Meloxicam functions as a nonsteroidal anti-inflammatory drug (NSAID) by decreasing the levels of hormones responsible for inducing pain, fever, and inflammation within the body. This medication is primarily utilized to alleviate discomfort, tenderness, swelling, and stiffness resulting from osteoarthritis – a type of arthritis triggered by the deterioration of joint linings.
It’s crucial to understand the appropriate dosing for both adults and pediatric patients, taking into account the various available forms and strengths of this medication.
We’ll also explore dosing considerations for special medical categories, ensuring that you receive the most accurate and tailored information to make informed decisions about your health.
Meloxicam Adult Dosing
Meloxicam Adult Dose for Osteoarthritis and Rheumatoid Arthritis
Osteoarthritis Dosage for Adults
Oral Tablets and Oral Disintegrating Tablets
- Initial dose: Take 7.5 mg orally once daily
- Maintenance dose: Increase to 15 mg orally once daily for patients requiring additional pain relief
- Maximum dose: 15 mg orally once daily
Oral Capsules
- Initial dose: Consume 5 mg orally once daily
- Maintenance dose: Raise to 10 mg orally once daily for patients needing extra pain relief
- Maximum dose: 10 mg orally once daily
Rheumatoid Arthritis Dosage for Adults
Oral Tablets and Oral Disintegrating Tablets
- Initial dose: Take 7.5 mg orally once daily
- Maintenance dose: Increase to 15 mg orally once daily for patients requiring additional pain relief
- Maximum dose: 15 mg orally once daily
The comment emphasizes that oral forms of the medication do not have identical systemic exposure and therefore should not be considered interchangeable. It stresses the importance of utilizing the smallest effective dose for the briefest duration in line with the individual’s treatment objectives. Additionally, this medication is intended for alleviating the indications and symptoms associated with osteoarthritis pain.
| Condition | Oral Tablets and Disintegrating Tablets | Oral Capsules |
| Osteoarthritis | Initial dose: 7.5 mg once daily | Initial dose: 5 mg once daily |
| – | Maintenance dose: 15 mg once daily for additional analgesia | Maintenance dose: 10 mg once daily |
| – | Maximum dose: 15 mg once daily | Maximum dose: 10 mg once daily |
| Rheumatoid Arthritis | Initial dose: 7.5 mg once daily | – |
| – | Maintenance dose: 15 mg once daily for additional analgesia | – |
| – | Maximum dose: 15 mg once daily | – |
Meloxicam Adult Dose for Pain
The standard adult dosage for pain management involves a 30 mg intravenous (IV) bolus administered over 15 seconds once daily. It’s important to note that in clinical trials, the median time to achieve significant pain relief ranged from 2 to 3 hours.
In some cases, patients might not experience sufficient pain relief within the initial 24 hours, warranting the consideration of a non-NSAID with a faster onset. The recommendation underscores the necessity of using the smallest effective dose for the shortest feasible duration in line with the individual’s treatment objectives. This medication is employed for the management of moderate-to-severe pain, either independently or in conjunction with non-NSAID analgesics.
| Usual Adult Dose for Pain |
| 30 mg IV bolus (over 15 seconds) once a day |
Meloxicam Pediatric Dosing
The typical pediatric dosage for Juvenile Rheumatoid Arthritis in children aged 2 years or older involves the use of oral tablets or oral disintegrating tablets. For children weighing 60 kg or more, the recommended dose is 7.5 mg taken orally once a day. It’s important to note that there’s no additional demonstrated benefit with doses higher than 7.5 mg daily. The comment stresses that oral formulations do not exhibit equivalent systemic exposure and, as such, are not interchangeable. Specifically, the oral tablets should not be administered to children weighing less than 60 kg. This medication is used to alleviate the indications and symptoms associated with both periarticular or polyarticular course juvenile rheumatoid arthritis.
| Age Group | Medication Type | Dosage |
| 2 years or older | Oral Tablets and Oral Disintegrating Tablets | For children weighing 60 kg or more: 7.5 mg orally once a day |
| No additional benefit has been observed with doses exceeding 7.5 mg/day. |
Meloxicam Renal Dose Adjustments
For oral administration, individuals with mild to moderate renal dysfunction do not necessitate any dosage adjustment. However, in cases of severe renal dysfunction, the use of this medication is not recommended.
Concerning parenteral administration, those with mild renal impairment do not require any dose adjustment. Yet, for patients with moderate to severe renal impairment, particularly those at risk of renal failure due to reduced fluid volume, the use of this medication is contraindicated. Additionally, for individuals with moderate to severe renal impairment, the medication is not recommended.
Meloxicam Liver Dose Adjustments
For individuals with mild to moderate liver dysfunction, no dosage adjustment is recommended. However, in cases of severe liver dysfunction, caution is advised when using this medication, and careful monitoring for potential adverse effects is recommended.
Dialysis
Regarding dialysis, specifically hemodialysis, the maximum recommended dosage for individuals receiving oral tablets or oral disintegrating tablets is 7.5 mg taken orally once a day. Similarly, for oral capsules, the maximum recommended dose is 5 mg taken orally once daily. These dosage recommendations are particularly relevant for patients undergoing hemodialysis treatment.
| Dialysis | Hemodialysis |
| Oral Tablets and Oral Disintegrating Tablets | Maximum dose: 7.5 mg orally once a day |
| Oral Capsules | Maximum dose: 5 mg orally once a day |
Meloxicam Administration Advice
Guidance for administration of this medication is as follows:
- For tablets or capsules, take orally once a day, with or without food.
- For oral disintegrating tablets, take orally once a day, also with or without food. Do not remove the tablet from the blister pack until just before dosing. Use clean, dry hands to peel open the blister pack, remove the tablet, and place it on the tongue. There’s no need for liquid when taking this tablet.
- For parenteral injection, it should be administered solely via intravenous (IV) administration. Administer by IV bolus over 15 seconds. To mitigate the risk of toxicity, patients should be adequately hydrated before administration.
Precautions
US Boxed Warnings: Risk of Serious Cardiovascular and Gastrointestinal Events
Nonsteroidal anti-inflammatory drugs (NSAIDs) pose an increased risk of severe cardiovascular (CV) thrombotic events, such as myocardial infarction and stroke, which may be fatal. This risk might arise early during treatment and escalate with prolonged use. Specifically contraindicated in cases involving coronary artery bypass graft (CABG) surgery. Additionally, NSAIDs heighten the risk of serious gastrointestinal (GI) adverse events, including stomach or intestinal bleeding, ulceration, and perforation, which can be fatal. These events may occur at any time during usage without warning symptoms. Elderly patients and those with a history of peptic ulcer disease or GI bleeding face a heightened risk of severe GI events.
Oral Capsules and Parenteral Injection
- Safety and efficacy have not been established in patients younger than 18 years.
Oral Tablets and Oral Disintegrating Tablets
- Safety and efficacy established in pediatric patients aged 2 to 17 years with juvenile arthritis, although use is not recommended for patients weighing less than 60 kg.
