What is meloxicam used for? What are the possible side effects of meloxicam? What are the dosages and interactions of meloxicam? What warnings should be considered when taking meloxicam?

Understanding Meloxicam: An Overview

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is primarily used to treat pain and inflammation associated with various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and juvenile idiopathic arthritis. It comes in three forms: an oral tablet, an injection, and an oral capsule.

Meloxicam: Generic and Brand-Name Versions

Meloxicam is available as both a generic and a brand-name drug. The brand-name version is known as Mobic. Generic medications usually cost less than their brand-name counterparts, but they may not always be available in all strengths or forms.

How Meloxicam Works

Meloxicam belongs to a class of drugs called NSAIDs, which help reduce pain, inflammation, and fever. It is believed to work by lowering the levels of prostaglandin, a hormone-like substance that typically causes inflammation.

Meloxicam: Common Side Effects

The more common side effects of meloxicam include abdominal pain, diarrhea, indigestion or heartburn, nausea, dizziness, and headache. If these effects are mild, they may go away within a few days or a couple of weeks. If they are more severe or persistent, it is important to talk to your doctor or pharmacist.

Serious Side Effects of Meloxicam

Meloxicam can also cause serious side effects, such as heart attack, stroke, stomach and intestinal problems (like bleeding, ulcers, or tearing), liver damage, increased blood pressure, water retention or swelling, skin problems, and kidney damage. If you experience any of these serious side effects, it is crucial to seek medical attention immediately.

Meloxicam: Drug Interactions

Meloxicam can interact with several other medications, including certain antidepressants and anxiety drugs, as well as some blood thinners and steroid medications. It is important to inform your doctor and pharmacist about all the medications, vitamins, herbs, and supplements you are taking to avoid potential interactions.

Dosage and Administration of Meloxicam

The appropriate dosage of meloxicam will depend on the condition being treated, the patient’s age and weight, and other factors. It is important to follow the instructions provided by your healthcare provider and to not exceed the recommended dosage.

What is the recommended dosage of meloxicam for osteoarthritis? The recommended dosage of meloxicam for osteoarthritis is typically 7.5 mg or 15 mg once daily.

What is the recommended dosage of meloxicam for rheumatoid arthritis? The recommended dosage of meloxicam for rheumatoid arthritis is typically 7.5 mg or 15 mg once daily.

What is the recommended dosage of meloxicam for juvenile idiopathic arthritis (JIA)? The recommended dosage of meloxicam for JIA in children ages 2 and older is typically 0.125 mg/kg or 0.25 mg/kg once daily.

Warnings and Precautions with Meloxicam

Meloxicam should be used with caution in patients with a history of heart or blood vessel disease, high blood pressure, or kidney or liver problems. It is also important to avoid alcohol while taking meloxicam, as it can increase the risk of stomach bleeding or ulcers.

Can meloxicam be taken with alcohol? No, it is generally recommended to avoid alcohol while taking meloxicam, as it can increase the risk of stomach bleeding or ulcers.

Can meloxicam be taken with blood thinners? Meloxicam should be used with caution if you are taking blood thinners, as it can increase the risk of bleeding.

Can meloxicam be taken with steroids? Meloxicam should be used with caution if you are taking steroids, as it can increase the risk of stomach and intestinal problems.

In conclusion, meloxicam is a widely used NSAID that can be effective in treating pain and inflammation associated with various forms of arthritis. However, it is important to be aware of the potential side effects and drug interactions, and to follow the guidance of your healthcare provider when taking this medication.

Side effects, dosage, uses, and more

1. Meloxicam oral tablet is available as both a generic and brand-name drug. Brand name: Mobic.
2. Meloxicam comes in three forms: an oral tablet, an injection, and an oral capsule.
3. Meloxicam oral tablets are nonsteroidal anti-inflammatory drugs (NSAIDs). They’re used to treat pain and inflammation caused by osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis.

Meloxicam is a prescription drug. It comes in three forms: an oral tablet, an injection, and an oral capsule.

Meloxicam oral tablet is available as the brand-name drug Mobic.

Meloxicam oral tablet is also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Meloxicam decreases inflammation and pain. It’s approved to treat:

• osteoarthritis
• rheumatoid arthritis
• juvenile idiopathic arthritis (JIA) in children ages 2 years and older

How it works

Meloxicam belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs help reduce pain, inflammation, and fever.

It isn’t known how this medication works to decrease pain. It may help reduce swelling by lowering levels of prostaglandin, a hormone-like substance that usually causes inflammation.

Meloxicam can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking meloxicam. This list does not include all possible side effects.

For more information on the possible side effects of meloxicam, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects that can occur with meloxicam include:

• abdominal pain
• diarrhea
• indigestion or heartburn
• nausea
• dizziness
• headache
• itching or rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain or discomfort
  • trouble breathing
  • cold sweat
  • pain or discomfort in one or both arms, your back, shoulders, neck, jaw, or area above your belly button
• Stroke. Symptoms can include:
  • numbness or weakness of your face, arm, or leg on one side of your body
  • sudden confusion
  • trouble speaking or understanding speech
  • vision problems in one or both eyes
  • trouble walking or loss of balance or coordination
  • dizziness
  • severe headache with no other cause
• Stomach and intestinal problems, such as bleeding, ulcers, or tearing. Symptoms can include:
  • severe stomach pain
  • vomiting blood
  • bloody stools
  • black, sticky stools
• Liver damage. Symptoms can include:
  • dark urine or pale stools
  • nausea
  • vomiting
  • not wanting to eat
  • pain in your stomach area
  • yellowing of your skin or whites of your eyes
• Increased blood pressure: Symptoms of extreme high blood pressure can include:
  • dull headache
  • dizzy spells
  • nosebleeds
• Water retention or swelling. Symptoms can include:
  • rapid weight gain
  • swelling in your hands, ankles, or feet
• Skin problems, such as blistering, peeling, or red skin rash
• Kidney damage. Symptoms can include:
  • changes in how much or how often you urinate
  • pain with urination
  • Decreased red blood cells (anemia)

GASTROINTESTINAL SIDE EFFECTS
Abdominal pain, diarrhea, upset stomach, and nausea occur very often with this drug. Pain, vomiting, and diarrhea may occur more often in children than adults. Sometimes these side effects can cause more serious stomach problems.

Was this helpful?

If you or your child has these side effects and they bother you or don’t go away, talk to your doctor.

Meloxicam oral tablet can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with meloxicam. This list does not contain all drugs that may interact with meloxicam.

Before taking meloxicam, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Antidepressants and anxiety drugs

Taking meloxicam with certain antidepressant and anxiety medications raises your risk of bleeding. Examples of these drugs include:

• selective serotonin reuptake inhibitors, such as citalopram
• selective serotonin and norepinephrine reuptake inhibitors, such as venlafaxine

Corticosteroids

Taking meloxicam with corticosteroids can increase your risk of stomach ulcers or bleeding. Examples of these drugs include:

• prednisone
• dexamethasone

Cancer drug

Taking pemetrexed with meloxicam can increase your risk for infection, kidney problems, and stomach issues.

Transplant drug

Taking cyclosporine with meloxicam can increase the levels of cyclosporine in your body, causing kidney problems. If you take these drugs together, your doctor should monitor your kidney function.

Disease-modifying antirheumatic drug

Taking methotrexate with meloxicam can increase the levels of methotrexate in your body. This can result in kidney problems and an increased risk of infection.

Anticoagulant/blood thinner

Taking warfarin with meloxicam increases your risk of stomach bleeding.

Bipolar disorder medication

Taking lithium with meloxicam can cause amounts of lithium in your blood to increase to dangerous levels. Symptoms of lithium toxicity may include tremors, excessive thirst, or confusion. If you take these drugs together, your doctor may monitor your lithium levels.

Blood pressure drugs

Taking these medications with meloxicam may reduce the blood pressure-lowering effects of these drugs. Examples of these drugs include:

• angiotensin receptor blockers (ARBs), such as candesartan and valsartan
• angiotensin-converting enzyme (ACE) inhibitors, such as benazepril and captopril
• beta blockers, such as propranolol and atenolol

Diuretics (water pills)

Taking certain diuretics with meloxicam can decrease the effect of these drugs. Examples of these diuretics include:

• hydrochlorothiazide
• furosemide

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Meloxicam is an NSAID. Combining it with other NSAIDs may increase your risk of side effects, such as stomach bleeding or ulcers. Examples of NSAIDs include:

• aspirin
• ibuprofen
• naproxen
• etodolac
• diclofenac
• fenoprofen
• ketoprofen
• tolmetin
• indomethacin

The meloxicam dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using meloxicam to treat
• your age
• the form of meloxicam you take
• other medical conditions you may have, such as kidney damage

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Meloxicam

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Brand: Mobic

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Dosage for osteoarthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for rheumatoid arthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for juvenile idiopathic arthritis (JIA)

Child dosage (ages 2–17 years)

• Typical starting dosage (130 lbs/60 kg): 7.5 mg once daily.
• Maximum dosage: 7.5 mg per day.

Child dosage (ages 0–1 years)

Dosage for children younger than 2 years hasn’t been established. This drug has not been found to be safe and effective in this age group.

Special dosage considerations

For people receiving hemodialysis: This drug isn’t removed in dialysis. Taking a typical dosage of meloxicam while receiving hemodialysis may cause a buildup of the drug in your blood. This could cause worsened side effects. The maximum daily dose for people ages 18 years and older and receiving hemodialysis is 7. 5 mg per day.

FDA warnings

• This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
• Heart risk warning: This drug may increase your risk of developing a blood clot, heart attack, or stroke, which can be fatal. Your risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure. You shouldn’t take meloxicam for pain before, during, or after coronary artery bypass graft surgery. This can increase your risk for a heart attack or stroke.
• Stomach problems warning: This medication may increase your risk of developing stomach and intestinal problems. These include bleeding, ulcers, and holes in your stomach or intestines, which can be fatal. These effects can occur any time while you’re taking this drug. They may happen without any signs or symptoms. Adults ages 65 years and older are at higher risk of these stomach or intestinal problems.

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Allergy warning

Don’t take meloxicam if you’ve had itchy skin, symptoms of asthma, or an allergic reaction to aspirin or other NSAIDs. A second reaction could be much more severe.

Liver damage warning

This drug may affect your liver. Symptoms may include yellowing of your skin or whites of your eyes and liver inflammation, damage, or failure. Your doctor may check your liver function while you take this drug.

Blood pressure warning

This medication may increase or worsen your blood pressure. This can increase your risk of heart attack or stroke. Your doctor may check your blood pressure while you’re taking meloxicam. Some medicines for high blood pressure may not work as well as they should when you’re taking meloxicam.

Allergy warning

Meloxicam can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives

Don’t take meloxicam if you have asthma, runny nose, and nasal polyps (aspirin triad). Don’t take it if you’ve had itching, trouble breathing, or an allergic reaction to aspirin or other NSAIDs.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life threatening. Call your doctor right away if you have symptoms, such as a rash, a fever, or swollen lymph nodes.

Harm to developing fetus warning

You shouldn’t take meloxicam if you’re pregnant or planning to become pregnant. Meloxicam can cause harm to a developing fetus if taken at 20 weeks or later in pregnancy. If you are between 20 to 30 weeks of pregnancy, only take this drug if your doctor has told you to. Do not take this drug if you are more than 30 weeks pregnant.

Warnings for people with certain health conditions

For people with heart or blood vessel diseases: This medication increases your risk of blood clots, which can cause a heart attack or stroke. It may also cause fluid retention, which is common with heart failure.

For people with high blood pressure: This medication may make your blood pressure worse, which can increase your risk of having a heart attack or stroke.

For people with stomach ulcer or bleeding: Meloxicam can make these conditions worse. If you have a history of these conditions, you have a higher chance of having them again if you take this medicine.

For people with liver damage: Meloxicam can cause liver disease and changes in your liver function. It may make your liver damage worse.

For people with kidney disease: If you take meloxicam for a long time, it may decrease your kidney function, making your kidney disease worse. Stopping this drug could reverse kidney damage caused by the drug.

For people with asthma: Meloxicam can cause bronchial spasm and difficulty breathing, especially if your asthma gets worse if you take aspirin.

Warnings for other groups

For pregnant women: Using meloxicam during your third trimester of pregnancy increases the risk of negative effects to your pregnancy. You should not take meloxicam after 30 weeks of pregnancy. If you’re pregnant, talk to your doctor. Meloxicam should be used during pregnancy only if the potential benefit justifies the potential risk.

You should also talk to your doctor if you’re trying to get pregnant. Meloxicam can cause a reversible delay in ovulation. If you’re having a hard time getting pregnant or are getting tested for infertility, don’t take meloxicam.

For women who are breastfeeding: It isn’t known if meloxicam passes into breast milk. If it does, it could cause side effects in your child if you breastfeed and take meloxicam. You and your doctor may decide whether you’ll take meloxicam or breastfeed.

For seniors: If you’re age 65 years or older, you may have a higher risk of side effects from meloxicam.

For children: For the treatment of JIA, this drug has been found to be safe and effective for use in children 2 years and older. It should not be used in children younger than 2 years.

For the treatment of other conditions, this drug has not been found to be safe and effective for children of any age. It should not be used in people younger than 18 years.

Meloxicam oral tablet may be used for short-term or long-term treatment. It comes with risks if you don’t take it as prescribed by your doctor.

If you stop taking the drug or don’t take it at all: Your symptoms will remain and may worsen.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• nausea
• vomiting
• stomach pain
• stomach bleeding

Overdosing on meloxicam can cause organ failure or serious heart problems. If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you can, However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on time.

Never try to catch up by taking two doses at once. This could result in serious side effects.

How to tell if the drug is working: You should have less pain and inflammation.

Keep these considerations in mind if your doctor prescribes meloxicam oral tablet for you.

General

• You can take meloxicam with or without food. If it upsets your stomach, take it with food or milk.
• You can cut or crush the oral tablet.

Storage

• Store this medication at room temperature, 77°F (25°C). If needed, you can keep it for short periods at temperatures between 59°F and 86°F (15°C and 30°C).
• Keep this medication away from high temperatures.
• Keep your medications away from areas where they could get damp, such as bathrooms.

Refills

A prescription for this medication is refillable.You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They won’t damage your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with this drug, your doctor may check your:

• blood pressure
• liver function
• kidney function
• red blood cell count to check for anemia

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Side effects, dosage, uses, and more

1. Meloxicam oral tablet is available as both a generic and brand-name drug. Brand name: Mobic.
2. Meloxicam comes in three forms: an oral tablet, an injection, and an oral capsule.
3. Meloxicam oral tablets are nonsteroidal anti-inflammatory drugs (NSAIDs). They’re used to treat pain and inflammation caused by osteoarthritis, rheumatoid arthritis, and juvenile rheumatoid arthritis.

Meloxicam is a prescription drug. It comes in three forms: an oral tablet, an injection, and an oral capsule.

Meloxicam oral tablet is available as the brand-name drug Mobic.

Meloxicam oral tablet is also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Why it’s used

Meloxicam decreases inflammation and pain. It’s approved to treat:

• osteoarthritis
• rheumatoid arthritis
• juvenile idiopathic arthritis (JIA) in children ages 2 years and older

How it works

Meloxicam belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs help reduce pain, inflammation, and fever.

It isn’t known how this medication works to decrease pain. It may help reduce swelling by lowering levels of prostaglandin, a hormone-like substance that usually causes inflammation.

Meloxicam can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking meloxicam. This list does not include all possible side effects.

For more information on the possible side effects of meloxicam, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects that can occur with meloxicam include:

• abdominal pain
• diarrhea
• indigestion or heartburn
• nausea
• dizziness
• headache
• itching or rash

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Heart attack. Symptoms can include:
  • chest pain or discomfort
  • trouble breathing
  • cold sweat
  • pain or discomfort in one or both arms, your back, shoulders, neck, jaw, or area above your belly button
• Stroke. Symptoms can include:
  • numbness or weakness of your face, arm, or leg on one side of your body
  • sudden confusion
  • trouble speaking or understanding speech
  • vision problems in one or both eyes
  • trouble walking or loss of balance or coordination
  • dizziness
  • severe headache with no other cause
• Stomach and intestinal problems, such as bleeding, ulcers, or tearing. Symptoms can include:
  • severe stomach pain
  • vomiting blood
  • bloody stools
  • black, sticky stools
• Liver damage. Symptoms can include:
  • dark urine or pale stools
  • nausea
  • vomiting
  • not wanting to eat
  • pain in your stomach area
  • yellowing of your skin or whites of your eyes
• Increased blood pressure: Symptoms of extreme high blood pressure can include:
  • dull headache
  • dizzy spells
  • nosebleeds
• Water retention or swelling. Symptoms can include:
  • rapid weight gain
  • swelling in your hands, ankles, or feet
• Skin problems, such as blistering, peeling, or red skin rash
• Kidney damage. Symptoms can include:
  • changes in how much or how often you urinate
  • pain with urination
  • Decreased red blood cells (anemia)

GASTROINTESTINAL SIDE EFFECTS
Abdominal pain, diarrhea, upset stomach, and nausea occur very often with this drug. Pain, vomiting, and diarrhea may occur more often in children than adults. Sometimes these side effects can cause more serious stomach problems.

Was this helpful?

If you or your child has these side effects and they bother you or don’t go away, talk to your doctor.

Meloxicam oral tablet can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with meloxicam. This list does not contain all drugs that may interact with meloxicam.

Before taking meloxicam, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Antidepressants and anxiety drugs

Taking meloxicam with certain antidepressant and anxiety medications raises your risk of bleeding. Examples of these drugs include:

• selective serotonin reuptake inhibitors, such as citalopram
• selective serotonin and norepinephrine reuptake inhibitors, such as venlafaxine

Corticosteroids

Taking meloxicam with corticosteroids can increase your risk of stomach ulcers or bleeding. Examples of these drugs include:

• prednisone
• dexamethasone

Cancer drug

Taking pemetrexed with meloxicam can increase your risk for infection, kidney problems, and stomach issues.

Transplant drug

Taking cyclosporine with meloxicam can increase the levels of cyclosporine in your body, causing kidney problems. If you take these drugs together, your doctor should monitor your kidney function.

Disease-modifying antirheumatic drug

Taking methotrexate with meloxicam can increase the levels of methotrexate in your body. This can result in kidney problems and an increased risk of infection.

Anticoagulant/blood thinner

Taking warfarin with meloxicam increases your risk of stomach bleeding.

Bipolar disorder medication

Taking lithium with meloxicam can cause amounts of lithium in your blood to increase to dangerous levels. Symptoms of lithium toxicity may include tremors, excessive thirst, or confusion. If you take these drugs together, your doctor may monitor your lithium levels.

Blood pressure drugs

Taking these medications with meloxicam may reduce the blood pressure-lowering effects of these drugs. Examples of these drugs include:

• angiotensin receptor blockers (ARBs), such as candesartan and valsartan
• angiotensin-converting enzyme (ACE) inhibitors, such as benazepril and captopril
• beta blockers, such as propranolol and atenolol

Diuretics (water pills)

Taking certain diuretics with meloxicam can decrease the effect of these drugs. Examples of these diuretics include:

• hydrochlorothiazide
• furosemide

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Meloxicam is an NSAID. Combining it with other NSAIDs may increase your risk of side effects, such as stomach bleeding or ulcers. Examples of NSAIDs include:

• aspirin
• ibuprofen
• naproxen
• etodolac
• diclofenac
• fenoprofen
• ketoprofen
• tolmetin
• indomethacin

The meloxicam dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using meloxicam to treat
• your age
• the form of meloxicam you take
• other medical conditions you may have, such as kidney damage

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: Meloxicam

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Brand: Mobic

• Form: oral tablet
• Strengths: 7.5 mg, 15 mg

Dosage for osteoarthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for rheumatoid arthritis

Adult dosage (ages 18 years and older)

• Typical starting dosage: 7.5 mg taken once per day.
• Maximum dosage: 15 mg per day.

Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug has not been found to be safe and effective in this age group for this condition.

Dosage for juvenile idiopathic arthritis (JIA)

Child dosage (ages 2–17 years)

• Typical starting dosage (130 lbs/60 kg): 7.5 mg once daily.
• Maximum dosage: 7.5 mg per day.

Child dosage (ages 0–1 years)

Dosage for children younger than 2 years hasn’t been established. This drug has not been found to be safe and effective in this age group.

Special dosage considerations

For people receiving hemodialysis: This drug isn’t removed in dialysis. Taking a typical dosage of meloxicam while receiving hemodialysis may cause a buildup of the drug in your blood. This could cause worsened side effects. The maximum daily dose for people ages 18 years and older and receiving hemodialysis is 7. 5 mg per day.

FDA warnings

• This drug has a black box warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients about drug effects that may be dangerous.
• Heart risk warning: This drug may increase your risk of developing a blood clot, heart attack, or stroke, which can be fatal. Your risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure. You shouldn’t take meloxicam for pain before, during, or after coronary artery bypass graft surgery. This can increase your risk for a heart attack or stroke.
• Stomach problems warning: This medication may increase your risk of developing stomach and intestinal problems. These include bleeding, ulcers, and holes in your stomach or intestines, which can be fatal. These effects can occur any time while you’re taking this drug. They may happen without any signs or symptoms. Adults ages 65 years and older are at higher risk of these stomach or intestinal problems.

Was this helpful?

Allergy warning

Don’t take meloxicam if you’ve had itchy skin, symptoms of asthma, or an allergic reaction to aspirin or other NSAIDs. A second reaction could be much more severe.

Liver damage warning

This drug may affect your liver. Symptoms may include yellowing of your skin or whites of your eyes and liver inflammation, damage, or failure. Your doctor may check your liver function while you take this drug.

Blood pressure warning

This medication may increase or worsen your blood pressure. This can increase your risk of heart attack or stroke. Your doctor may check your blood pressure while you’re taking meloxicam. Some medicines for high blood pressure may not work as well as they should when you’re taking meloxicam.

Allergy warning

Meloxicam can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives

Don’t take meloxicam if you have asthma, runny nose, and nasal polyps (aspirin triad). Don’t take it if you’ve had itching, trouble breathing, or an allergic reaction to aspirin or other NSAIDs.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Multiorgan hypersensitivity/DRESS warning

This medication can cause multiorgan hypersensitivity. This is also known as a drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome can be life threatening. Call your doctor right away if you have symptoms, such as a rash, a fever, or swollen lymph nodes.

Harm to developing fetus warning

You shouldn’t take meloxicam if you’re pregnant or planning to become pregnant. Meloxicam can cause harm to a developing fetus if taken at 20 weeks or later in pregnancy. If you are between 20 to 30 weeks of pregnancy, only take this drug if your doctor has told you to. Do not take this drug if you are more than 30 weeks pregnant.

Warnings for people with certain health conditions

For people with heart or blood vessel diseases: This medication increases your risk of blood clots, which can cause a heart attack or stroke. It may also cause fluid retention, which is common with heart failure.

For people with high blood pressure: This medication may make your blood pressure worse, which can increase your risk of having a heart attack or stroke.

For people with stomach ulcer or bleeding: Meloxicam can make these conditions worse. If you have a history of these conditions, you have a higher chance of having them again if you take this medicine.

For people with liver damage: Meloxicam can cause liver disease and changes in your liver function. It may make your liver damage worse.

For people with kidney disease: If you take meloxicam for a long time, it may decrease your kidney function, making your kidney disease worse. Stopping this drug could reverse kidney damage caused by the drug.

For people with asthma: Meloxicam can cause bronchial spasm and difficulty breathing, especially if your asthma gets worse if you take aspirin.

Warnings for other groups

For pregnant women: Using meloxicam during your third trimester of pregnancy increases the risk of negative effects to your pregnancy. You should not take meloxicam after 30 weeks of pregnancy. If you’re pregnant, talk to your doctor. Meloxicam should be used during pregnancy only if the potential benefit justifies the potential risk.

You should also talk to your doctor if you’re trying to get pregnant. Meloxicam can cause a reversible delay in ovulation. If you’re having a hard time getting pregnant or are getting tested for infertility, don’t take meloxicam.

For women who are breastfeeding: It isn’t known if meloxicam passes into breast milk. If it does, it could cause side effects in your child if you breastfeed and take meloxicam. You and your doctor may decide whether you’ll take meloxicam or breastfeed.

For seniors: If you’re age 65 years or older, you may have a higher risk of side effects from meloxicam.

For children: For the treatment of JIA, this drug has been found to be safe and effective for use in children 2 years and older. It should not be used in children younger than 2 years.

For the treatment of other conditions, this drug has not been found to be safe and effective for children of any age. It should not be used in people younger than 18 years.

Meloxicam oral tablet may be used for short-term or long-term treatment. It comes with risks if you don’t take it as prescribed by your doctor.

If you stop taking the drug or don’t take it at all: Your symptoms will remain and may worsen.

If you miss doses or don’t take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include:

• nausea
• vomiting
• stomach pain
• stomach bleeding

Overdosing on meloxicam can cause organ failure or serious heart problems. If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you can, However, if it’s just a few hours until your next dose, skip the missed dose and take the next one on time.

Never try to catch up by taking two doses at once. This could result in serious side effects.

How to tell if the drug is working: You should have less pain and inflammation.

Keep these considerations in mind if your doctor prescribes meloxicam oral tablet for you.

General

• You can take meloxicam with or without food. If it upsets your stomach, take it with food or milk.
• You can cut or crush the oral tablet.

Storage

• Store this medication at room temperature, 77°F (25°C). If needed, you can keep it for short periods at temperatures between 59°F and 86°F (15°C and 30°C).
• Keep this medication away from high temperatures.
• Keep your medications away from areas where they could get damp, such as bathrooms.

Refills

A prescription for this medication is refillable.You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They won’t damage your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with this drug, your doctor may check your:

• blood pressure
• liver function
• kidney function
• red blood cell count to check for anemia

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

“golden mean” of non-steroidal anti-inflammatory drugs

Rapid and most complete pain relief is one of the priorities of medical care. Pain is the most unpleasant manifestation of the main pathological conditions, so its effective suppression can significantly improve the quality of life of patients and gain their confidence, which is important when it comes to the onset of a chronic disease requiring long-term pathogenetic therapy.

Pain therapy is of fundamental importance in musculoskeletal diseases such as osteoarthritis (OA) and low back pain (LBP), which are currently associated with most cases of chronic non-cancer pain [1-3].

From the point of view of medical science, chronic pain is a serious and independent threat to the patient’s life. Persistent severe pain determines the negative changes in homeostasis, mediated by the reaction of the sympathetic-adrenal system – an increase in blood pressure and heart rate, as well as procoagulative changes in the blood coagulation system. These changes lead to a significant increase in the risk of developing dangerous cardiovascular complications (CVS) [1, 2].

In such nosological forms as OA and chronic LBP, which are not accompanied by visceral pathology, but are characterized by severe pain that often persists for months and years, the risk of developing fatal CVCs is significantly increased [1, 2].

This statement is confirmed by a study by Swiss scientists E. Nüesch et al. [4], who assessed the frequency of deaths in 1163 patients with OA with a follow-up period of about 5 years. According to the data obtained, the risk of death due to CVD in patients suffering from this “non-fatal” disease is 1.7 times higher than in the general population. In the course of the subsequent analysis, the scientists identified the only factor that was clearly associated with the development of fatal CVCs in patients with OA – a pronounced dysfunction of the joints, preventing normal movement. Among the dead, such disorders were observed in 35%, while among the survivors – only 17% ( p <0.001) [4].

Similar results are presented by Japanese researchers M. Tsuboi et al. [5], who observed the dynamics of the state in 944 patients with various rheumatic diseases for 10 years. It was found that in patients with gonarthrosis the risk of death from CVE is more than 2 times higher than in the population (odds ratio – OR – 2.32).

The work of Australian scientists K. Zhu et al. [6], who followed a group of 1484 elderly women (over 70 years of age) with chronic LBP for 5 years. Among them, 21.7% initially and 26.9% at the end of the observation period experienced pain daily. In this subgroup, the risk of death from CVE was more than 2 times higher (relative risk – RR 2.13 at 95% confidence interval – CI – from 1.35 to 3.34) than in the group of patients who had less pain .

It is impossible not to note one more, purely practical aspect of the problem of adequate anesthesia. Patients come to the doctor’s office primarily for relief of suffering; “understanding” the situation, finding out the exact diagnosis is a secondary, although undoubtedly important, goal of seeking medical help. Excessive enthusiasm for diagnostic measures and “basic” means to the detriment of simple and effective methods of pain control can cause a negative attitude of the patient towards the attending physician and turn him away from the methods of classical medicine. On the contrary, the effective elimination of the most painful symptoms will be the most effective way to win the patient’s trust and achieve strict adherence to a complex scheme of long-term pathogenetic therapy [1, 2].

However, effective control of chronic pain is not easy. An illustration of this is the work of the Spanish scientists L. Arboleya et al. [7], who assessed the opinion on the results of treatment of 897 patients with OA who received analgesics for at least 6 months, most often non-steroidal anti-inflammatory drugs (NSAIDs): diclofenac, aceclofenac and piroxicam. 46% of the respondents were dissatisfied with the effect of prescribed drugs, and only 1 patient out of 6 considered himself completely satisfied with the result of analgesic therapy.

In this regard, the data of British researchers M. Gore et al. [8], who evaluated the practice of prescribing analgesics (paracetamol, NSAIDs, tramadol, “weak” and “strong” opioids) in patients with OA and LBP. For various reasons – due to inefficiency, adverse events, etc., during the 1st month of treatment, prescribed drugs were canceled in almost 90% of patients (from 30 to 60% were cases of replacement therapy, up to 15% – its increase – the use of various combinations). It can be seen that in most cases (not less than ⅔), the analgesic drug initially recommended by the doctor did not justify hopes and did not become a solution to the pain problem [8].

It should be remembered that the development of pain, especially chronic pain, is a complex, multicomponent pathological process. Its development involves local inflammation, muscle spasm, damage to the elements of the ligamentous apparatus, biomechanical disorders, dysfunction of the pain system (peripheral and central sensitization, “exhaustion” of antinociceptive mechanisms, etc. ) [1, 2, 9, 10]. It is obvious that monotherapy, even with the most effective means, cannot always ensure therapeutic success. Only an integrated approach based on the combined use of drugs with different mechanisms of action can achieve effective control of chronic pain (Table 1) .

First-line pharmacotherapy for musculoskeletal pain is undoubtedly NSAIDs. They have a unique combination of analgesic, anti-inflammatory and antipyretic effects, providing effective relief of the main symptoms associated with the pathology of the OPS organs [1-3].

The main mechanism of the pharmacological action of NSAIDs is associated with the blockade of cyclooxygenase-2 (COX-2), which is formed in the foci of tissue damage and is responsible for the active synthesis of prostaglandins (PG) – the most important mediators of pain and inflammation. It is important to note that the analgesic effect of NSAIDs is realized not only by reducing the excitability of peripheral pain receptors. Probably no less important is the effect of NSAIDs on the central mechanisms of pain formation – the phenomenon of central sensitization, which is also mediated by hyperproduction of PG (aseptic neuronal inflammation) and activation of glial cells that occur in response to persistent and powerful pain stimulation of the structures of the nociceptive system [1-3 ].

Obviously, if inflammation plays an important role in the pathogenesis of acute or chronic pain (even subclinical, as in OA and dorsalgia), accompanied by active synthesis of biologically active substances such as interleukins 1 and 6, tumor necrosis factor, the use of NSAIDs will be appropriate and necessary . Moreover, in this situation, as the data of many clinical studies show, in terms of their therapeutic activity, NSAIDs have a clear advantage over other analgesics – paracetamol and opioids, which do not have anti-inflammatory properties [1-3].

The therapist has an exceptional variety of NSAIDs in his arsenal. This creates difficulties for practitioners, because even experts cannot always determine the criteria for the merit of drugs that should be used to decide on the choice of one or another NSAID. The situation is further complicated by the active advertising activities of some manufacturing companies promoting their product as “the most effective and safe among all possible.” However, real practice clearly shows that none of the NSAIDs can be considered the best, and if the drug has an advantage in any parameter, it is likely that it will also have certain disadvantages.

The analgesic effect of all NSAIDs when used in therapeutic doses is practically the same. At least there is no conclusive data obtained in the course of a series of methodically correctly organized clinical trials that any drug from this group is significantly superior to others in analgesic action. The main difference between NSAIDs (sometimes very significant) is determined by their safety [3].

Among NSAIDs, two polar groups are distinguished, differing in their selectivity for COX-2 (their main pharmacological “target”): non-selective (n-NSAIDs) and highly selective – “coxibs”. The selectivity of NSAIDs avoids the suppression of the activity of the biochemical “brother” of COX-2 – the COX-1 enzyme, the work of which is extremely important for maintaining many vital functions, such as the protective properties of the mucous membrane (CO) of the gastrointestinal tract (GIT). The blockade of COX-1 (characteristic of n-NSAIDs) leads to a significant increase in the risk of developing severe, life-threatening gastrointestinal pathology (gastropathy and enteropathy associated with NSAIDs – NSAID gastropathy and NSAID enteropathy. In this regard, “coxibs” are much less dangerous [3 ].

However, selective suppression of COX-2 (without affecting COX-1) can lead to an imbalance in the synthesis of thromboxane A2 and prostacyclin, which increases the risk of vascular thrombosis. In patients with cardiovascular diseases, this is fraught with an increased risk of developing severe CV events – myocardial infarction (MI) and ischemic stroke [3]. As can be seen, the use of n-NSAIDs and “coxibs” has serious limitations: they are not suitable for all patients (Table 2) . Accordingly, two main scenarios can be presented in which the use of representatives of these drug groups is most appropriate.

Thus, “coxibs” are more suitable for relatively young patients who need short-term analgesic therapy and have a moderate risk of developing complications in the form of organic and functional disorders of the gastrointestinal tract in the absence of severe concomitant CVS pathology.

n-NSAIDs (except for ketorolac, suitable only for short-term use) are more acceptable for patients of the older age group with a moderate risk of developing CVC, but without significant risk factors for developing NSAID gastropathy. In most cases, these drugs can only be used in combination with a gastroprotector (proton pump inhibitor).

A position between n-NSAIDs and “coxibs” should be assigned to drugs with moderate selectivity for COX-2. Their use should lead to a smaller number of pronounced complications in the form of organic and functional disorders of the gastrointestinal tract, but not be accompanied by a significant increase in the risk of developing CVS. This is a kind of “golden mean”, which is acceptable for most patients and is especially interesting now, when the medical community, after the bad memory of the “coxibs crisis”, is very wary of highly selective COX-2 inhibitors. At the same time, the problem of NSAID gastropathy, which is so characteristic of n-NSAIDs, will never lose its relevance.

In the mid-1990s, this position was occupied by diclofenac. However, at present, this drug no longer meets the high requirements of safe pharmacotherapy. In our country, primarily due to the widespread use of cheap generics of this drug, it is with diclofenac that the greatest number of complications in the form of organic and functional disorders of the gastrointestinal tract are associated [11]. The situation with the MTR is even worse. Thus, according to a meta-analysis conducted by P. McGettigan and D. Henry [12], (30 case-control studies, including 184 946 patients with CVD and 21 cohort studies, a total of > 2.7 million individuals), the risk of MI increases with the use of diclofenac by approximately 40% (OR 1. 4). In a population study by Danish scientists E. Fosbøl et al. [13], taking diclofenac was accompanied by the highest risk of developing myocardial infarction, stroke, and death from CVD among NSAIDs, higher than that of coxibs.

Significantly more interest is attracted by another representative of the “golden mean” – a moderately selective COX-2 inhibitor meloxicam, which appeared in 1995 g. Since then, this effective and fairly safe drug remains one of the most popular representatives of the NSAID group, which is actively used in almost all countries of the world.

Meloxicam has been extensively tested in a large number of clinical trials; its effectiveness has been studied in a wide range of diseases and pathological conditions, ranging from anesthetic practice to chronic joint diseases. These studies clearly confirmed that meloxicam is in no way inferior in its therapeutic potential to the “traditional” NSAIDs in the most common diseases characterized by musculoskeletal pain (OA, LBP, rheumatoid arthritis – RA and ankylosing spondylitis – AS) [14-22].

However, the main advantage of meloxicam is its good tolerability. In a series of large randomized clinical trials (RCTs), a significantly lower number of complications in the form of organic and functional disorders of the gastrointestinal tract was unambiguously confirmed when using this drug compared to n-NSAIDs.

The 4-week MELISSA study ( n =9323) compared meloxicam 7.5 mg with diclofenac 100 mg/day. The total number of side effects in the form of organic and functional disorders of the gastrointestinal tract when using meloxicam was significantly less – 13.3% versus 18.7% in the diclofenac group. At the same time, the number of episodes of discontinuation of therapy due to complications in patients treated with meloxicam was 2 times less: 3 and 6.1%, respectively ( p <0.001). Dangerous complications - clinically pronounced ulcers, gastrointestinal bleeding (GI) and perforation while taking meloxicam were also less common (but not significant) - 5 and 7 cases, respectively [23].

A SELECT RCT ( n = 8656) was conducted in a similar manner, but piroxicam 20 mg was used as a comparison. This study showed a significant advantage of meloxicam in relation to the risk of developing severe complications in the form of organic and functional disorders of the gastrointestinal tract, which occurred in 7 and 16 patients, respectively ( p <0.05). As in the RCT MELISSA, dyspepsia and associated episodes of discontinuation of therapy were significantly more common in patients treated with the comparator drug: 10.3 and 3.8% versus 15.4 and 5.3%, respectively ( p <0.001) [ 24].

D. Yocum et al. [25] 774 patients with OA received meloxicam at a dose of 3.75, 7.5 and 15 mg, diclofenac 100 mg or placebo for 3 months. The results of the study showed that the total number of complications in the form of organic and functional disorders of the gastrointestinal tract while taking meloxicam was significantly less than when using diclofenac – 19and 28%, respectively ( p <0. 05).

The safety of meloxicam has also been confirmed in a number of cohort studies, such as H. Zeidler et al. [26]. This study involved 2155 German doctors who observed 13,307 rheumatological patients who received meloxicam at a dose of 7.5 mg (65%) or 15 mg (33%) for 1-3 months. The efficacy and tolerability of the drug was assessed by analyzing the data provided by the attending physicians in the relevant questionnaires. Although the majority of patients were over 60 years old, and 12% had a history of ulcers, undesirable effects in the form of organic and functional disorders of the gastrointestinal tract were noted in 0.8%, and pronounced ones – only in 5 patients (4 uncomplicated gastric ulcers and 1 perforation) [26 ].

Somewhat earlier P. Schoenfeld et al. [27] conducted a meta-analysis of 12 RCTs lasting from 1 to 24 weeks, comparing meloxicam with diclofenac, piroxicam, and naproxen in patients with OA, RA, and dorsalgia. It was shown that taking meloxicam was associated with a significantly lower total number of complications in the form of organic and functional disorders of the gastrointestinal tract (RR 0. 64 at 95% CI from 0.59 to 0.69), the incidence of dyspepsia (OR 0.73 at 95% CI from 0.64 to 0.84), symptomatic ulcers, GI and perforations (OR 0.52 at 95% CI from 0.28 to 0.96), as well as the risk of discontinuation of therapy due to complications in the form of organic and functional disorders of the gastrointestinal tract (OR 0.59 at 95% CI from 0.52 to 0.67).

A later meta-analysis by G. Singh [25], which included data from 28 RCTs (24,196 patients), also confirms the higher safety of meloxicam at a dose of 7.5 mg compared to traditional NSAIDs in relation to the gastrointestinal tract. Thus, the frequency of gastrointestinal bleeding when using this dose of meloxicam was only 0.03% (when taking 15 mg 0.2%), while in those receiving diclofenac at a dose of 100-150 mg / day – 0.15% [28].

In order to study the effect of meloxicam on the upper gastrointestinal tract, several years ago we conducted a retrospective analysis of the development of gastric and/or duodenal ulcers in rheumatological patients who were in 2002-2005. on inpatient treatment at the clinic of the FGBU NIIR RAMS. The studied groups consisted of persons who underwent esophagogastroduodenoscopy during this period for various reasons: 425 patients who received meloxicam, and 2428 – diclofenac (Fig. 1) . Figure 1. Detection of ulcers and multiple (> 10) erosions of the stomach and / or duodenal ulcer in patients who regularly received meloxicam or diclofenac [29]. In patients taking meloxicam, ulcers occurred almost 2 times less often, including patients with such a risk factor as an ulcer history [29].

In recent years, the problem of the negative effects of NSAIDs on the distal gastrointestinal tract has attracted much attention of researchers and practitioners. First of all, we are talking about NSAID enteropathy – a pathology of the small intestine (TC), which is accompanied by an increase in its permeability and the development of chronic inflammation associated with the penetration of bacteria or their components contained in the chyme into the intestinal wall. This complication can manifest itself as severe GI bleeding, perforation and strictures of the TC; however, its most characteristic symptom is subclinical blood loss leading to the development of chronic iron deficiency anemia (IDA) [3, 30, 31]. Recently, interest in this pathology has been very high, since even in the absence of life-threatening complications, NSAID enteropathy can have a significant negative impact on the patient’s health. After all, chronic IDA determines a significant decrease in the oxygen capacity of the blood, a decrease in resistance to stress and, ultimately, an increase in the risk of developing severe CVD.

This is confirmed by the work of G. Sands et al., published in 2012. [32]. The researchers conducted a meta-analysis of 51 RCTs comparing the safety of celecoxib and n-NSAIDs ( n = 50,116) to determine the relationship between reduced hemoglobin levels and the incidence of life-threatening systemic complications. It turned out that anemia dramatically increased the risk of developing severe CVD. Thus, in 932 patients who developed a clinically significant decrease in hemoglobin levels (more than 20 g/l), the incidence of MI was 0.6%, while in patients who did not have signs of anemia, it was only 0.2%. Similarly, the progression of coronary heart disease (CHD) was observed in 1.2 and 0.3% of patients [32].

NSAID enteropathy is a problem characteristic of “traditional” NSAIDs. There is strong evidence that c-NSAIDs (“coxibs”) are significantly safer than “traditional” NSAIDs in terms of the risk of developing this pathology [3].

The most modern technique for accurately diagnosing pathology of the mucous membrane of the jejunum and ileum, which occurs while taking NSAIDs, is video capsule endoscopy (VCE). It was she who was used in a number of studies that compared the effect of “coxibs” and n-NSAIDs on the state of TC [3, 33].

In recent years, the first reports of a relatively low incidence of NSAID enteropathy with the use of meloxicam have appeared, confirmed by TBEV data. Thus, we recently conducted a study on the effect of meloxicam (Movalis) and diclofenac on the state of TC in 15 patients with AS. The choice of this nosological form for studying the development of NSAID enteropathy was not accidental. Patients with AS have an increased risk of developing TC pathology – there is a known association between chronic inflammatory bowel diseases and seronegative spondylitis. In addition, patients with AS often take NSAIDs, often for a long time and in high doses [34].

According to the results obtained, certain changes in the SO TC – the presence of inflammation, hemorrhages, erosions or ulcers were detected equally often while taking meloxicam 15 mg / day or diclofenac 100-200 mg / day: 71.4 and 75%, respectively. However, the average number of erosions was significantly less in those who received movalis: 6.2±4.7 and 9.4±7.3, respectively [34].

Our data are consistent with those of Y. Maehata et al. [35]. They performed VCE in 29 volunteers with initially normal SO TC who received meloxicam 10 mg/day or celecoxib 200 mg/day for 2 weeks. The number of persons who, after a course of NSAIDs, had a pathology of the TC, when using meloxicam, was less than when taking “coxib” – 26.7 and 42.9% respectively.

It can be stated that, in relation to CVR, meloxicam is at least no worse than “traditional” NSAIDs. So, in a series of RCTs conducted in the late 90s of the XX century, it was shown that the risk of developing severe CV events when using meloxicam does not exceed that against placebo.

According to the results of the meta-analysis of 28 RCTs conducted by G. Singh [28], the incidence of myocardial infarction with the use of meloxicam was lower than with diclofenac: 0.09% for a dose of 7.5 mg / day, 0.19% for 15 mg/day and 0.22% for diclofenac 100-150 mg/day.

It should be noted that according to the results of the above work by P. McGettigan and D. Henry [12], meloxicam showed a mild (not exceeding the average level for all NSAIDs), inherent in the entire class of NSAIDs, the ability to increase the risk of developing MI – by about 20% (OR 1. 2). According to these data, meloxicam is inferior to naproxen, but is at the level of celecoxib and ibuprofen and superior to diclofenac (OR 1.4, i.e. 40% increased risk).

Comparable results presented by Finnish scientists A. Helin-Salmivaara et al. [36]. They conducted a large population-based study in which the RR of developing NSAID-related CV events was assessed in 33,309 patients with MI (138,949 – corresponding control; Fig. 2 ). data from a population study conducted in Finland: 33,309 patients with MI, 138,949 – controls) [36]. The risk level for those taking meloxicam was at the average level – OR 1.25. This is somewhat higher than in those taking naproxen (OR 1.19), but clearly less compared to diclofenac (OR 1.35) and especially nimesulide (OR 1.69).

There is a very curious fact: meloxicam was once studied as a component of IHD therapy (!). During the NUT-2 study, 60 patients with acute coronary syndrome who received aspirin and heparin as antithrombotic therapy for 1 month were additionally prescribed meloxicam 15 mg/day. Another 60 patients who underwent similar antithrombotic therapy constituted the control – they were assigned a placebo. Treatment outcomes in the meloxicam group were clearly better. So, among the patients who received this drug, no one developed MI and no patient died; at the same time, there were 2 cases of MI and one coronary death in the control group. In the 1st group, revascularization was required in 6 (10%) patients, and in the 2nd – 15 (25%; р <0.05) [37].

Nowadays, such a study seems rather like medical casuistry; nevertheless, it can serve as a good illustration of the favorable tolerability of meloxicam in patients with risk factors for CVD.

Meloxicam has another important advantage: unlike “traditional” NSAIDs, it does not interact adversely with low doses of aspirin and does not reduce the antiplatelet potential of the latter. This was confirmed by an epidemiological study by G. Singh et al. [38], based on the analysis of the California Database of Patients with MI ( n =15 343). In patients treated with meloxicam in combination with aspirin, the risk of MI was significantly lower than in those treated with this drug without aspirin: OR 0.53 and 1.56, respectively. At the same time, the popular analgesic ibuprofen clearly worsened the effect of aspirin. In patients treated with these drugs together, the risk of MI was even slightly higher than in patients who took ibuprofen alone: ​​OR 1.2 and 1.08, respectively [38].

When discussing the benefits of meloxicam, attention should be paid to the low risk of allergic skin reactions. Although these complications are rare with the use of NSAIDs, in some cases they can be a serious problem. Meloxicam in this regard is quite safe. Thus, according to American authors, during the first 2 years of using this drug in the United States, not a single episode of Stevens-Johnson syndrome or toxic epidermal necrolysis was recorded (for example, 47 episodes while taking celecoxib) [39]. The low frequency of skin reactions when using meloxicam was also noted by K. Ward et al. [40], who published a methodological review in 2010.

Moreover, there are a number of studies that have shown the possibility of using meloxicam in patients who have previously experienced skin allergic or bronchospastic reactions when using aspirin or other “traditional” NSAIDs [41, 42].

Severe hepatotoxic reactions are also rare side effects of NSAIDs. Nevertheless, the assessment of the risk of complications in the form of liver dysfunction is relevant for a number of representatives of this drug group, such as diclofenac and nimesulide [3]. For example, among 17,289of participants in an 18-month MEDAL RCT (comparison of etoricoxib and diclofenac) who received diclofenac, a three-fold increase in alanine aminotransferase activity was noted in 3.1%, and a ten-fold increase in 0.5% [43]. Although not a single episode of liver failure or jaundice was recorded, such a clear negative dynamics of biochemical parameters is of concern and is the reason for interrupting therapy.

Fortunately, these problems are not typical for meloxicam.

In the available literature, against the background of treatment with this drug, only isolated cases of asymptomatic, but a significant increase in the level of transaminases or clinically pronounced liver dysfunctions were not noted [44, 45].

Comparative hepatotoxicity of various NSAIDs was studied by Italian authors G. Traversa et al. [46]. They compared the incidence of liver dysfunction in 397,537 patients treated with NSAIDs in 1997-2001. According to the data obtained, meloxicam showed the best tolerance. The frequency of hepatotoxic reactions during its use was 23.6 episodes per 100,000 person-years. A similar indicator for nimesulide, diclofenac and ibuprofen was significant – 35.2, 39,2 and 44 episodes per 100,000 person-years [46].

Concluding the review, it should be noted that the benefits of any drug are determined not only by successful pharmacological properties and favorable results of clinical trials. For practicing physicians, the “reputation” of the drug is of great importance, which is acquired over the years of its successful use in real clinical practice.

Meloxicam is a representative of NSAIDs, whose good “reputation” is beyond doubt. This drug is well known to doctors all over the world, they trust its effectiveness and good tolerance and actively use it in their work. It should be noted that the good “reputation” of meloxicam is due to a specific original drug, known abroad as mobic (mobic), and in Russia as movalis. It was he who was tested in numerous clinical trials, ultimately proving its therapeutic potential and a favorable tolerability profile. The presence of similar benefits in numerous generic meloxicam still requires strong evidence.

The position of meloxicam (Movalis) among other NSAIDs seems to be the most successful. Of course, this drug cannot be considered completely safe, like any other representative of this drug group. However, it is well tolerated and has a relatively low risk of developing serious complications, in the form of dysfunction of both the gastrointestinal tract and the cardiovascular system; it is quite efficient and easy to use. In general, meloxicam today is the first-line drug for many patients suffering from acute and chronic diseases of the joints and spine.

Catalog :: Medicines :: Musculoskeletal system :: Anti-inflammatory drugs :: Meloxicam-Teva 7.5 mg №20 tab

Trade name

Meloxicam-Teva

International generic name

Meloxicam

Dosage form, dosage

Tablets 7.5 mg or 15 mg0144

Musculoskeletal system. Anti-inflammatory and antirheumatic drugs. Anti-inflammatory and antirheumatic drugs, non-steroidal. Oxycams. Meloxicam.

ATC code M01AC06

Indications for use

• short-term symptomatic treatment of exacerbations of osteoarthritis
• long-term symptomatic treatment of rheumatoid arthritis or ankylosing arthritis spondyloarthritis.

Checklist before use

Contraindications

• hypersensitivity to the active substance or excipients
• hypersensitivity to active molecules with similar effects, such as NSAIDs ( non-steroidal anti-inflammatory drugs), acetylsalicylic acid
• considering the presence of an excipient lactose, contraindicated in persons with hereditary fructose intolerance, Lapp-lactose, glucose-galactose malabsorption
• history of symptoms of asthma, nasal polyps, angioedema, or urticaria after use of acetylsalicylic acid or other NSAIDs
• history of gastrointestinal bleeding or gastrointestinal perforation associated with NSAID treatment /bleeding (two or more obvious attacks of ulcer or bleeding)
• gastrointestinal bleeding, history of intracerebral hemorrhage or other bleeding disorders
• severe liver failure
• severe renal failure without dialysis
• heart failure
• III trimester of pregnancy and lactation
• children and adolescents under 16 years of age

900 02

Precautions for use

Meloxicam-Teva is suitable for the treatment of patients who require pain relief for acute pain. Adverse events can be minimized by using the lowest effective dose for the shortest duration of treatment. In case of insufficient therapeutic effect, the maximum recommended daily dose should not be exceeded or additional NSAIDs should be added.

If there is no improvement after a few days, the clinical benefit of treatment should be reassessed.

As with other NSAIDs, special attention should be paid to the elderly, who are more likely to have impaired renal, hepatic and cardiac function, who are more likely to have adverse reactions to NSAIDs.

Like all NSAIDs, Meloxicam-Teva may mask symptoms of an infectious disease.

Meloxicam-Teva, like any other drug that inhibits cyclooxygenase/prostaglandin synthesis, may cause fertility problems and is not recommended for women who are planning a pregnancy. Women undergoing fertility testing should consider discontinuing Meloxicam-Teva.

Meloxicam-Teva Sodium

This medicinal product contains less than 1 mmol sodium (23 mg) per dose, i. generally “sodium-free”.

Interactions with other medicinal products potassium, potassium-sparing diuretics, angiotensin-converting enzyme (ACE) inhibitors, antagonists angiotensin II receptor, non-steroidal anti-inflammatory drugs, heparins (low molecular weight or unfractionated), cyclosporine, tacrolimus and trimethoprim.

The risk of hyperkalemia is increased when the above drugs are taken concomitantly with Meloxicam-Teva.

Interaction studies have only been performed in adults.

Other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetylsalicylic acid >3g/day

Co-administration with other nonsteroidal anti-inflammatory drugs, including acetylsalicylic acid at anti-inflammatory doses (≥1g per dose or ≥3g per day) is not recommended ) . The combined use of several NSAIDs may increase the risk of gastrointestinal ulcers and bleeding due to a synergistic effect.

Corticosteroids (eg, glucocorticosteroids)

Use with caution in combination with corticosteroids because of the high risk of bleeding or gastrointestinal ulceration.

Oral anticoagulants, heparin used in geriatrics at therapeutic doses

There is a markedly increased risk of bleeding, NSAIDs may increase the effect of anticoagulants such as warfarin. The use of NSAIDs and anticoagulants or heparin concomitantly in the elderly or at therapeutic doses is not recommended and caution is required due to the increased risk of bleeding.

In the event that it is impossible to avoid a combination of drugs, careful monitoring of the blood test – INR (International Normalized Ratio) is required.

Thrombolytics and antiplatelet drugs

Increased risk of bleeding.

Selective serotonin reuptake inhibitors (SSRIs)

Increased risk of gastrointestinal bleeding.

Diuretics, ACE inhibitors and angiotensin II antagonists

NSAIDs may decrease the effect of diuretics and other antihypertensives. In some patients with impaired renal function (eg, dehydrated or elderly with impaired renal function), concomitant use of ACE inhibitors or angiotensin II receptor antagonists and substances that inhibit cyclooxygenase may lead to further impairment of kidney function, including acute forms (acute renal failure), which are usually reversible. Therefore, such drugs should be combined with caution, especially in the elderly. At the start of combination therapy, and thereafter, patients should drink adequate amounts of water and their renal function should be monitored.

Other antihypertensive drugs (including beta-blockers)

May reduce the antihypertensive effect of beta-blockers

Calcineurin inhibitor (eg, cyclosporine, tacrolium) The activity of calcineurin inhibitors may increase due to the use of NSAIDs as a result of activation action of renal prostaglandins. When combining these drugs with NSAIDs, it is necessary to monitor kidney function, especially in the elderly.

Intrauterine devices

NSAIDs have been reported to reduce the effect of intrauterine contraceptives.

Lithium

NSAIDs may increase blood levels of lithium by reducing its excretion in the urine, which may subsequently increase the toxicity of lithium preparations. It is not recommended to combine lithium and NSAIDs. If co-administration is necessary, plasma lithium concentrations should be closely monitored at the start of administration by adjusting the intake or withdrawal of Meloxicam-Teva.

Methotrexate

NSAIDs can eliminate methotrexate from the body, and therefore increase the concentration of methotrexate in the blood before the toxic effects of methotrexate are manifested. For this reason, patients taking high doses of methotrexate (more than 15 mg/week) are not recommended for concomitant use of NSAIDs.

The risk of interaction between NSAIDs and methotrexate should also be considered in patients taking low doses of methotrexate, especially those with impaired renal function. If co-administration cannot be avoided, it is necessary to monitor the number of blood cells and kidney function. Special precautions are required in the case of simultaneous use of methotrexate and NSAIDs for 3 days, due to the risk of toxicity associated with an increase in plasma levels of methotrexate.

Cholestyramine

Cholestyramine accelerates the elimination of Meloxicam-Teva, causes an increase in the excretion of Meloxicam-Teva by 50%, and the half-life is reduced to 13 + 3 hours.

No clinically significant drug interactions were found when antacids, cimetidine and digoxin were coadministered.

Oral antidiabetic agents (sulfonylurea derivatives)

The possibility of drug interactions can be expected in the case of the use of Meloxicam-Teva in combination with oral antidiabetic agents (sulfonylurea drugs, nateglinide), which can lead to an increase in the level of these drugs and Meloxicam-Teva in blood. Patients taking Meloxicam with a sulfonylurea or nateglinide should be carefully monitored for the possibility of hypoglycemia.

Special warnings

Adverse events can be reduced by using the lowest effective dose of Meloxicam-Teva with the minimum duration of treatment.

In case of insufficient therapeutic effect, do not exceed the maximum recommended daily dose or add additional NSAIDs, as this may increase the toxicity of the drug. The simultaneous use of Meloxicam-Teva with NSAIDs, including selective cyclooxygenase-2 (COX-2) inhibitors, should be avoided.

If there is no improvement after a few days of using Meloxicam-Teva, the benefit of treatment should be reviewed by a physician.

Before treatment with Meloxicam-Teva, it is necessary to make sure that there is no exacerbation of esophagitis, gastritis and / or gastric and duodenal ulcers. Attention should be paid to patients who have previously had such diseases. without or with warning symptoms, or with a history of serious gastrointestinal disease.

The risk of gastrointestinal bleeding, ulceration, or perforation is increased with higher doses of NSAIDs in patients with a history of ulcers, especially those with complications such as bleeding or perforation, and in elderly patients. In these patients, the course of treatment should be started with a minimum dose. For these patients, as well as for patients requiring concomitant use of low-dose aspirin or other drugs that may increase gastrointestinal risk, combination therapy with oxidation inhibitors (eg, misoprostol or proton pump inhibitors) should be considered.

Patients with a history of gastrointestinal disease, and especially the elderly, should report all unusual gastric symptoms (especially gastrointestinal bleeding) from the first day of treatment.

Caution should be exercised in patients taking drugs that may increase the risk of ulceration or bleeding, such as heparin as a radical treatment or in geriatrics, anticoagulants such as warfarin, or other non-steroidal anti-inflammatory drugs, including acetylsalicylic acid at an anti-inflammatory dose (≥ 500 mg single dose or ≥ 3 g daily dose).

If gastrointestinal bleeding or ulcers occur in patients taking Meloxicam-Teva, treatment should be discontinued.

NSAIDs should be used with caution in patients with a history of gastrointestinal disease (ulcerative colitis, Crohn’s disease), as these conditions may worsen.

Cardiovascular and cerebrovascular disorders

taking NSAIDs.

It is recommended to monitor blood pressure in patients at risk at the beginning of Meloxicam-Teva.

The use of some NSAIDs, including meloxicam (especially at high doses and with long-term use) may be associated with the risk of arterial thrombosis (including myocardial infarction and stroke). There is not enough data to exclude this risk from taking Meloxicam-Teva.

Meloxicam-Teva should only be used in patients with uncontrolled hypertension, congestive heart failure, established coronary artery disease, and/or cerebrovascular disease after careful consideration and risk assessment. Careful examination should also be carried out before long-term treatment for patients with risk factors for cardiovascular disease (for example, hypertension, hyperlipidemia, diabetes mellitus and smoking).

Skin reactions

Life-threatening skin reactions (Stevens-Johnson syndrome (SS) and toxic epidermal necrolysis (TEN)) have been reported with Meloxicam-Teva. If symptoms or signs of SJS or TEN occur (for example, an increasing skin rash, often with blistering or mucosal lesions), the attending physician should be informed and treatment with Meloxicam-Teva should be discontinued. The appearance of such signs is possible in the first days of treatment.

If a patient has signs of SJS or TEN while taking Meloxicam-Teva, then repeated administration of the drug is prohibited.

Hepatic and renal function parameters

As with most NSAIDs, intermittent increases in blood transaminase, bilirubin, or other liver function parameters have been reported, as well as increases in blood creatinine and urea nitrogen, and other laboratory abnormalities. Most of these abnormalities in blood tests were short-term and insignificant. If one of these deviations is considered significant by the doctor, Meloxicam-Teva should be discontinued.

Functional renal failure

NSAIDs may cause functional renal failure by reducing glomerular filtration in the kidneys. This undesirable phenomenon depends on the dose of the drug. At the beginning of treatment or after increasing the dose, diuresis and renal function should be carefully monitored in patients at risk:

• Elderly
• Concomitant therapy with ACE inhibitors, angiotensin II antagonists, sartans, diuretics. Interaction with other medical drugs and other forms of interaction)
• Hypovolemia (regardless of cause)
• Congestive heart failure
• Renal failure
• Nephrotic syndrome
• Systemic lupus erythematosus nephropathy
• Severe hepatic dysfunction (s serum albumin <25 g/L or ≥10 Child-Pugh)

Rarely, NSAIDs can cause interstitial nephritis, glomerulonephritis, renal papillary necrosis, or nephrotic syndrome.

The dose of Meloxicam-Teva in patients with end-stage renal disease or hemodialysis should not exceed 7.5 mg. For patients with mild to moderate renal insufficiency, a dose reduction is not required (i.e. patients with creatinine clearance above 25 ml / min).

Retention of sodium, potassium and water in the body

While taking NSAIDs, there may be a retention of sodium, potassium and water in the body, as well as a decrease in the effect of taking diuretics, antihypertensive drugs. Therefore, for patients at risk, supervision by a doctor is necessary.

Hyperkalemia

Hyperkalemia occurs more often in patients with diabetes mellitus or with the simultaneous use of drugs that cause an increase in the level of potassium in the blood. In such cases, monitoring of potassium levels is carried out.

Combination with pemetrexed

In patients with mild or moderate renal impairment receiving pemetrexed, Meloxicam-Teva should be discontinued at least 5 days before and 2 days after the day of pemetrexed administration.

Pediatric use

Meloxicam-Teva is contraindicated in children and adolescents under 18 years of age.

During pregnancy or lactation

Taking Meloxicam-Teva during early pregnancy may increase the risk of miscarriage, heart defects and gastroschisis. The absolute risk of developing an abnormality of the cardiovascular system rises from 1% to about 1.5%. It is assumed that the risk of abnormalities increases due to the high dose and longer treatment.

Meloxicam-Teva should be avoided, unless clearly necessary, during the first and second trimesters of pregnancy. If a woman is taking Meloxicam-Teva during pregnancy planning, or in the first or second trimester of pregnancy, the dose should be minimal and the duration of treatment short.

In the third trimester of pregnancy, prostaglandin synthesis inhibitors may

In the fetus increase the risk of:

• malformations with early closure of the ductus arteriosus and pulmonary hypertension;
• impaired renal function, followed by a complication in the form of renal failure with oligohydroamniosis.
  • prolongation of bleeding time, antiplatelet effect may occur even at low doses;

In a mother in the last stages of pregnancy:

• weakening of uterine contractions with a subsequent effect on the duration of labor.

Therefore, Meloxicam-Teva is contraindicated in the third trimester of pregnancy.

Meloxicam-Teva passes into breast milk. Therefore, it is not recommended for women who are breastfeeding.

Meloxicam-Teva tablets contain lactose monohydrate. Patients with rare hereditary problems of galactose intolerance, lactase deficiency or glucose-galactose malabsorption are not recommended to take this medicine.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous machinery

Meloxicam-Teva is unlikely to affect the ability to drive a vehicle or use machinery. However, in case of visual impairment or drowsiness, vertigo or other disorders of the central nervous system, it is recommended to refrain from driving and driving.

Directions for use

Dosing regimen 1 tablet of 7.5 mg). If necessary, in the absence of improvement, the dosage can be increased to 15 mg / day (2 tablets of 7.5 mg).

Rheumatoid arthritis, ankylosing spondylitis:

15 mg daily (2 x 7. 5 mg tablets) (see also Special Populations). In accordance with the response to treatment, the dose may be reduced to 7.5 mg once a day (1 tablet of 7.5 mg).

Adolescents (from 16 years of age): The maximum daily dose is 0.25 mg/kg, not to exceed 15 mg.

The duration of the drug is individual and determined by the attending physician.

Special patient populations

Elderly patients and patients at increased risk of developing adverse events

For the elderly, the recommended dose is 7.5 mg/day. For patients in the category of increased risk of developing adverse events, treatment is carried out at a dose of 7.5 mg.

Patients with impaired renal function

For patients with impaired renal function undergoing hemodialysis, the dose should not exceed 7.5 mg/day. There is no need to reduce the dose for patients with mild to moderate renal impairment (for example, patients whose creatinine clearance exceeds 25 ml / min). For patients with severe renal insufficiency without dialysis, the drug is contraindicated.

Patients with hepatic impairment

No dose reduction is necessary in patients with mild to moderate hepatic impairment. For patients with severe hepatic insufficiency, the drug is contraindicated.

Pediatric patients

Meloxicam-Teva is contraindicated in children and adolescents under 16 years of age.

Method and route of administration

For oral administration.

Tablets should be taken with food, with water or other liquid.

Duration of treatment

Treatment is usually limited to a maximum duration of treatment of 2-3 days

Measures to be taken in case of overdose

Symptoms of acute NSAID overdose are generally limited to the following: drowsiness, dryness in the mouth, nausea, vomiting and pain in the epigastric region, which can be cured by symptomatic therapy. Possible gastrointestinal bleeding. Severe poisoning may develop leading to hypertension, acute renal failure failure, hepatic dysfunction, respiratory depression, coma, convulsions, cardiovascular failure and cardiac arrest. Anaphylactoid reactions have been reported in the treatment of NSAIDs, which can also occur with overdose.

Patients with NSAID overdose should receive symptomatic and supportive treatment.

Accelerated excretion of Meloxicam-Teva is possible after ingestion of cholestyramine (4 g, 3 times a day).

Ask your doctor or pharmacist for advice before taking this medicine.

Description of adverse reactions that occur with the standard use of the drug and measures to be taken in this case (if necessary)

The distribution of adverse reactions based on the frequency of occurrence is given below:

9 0011 Very common

• dyspepsia, nausea, vomiting, abdominal pain, constipation, flatulence, diarrhea

Common

Headache

–

Uncommon

Anemia with anaphylactic or anaphylactoid reaction

– dizziness, drowsiness

– vertigo

– increased arterial pressure, hyperemia

– concealed or profuse bleeding from the gastrointestinal tract, stomatitis, gastritis, belching

– abnormal liver function (for example, increased transaminase or bilirubin)

– Quincke’s edema, itching, rash

– sodium and water retention in the body, hyperkalemia, increased creatinine, blood urea

– edema, including edema of the lower extremities

– leukopenia, thrombocytopenia

– mood swings, nightmares in sleep

– visual disturbances including blurred vision, conjunctivitis

– tinnitus

– palpitations

– asthma in persons allergic to aspirin or other NSAIDs

– colitis, peptic ulcer of the stomach and duodenum, esophagitis

– urticaria

Very rare tract, with severe consequences or death, especially in the elderly

– hepatitis

– bullous dermatitis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrosis

– acute renal failure, especially in patients with high risk factor

Unknown

• anaphylactic shock, anaphylactic/anaphylactoid reaction
• state of confusion, disorientation
• cases of heart failure, flushing
• pancrea titan
• photosensitivity reaction

Contact a healthcare professional if adverse drug reactions occur , a pharmaceutical worker or directly to the information database on adverse reactions (actions) to drugs, including reports of drug failure

RSE on REM “National Center for Expertise of Medicines and Medical Devices” http://www. ndda.kz

Additional information

Composition of the drug

One tablet contains

active substance – meloxicam 7.5 mg or 15 mg

excipients : sodium citrate, lactose monohydrate, microcrystalline cellulose (Avicel PH 102), povidone (PVP K-30), crospovidone, anhydrous colloidal silicon (Aerosil 200) , magnesium stearate.

Description of appearance, smell, taste

Round, flat, yellow marbled tablets with beveled, scored on one side and engraved “MLX 7.5” on the other side (for dosage 7.5 mg).

Yellow marbled oval tablets, scored on one side and engraved with “MLX 15” on the other side (for 15 mg dosage).

Form and packaging

10 tablets in a blister pack made of PVC/PE/PVDC film and aluminum foil.

2 blister packs, together with instructions for medical use in Kazakh and Russian, are put into a cardboard box.