Meloxicam

Meloxicam is a prescription medication used to relieve the pain and swelling of osteoarthritis and rheumatoid arthritis. Meloxicam belongs to a group of medications called non-steroidal anti-inflammatory drugs (NSAIDs), which work by stopping substances in your body that cause inflammation and pain.

This medication comes in tablet, capsule and oral suspension forms and is taken once a day, with or without food.

Common side effects of meloxicam include diarrhea, upset stomach, and upper respiratory infections.

Meloxicam can cause dizziness. Do not drive or operate heavy machinery until you know how meloxicam will affect you.

Meloxicam is a prescription medication used to relieve symptoms of:

• osteoarthritis (arthritis from the damage of joint linings)
• rheumatoid arthritis (arthritis from the swelling of joint linings)
• juvenile rheumatoid arthritis in children 2 years of age and older

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Meloxicam may be found in some form under the following brand names:

• Loxicom

• Metacam

• Mobic

• Vivlodex

Serious side effects have been reported with meloxicam. See “Drug Precautions” section.

Common side effects of meloxicam include:

• diarrhea
• upper respiratory infection
• upset stomach
• flu-like symptoms
• edema, or swelling
• stomach pain
• gas
• digestive problems
• heartburn
• nausea
• headache
• dizziness
• joint pain
• urinary tract infections

This is not a complete list of meloxicam side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• ACE inhibitors such as lisinopril (Prinivil), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec) and others
• angiotensin II receptor blockers (ARBs) such as candesartan (Atacand), irbesartan (Avapro) and others
• beta blockers such as atenolol (Tenormin), metoprolol (Lopressor, Toprol XL) and others
• aspirin (Ecotrin) and other non-steroidal anti-inflammatory drugs (NSAIDs)
• diuretics, or water pills, such as thiazides (hydrochlorothiazide) and furosemide (Lasix)
• lithium (Eskalith, Lithobid, others)
• methotrexate (Rheumatrex, Trexall)
• cyclosporine (Neoral, Gengraf, Sandimmune)
• warfarin (Coumadin)
• cholestyramine (Questran)
• cimetidine (Tagamet)
• digoxin (Digitek, Lanoxin)

This is not a complete list of meloxicam drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with meloxicam including:

• Cardiovascular thrombotic events. Meloxicam can increase your risk of cardiovascular and heart diseases such as strokes and myocardial infarctions, which can lead to death. Tell your doctor if you have a history of heart disease.
• Gastrointestinal effects. Meloxicam can cause digestive tract problems such as ulcers, bleeding, inflammation, and perforations (small holes). Tell your doctor if you have a history of digestive problems, or if you smoke or frequently drink alcohol. Alert your doctor if you take anticoagulants (blood-thinners) or corticosteroids such as prednisone.
• Hepatic events. Meloxicam c­­an cause damage to the liver and increase liver tests. Tell your doctor if you have a history of liver disease.
• Hypertension. Meloxicam may raise your blood pressure. Tell your doctor if you have a history of high blood pressure or take ACE inhibitors (such as lisinopril and enalapril) or diuretics (water pills).
• Congestive heart failure and edema. Meloxicam can increase the chance of congestive heart failure, fluid retention, and weight gain.
• Renal effects. Kidney damage can result from the use of meloxicam. Tell your doctor if you have a history of kidney disease or take ACE inhibitors (such as lisinopril and enalapril) or diuretics (water pills).
• Hypersensitivity reaction. An allergic reaction to meloxicam can occur. Symptoms of a hypersensitivity reaction include:
  • hives
  • rash
  • difficulty breathing or swallowing
  • itching
  • swelling
• Adverse skin reactions. Meloxicam can lead to dangerous skin reactions. Symptoms of a skin reaction include:
  • rash
  • red, itchy, or scaly skin
  • blisters
  • fever
• Pregnancy. Meloxicam is not recommended to be taken past the 30th week of pregnancy.

Meloxicam can cause dizziness. Do not drive or operate heavy machinery until you know how meloxicam affects you.

Do not take meloxicam if you:

• are allergic to meloxicam
• have a history of asthma, hives, or other allergic-type reactions after taking aspirin or other NSAIDs
• will have or have recently had coronary (heart) surgery

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of meloxicam, there are no specific foods that you must exclude from your diet when receiving meloxicam.

Before taking meloxicam tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to meloxicam or to any of its ingredients
• have a history of heart, liver, or kidney disease
• have a history of gastrointestinal (digestive) problems
• have high blood pressure
• have a history of asthma
• take ACE inhibitors such as lisinopril (Prinivil) and enalapril (Vasotec)
• take aspirin (Ecotrin) and other non-steroidal anti-inflammatory drugs (NSAIDs)
• take diuretics, or water pills, such as thiazides (hydrochlorothiazide) and furosemide (Lasix)
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Meloxicam falls into category C before the 30th week of pregnancy and category D after the 30th week.

Pregnancy Category C before the 30th week of pregnancy: Studies in animals have shown a harmful and undesired effect on the unborn baby, yet there are no adequate and well-controlled studies in pregnant women. This medication may be given to a pregnant woman if her healthcare provider believes that its benefits to the pregnant woman outweigh any possible risks to her unborn baby.

Pregnancy Category D after the 30th week of pregnancy: Meloxicam should be avoided during the third trimester of pregnancy. There is evidence of risk to the unborn baby based on studies in humans or adverse reaction data. 

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if meloxicam passes into your breast milk. You and your doctor should decide if you will take meloxicam or breastfeed. You should not do both without talking to your doctor.

Take meloxicam exactly as prescribed.

• This medication comes in tablet, capsule and oral suspensions forms and is taken once a day, with or without food.
• This medication may be taken with food to help prevent upset stomach. 
• Make sure to shake well before use when taking the oral suspension of meloxicam. 
• Capsules are not interchangeable with other formulations of oral meloxicam even if the total milligram strength is the same. Do not substitute similar dose strengths of other meloxicam products.
• If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of meloxicam at the same time.

Take meloxicam exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

Your doctor will prescribe the appropriate dose of meloxicam depending on the severity of your arthritis and your response to the medication.

Adults: The dosage range of meloxicam is between 5 and 15 mg per day. 

• Osteoarthritis: The recommended starting dose of Vivlodex (meloxicam) capsules is 5 mg once daily. The maximum dose is 10 mg/day
• Osteoarthritis, rheumatoid arthritis: Tablet/Suspension: The recomended starting dose of Mobic (meloxicam) tablets and suspension is 7.5 mg once daily. The maximum dose is 15 mg/day. 

The dose will be lowerd for those patients with kidney problems (impairment).

For the treatment of children over two years old with juvenile rheumatoid arthritis, the child’s body weight will determine the dosage of the medication. The maximum daily dose in children is 7.5 mg.

If you take too much meloxicam, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store meloxicam at room temperature.
• Keep this medication in a dry place.
• Keep this and all medicines out of the reach of children.

Cardiovascular Risk:

NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk.

Meloxicam is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery.

Gastrointestinal Risk:

NSAIDs cause an increased risk of serious gastrointestinal 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 are at greater risk for serious gastrointestinal events.