via blockade of thromboxane A2 (TxA2) formation, and COX-2, the enzyme that mediates inflammatory responses. Meloxicam is a relatively COX-2-selective anti-arthritis drug that shows significant TxA2 inhibition, albeit less than traditional NSAIDs. A randomized, double-blind, placebo-controlled trial was conducted in 79 healthy adults to compare the effects of once-daily therapeutic (7.5 mg, 15 mg) and supratherapeutic (30 mg) doses of meloxicam with extended-release indomethacin (Indo-ER 75 mg once daily) on bleeding time, TxA2 formation, and platelet aggregation. The authors measured platelet aggregation to COX-1-dependent (ADP arachidonate) and COX-1-independent (high-dose collagen) agonists, bleeding time, serum TxB2, and clotting times (aPTT and PT) after 8 days’ administration and at 3 and 6 hours after steady-state dosing. Meloxicam significantly decreased TxB2 production compared with placebo in a dose-dependent fashion, reaching a peak of 77% inhibition 6 hours after 30 mg meloxicam; Indo-ER blocked TxB2 formation by 96% at the same time point. However, neither acute nor 8 days’ administration of meloxicam at any dose caused a significant increase in bleeding time or inhibition of platelet aggregation to any agonist when compared with placebo. By contrast, Indo-ER significantly increased the bleeding time and inhibited platelet aggregation to COX-1-dependent agonists 6 hours after dosing. Clotting times were unaffected by any drug. It was concluded that unlike nonselective NSAIDs, meloxicam’s blockade of TxA2 formation (even at supratherapeutic doses) does not reach levels that result in decreased in vivo platelet function, as measured by bleeding time and aggregometry. In this study of healthy subjects, meloxicam did not interfere with platelet-mediated hemostasis.

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Meloxicam side effects and how to avoid them

Meloxicam side effects | Headaches | Weight gain | Overdose | How long do side effects last? | Warnings | Interactions | How to avoid side effects

Meloxicam is a generic prescription drug that relieves pain and swelling caused by osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis. Also found in pharmacies under the brand names Mobic, Vivlodex, Qmiiz, and Anjeso, meloxicam can be taken by mouth as a tablet, capsule, disintegrating tablet, or oral suspension, or it can be injected directly into the bloodstream by a healthcare professional. 

As a nonsteroidal anti-inflammatory drug (NSAID), meloxicam belongs to the same family of the well-known drugs aspirin, ibuprofen, and naproxen. However, meloxicam is not just an amped-up version of Advil or Aleve. People should be aware that meloxicam as a prescription NSAID comes with more serious risks, side effects, warnings, and drug interactions than ordinary over-the-counter NSAIDs.   

RELATED: Learn more about meloxicam | Get meloxicam discounts

Common side effects of meloxicam

The most common side effects of meloxicam (affecting 2% or more of people taking the medication) are:

• Abdominal pain
• Headache
• Flu-like symptoms
• Dizziness
• Nausea
• Diarrhea
• Sore throat 
• Fluid retention
• Accidents and falls
• Constipation
• Insomnia
• Upper respiratory tract infection
• Urinary tract infection
• Joint pain
• Back pain
• Stomach upset
• Flatulence
• Rash
• Itching
• Urination problems
• Vomiting

Serious side effects of meloxicam

Meloxicam can produce serious and even life-threatening side effects, particularly if used in high doses or for an extended time. These include:

• Heart attack
• Stroke
• Blood clots
• High blood pressure
• Congestive heart failure
• Bleeding, ulcers, or perforations in the stomach or intestine
• Liver damage or liver failure
• Kidney dysfunction or kidney failure
• Anemia
• Bleeding problems
• Asthma attacks in people with asthma
• Severe and potentially life-threatening allergic reactions such as anaphylaxis, trouble breathing, or severe skin reactions

Serious side effects will require immediate medical attention.

Meloxicam and headaches

Headaches are a common, less serious side effect of meloxicam. In two 12-week clinical trials in patients with osteoarthritis or rheumatoid arthritis, between 5.5% to 8.3% of people taking meloxicam reported headaches. In six-month trials, 2.6% to 3.6% of people taking meloxicam experienced headaches. However, headaches as a side effect do not seem to be dose-dependent.

Meloxicam and weight gain

Weight gain and loss are uncommon side effects of meloxicam, observed in less than 2% of people taking it. However, fluid retention (edema) is a common side effect, reported in 0.6% to 4.5% of people taking meloxicam in clinical studies. Left untreated, edema can lead to cardiovascular problems including congestive heart failure in vulnerable people. Fluid retention can be partly identified by an unexplained rise in body weight, so involuntary weight gain should be reported to the prescribing physician or other healthcare professional. 

Meloxicam overdose

As an NSAID, a meloxicam overdose can lead to serious health issues, evident from more common experiences of people overdosing on common over-the-counter NSAIDs, such as aspirin or ibuprofen. The most common symptoms of an NSAID overdose are:

• Lack of energy
• Drowsiness
• Nausea
• Vomiting
• Stomach pain
• Blurred vision
• Dizziness
• Bloody vomiting
• Black or tarry stools

A severe overdose can result in high blood pressure, kidney failure, seizures, coma, respiratory distress, and death. People with any symptoms of NSAID overdose will require immediate medical attention.

How long do meloxicam side effects last?

Most of the common side effects of meloxicam are temporary and will abate after the drug is discontinued. Unfortunately, meloxicam stays in the body much longer than other NSAIDs, so side effects may linger a day or two after the last dose. More serious side effects, such as ulcers and gastrointestinal bleeding, can take much longer to resolve, even after discontinuing meloxicam.

Meloxicam contraindications & warnings

Like all prescription NSAIDs, meloxicam has risks that may outweigh the benefits for some people. The FDA determines if a medicine is safe for certain people by issuing contraindications and warnings. When a medicine carries a high risk for hazardous adverse effects in certain people, it is contraindicated for those people—it is never to be used in those patients. When a medication is riskier than normal in some patients, the medication comes with a warning. It is okay to take the medicine, but use and dosage will require monitoring or modification. 

Allergies

Meloxicam should never be used in people with known allergies to meloxicam or other NSAIDs.

Coronary artery bypass graft (CABG) surgery

Better known as “bypass surgery” or “coronary bypass,” CABG surgery restores normal blood flow to the heart’s muscles by either diverting a coronary artery or using a blood vessel graft to “go around” an obstructed coronary artery. Because meloxicam can cause blood clotting and cardiovascular problems, it is never used in the period leading up to bypass surgery or in the weeks after.

Asthma

Some people have aspirin-sensitive asthma, also known as aspirin-exacerbated respiratory disease (AERD). When given aspirin or other NSAIDs, those with AERD react with classic asthma symptoms, such as wheezing and coughing. This reaction can be fatal. Meloxicam should never be given to people with aspirin-sensitive asthma. Other people with asthma will require caution and monitoring just in case there is a serious reaction.

Other medical conditions

Meloxicam and other NSAIDs may worsen existing medical conditions, so these medications require  caution and monitoring when prescribed to people with risk factors such as:

• Heart disease
• Congestive heart failure
• Blood clots and stroke
• Ulcers or bleeding in the digestive system
• High blood pressure
• Fluid retention
• Bleeding disorders
• Kidney problems
• Liver disease and
• Poor general health

Children

Meloxicam is FDA approved to treat juvenile rheumatoid arthritis in children 2 years of age and older. In three clinical trials, children experienced the same types of side effects as adults, but at a higher rate.

Seniors

People 65 years and older are at a higher risk for side effects, so they may be started at a lower dose and monitored. 

Fertility

Meloxicam may cause a delay in ovulation, so women who are trying to get pregnant or undergoing fertility treatment may not be prescribed meloxicam.

Pregnancy

Meloxicam is not to be taken by pregnant women after 30 weeks because NSAIDs affect the heart development in the unborn baby. There is not enough research to know if meloxicam is safe for women or an unborn baby in the first 30 weeks of pregnancy. Women who are pregnant or considering getting pregnant should discuss the risks with a doctor. 

Breastfeeding

It is not certain if meloxicam is safe to take while nursing or how much passes into human breast milk. Nursing mothers should seek medical advice before taking meloxicam.

Dependence

Meloxicam does not create dependence nor does it require a tapered dose when stopping the medication.  

Meloxicam interactions

Taking two or more drugs can sometimes lead to trouble. Meloxicam is no exception. Because of the way it works, meloxicam affects many organs and systems in the body, particularly the blood, stomach, and kidneys. There are, then, a variety of ways that meloxicam can interact with other medications and foods. Here is how to make sense of all of them:

Meloxicam and NSAIDs

As previously stated, meloxicam is an NSAID. When taken with other NSAIDs, including ordinary aspirin or ibuprofen, the risk of side effects increases due to their additive effects. This is because all NSAIDs more or less cause similar side effects, particularly gastrointestinal problems including stomach pain, bleeding, and ulcers. As a general rule, taking two or more NSAIDs should be avoided except under the advice of a doctor. Taking multiple types of NSAIDs will delay it leaving your body and put you at a higher risk of side effects. Acetaminophen, the active ingredient in Tylenol, can acutely be substituted for NSAIDs for treating pain or fever, but not long-term when taking meloxicam.

Meloxicam and bleeding

Meloxicam interferes with the body’s ability to form blood clots. So, when meloxicam is taken with blood thinners such as warfarin, there is an increased risk of bleeding episodes, particularly stomach bleeding. This is because NSAIDs also target COX-1receptors, which protect the mucus lining of the stomach.  A physician will need to monitor blood coagulation in any person taking meloxicam with blood thinners. SSRIs (antidepressants), SNRIs (antidepressants), and some anticancer drugs also increase the risk of bleeding and gastrointestinal bleeding when combined with meloxicam.

Some drugs specifically raise the risk of gastrointestinal bleeding, including corticosteroids, some osteoporosis drugs (bisphosphonates), and some anticancer drugs. These, too, need to be used carefully when combined with meloxicam.

There are several over-the-counter dietary and herbal supplements that also interfere with blood clotting, such as fish oil, garlic, ginkgo, willow bark, krill oil, and saw palmetto. A healthcare professional can provide sound advice about combining these supplements with meloxicam.

Meloxicam and blood pressure

Elevated blood pressure is a common side effect of meloxicam, so taking meloxicam may counteract the effects of medications intended to lower blood pressure. Also, taking meloxicam with ACE inhibitors and angiotensin II receptor blockers (ARBs)—two common types of blood pressure medications—increases the risk of kidney problems and elevated potassium (hyperkalemia) in seniors or people with existing kidney problems. 

Several types of drugs also raise blood pressure. Combining any of them with meloxicam raises the risk of high blood pressure:

• Caffeine, alcohol, and nicotine
• Stimulants
• Antidepressants
• Asthma medications
• Decongestants
• Birth control pills
• Migraine medications
• Some immune-suppressing anticancer drugs
• Parkinson’s disease medications

These drugs are not necessarily prohibited from taking with meloxicam, but blood pressure should be monitored when taking them together.  

Some popular herbal remedies and supplements also raise blood pressure, such as ephedra, licorice, and Yohimbe. Again, the risk of high blood pressure increases when these supplements are taken with meloxicam.

Meloxicam and diuretics

Taking meloxicam with certain types of loop diuretics or thiazide diuretics may lower sodium levels, which can be potentially hazardous, or diminish kidney function. If you’re uncertain what type of diuretic you’re taking, a doctor, pharmacist, or another healthcare provider can help identify it. Therapy will need to be monitored and may need to be modified.

Meloxicam and the kidneys

Meloxicam affects substances that regulate blood flow in the kidneys, changing how well the kidneys eliminate drugs from the body. This can increase the damage to the kidneys caused by other drugs, such as cyclosporine and tacrolimus. Alternatively, meloxicam can decrease the ability of the kidneys to eliminate certain drugs, particularly lithium, a drug used to treat bipolar disorder, methotrexate, a drug used to treat cancer or rheumatism, and pemetrexed, an anticancer drug. This may sound like a good thing, but it actually means that these drugs linger longer in the body at higher concentrations, increasing their toxicity and the likelihood of adverse effects. Again, these drugs are not to be avoided outright, but their dosing regimens may need to be modified.

How to avoid meloxicam side effects

Like all medications, meloxicam can have side effects, particularly problems with the stomach and small intestine. A few rules of thumb can help improve the odds:

1.  Take meloxicam as directed

Take the daily dose as prescribed. Don’t increase or decrease the dose. Don’t miss a dose and, if you do, don’t take extra medicine to make up for a missed dose.

2.  Avoid taking other NSAIDs

Many over-the-counter pain relievers belong to the same class of drugs as meloxicam, including aspirin. They have many of the same side effects as meloxicam and are eliminated the same way, so it’s a good idea to avoid them while taking meloxicam.  

3.  Take meloxicam with food

Meloxicam can be taken with or without food. If taking meloxicam produces stomach problems, consider taking meloxicam with food. Meloxicam can also be taken safely with antacids.

4.  Avoid taking meloxicam long-term

The likelihood of side effects, including serious side effects, increases the longer the medication is taken. To minimize adverse effects, meloxicam is intended to be taken at the lowest possible dose for the shortest duration possible to achieve therapy goals. If a medical condition like rheumatoid arthritis requires continual use of pain relievers, a healthcare professional can suggest alternatives to the long-term use of meloxicam.

5.  Avoid smoking and alcohol

Smoking and drinking alcohol raise the risk of stomach ulcers in people taking NSAIDs such as meloxicam. 

6.  Tell the doctor about all medical conditions

To reduce the risk of side effects, make sure the prescribing doctor is aware of all medical conditions past and present, particularly:

• Heart problems including heart disease or heart attack
• A history of blood clots or stroke
• Ulcers or gastrointestinal bleeding
• Fluid retention
• Asthma
• High cholesterol
• Diabetes
• Liver problems or
• Kidney problems
• Allergies to NSAIDs

The prescribing doctor will also need to know about pregnancy status, breastfeeding, fertility treatments, or any plans on becoming pregnant.

7.  Tell the doctor about all medications being taken

Many side effects of prescription drugs like meloxicam are simply caused by combining them with the wrong medications. For anyone with a chronic condition like arthritis, it’s helpful to keep a list of all medications used. Prescription drugs, over-the-counter drugs, dietary supplements, and herbal remedies, taken both regularly or rarely should be included. Keep this list on hand so it can be readily shared with a doctor, pharmacist, or another healthcare provider before a prescription is written. Follow their advice if they indicate certain drugs, supplements, or foods should be avoided.

Resources:

• Meloxicam, Epocrates
• Prescribing information, Food and Drug Administration (FDA)
• Prescribing information, DailyMed
• Toxic effects of nonsteroidal anti-inflammatory drugs in overdose, Drug Safety
• Meloxicam compound summary, National Library of Medicine
• Aspirin-exacerbated respiratory, American Academy of Allergy Asthma & Immunology (AAAAI)

Meloxicam – anti-inflammatory and analgesic

One of the common anti-inflammatory drugs is meloxicam. Meloxicam belongs to the group of oxicams.

Oxycams are a group of drugs that are non-steroidal anti-inflammatory drugs or NSAIDs. Meloxicam is available in 7.5 mg tablets. Meloxicam is available in yellow and flat-cylindrical tablets.

Meloxicam has anti-inflammatory, analgesic and antipyretic effects on the body. Basically, these effects are due to the effect on the enzyme cyclooxygenase. The anti-inflammatory effect of this drug has been tested on all standard biological models of inflammation.

With the development of inflammation, a large amount of prostaglandins (PG) is released into the blood, which cause the main manifestations and symptoms. Meloxicam inhibits the action of PG. Two forms of the cyclooxygenase enzyme circulate in the human body: COX 1 and COX 2. COX 1 works constantly, COX 2 is activated only during inflammation. Meloxicam in the body inhibits more COX-2 than COX-1. Therefore, when using it, there are much fewer side effects than when taking other non-steroidal anti-inflammatory drugs. This fact has been proven during testing on various systems, both in laboratory conditions and in clinical trials. In addition, it was shown that greater blocking of the work of COX-2 than COX-1 depended on the dosage of the drug.

When taken orally, meloxicam enters the blood from the gastrointestinal tract. The maximum concentration of the substance occurs after 6 hours. The absorption of the drug is not affected by food or antacids.

Meloxicam, once in the body, binds to plasma proteins, with 99% of the substance bound to albumin. In addition, it enters the synovial fluid of the joints, while the concentration of the substance is 50% of the concentration of the substance in the blood.

Meloxicam is processed in the liver, and 4 inactive components are synthesized. In the process of deactivation, isoenzymes like CYP2C9 and CYP3A4 also play a major role. Thanks to their work, the formation of two main metabolites occurs. The peroxidase enzyme is involved in the formation of two other inactive substances.

Meloxicam is eliminated from the body via the intestines and kidneys. The half-life of the drug takes about a day. With various liver diseases or liver failure, meloxicam is excreted from the body at the same rate. In the case of renal insufficiency, the rate of excretion increases significantly. If the patient is diagnosed with terminal renal failure, a high concentration of the active substance is noted in the blood, which requires adjustment of the dosage of the drug. In elderly patients, there were no significant differences in the pharmacokinetics of the drug.

Meloxicam is prescribed as a symptomatic treatment for various joint diseases, such as osteoarthritis, rheumatoid arthritis, spondylitis. In addition, the drug is taken to reduce pain and inflammation. At the same time, this drug does not affect the course of the disease.

When taking the drug, it is necessary to take into account a large number of contraindications, such as hypersensitivity to the drug, bronchial asthma, urticaria, nasal polyposis, as well as intolerance to aspirin and NSAIDs of other groups.

In addition, various diseases of the stomach and duodenum (erosions or ulcers), as well as inflammatory processes in the intestines, are also a contraindication for prescribing meloxicam. As with the use of other NSAIDs, meloxicam is contraindicated in patients with various stages of renal and hepatic insufficiency. In addition, severe heart disease, bleeding from various parts of the gastrointestinal tract, as well as diseases of the blood coagulation system, are a contraindication for meloxicam. Meloxicam should also not be taken during pregnancy at any time and breastfeeding.

When prescribing meloxicam, the doctor takes into account the patient’s concomitant pathology and, depending on the presence of any diseases, adjusts the dosage of the drug. To exclude the development of various complications from the gastrointestinal tract, the drug is prescribed in the minimum dosage, and the course of treatment is also reduced as much as possible.

There are a large number of adverse or unwanted reactions when taking meloxicam. At the same time, anemia, headache, emotional lability, tinnitus, various abdominal pains and other dyspeptic disorders can most often develop. Other possible complications are quite rare.

When taking other drugs, it must be remembered that if the patient is additionally taking other prostaglandin inhibitors, this may significantly increase the risk of ulcers and erosions of the gastrointestinal tract. In addition, the simultaneous use of anticoagulants, thrombolytics and other drugs that affect hematopoiesis with meloxicam may increase the risk of bleeding.

It is also not recommended to take meloxicam together with methotrexate, lithium preparations, contraceptives and diuretics. The dosage of the drug is determined depending on the type of disease, the stage of exacerbation and concomitant pathology. The drug is prescribed inside. Usually start with 7.5 mg per day, or if the disease is in the acute stage, start with 15 mg per day and then reduce to 7.5 mg.

Overdose symptoms are non-specific: vomiting, nausea, abdominal pain, kidney and liver failure and others. Treatment usually consists of gastric lavage, activated charcoal, and forced diuresis.

With long-term use of the drug, constant medical supervision is required, laboratory data and clinical symptoms should be evaluated.

Meloxicam is a non-steroidal anti-inflammatory drug that causes fewer side effects compared to other drugs, but still remains quite effective.

meloxicamo pain reliever analgesic drug anti-inflammatory drug effective analgesic drug effective anti-inflammatory drug

Injections, gel, ointment, tablets, suppositories

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED.Joint painHeadacheToothachePainkiller tabletsPainkiller injectionsBruises

The author of the article

Dolgikh Natalia Vadimovna,

Diploma of pharmaceutical education: 105924 3510859 reg. number 31944

All authors

Contents of the article

• Amelotex: composition
• Amelotex: from what
• Amelotex: contraindications
• Amelotex and alcohol: compatibility
• A melotex gel: analogues
• Amelotex or Diclofenac: which is better
• Movalis or Amelotex: which is better
• Amelotex or Meloxicam: which is better
• Summary
• Ask an expert on the topic of the article

Pain, inflammation and stiffness in the joints greatly affect people’s quality of life. The range is extensive: from sprains, fractures and dislocations to life-long disorders – arthrosis and arthritis. This leads to early termination of employment, a decrease in the level of well-being and the loss of the opportunity to participate in society.

Pain relief is a request that doctors and pharmacists hear every day. Therefore, we asked the pharmacist Natalia Dolgikh to talk about such a drug as Amelotex. From the article you will learn: what the drug is for, its composition, contraindications, compatibility with alcohol, and also expand knowledge about analogues.

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Amelotex: composition

Amelotex is available in several dosage forms:

• Tablets
• Gel for external use
• Intramuscular solution ampoules
• Oral suspension
• Rectal suppositories

The active ingredient in all formulations is Meloxicam.

The composition of excipients depends on the type of preparation. So, for example, Amelotex gel contains: methylpyrrolidone, ethanol 95%, carbomer, trometamol, orange blossom oil, lavender oil and purified water.

Amelotex: from what

Amelotex belongs to the group of non-steroidal anti-inflammatory drugs. Common indications for use include: pain relief and inflammation in diseases of the musculoskeletal system, such as arthrosis, rheumatoid arthritis and arthropathy.

But it should be noted that each form of release has its own characteristics. For example, Amelotex gel is also used to relieve pain from injuries, bruises and dislocations. Amelotex in the form of injections is more effective to use with the rapid progression of the disease.

Amelotex: contraindications

All types of the drug, with the exception of the gel, are dispensed by prescription, as they have serious contraindications. Amelotex Gel may cause an allergic reaction, redness or rashes on the skin. If these effects occur, the use of the gel is stopped.

Amelotex tablets are contraindicated in case of:

• hypersensitivity to the drug components
• intolerance to acetylsalicylic acid or other NSAIDs*
• erosive and ulcerative lesions of the stomach and duodenum in the acute phase or recently transferred
• inflammatory bowel disease
• severe liver or kidney failure
• gastrointestinal or cerebrovascular bleeding
• established diagnosis of blood coagulation
• severe uncontrolled heart failure
• rare hereditary galactose intolerance, lactase deficiency, glucose-galactose malabsorption
• pregnancy
• breastfeeding period

Amelotex intramuscular injection is contraindicated in children under 15 years of age.

*NSAIDs – non-steroidal anti-inflammatory drugs: ibuprofen, nimesulide, diclofenac and others.

Amelotex and alcohol: compatibility

Alcohol does not affect the absorption and effectiveness of the active substance. However, during the course of treatment with Amelotex, you should refrain from drinking alcohol. This is because alcohol increases the risk of adverse drug effects such as blood thinning and stomach bleeding.

Also, a joint intake with alcohol threatens with a sharp decrease in blood pressure, exacerbation of asthma attacks and problems with the gastrointestinal tract. Amelotex gel acts locally, respectively, undesirable effects will be less pronounced, but will not disappear.

Amelotex gel: analogues

Amelotex, as mentioned above, belongs to the group of NSAIDs. It includes many topical preparations with a similar effect. These include: Meloxicam-Canon, the combination drug Teraflex, Voltaren, Aertal, Bystrumgel, Pentalgin and others.

Please note that Amelotex is a gel. The gel penetrates well through the skin, while being quickly absorbed and does not leave greasy marks. Such a form as Amelotex ointment or cream is not registered. Let’s take a closer look at some of the analogues.

Amelotex or Diclofenac: which is better

Amelotex and Diclofenac effectively cope with pain relief and inflammation, but contain different active substances, as a result, they differ in contraindications and side effects.

Diclofenac is a strong NSAID, but acts indiscriminately. This means that it has more side effects. For example, a pronounced negative effect on the gastrointestinal tract contributes to the formation of ulcers. This action is called ulcerogenic.

Amelotex is a more modern drug and is selective or otherwise selective. Accordingly, it boasts fewer contraindications and side effects.

Movalis or Amelotex: which is better

The active substance of both drugs is Meloxicam, which makes them identical in categories: indications for use, contraindications and side effects. The difference lies in the manufacturers and forms of release.

Movalis is an original German drug. It is produced in two dosage forms: tablets and solution for intramuscular injection.

Amelotex is a generic or generic drug produced in Russia. Has five dosage forms:

• tablets,
• gel for external use,
• solution for intramuscular injection,
• rectal suppositories
• oral suspension.

Which is better, Movalis or Amelotex, the patient chooses based on medical indications and the availability of the drug.

Amelotex or Meloxicam: which is better? Meloxicam is produced in Russia, Belarus, India, Israel, Romania.

Meloxicam from some manufacturers contains lactose as an excipient, so you should not take the drug if you are intolerant to it.

Also, Meloxicam does not have a suspension as a dosage form, but is used as an injection from the age of 18.

In general, the preparations are very similar. When choosing a gel, you can be guided by personal preferences and availability criteria. However, due to differences, you should consult your doctor when choosing other dosage forms.