Mobic for. Mobic (Meloxicam): Comprehensive Guide to Dosing, Interactions, and Side Effects
What are the key indications for Mobic. How does meloxicam interact with other medications. What are the most common side effects of Mobic. When should caution be exercised while taking meloxicam.
Understanding Mobic: An Overview of Meloxicam
Mobic, also known by its generic name meloxicam, is a nonsteroidal anti-inflammatory drug (NSAID) widely used in medical practice. This medication plays a crucial role in managing various inflammatory conditions and alleviating pain. To fully grasp the significance of Mobic, it’s essential to delve into its mechanisms of action, approved uses, and potential impacts on patient health.
How does Mobic work in the body? Meloxicam primarily functions by inhibiting the production of prostaglandins, which are hormone-like substances responsible for inflammation, pain, and fever. By targeting cyclooxygenase (COX) enzymes, particularly COX-2, Mobic effectively reduces inflammation without significantly affecting COX-1, which is involved in protecting the stomach lining. This selective action contributes to its improved gastrointestinal safety profile compared to some other NSAIDs.
Key Indications for Mobic
Mobic is prescribed for several conditions characterized by inflammation and pain. The primary indications include:
- Osteoarthritis
- Rheumatoid arthritis
- Juvenile rheumatoid arthritis (in patients 2 years of age and older)
- Management of acute pain in adults
In what situations might a healthcare provider consider prescribing Mobic? This medication is often recommended when patients require long-term pain management for chronic conditions or short-term relief for acute pain episodes. Its once-daily dosing schedule and relatively lower risk of gastrointestinal side effects make it an attractive option for many patients.
Dosing Guidelines for Meloxicam
Proper dosing of Mobic is crucial for achieving optimal therapeutic effects while minimizing the risk of adverse reactions. The dosage varies depending on the condition being treated and individual patient factors.
Osteoarthritis and Rheumatoid Arthritis
For adults with osteoarthritis or rheumatoid arthritis, the recommended starting dose is:
- 7.5 mg once daily
- May be increased to 15 mg once daily if needed for better symptom control
Juvenile Rheumatoid Arthritis
In pediatric patients with juvenile rheumatoid arthritis:
- 0.125 mg/kg once daily, with a maximum daily dose of 7.5 mg
Acute Pain Management
For managing acute pain in adults:
- Initial dose: 10 mg once daily
- May be followed by 10 mg once daily as needed
How should patients take Mobic for best results? It’s generally recommended to take Mobic with food to reduce the risk of gastrointestinal upset. Patients should always follow their healthcare provider’s instructions and never exceed the prescribed dose.
Potential Side Effects and Precautions
While Mobic is generally well-tolerated, like all medications, it can cause side effects. Understanding these potential adverse reactions is crucial for both healthcare providers and patients.
Common Side Effects
The most frequently reported side effects of Mobic include:
- Stomach pain or discomfort
- Nausea
- Diarrhea
- Headache
- Dizziness
Serious Side Effects
Although less common, some serious side effects may occur and require immediate medical attention:
- Cardiovascular events (heart attack, stroke)
- Gastrointestinal bleeding or ulceration
- Liver or kidney problems
- Allergic reactions
- Skin reactions (e.g., Stevens-Johnson syndrome)
What precautions should be taken when using Mobic? Patients with a history of gastrointestinal issues, cardiovascular disease, or impaired kidney or liver function should use Mobic with caution. It’s essential to inform healthcare providers of any pre-existing conditions or medications before starting treatment with meloxicam.
Drug Interactions: A Comprehensive Analysis
Mobic can interact with various medications, potentially altering their effectiveness or increasing the risk of side effects. Understanding these interactions is crucial for safe and effective treatment.
Interactions with Cardiovascular Medications
Meloxicam can interact with several cardiovascular drugs:
- ACE inhibitors and ARBs: May reduce antihypertensive effects and increase risk of kidney problems
- Beta-blockers: Can decrease the effectiveness of beta-blockers
- Diuretics: May increase the risk of kidney problems
Interactions with Anticoagulants
Combining Mobic with anticoagulants can increase the risk of bleeding:
- Warfarin: Increased risk of gastrointestinal bleeding
- Novel oral anticoagulants (NOACs): Potential for increased bleeding risk
Other Significant Interactions
Additional medications that may interact with Mobic include:
- Other NSAIDs: Increased risk of gastrointestinal side effects
- Methotrexate: May increase methotrexate levels
- Lithium: Can increase lithium levels
- Cyclosporine: May increase the risk of kidney toxicity
How can healthcare providers manage these interactions? Careful monitoring, dose adjustments, or alternative medications may be necessary when prescribing Mobic alongside these drugs. Patient education about potential interactions is also crucial.
Special Populations and Considerations
Certain patient groups require special attention when considering treatment with Mobic due to increased risks or altered drug metabolism.
Elderly Patients
Older adults may be at higher risk for side effects, particularly gastrointestinal and cardiovascular events. Considerations for this population include:
- Starting at the lowest effective dose
- Close monitoring for adverse reactions
- Assessing risk factors for GI and cardiovascular complications
Pregnant and Breastfeeding Women
The use of Mobic during pregnancy and breastfeeding requires careful consideration:
- Pregnancy: Avoid use, especially in the third trimester due to potential fetal harm
- Breastfeeding: Limited data available; use with caution and only if benefits outweigh risks
Patients with Renal or Hepatic Impairment
Individuals with kidney or liver problems may require dose adjustments or alternative treatments:
- Renal impairment: Monitor kidney function closely; avoid in severe cases
- Hepatic impairment: Use with caution; consider dose reduction in moderate to severe cases
What strategies can be employed to ensure safe use of Mobic in these populations? Regular monitoring, dose adjustments, and consideration of alternative treatments are key approaches. Individualized treatment plans should be developed based on each patient’s specific circumstances and risk factors.
Pharmacokinetics and Formulations of Meloxicam
Understanding the pharmacokinetics of Mobic is essential for optimizing its use in clinical practice. This section explores how the body processes meloxicam and the various formulations available.
Absorption and Distribution
Meloxicam demonstrates favorable pharmacokinetic properties:
- Oral bioavailability: Approximately 89%
- Time to peak plasma concentration: 5-6 hours
- Protein binding: Highly protein-bound (99.4%)
- Volume of distribution: 10-15 L
Metabolism and Elimination
The metabolism and excretion of meloxicam occur as follows:
- Primary metabolism: Hepatic, via CYP2C9 with some involvement of CYP3A4
- Half-life: Approximately 20 hours
- Excretion: Primarily in urine (50%) and feces (50%)
Available Formulations
Mobic is available in several formulations to accommodate different patient needs:
- Oral tablets: 7.5 mg and 15 mg
- Oral suspension: 7.5 mg/5 mL
- Disintegrating tablets: 7.5 mg and 15 mg
- Injectable solution: 30 mg/mL (for veterinary use)
How do these pharmacokinetic properties influence clinical use? The long half-life of meloxicam allows for once-daily dosing, improving patient compliance. The high protein binding contributes to its prolonged action but may also increase the potential for drug interactions with other highly protein-bound medications.
Monitoring and Management of Mobic Therapy
Effective management of Mobic therapy involves regular monitoring and proactive strategies to minimize risks and optimize benefits.
Baseline and Follow-up Assessments
Before initiating Mobic and during ongoing treatment, healthcare providers should conduct:
- Comprehensive medical history review
- Cardiovascular risk assessment
- Baseline liver and kidney function tests
- Blood pressure monitoring
- Gastrointestinal risk evaluation
Laboratory Monitoring
Regular laboratory tests can help detect potential adverse effects early:
- Complete blood count (CBC)
- Liver function tests (LFTs)
- Serum creatinine and estimated glomerular filtration rate (eGFR)
- Electrolyte levels, particularly potassium
Patient Education and Counseling
Educating patients about the proper use of Mobic and potential warning signs is crucial:
- Importance of adherence to prescribed dosage
- Recognition of signs of gastrointestinal bleeding or cardiovascular events
- Avoidance of alcohol and other potentially interacting substances
- Proper storage and handling of medication
What strategies can healthcare providers employ to ensure optimal outcomes with Mobic therapy? Regular follow-ups, tailored monitoring plans, and open communication with patients are key components of successful management. Providers should also consider periodic reassessment of the need for continued NSAID therapy and explore alternative pain management strategies when appropriate.
Comparing Mobic to Other NSAIDs: Efficacy and Safety Profile
Understanding how Mobic compares to other NSAIDs in terms of efficacy and safety is crucial for making informed treatment decisions.
Efficacy Comparison
Studies have compared meloxicam’s effectiveness to other common NSAIDs:
- Vs. Diclofenac: Similar efficacy in osteoarthritis and rheumatoid arthritis
- Vs. Naproxen: Comparable pain relief in osteoarthritis
- Vs. Piroxicam: Equivalent efficacy in various rheumatic conditions
Gastrointestinal Safety Profile
Meloxicam’s selective COX-2 inhibition contributes to its improved gastrointestinal safety:
- Lower incidence of GI ulcers compared to non-selective NSAIDs
- Reduced risk of serious GI complications versus diclofenac and piroxicam
- Similar GI safety profile to celecoxib in some studies
Cardiovascular Risk
The cardiovascular risk profile of meloxicam is an important consideration:
- Similar cardiovascular risk to other non-selective NSAIDs
- Potentially lower risk compared to some COX-2 selective inhibitors
- Individual patient factors significantly influence overall cardiovascular risk
How should healthcare providers weigh these comparisons when choosing between NSAIDs? The decision to use meloxicam or another NSAID should be based on individual patient characteristics, comorbidities, and risk factors. While meloxicam offers some advantages in terms of gastrointestinal safety, the overall risk-benefit profile should be carefully considered for each patient.
Future Directions and Ongoing Research
As medical science advances, ongoing research continues to explore new aspects of meloxicam’s use and potential applications.
Novel Formulations
Researchers are investigating innovative delivery methods for meloxicam:
- Transdermal patches for localized pain relief
- Nanoparticle formulations for enhanced bioavailability
- Extended-release preparations for prolonged action
Combination Therapies
Studies are exploring the potential benefits of combining meloxicam with other drugs:
- Meloxicam with gastroprotective agents for improved GI safety
- Combination with opioids for enhanced pain management
- Synergistic effects with disease-modifying antirheumatic drugs (DMARDs)
Expanded Indications
Ongoing clinical trials are investigating meloxicam’s potential in new therapeutic areas:
- Postoperative pain management
- Neuropathic pain conditions
- Oncology-related pain and inflammation
What implications do these research directions have for future clinical practice? As new formulations and applications emerge, healthcare providers may have more options for tailoring treatment to individual patient needs. However, rigorous evaluation of safety and efficacy will be crucial before implementing any new approaches in clinical practice.
In conclusion, Mobic (meloxicam) remains an important tool in the management of inflammatory conditions and pain. Its unique pharmacological profile, combined with ongoing research and development, positions it as a valuable option in the NSAID class. As with all medications, the key to successful use lies in careful patient selection, appropriate dosing, and vigilant monitoring. By staying informed about the latest research and guidelines, healthcare providers can optimize the use of meloxicam to improve patient outcomes while minimizing risks.
Mobic, Vivlodex (meloxicam) dosing, indications, interactions, adverse effects, and more
Monitor Closely (2)meloxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
acebutolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (2)aceclofenac and meloxicam both increase anticoagulation. Use Caution/Monitor.
aceclofenac and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)aceclofenac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)acemetacin and meloxicam both increase anticoagulation. Use Caution/Monitor.
acemetacin and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)acemetacin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Minor (1)meloxicam will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and agrimony both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (1)meloxicam, alendronate.
Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.
Monitor Closely (1)meloxicam and alfalfa both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam will decrease the level or effect of aliskiren by Other (see comment).
Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.
Monitor Closely (1)meloxicam and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
Monitor Closely (1)meloxicam and American ginseng both increase anticoagulation. Use Caution/Monitor.
Minor (1)meloxicam increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
Monitor Closely (1)amiloride and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
Minor (1)meloxicam will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Serious – Use Alternative (1)aminolevulinic acid oral, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
Serious – Use Alternative (1)meloxicam, aminolevulinic acid topical.
Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
Minor (1)amiodarone will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)amobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)meloxicam and anamu both increase anticoagulation.
Minor/Significance Unknown.
Monitor Closely (1)antithrombin alfa and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)antithrombin III and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Serious – Use Alternative (1)meloxicam and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.
Monitor Closely (1)meloxicam increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)argatroban and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (2)aspirin and meloxicam both increase anticoagulation.
Use Caution/Monitor.
aspirin and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)aspirin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)aspirin rectal and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin rectal and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)aspirin rectal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)aspirin/citric acid/sodium bicarbonate and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)aspirin/citric acid/sodium bicarbonate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
atenolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)azficel-T, meloxicam. Other (see comment). Use Caution/Monitor.
Comment: Patients taking anticoagulants may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of anticoagulants is not recommended. Decisions regarding continued use or cessation of anticoagulants should be made by a physician.
Monitor Closely (2)meloxicam, azilsartan.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of azilsartan by pharmacodynamic antagonism.
Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
Minor (1)meloxicam will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)bemiparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)benazepril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors.
The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)meloxicam increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)bendroflumethiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
betaxolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)meloxicam, betrixaban.
Either increases levels of the other by anticoagulation. Use Caution/Monitor.
Monitor Closely (1)bimatoprost, meloxicam.
unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
Monitor Closely (2)meloxicam decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
bisoprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)bivalirudin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Minor (1)bosentan will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam, budesonide.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (2)meloxicam decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
meloxicam increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (1)butabarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)butalbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (3)candesartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of candesartan by pharmacodynamic antagonism.
Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
candesartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)captopril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Minor (1)carbamazepine will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism..png){kind=logo}
Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (2)meloxicam decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
carvedilol and meloxicam both increase serum potassium. Use Caution/Monitor.
Minor (1)cefadroxil will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)cefamandole will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)cefixime will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Minor (1)cefpirome will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)ceftibuten will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)celecoxib and meloxicam both increase anticoagulation. Use Caution/Monitor.
celecoxib and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)celecoxib will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
celiprolol and meloxicam both increase serum potassium.
Use Caution/Monitor.
Minor (1)cephalexin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)chlorothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.Minor (1)meloxicam will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution.
Use Caution/Monitor.Minor (1)chlorthalidone will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)cholestyramine decreases levels of meloxicam by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
Monitor Closely (2)meloxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
meloxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and cinnamon both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam, ciprofloxacin.
Other (see comment). Modify Therapy/Monitor Closely.
Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
Monitor Closely (1)citalopram, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.
Monitor Closely (1)meloxicam, clobetasone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (1)clomipramine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.
Monitor Closely (1)clopidogrel, meloxicam.
Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely.
Clopidogrel and NSAIDs both inhibit platelet aggregation.
Minor (1)colestipol decreases levels of meloxicam by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and cordyceps both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam, cortisone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Minor (1)creatine, meloxicam. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.
Monitor Closely (1)meloxicam increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)cyclopenthiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Monitor Closely (1)meloxicam, cyclosporine.
Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
Monitor Closely (1)dabigatran and meloxicam both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
Monitor Closely (1)dalteparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Minor (1)meloxicam and danshen both increase anticoagulation. Minor/Significance Unknown.
Monitor Closely (1)deferasirox, meloxicam. Other (see comment). Use Caution/Monitor.
Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.
Monitor Closely (1)defibrotide increases effects of meloxicam by P-glycoprotein (MDR1) efflux transporter.
Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.
Monitor Closely (1)meloxicam, deflazacort.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Minor (1)meloxicam and devil’s claw both increase anticoagulation. Minor/Significance Unknown.
Monitor Closely (1)meloxicam, dexamethasone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (2)diclofenac and meloxicam both increase anticoagulation. Use Caution/Monitor.
diclofenac and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)diclofenac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)diclofenac topical, meloxicam.
Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.
Monitor Closely (2)diflunisal and meloxicam both increase anticoagulation. Use Caution/Monitor.
diflunisal and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)diflunisal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and digoxin both increase serum potassium. Use Caution/Monitor.
Minor (1)disulfiram will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and dobutamine decreases serum potassium.
Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meloxicam and dong quai both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meloxicam decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)drospirenone and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
Monitor Closely (1)duloxetine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (1)edoxaban, meloxicam.
Either increases toxicity of the other by anticoagulation.
Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.
Monitor Closely (1)efavirenz will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
Monitor Closely (1)eltrombopag increases levels of meloxicam by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF, meloxicam.
Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
Monitor Closely (1)emtricitabine, meloxicam.
Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
Monitor Closely (1)enalapril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)enoxaparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (1)meloxicam decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam and epoprostenol both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (3)meloxicam decreases effects of eprosartan by pharmacodynamic antagonism.
Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
eprosartan and meloxicam both increase serum potassium. Use Caution/Monitor.
eprosartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
Monitor Closely (1)escitalopram, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (2)meloxicam decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
esmolol and meloxicam both increase serum potassium.
Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (2)etodolac and meloxicam both increase anticoagulation. Use Caution/Monitor.
etodolac and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)etodolac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)etravirine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)felbamate will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and fennel both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (2)fenoprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
fenoprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)fenoprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and feverfew both increase anticoagulation. Use Caution/Monitor.Minor (1)meloxicam decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.
Monitor Closely (1)fish oil triglycerides will increase the level or effect of meloxicam by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
Minor (1)fluconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam, fludrocortisone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (2)fluoxetine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
fluoxetine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (2)flurbiprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
flurbiprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)flurbiprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Monitor Closely (1)fluvoxamine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.
Monitor Closely (1)fondaparinux and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meloxicam and forskolin both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)fosinopril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, fosinopril.
pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)meloxicam increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)meloxicam decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
Minor (1)meloxicam will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and garlic both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)gemifloxacin, meloxicam.
Other (see comment). Modify Therapy/Monitor Closely.
Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
Monitor Closely (1)meloxicam increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)meloxicam increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
Monitor Closely (1)meloxicam and ginger both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
Monitor Closely (1)meloxicam increases effects of glipizide by unknown mechanism. Use Caution/Monitor.
Risk of hypoglycemia.
Monitor Closely (1)meloxicam increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
Monitor Closely (1)green tea, meloxicam. Other (see comment). Use Caution/Monitor.
Comment: Combination may increase risk of bleeding.
Monitor Closely (1)heparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)hydrochlorothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Monitor Closely (1)meloxicam, hydrocortisone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (1)ibrutinib will increase the level or effect of meloxicam by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.
Monitor Closely (2)ibuprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
ibuprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)ibuprofen IV and meloxicam both increase anticoagulation. Use Caution/Monitor.
ibuprofen IV and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ibuprofen IV will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)imatinib will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
imatinib, meloxicam.
Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely.
Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents.
Minor (1)meloxicam decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam increases and indapamide decreases serum potassium.
Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)indapamide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)indomethacin and meloxicam both increase anticoagulation. Use Caution/Monitor.
indomethacin and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)indomethacin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (3)irbesartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
irbesartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (1)ketoconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (2)ketoprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketoprofen and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)ketoprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)ketorolac and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac and meloxicam both increase serum potassium. Use Caution/Monitor.
Serious – Use Alternative (1)meloxicam, ketorolac.
Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ketorolac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)ketorolac intranasal and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and meloxicam both increase serum potassium. Use Caution/Monitor.Serious – Use Alternative (1)meloxicam, ketorolac intranasal.
Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.Minor (1)ketorolac intranasal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use.
NSAIDs decrease prostaglandin synthesis.
labetalol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)latanoprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
Monitor Closely (1)latanoprostene bunod ophthalmic, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
Minor (1)leflunomide will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and levalbuterol decreases serum potassium.
Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)levofloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely.
Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
Monitor Closely (1)levomilnacipran, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.
Monitor Closely (1)lisinopril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function.
NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)meloxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.
Monitor Closely (2)lornoxicam and meloxicam both increase anticoagulation. Use Caution/Monitor.
lornoxicam and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)lornoxicam will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (3)losartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of losartan by pharmacodynamic antagonism.
Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
losartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (2)meclofenamate and meloxicam both increase anticoagulation. Use Caution/Monitor.
meclofenamate and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)meclofenamate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)mefenamic acid and meloxicam both increase anticoagulation. Use Caution/Monitor.
mefenamic acid and meloxicam both increase serum potassium. Use Caution/Monitor.Minor (1)mefenamic acid will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)mesalamine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.Minor (1)meloxicam will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Serious – Use Alternative (1)meloxicam increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity. .
Monitor Closely (1)meloxicam increases and methyclothiazide decreases serum potassium.
Effect of interaction is not clear, use caution. Use Caution/Monitor. .Minor (1)methyclothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Serious – Use Alternative (1)meloxicam, methyl aminolevulinate.
Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
Monitor Closely (1)meloxicam, methylprednisolone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (1)meloxicam increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)metolazone will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance.
Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
metoprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Minor (1)metronidazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)miconazole vaginal will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)milnacipran, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (1)mipomersen, meloxicam.
Either increases toxicity of the other by Other (see comment).
Use Caution/Monitor.
Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
Monitor Closely (1)meloxicam increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)moexipril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)moxifloxacin, meloxicam.
Other (see comment). Modify Therapy/Monitor Closely.
Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
Monitor Closely (1)meloxicam decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
Monitor Closely (2)meloxicam and nabumetone both increase anticoagulation. Use Caution/Monitor.
meloxicam and nabumetone both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of nadolol by pharmacodynamic antagonism.
Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nadolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (2)meloxicam and naproxen both increase anticoagulation. Use Caution/Monitor.
meloxicam and naproxen both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)nateglinide will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
nebivolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)nefazodone, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Minor (1)meloxicam increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
Monitor Closely (1)meloxicam increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)nevirapine will decrease the level or effect of meloxicam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
Minor (1)nilotinib will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Minor (1)meloxicam and noni juice both increase serum potassium.
Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (1)ofloxacin, meloxicam. Other (see comment). Minor/Significance Unknown.
Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
Monitor Closely (3)olmesartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
olmesartan and meloxicam both increase serum potassium.
Use Caution/Monitor.
Monitor Closely (2)meloxicam and oxaprozin both increase anticoagulation. Use Caution/Monitor.
meloxicam and oxaprozin both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and panax ginseng both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (2)meloxicam and parecoxib both increase anticoagulation. Use Caution/Monitor.
meloxicam and parecoxib both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)meloxicam increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown.
Interaction mainly occurs in preterm infants.
Monitor Closely (1)paroxetine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (1)meloxicam and pau d’arco both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)pegaspargase increases effects of meloxicam by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
Serious – Use Alternative (1)meloxicam increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity..png)
Monitor Closely (2)meloxicam decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
penbutolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Minor (1)pentobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)perindopril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)phenindione and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Minor (1)phenobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (2)meloxicam decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
pindolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (2)meloxicam and piroxicam both increase anticoagulation. Use Caution/Monitor.
meloxicam and piroxicam both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)pivmecillinam, meloxicam.
Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
pivmecillinam, meloxicam.
Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
Monitor Closely (1)meloxicam and potassium acid phosphate both increase serum potassium.
Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
Monitor Closely (1)meloxicam and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
Monitor Closely (1)potassium iodide and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.
Monitor Closely (1)meloxicam, prasugrel.
Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.
Monitor Closely (1)meloxicam decreases effects of prazosin by pharmacodynamic antagonism.
Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam, prednisolone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Monitor Closely (1)meloxicam, prednisone.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
Minor (1)primidone will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
Monitor Closely (2)meloxicam decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
propranolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)protamine and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Monitor Closely (1)quinapril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)ramipril, meloxicam.
Either increases toxicity of the other by Other (see comment).
Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)meloxicam and reishi both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
Minor (2)rifampin will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
rifampin decreases levels of meloxicam by increasing metabolism.
Minor/Significance Unknown.
Minor (1)rifapentine will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)rivaroxaban, meloxicam. Other (see comment). Use Caution/Monitor.
Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.
Monitor Closely (1)rivastigmine increases toxicity of meloxicam by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.
Minor (1)rose hips will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (3)sacubitril/valsartan, meloxicam.
Either increases toxicity of the other by Other (see comment).
Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
sacubitril/valsartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (2)meloxicam and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.
meloxicam and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam increases and salmeterol decreases serum potassium.
Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (2)meloxicam and salsalate both increase anticoagulation. Use Caution/Monitor.
meloxicam and salsalate both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)saw palmetto increases toxicity of meloxicam by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
Minor (1)secobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)sertraline, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib.
serotonin uptake by platelets.
Monitor Closely (1)meloxicam and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
Monitor Closely (1)meloxicam decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam, sodium picosulfate/magnesium oxide/anhydrous citric acid.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May be associated with fluid and electrolyte imbalances.
Contraindicated (1)meloxicam increases toxicity of sodium polystyrene sulfonate by Other (see comment). Contraindicated.
Comment: Cases of intestinal necrosis (possibly fatal) described with concomitant sorbitol and sodium polystyrene sulfonate; due to sorbitol in meloxicam oral suspension, coadministration is not recommended.
Monitor Closely (1)sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor.
Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
Monitor Closely (1)sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor.
Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
Monitor Closely (1)meloxicam, sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor.
Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.
Monitor Closely (2)meloxicam decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
sotalol and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)spironolactone and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
Minor (1)meloxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
Monitor Closely (1)meloxicam and succinylcholine both increase serum potassium. Use Caution/Monitor.
Minor (1)sulfamethoxazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (2)meloxicam and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
meloxicam and sulfasalazine both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam and sulindac both increase anticoagulation. Use Caution/Monitor.
meloxicam and sulindac both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Serious – Use Alternative (1)meloxicam, tacrolimus.
Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug.
Comment: Concomitant administration increases risk of nephrotoxicity.
Monitor Closely (1)tafluprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
Monitor Closely (3)telmisartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
telmisartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Monitor Closely (2)temocillin, meloxicam.
Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
temocillin, meloxicam.
Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
Monitor Closely (1)meloxicam and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
Monitor Closely (1)tenofovir DF, meloxicam.
Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
Monitor Closely (1)meloxicam decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Monitor Closely (1)meloxicam increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)ticagrelor, meloxicam.
Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding with use of ticagrelor and chronic NSAID use. .
Monitor Closely (2)ticarcillin, meloxicam.
Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
ticarcillin, meloxicam.
Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
Minor (1)ticlopidine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (2)meloxicam decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
timolol and meloxicam both increase serum potassium. Use Caution/Monitor.
Minor (1)meloxicam increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
Monitor Closely (1)meloxicam increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
Monitor Closely (1)meloxicam increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
Monitor Closely (2)meloxicam and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
meloxicam and tolfenamic acid both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (2)meloxicam and tolmetin both increase anticoagulation. Use Caution/Monitor.
meloxicam and tolmetin both increase serum potassium. Use Caution/Monitor.Minor (1)meloxicam will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Monitor Closely (1)meloxicam and tolvaptan both increase serum potassium. Use Caution/Monitor.
Monitor Closely (1)meloxicam increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)trandolapril, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.Serious – Use Alternative (1)meloxicam, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (1)travoprost ophthalmic, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
Monitor Closely (1)trazodone, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (1)meloxicam, triamcinolone acetonide injectable suspension.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .
Monitor Closely (1)triamterene and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.Minor (2)triamterene, meloxicam. Other (see comment). Minor/Significance Unknown.
Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
meloxicam increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity.
Minor (1)meloxicam will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)valproic acid will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (3)valsartan, meloxicam.
Either increases toxicity of the other by Other (see comment). Use Caution/Monitor.
Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
valsartan and meloxicam both increase serum potassium. Use Caution/Monitor.
Minor (1)meloxicam increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.
Monitor Closely (1)venlafaxine, meloxicam.
Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
Monitor Closely (1)meloxicam increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)voclosporin, meloxicam.
Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
Monitor Closely (1)meloxicam, vorapaxar.
Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.
Minor (1)voriconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam, vortioxetine.
Either increases effects of the other by anticoagulation. Use Caution/Monitor.
Monitor Closely (1)warfarin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
Minor (1)meloxicam will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Minor (1)zafirlukast will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Monitor Closely (1)meloxicam, zanubrutinib.
Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
Monitor Closely (1)meloxicam decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Mobic (meloxicam) Tablets | CenterWatch
General Information
Mobic (meloxicam) is a non-steroidal anti-inflammatory drug (NSAID).
Mobic is specifically indicated for:
- relief of the signs and symptoms of osteoarthritis
- relief of the signs and symptoms of rheumatoid arthritis
- relief of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in patients who weigh ≥60 kg
Mobic is supplied as tablets for oral administration. In adults, the maximum recommended daily oral dose of Mobic is 15 mg regardless of formulation. In patients with hemodialysis, a maximum daily dosage of 7.5 mg is recommended. Mobic may be taken without regard to timing of meals.
The recommended dosing is as follows:
Osteoarthritis
- For the relief of the signs and symptoms of osteoarthritis the recommended starting and maintenance oral dose of Mobic is 7.5 mg once daily. Some patients may receive additional benefit by increasing the dose to 15 mg once daily.
Rheumatoid Arthritis
- For the relief of the signs and symptoms of rheumatoid arthritis, the recommended starting and maintenance oral dose of Mobic is 7.5 mg once daily. Some patients may receive additional benefit by increasing the dose to 15 mg once daily.
Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course
- For the treatment of juvenile rheumatoid arthritis, the recommended oral dose of Mobic is 7.5 mg once daily in children who weigh ≥60 kg. There was no additional benefit demonstrated by increasing the dose above 7.5 mg in clinical trials. Mobic tablets should not be used in children who weigh <60 kg.
Mechanism of Action
Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities in models. The mechanism of action of meloxicam, like that of other NSAIDs, may be related to prostaglandin synthetase (cyclooxygenase) inhibition.
Side Effects
Adverse effects associated with the use of Mobic may include, but are not limited to, the following:
- diarrhea
- upper respiratory tract infections
- dyspepsia
- influenza like symptoms
The Mobic drug label comes with the following Black Box Warning: Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use. Mobic is contraindicated in the setting of coronary artery bypass graft (CABG) surgery. NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events.
Clinical Trial Results
Osteoarthritis
A double-blind, controlled study was conducted in the U.S. to evaluate the safety and efficacy of Mobic. The 12-week study involved 464 patients who had osteoarthritis of the knee and hip. When three different doses of Mobic (3.5 mg, 7.5 mg, and 15 mg daily) were compared to placebo, results indicated that both the 7.5 and 15 mg daily doses of Mobic significantly decreased symptoms of pain, function, and stiffness in patients, with a low incidence of gastrointestinal side effects. Six similar studies were conducted outside of the U.S. Results were consistent with those found in the U.S. study.
Rheumatoid Arthritis
The use of Mobic for the treatment of the signs and symptoms of rheumatoid arthritis was evaluated in a 12-week, double-blind, controlled multinational trial. Mobic (7.5 mg, 15 mg, and 22.5 mg daily) was compared to placebo. The primary endpoint in this study was the ACR20 response rate, a composite measure of clinical, laboratory, and functional measures of RA response. Patients receiving Mobic 7.5 mg and 15 mg daily showed significant improvement in the primary endpoint compared with placebo. No incremental benefit was observed with the 22.5 mg dose compared to the 15 mg dose.
Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course
The use of Mobic for the treatment of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in patients 2 years of age and older was evaluated in two 12-week, double-blind, parallel-arm, active-controlled trials. Both studies included three arms: naproxen and two doses of meloxicam. In both studies, meloxicam dosing began at 0.125 mg/kg/day (7.5 mg maximum) or 0.25 mg/kg/day (15 mg maximum), and naproxen dosing began at 10 mg/kg/day. One study used these doses throughout the 12-week dosing period, while the other incorporated a titration after 4 weeks to doses of 0.25 mg/kg/day and 0.375 mg/kg/day (22.5 mg maximum) of meloxicam and 15 mg/kg/day of naproxen. The efficacy analysis used the ACR Pediatric 30 responder definition, a composite of parent and investigator assessments, counts of active joints and joints with limited range of motion, and erythrocyte sedimentation rate. The proportion of responders were similar in all three groups in both studies, and no difference was observed between the meloxicam dose groups.
| 107.235.23 Arkansas Children’s Hospital | |
| Little Rock, Arkansas, United States | |
| 107.235.17 Valley Children’s Hospital | |
| Madera, California, United States | |
| 107.235.37 | |
| San Diego, California, United States | |
| 107.235.4 Boehringer Ingelheim Investigational Site | |
| Denver, Colorado, United States | |
| 107.235.12 Boehringer Ingelheim Investigational Site | |
| Hartford, Connecticut, United States | |
| 107.235.13 Alfred I. DuPont Hospital for Children | |
| Wilmington, Delaware, United States | |
| 107.235.36 Arthritis Associates Clinical Research of South Florida | |
| Del Ray Beach, Florida, United States | |
| 107.235.21 Miami Children’s Hospital | |
| Miami, Florida, United States | |
| 107.235.38 Clinical Research Dept #7006 | |
| St. Petersberg, Florida, United States | |
| 107.235.8 Boehringer Ingelheim Investigational Site | |
| Chicago, Illinois, United States | |
| 107.235.7 Boehringer Ingelheim Investigational Site | |
| Kansas City, Kansas, United States | |
| 107.235.25 University of Louisville | |
| Louisville, Kentucky, United States | |
| 107.235.16 Children’s Hospital – Department of Rheumatology | |
| New Orleans, Louisiana, United States | |
| 107.235.26 Deparment of Rheumatology | |
| Boston, Massachusetts, United States | |
| 107.235.2 E15 Mayo Clinic | |
| Rochester, Minnesota, United States | |
| 107.235.18 Washington University School of Medicine | |
| St. Louis, Missouri, United States | |
| 107.235.9 Boehringer Ingelheim Investigational Site | |
| St. Louis, Missouri, United States | |
| 107.235.31 Department of Pediatrics | |
| Omaha, Nebraska, United States | |
| 107.235.35 Arthritis and Rheumatic Disease Center | |
| Livingston, New Jersey, United States | |
| 107.235.24 The Children’s Hospital of Buffalo | |
| Buffalo, New York, United States | |
| 107.235.19 Columbia Presbyterian Medical Center | |
| New York, New York, United States | |
| 107.235.22 Oklahoma Medical Research Foundation | |
| Oklahoma City, Oklahoma, United States | |
| 107.235.33 Healthcare Research Consultants | |
| Tulsa, Oklahoma, United States | |
| 107.235.32 Arthritis and Osteoporosis Center | |
| Duncansville, Pennsylvania, United States | |
| 107.235.39 Division of Ambulatory Pediatrics | |
| Providence, Rhode Island, United States | |
| 107.235.10 Texas Scottish Rite Hospital | |
| Dallas, Texas, United States | |
| 107.235.1 University of Utah School of Medicine | |
| Salt Lake CIty, Utah, United States | |
| 107.235.30 Children’s Hospital | |
| Seattle, Washington, United States | |
| 107.235.20 Medical College of Wisconsin | |
| Milwaukee, Wisconsin, United States | |
| 107.235.61 | |
| Cerqueira César, Brazil | |
| 107.235.62 | |
| Santa Cecília, Brazil | |
| 107.235.60 | |
| Sao Paulo, Brazil | |
| 107.235.40 | |
| México, D.F., Mexico | |
| 107.235.71 Institute of Children and Adolescents Health | |
| Kharkov, Ukraine | |
| 107.235.70 Children Clinical Hospital No. 1 | |
| Kiev, Ukraine | |
| 107.235.72 Institute of Pediatrics | |
| Kiev, Ukraine | |
| 107.235.73 2nd Children Specialized Clinical Hospital “OHMADIT” | |
| Kiev, Ukraine | |
8 Uses of Meloxicam (Mobic) + Side Effects
Meloxicam (Mobic) is a relatively newer medication used for pain relief. It is commonly used for osteoarthritis and rheumatoid arthritis. It may also cause side effects and interactions that patients should be aware of. Learn about the uses of meloxicam as well as the health risks.
What is Meloxicam?
Meloxicam is a prescription medication that belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAID). This class of drugs is typically used to help reduce fever, pain, and inflammation [1].
NSAIDs are associated with several health risks, including side effects that impact the stomach and heart. Meloxicam may have a lower risk of stomach side effects due to how it works [1].
Meloxicam is FDA-approved to treat chronic inflammatory diseases, including osteoarthritis and rheumatoid arthritis in adults and children. It is also used off-label for other painful conditions, such as lower back pain and pain after surgery [2, 3].
Mechanism of Action
Meloxicam primarily works by blocking COX enzymes [4].
There are two types of COX enzymes, COX-1 and COX-2. Both of these enzymes are responsible for producing various compounds, including prostaglandins and thromboxane [5].
Prostaglandins play a number of different roles in the body, such as regulating inflammation, pain, and fever. For this reason, NSAIDs can reduce pain and inflammation by blocking COX enzymes, which reduces the amount of prostaglandins produced [5].
However, prostaglandins also protect the stomach by regulating acid and mucus production. By blocking prostaglandin activity, NSAIDs can cause problems in the stomach, like ulcers [5].
Meloxicam is unique among NSAIDs because it has selective activity on COX-2. The COX-2 enzyme is not present in the stomach like COX-1 is. This means that meloxicam may not cause as many side effects in the stomach compared to NSAIDs that are non-selective for COX enzymes [4].
Meloxicam Uses
FDA-Approved Uses
1) Osteoarthritis
Osteoarthritis (OA) is a common form of arthritis that affects the joint cartilage that protects the ends of the bones. A number of clinical trials show that meloxicam can reduce pain and inflammation associated with this condition.
For example, a 12-week randomized placebo-controlled trial including 774 patients with OA found that meloxicam can reduce symptoms of pain and stiffness. In the study, the number of stomach side effects did not differ between meloxicam and placebo [6].
Meloxicam also reduced pain in a 6-month multicenter randomized trial of 336 patients with OA. Meloxicam caused fewer side effects than diclofenac, another type of NSAID [7].
In another randomized trial of 229 patients with OA of the lumbar spine, meloxicam improved pain and movement. Meloxicam was better tolerated than diclofenac once again [8].
2) Rheumatoid Arthritis in Adults
Rheumatoid arthritis (RA) is an autoimmune disorder where the body’s immune system attacks its own cells, causing pain and inflammation throughout the body. Meloxicam is approved to treat rheumatoid arthritis in both adults and children [3].
A 12-week randomized placebo-controlled trial of 894 patients with RA suggests that meloxicam may reduce joint swelling, tenderness, pain, and overall symptoms. Meloxicam did not cause significantly more stomach side effects compared to placebo [9].
In a 6 month double-blind trial of 379 patients with RA, meloxicam reduced joint pain and swelling better than naproxen, another common NSAID. Significantly more patients had to discontinue naproxen due to stomach side effects than those on meloxicam [10].
According to an 18-month long-term trial of 357 patients with RA, meloxicam may reduce stiffness and pain, while increasing grip st65rength. When taken daily for 1.5 years, meloxicam was deemed safe, but about 1/3 of patients did experience stomach side effects [11].
Meloxicam is also available as an intramuscular injection. Injections may have similar effectiveness to oral forms, according to a randomized trial of 173 patients with RA. Other studies have found similar results. Injections may have some benefits over oral forms, such as quicker onset of action [12, 13].
3) Rheumatoid Arthritis in Children
Children under the age of 16 can have a type of arthritis called juvenile rheumatoid arthritis. Meloxicam is FDA-approved to treat this condition in patients 2 years of age or older. A liquid suspension form of meloxicam is often used for children [3].
An international multicenter randomized trial of 232 children evaluated the short-term (3 months) and long-term safety and effectiveness of daily meloxicam in liquid form. The researchers suggest that meloxicam is safe and effective for both short-term and long-term use in children [14].
Off-Label Uses
Meloxicam is used for several off-label conditions, which we’ll discuss in the following sections. If you are prescribed this medication, always take the medication as directed by your doctor.
4) Lower Back Pain
A randomized controlled trial of 169 patients with lower back pain (lumbago) found that a 1-week treatment with meloxicam injection and oral doses may reduce pain and limitations to daily life. Other studies have found similar results [15, 16, 17].
Intravenous (IV) meloxicam is also an option for patients in need of immediate pain relief, as the medication can act quickly (within 30 minutes) when given this way [18].
In a randomized controlled trial of 183 patients experiencing sudden lower back pain, meloxicam IV injections followed by daily tablets for 8 days significantly reduced pain [18].
5) Sciatica
Sciatica can be caused by inflammation or pressure on the sciatic nerves in the lower back, which causes pain that can spread down into the legs. Research suggests that meloxicam may be an alternative to opioids for nerve pain relief [19].
In a 6-year open-label study of 72 patients with painful nerve inflammation (including sciatica), meloxicam injections provided long-term pain relief to most patients after 1 to 3 doses [16].
Two randomized placebo-controlled trials with 532 and 489 patients each found that oral meloxicam may be effective for sudden (acute) sciatica [20].
6) Neck Pain
An open-label study of 48 patients with neck and shoulder pain found that 1-3 injections of meloxicam may provide pain relief that lasts up to 90 days. In the study, the functional activity level of all patients increased after receiving the injection [21].
7) Pain Associated with Dental Surgery
In a randomized trial of 60 patients with inflammatory gum disease, an adhesive film containing meloxicam was applied to the gums after gum surgery for 3 days. Researchers found that the higher doses of meloxicam film (30 and 45 mg) may reduce pain after dental surgery [22].
A randomized study of 36 patients suggests that one dose of oral meloxicam before a molar tooth extraction may reduce post-surgery pain, swelling, and symptoms of lockjaw (trismus) [23].
8) Pain After Surgery
Meloxicam is sometimes given as a single dose to reduce pain after surgery. However, a systematic review did not identify any strong clinical trials that support this use [24].
Meloxicam Safety
Side Effects
Meloxicam can cause several side effects. If any side effects persist or worsen, let your doctor know. This is also not a complete list of possible side effects. Tell your doctor if you experience any serious side effects or notice any effects not listed here.
Some common side effects include [3]:
- Dizziness
- Nausea
- Upset stomach
- Diarrhea
- Upper respiratory tract infections
- Indigestion
- Flu-like symptoms
Some serious side effects include [3]:
- Bloody or black stools
- Severe stomach pain
- Severe or persistent headache
- Swelling in the ankles or feet
- Sudden weight gain
- Dark urine
- Persistent nausea or vomiting
Warnings
Heart Risks
Meloxicam is associated with an increased risk for serious cardiovascular complications, including heart attack and stroke. Meloxicam should be used cautiously in patients with heart conditions, such as heart failure [25].
Gastrointestinal Risks
Meloxicam is associated with an increased risk for serious gastrointestinal complications, including ulcers and bleeding. Patients taking meloxicam, especially elderly patients and those with a history of peptic ulcer disease, should be aware of these risks and symptoms [25].
Liver Toxicity
There’s evidence that meloxicam may have toxic effects on the liver. This medication should be discontinued if there are any signs or symptoms of liver disease [25].
Kidney Toxicity
Meloxicam may be toxic to the kidneys. Patients on meloxicam should have their renal function monitored. This medication should not be used in those with advanced kidney disease unless a doctor determines that the benefits outweigh the risks [25].
Contraindications
Meloxicam should not be taken if a patient has any of the following [3]:
- Allergies or sensitivity to meloxicam
- Any allergies to aspirin or other NSAIDs
- Is undergoing CABG surgery
Pregnancy and Breastfeeding
There’s evidence that meloxicam may increase the risk of birth defects when taken during the third trimester of pregnancy. The FDA recommends avoiding the use of NSAIDs, in general, starting in the third trimester (30 weeks) of pregnancy [3].
It’s unclear if meloxicam is present in breast milk. A doctor will weigh the benefits and risks when determining if the use of meloxicam is appropriate during breastfeeding.
Drug Interactions
The following drugs have been reported to interact with meloxicam. However, this is not a complete list, let your doctor know of all the medications you are currently taking to avoid any unexpected interactions.
- Aspirin – Use of meloxicam together with aspirin (even at low doses) is not recommended and can increase the risk of stomach damage [26].
- ACE Inhibitors – Meloxicam can reduce the blood pressure-lowering effect of ACE inhibitors [27].
- Lithium – Meloxicam may dangerously increase lithium levels, causing overdose [28].
- Warfarin – There is an increased risk of severe bleeding (internal or external) in combination with meloxicam [29].
Meloxicam Dosage
The dosing of meloxicam can vary. Always take this medication as directed by a doctor.
Meloxicam is available as tablets, capsules, liquid suspensions, and injections (IV or IM). Gels and patches are also being developed [30, 31].
In general, meloxicam should be used at the lowest effective dose for the shortest duration possible for pain relief.
Tablets are available in strengths of 7.5 and 15 mg.
For osteoarthritis and rheumatoid arthritis in adults, patients are usually started on 7.5 mg per day, which may be increased to 15 mg per day if needed.
Complementary Options
The following section details some complementary options that may help with pain. You should always consult your doctor before changing or stopping your medications.
It’s also important to let your doctor know of all the supplements you are currently taking, in case of potential interactions. These alternatives should not be used to replace medical treatment.
Fish Oil
There’s some evidence that fish oils (DHA and EPA) may help reduce pain and inflammation.
A review of 42 clinical trials found that fish oil supplements may help reduce pain associated with osteoarthritis and rheumatoid arthritis. However, the quality of evidence was low for osteoarthritis, while the quality was only moderate for rheumatoid arthritis [32].
White Willow Bark
White willow bark (Salix alba) contains salicin, the same compound that aspirin is derived from [33, 34].
A review of 14 clinical trials involving 2,050 participants suggests that white willow bark may reduce lower back pain. However, the quality of evidence was moderate at best [35].
Willow bark also shares many of the same safety concerns with aspirin, including interactions with blood thinners and the risk of Reye’s syndrome in children [36, 37].
Resveratrol
Resveratrol is a compound found in many foods, like berries, peanuts, and most famously in red wine [38].
Resveratrol may be effective as an add-on to conventional NSAIDs. A randomized trial of 110 people with osteoarthritis of the knee found that resveratrol supplements plus meloxicam may provide more pain relief than meloxicam alone [39].
Boswellia, Curcumin, and Pycnogenol
A systematic review investigated the effectiveness of 20 different supplements for pain associated with osteoarthritis. According to the 69 trials included in the review, Boswellia, curcumin, and Pycnogenol may be effective for short-term pain relief [40].
However, the researchers concluded that the quality of evidence was very low. There was also no evidence that these supplements improve long-term pain [40].
Alcohol & Mobic – The Recovery Village Drug and Alcohol Rehab
If you have chronic pain, you may be prescribed a pain medication called Mobic. This drug works very well against some types of pain, making it easier for you to take part in your daily activities. Unfortunately, if your normal activities include drinking alcohol, you may be putting yourself at risk. Combining Mobic and alcohol can harm your health.
Article at a Glance:
Important points to remember about alcohol and Mobic include:
- Mobic is a prescription-strength NSAID drug which should not be mixed with alcohol
- Your risk of bleeding, especially in your stomach and intestines, increases if you drink and use Mobic
- Your risk of gout flares, for which Mobic is prescribed, increases if you drink alcohol
- Your risk of gastritis is higher if you combine alcohol and Mobic
- Mobic and drinking alcohol can harm the heart and lead to cardiovascular problems
Mixing Alcohol and Mobic
Mobic is one of several brand names for the drug meloxicam. The drug is also sold under other brand names of Vivlodex and Qmiiz. Mobic belongs to a class of medicines called non-steroidal anti-inflammatory drugs, or NSAIDs. Mobic is a very strong NSAID and is only available with a prescription.
Mobic treats pain related to:
- Different forms of arthritis, including rheumatoid arthritis and osteoarthritis
- Gout flares
- Other pain conditions
Mixing alcohol and Mobic can be dangerous, as it can increase your risk of several complications, including:
Bleeding Risk
Doctors advise not to drink alcohol while taking Mobic because, like other NSAIDs, Mobic can increase bleeding risk. Although doctors do not know how NSAIDs increase bleeding risk, many different studies have found that internal bleeding can occur. The Food and Drug Administration (FDA) has put a black box warning on prescription NSAIDs like Mobic because it can cause bleeding.
The warning is for increased risk of:
- Bleeding
- Ulcers
- Holes in your stomach or intestine
Alcohol use and abuse can also increase bleeding risk. The more you drink, and the longer you drink, the more you are at risk of bleeding from drinking. Drinking harms your body’s ability to make a type of blood cell called platelets. Platelets help your blood clot when you are bleeding. However, if you struggle with alcohol use, your body often has trouble making platelets.
In some cases, your body may make platelets that are abnormal and do not work as well as they should. This condition can be harmful, because if your platelets cannot stop bleeding, then you may continue to bleed internally. Sometimes you may not even know that you are bleeding, especially if the bleeding is on the inside of your body.
Because both alcohol and Mobic can each increase bleeding risk, using them together can be dangerous. Doctors think that if you use alcohol and Mobic together, your risk of bleeding may be even higher.
Gastritis Risk
Both alcohol and Mobic increase your risk of gastritis, which is inflammation of the stomach. Therefore, using alcohol and Mobic together can make your risk of gastritis even higher.
Gastritis can cause health problems like:
- Ulcers
- Permanent stomach damage
- Low blood iron, which means your blood cells cannot transport oxygen as well as they should
- Low vitamin B12, which can cause mental changes and irreversible nerve damage
- Stomach cancer
Gout Risk
If you are taking Mobic for gout flares, it is crucial to remember that drinking can cause a gout flare. Therefore, it is doubly important to avoid alcohol if the reason you are taking Mobic is gout.
If you are drinking alcohol while using Mobic for a gout flare, it is also important to look out for gout symptoms like:
- Severe pain in a single joint (often your big toe)
- Swelling in a single joint
- Redness in a single joint
- Feeling like a single joint is hot when you touch it
Heart Attack and Stroke
The FDA has a black box warning on NSAIDs like Mobic for increasing the risk of heart attack and stroke.
Watch for symptoms of a heart attack or stroke, including:
- Chest pain
- Shortness of breath
- Left arm or shoulder pain
- Exhaustion (in women)
- Nausea (in women)
- Weakness on one side of the body
- Sudden changes in vision
- Suddenly slurred speech
Excessive use of alcohol can also lead to problems with the heart, including cardiomyopathy, which is a condition that can lead to heart failure. Therefore, mixing alcohol and NSAIDs like Mobic is not recommended as it increases the risk of heart problems.
Symptoms of Mixing Alcohol and Mobic
Because mixing alcohol and Mobic can increase your risk of bleeding in your stomach and intestines, it is essential to be aware of bleeding symptoms, including:
- Red blood in your vomit
- Red blood in your stool
- Particles that look like coffee grounds in your vomit
- Stool that is black and tarry
As Mobic and alcohol can increase your risk of gastritis, it is also important to be aware of gastritis symptoms like:
- Stomach pain
- Stomach discomfort
- Nausea or vomiting
If you or a loved one struggle with alcohol addiction, a compassionate team of medical professionals at The Recovery Village Drug and Alcohol Rehab can help. We offer many different addiction treatment options to help you lead a healthier life. Contact us today for more information on how to lead a life free from drinking.
- Sources
- DailyMed. “Mobic.” Updated October 11, 2018. Accessed June 7, 2019.
- Ballard, Harold S. “The Hematological Complications of Alcoholism.” Alcohol Health and Research World, 1997. Accessed June 7, 2019.
- The National Institute of Diabetes and Digestive and Kidney Diseases. “Gastritis.” Published July 2015. Accessed June 7, 2019.
- The Centers for Disease Control and Prevention. “Gout.” Reviewed January 28, 2019. Accessed June 7, 2019.
- The National Institutes of Health, News in Health. “Can You Recognize a Heart Attack or Stroke?” Published August 2014. Accessed June 7, 2019.
Meloxicam (Anti-inflammatory Painkiller) | Patient
About meloxicam
| Type of medicine | Non-steroidal anti-inflammatory drug (NSAID) |
| Used for | Pain and inflammation in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis |
| Available as | Tablets and melt-in-the-mouth (orodispersible) tablets |
Anti-inflammatory painkillers like meloxicam are also called non-steroidal anti-inflammatory drugs (NSAIDs), or sometimes just ‘anti-inflammatories’. Meloxicam eases pain and swelling (inflammation) in long-term conditions like rheumatoid arthritis and ankylosing spondylitis, but it may also be used for a shorter period of time in osteoarthritis.
Meloxicam works by blocking the effect of natural chemicals called cyclo-oxygenase (COX) enzymes. These enzymes help to make other chemicals in the body, called prostaglandins. Some prostaglandins are produced at sites of injury or damage, and cause pain and inflammation. By blocking the effect of COX enzymes, fewer prostaglandins are produced, which means pain and inflammation are eased.
Before taking meloxicam
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking meloxicam, it is important that your doctor or pharmacist knows:
- If you have asthma or any other allergic disorder.
- If you have ever had a stomach or duodenal ulcer, or if you have an inflammatory bowel disorder such as Crohn’s disease or ulcerative colitis.
- If you are pregnant, trying for a baby or breastfeeding.
- If you have liver or kidney problems.
- If you have a heart condition or a problem with your blood vessels or circulation.
- If you have high blood pressure.
- If you have high blood sugar or cholesterol levels.
- If you are a smoker.
- If you have ever had blood clotting problems.
- If you have systemic lupus erythematosus. This is an inflammatory condition which is also called lupus or SLE.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as as herbal and complementary medicines.
- If you have ever had an allergic reaction to any other NSAID (such as aspirin, ibuprofen, diclofenac, and indometacin), or to any other medicine.
How to take meloxicam tablets
- Before you start taking meloxicam, read the manufacturer’s printed information leaflet from inside the pack. The leaflet will give you more information about the tablets and provide a full list of side-effects which you may experience from taking them.
- Take meloxicam exactly as your doctor has told you to. The usual dose is one tablet a day. You will be prescribed either 7.5 mg tablets or 15 mg tablets.
- Swallow the tablet whole with a drink of water.
- Take each dose with a snack or just after eating a meal and drink plenty of water whilst on meloxicam.
- If your doctor has prescribed melt-in-the-mouth (orodispersible) tablets:
- Moisten your mouth first, taking a sip of water if needed.
- Remove the tablet from the packaging, taking care not to moisten it.
- Place the tablet on your tongue and allow it to dissolve slowly. This should take about five minutes.
- After five minutes drink a large glass of water and swallow the dissolved tablet.
- Do not chew the tablet or swallow it before it has dissolved.
- Try to take your doses at the same time each day, as this will help you to remember to take them.
- If you do forget to take a dose, take it as soon as you remember along with something to eat. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Your doctor will try to prescribe you the lowest dose for the shortest time to reduce the risk of side-effects. Your doctor may also want to prescribe another medicine for you to take along with meloxicam to protect your stomach from irritation.
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
- If you have asthma, symptoms such as wheeze or breathlessness can be made worse by anti-inflammatories like meloxicam. If this happens to you, you should stop taking the tablets and see your doctor as soon as possible.
- If you buy any medicines, check with a pharmacist that they are safe to take with an anti-inflammatory like meloxicam.
- If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
Can meloxicam cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
| Common meloxicam side-effects | What can I do if I experience this? |
| Feeling sick (nausea) or being sick (vomiting) | Stick to simple foods. Drink plenty of liquid to replace any lost fluids |
| Loose, watery stools (diarrhoea) | Stick to simple foods. Drink plenty of liquid to replace any lost fluids |
| Constipation | Try to eat more foods that are high in fibre, such as fruits and vegetables, and drink plenty of water |
| Indigestion, stomach discomfort, wind | Remember to take the tablets after a meal if you are not already doing so. If the discomfort continues, speak with your doctor |
| Other less common side-effects: headache, feeling dizzy or sleepy, nervousness, mood changes, difficulty sleeping, a spinning sensation (vertigo), and ringing noises (tinnitus) | If any of these become troublesome, speak with your doctor |
Important: if you experience any of the following uncommon but possibly serious symptoms, stop taking meloxicam and contact your doctor for advice straightaway:
- If you have any breathing difficulties such as wheeze or breathlessness.
- If you have any signs of an allergic reaction such as swelling around your mouth or face, or an itchy skin rash.
- If you pass blood or black stools, vomit blood, or have tummy (abdominal) pains.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store meloxicam
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Keep the tablets in their original packaging.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty. This medicine is for you. Never give it to other people even if their condition appears to be the same as yours. Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you. If you have any questions about this medicine ask your pharmacist. |
Discount Generic & Prescription Drugs
GENERIC ALTERNATIVE LISTING – Meloxicam
Price Guarantee
| Dosage | Pack Size & Price | Qty | ||
|---|---|---|---|---|
Dosage: 7.5mg | Pack Size & Price: Pack Size – Price30.00 pills – $26.0990.00 pills – $35.09180.00 pills – $69.49 | Quantity: 1234567891011121314151617181920 | ||
Dosage: 15mg | Pack Size & Price: Pack Size – Price30.00 pills – $26.0990.00 pills – $35.09 | Quantity: 1234567891011121314151617181920 |
BRAND LISTING – Mobic (Meloxicam)
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| Dosage | Pack Size & Price | Qty | ||
|---|---|---|---|---|
Dosage: 7.5mg | Pack Size & Price: Pack Size – Price100.00 pills – $148.29 (Out Of Stock) | Quantity: 1234567891011121314151617181920 |
Mobic Description
Mobic or the generic alternative called Meloxicam is a non-steroidal anti-inflammatory drug referred to as an NSAID. If you are enduring the pain of arthritis, your doctor may prescribe Mobic to reduce the joint pain and swelling that inflammation can cause. Prescription strength Mobic or generic Meloxicam is taken orally, usually once per day and may be taken with or without food. The generic alternative is not manufactured by the company that makes the brand product.
How This Cyclooxygenase Inhibitor Works to Reduce Inflammation
When taken as directed, Mobic and Meloxicam generic works as a non-selective cyclooxygenase (COX) inhibitor. This means that its purpose is to block both of the enzymes (COX 1 and COX 2) that are responsible for the production of prostaglandins, a chemical that causes the pain and swelling as an immune response to injury.
Conditions Treated by Mobic
Arthritis is an ongoing inflammatory disease that occurs because of cartilage erosion and degradation of your synovial tissue and fluid that cushions your joints. Osteoarthritis is the most common form of arthritis and can happen from normal wear and tear on your body joints over the years. Mobic will not cure your arthritis, but it can help bring you relief from joint pain so you can perform daily tasks and enjoy other activities.
Rheumatoid arthritis is the 2nd most common type of chronic arthritis that occurs in joints on both sides of the body. Rheumatoid arthritis can also affect other body parts such as skin, eyes, heart, lungs, nerves or blood. This is an autoimmune disease which means that the body’s immune system attacks its own healthy tissues when it believes a threat is imminent and is characterized by joint swelling and pain, stiffness, and fatigue.
Before Mobic is Prescribed
Advise your doctor if you have any of the following medical conditions that may affect your ability to safely take Mobic: seizure disorder; nasal polyps; asthma; liver or kidney disease; stomach ulcers; high blood pressure; history of heart attack or stroke. It is important to tell your doctor about any medications you are taking to know if there is a risk of an adverse reaction with Mobic.
Mobic Risks and Precautions
Taking Mobic or generic Meloxicam may increase your risk of stroke or heart attack. Keep Mobic out of children’s reach and never share your meds with anyone else. Long-term use of Mobic should be monitored by your doctor as it suppresses your immune system.
Possible Side Effects of Mobic
- Nausea
- Diarrhea
- Dizziness
- Abdominal pain
You should contact your physician if you experience any of the following more serious side effects associated with meloxicam: back pain; lack of energy; fast heartbeat; weight gain; difficult or painful urination.
Drugs Similar to Mobic
The information provided on the NorthWestPharmacy.com website is intended to facilitate awareness about healthcare products and medical conditions generally but it is not a substitute for professional medical attention or advice. You should always speak with a qualified healthcare practitioner before taking any prescription or non-prescription drug.
Mobil ™ | Russia
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Mobil Super 3000 X1 5W-40: 5L at a price of 4L
This fall you can find our bestseller Mobil Super 3000 x1 5W-40 in an advantageous 5-liter package at a price of 4 liters in retail and online stores in Russia, Kazakhstan, Ukraine and Belarus.
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We are pleased to share the latest releases of training videos about the lubricants industry.
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Office Mobile Windows 10 Apps Getting Started
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The Office Mobile applications (Word Mobile, Excel Mobile, PowerPoint Mobile, and OneNote) are touch-based, offer familiar experiences for Office users and give users the ability to work on the go.
Note: This article applies to Office Mobile applications on a tablet or touchscreen computer with Windows 10.
Install applications
You may already have applications installed. However, if you’ve installed Windows 10 or purchased a new device, you can install them.
How to find applications
To find mobile apps, tap All apps in Windows 10.If you want the desktop versions, click All Applications , and then select the Microsoft Office folder.
Word Mobile Features
“Reading View” – a new way of viewing documents: Word improved the flow of the document to adapt to small screens. And Bing-powered smart search brings additional online resources, such as images and web links, directly into a document to provide you with more details and new ideas.
Excel Mobile Capabilities
All the power and precision of Excel is now lightweight for mobile devices. In this animation, we will show you how to enter a formula. When using the on-screen keyboard, you’ll find familiar touch-friendly controls so you can work with extended spreadsheets on a small tablet.
PowerPoint Mobile Features
This animation shows you how to scroll through your presentation.But PowerPoint Mobile can do more. You can easily create gorgeous slides, and use all the transitions and animations familiar to you on a desktop computer. In addition, new ink, laser pointer, and highlighting features let you focus on key concepts.
Features OneNote on Tablet
Record, organize and share your ideas.You can open your notebooks on any device. You can enter text using the keyboard, write by hand, sketch and quickly find the notes you want (even handwritten). Make your notes more eloquent by adding tags, tables, and images. You can also share your notebook with others to collaborate on.
How these applications differ from other versions
Comparison of different versions of Excel
Comparison of Word Features for Different Platforms
Additional information
Excel Mobile for Windows Help
PowerPoint Mobile for Windows Help
Word Mobile for Windows Help
OneNote Help Topics
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Video communication software |
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Note: An internet connection is required to access this game.
Keep in mind that the game contains social features that allow you to chat and play with friends, as well as a push notification system for interesting events and new content.You can enable or disable these features of your choice.
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Choice of MOBIL oil for Volkswagen car
Today, ExonnMobil manufactures a wide range of Mobil engine oils suitable for various Volkswagen vehicle models, including both gasoline and Volkswagen TDI diesel engine oils. For example, Mobil engine oils are produced, specially designed for Volkswagen Golf cars, such as the VW Golf 1.9 TDI as well as engine oils for Volkswagen Polo vehicles such as VW Polo 1.2 TSI.
Oil Mobile for Volkswagen cars with VW 504 00 and VW 507 00 90 142 approvals
Mobil 1 ESP Formula 5W-30 is a fully synthetic low ash oil approved by Volkswagen for gasoline vehicles requiring VW 504 00 approval and for VW diesel vehicles requiring a VW diesel engine. oils with VW 507 00 approval.
Oil for Volkswagen cars with VW 502 00, VW 505 00 90 142 approvals
Mobil 1 0W-40 is a fully synthetic oil approved by Volkswagen for its gasoline vehicles requiring VW 502 00 approved oils and for VW diesel vehicles requiring approval VW 505 00.
Oil selection on the site allows you to choose the right one or another Mobile engine oil that is most suitable for the design of your VW car engine.The site contains various technical documentation for Mobil 1 engine oil, containing complete information on the various physical and chemical properties of engine oil for the engine of your Volkswagen car.
How does Mobil 1 save money?
Fully synthetic oils such as Mobil 1 are lighter than conventional mineral oils and provide better fluidity in your VW engine, allowing your vehicle to run more efficiently.In addition, Mobile 1 engine oil starts to work faster, the engine reaches its maximum efficiency earlier. Each of these benefits provides improved fuel efficiency, which translates into savings.
How does Mobile Fully Synthetic Oil protect Volkswagen engines?
Tests have shown that Mobil 1 engine oil can reach any friction point in the engine 15 seconds faster than conventional mineral oils.Before the engine oil can fully circulate, dry friction can occur between engine parts, which is inevitable and will significantly shorten engine life. Synthetic motor oils like Mobil 1 begin to circulate immediately, protecting every moving part at the friction points, resulting in reduced maintenance costs.
How to choose the right engine oil for your VW car?
It is important to use an original oil that meets the VW manufacturer’s specifications and approvals.In order not to violate the warranty conditions and to maintain the VW manufacturer’s warranty coverage, the correct Mobil 1 oil must be used, and the vehicle’s operating instructions must be followed. Recommendations for the use of one or another Mobile oil can be obtained using the appropriate oil selection software by searching for a specific make and model of a VW car engine.
Use our oil selection functionality – this will allow you to get the right recommendations for choosing an original oil for your car.
How to Add Another User for Authentication with IBKR Mobile – Android
Overview:
This article shows you how to add another user in the Authentication section of the IBKR Mobile app for Android devices.
Requirements:
- The Android device must have the IBKR Mobile app installed and IBKR Mobile authentication activated.
- More information on installation and activation on Android devices is available in KB2270.
Instructions:
1. Open the IBKR Mobile app on your Android device.
1.a. If after starting the application a login window opens ( fig. 1 ), click on Services (Services) in the upper left corner (marked with a red arrow) and go to step 2.
1.b. If after launching the application, the main page, portfolio, watchlists or another page opens, click on the button More than in the upper left corner ( image 2 ). Select Two-Factor Authentication (Two-Factor Authentication) ( Image 3 ) and then Add User (Add User) ( Image 4 ) and go to Step 3.
Fig. 1. Fig. 2. Fig. 3.
Fig. 4.
2. Select Authenticate (Authenticate) ( Img.5 ) and then Add User (Add User) ( Img.6 ).
Fig. 5 Fig. 6.
3. Read the instructions, then press Next (Continue) ( fig. 7 ).
Fig. 7
4. Enter your username and password and press Next (Continue) ( fig.8 ).
Fig. 8.
5. An SMS message with the code ( fig. 9) will be sent to your phone. Enter received code in the field activation code and press Send (Send) ( image 10 ).
Fig. 9. Fig. 10.
6.Enter your PIN code and press Activate (Activate) ( fig. 11 ).
Fig. 11.
7. Confirmation will be displayed upon successful authentication. Press to finish Done (Done) ( fig. 12 ).
Fig. 12
SAP introduced an updated version of SAP SuccessFactors Mobile for iOS
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SAP SE announced an update to SAP SuccessFactors Mobile for iOS, which will be available in the Apple App Store later this month.Through the joint efforts of Apple and SAP developers, the updated iOS application will help modernize current HR processes, increase employee engagement and improve the overall efficiency of all solutions based on SAP SuccessFactors human capital management (HCM) for more than 47 million users worldwide.
The mobile application was announced during the SuccessConnect conference, which took place June 12-14 in London.
SAP SuccessFactors Mobile will improve business agility by providing instant access to HR services in SAP SuccessFactors HCM Suite and eliminating office outages delays.HR services can now take a completely new approach to work with employees, constantly maintaining and developing a lively and effective interaction. As a result, digital transformation of the workspace will lead to greater engagement and productivity of the entire team.
“Brooks Brothers has a long history in the United States of America retail market and we pride ourselves on the people – our people, our customers and partners,” said Justin Watras , Director of Product Development. talent management and organizational performance Brooks Brothers.“We strive for global expansion and our talent strategy is also constantly transforming: we add new functionality to the system almost every quarter. Having the ability for management and employees to organize work processes remotely from various devices – whether it be accessing a company’s organizational chart, approving transactions, submitting any materials or feedback from production – ensured efficiency and increased our productivity. ”
“Our employees must be able to work anywhere, anytime.For an electronics retailer looking to grow from 750,000 to 10 million products in the B2B market within two years, being able to remain an attractive employer in the region is critical. All SAP SuccessFactors solutions are mobile-friendly – they not only save time and empower users to get the job done, but they also involve people in the digitalization process, ”said Aleš Drábek, Chief Digital Officer at Conrad Electronic “.
New version of SAP SuccessFactors Mobile has merged SAP Fiori with Apple iOS and includes performance management and overview, training certificates, history, task list, cataloged search, time tracking, pending requests and approvals, updated search engine and organizational chart, unified work space on iPhone and iPad.