Meloxicam: Side Effects, Uses, Interactions, Warnings

Meloxicam

Generic Name: Meloxicam

Brand Names: Mobic, Anjeso

Ingredients: Meloxicam

Drug Class: Nonsteroidal anti-inflammatory drugs (NSAID)

Controlled Status: Not a Controlled Substance

Availability: Prescription Medication only

What is Meloxicam?

Meloxicam is the active ingredient of this medication, classified under the drug class of nonsteroidal anti-inflammatory drugs (NSAID). The generic name of this drug is Meloxicam, and it is available under the brand names Mobic and Anjeso. It is primarily offered in oral tablet form in strengths of 7.5 mg and 15 mg,  Tablet Suspension, Capsule and  Disintegrating. Not a controlled substance, this medication is available solely as a prescription medicine.

Meloxicam is prescribed to alleviate pain, tenderness, swelling, and stiffness associated with osteoarthritis and rheumatoid arthritis. It is also employed to relieve these symptoms in juvenile rheumatoid arthritis among children aged 2 years and older. 

Common side effects associated with meloxicam encompass abdominal pain, diarrhea, indigestion or heartburn, nausea, dizziness, headache, and itching or rash.

Meloxicam received its patent in 1977 and was sanctioned for medical use in the United States in 2000. Initially developed by Boehringer Ingelheim, it has been made available as a generic medication.

What is Meloxicam Used for?

Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) primarily used to relieve pain and inflammation associated with conditions like osteoarthritis and rheumatoid arthritis. Its primary application is to manage the symptoms of these arthritic conditions, including pain, swelling, and stiffness.

Additionally, meloxicam is prescribed as a secondary treatment for juvenile rheumatoid arthritis in children aged two and above, providing relief from similar symptoms experienced in this pediatric form of arthritis. Other less common uses for meloxicam include its application in moderate-to-severe pain management, typically used in the short term. However, its utility for these purposes might vary based on individual patient needs and the assessment of healthcare professionals. Always consult with a medical provider for guidance on the appropriate usage and dosing for these diverse conditions.

How does Meloxicam  Work?

Meloxicam works by inhibiting the enzyme cyclooxygenase (COX), which is responsible for producing prostaglandins, mediators of inflammation, from arachidonic acid. It is particularly effective in selectively inhibiting COX-2 over COX-1, especially at low therapeutic doses which is thought to explain why meloxicam has generally less stomach and kidney side effects compared to other NSAIDs.

Meloxicam  Dosage

Meloxicam is available in different formulations. It comes in an oral suspension presented in a 100ml bottle, where each 5ml of the suspension contains 7.5mg of Meloxicam. It’s also available in capsule form, with doses of 5mg and 10mg. Additionally, Meloxicam can be found in tablet form, with strengths of 7.5mg and 15mg. Moreover, your dosage might vary if you have kidney problems.

For more information about Meloxicam Dosage

For Meloxicam capsules

• Osteoarthritis Pain: Initial dose is 5 mg once daily by mouth. Maximum dose is 10 mg per day.

For Meloxicam tablets and suspension

• Each 5 mL of suspension holds 7.5 mg of Meloxicam.
• Pain from rheumatoid arthritis or osteoarthritis: Usual dosage is 7.5 mg to 15 mg taken orally once daily. Maximum daily dose is 15 mg.
• Juvenile rheumatoid arthritis (children over 60 kg): Usual dose is 7.5 mg once daily. Maximum daily dose is 7.5 mg.
• Juvenile rheumatoid arthritis (children under 60 kg): Your child’s dose will be determined by their weight, typically at 0.125 mg/kg of body weight daily. Maximum daily dose is 7.5 mg.

Anjeso (meloxicam) injection

• For moderate to severe pain: The typical dose is 30 mg administered into the veins (IV) over 15 seconds, once daily by a healthcare professional.

What are the Side Effects of Meloxicam? 

Meloxicam can lead to both mild and severe side effects. The subsequent roster outlines significant side effects that might arise while taking meloxicam, yet it does not encompass all potential side effects. For more insights into the possible impacts of meloxicam or suggestions for managing concerning side effects, consult your doctor or pharmacist.

The more prevalent side effects may involve abdominal pain, diarrhea, indigestion, nausea, dizziness, headache, itching, or rash. If these effects are mild, they might dissipate within a few days or weeks.

However, if they persist or become more severe, consult your doctor or pharmacist. Serious side effects necessitating immediate medical attention include symptoms associated with heart attack, stroke, stomach and intestinal issues like bleeding or ulcers, liver damage, increased blood pressure, water retention, skin problems, kidney damage, and decreased red blood cells. It’s crucial to seek medical help promptly if any of these severe side effects occur, especially if the symptoms feel life-threatening or indicate a medical emergency.

For more information about Meloxicam side effects

How to Use Meloxicam?

Take Meloxicam precisely as directed by your doctor, adhering to the prescription label instructions and comprehending all medication guides. The oral form of Meloxicam is ingested by mouth, while the injectable form is administered through a vein infusion by a healthcare professional. Any change in brand, strength, or form of Meloxicam may alter your required dose, so ensure you use the medicine prescribed by your doctor to avoid errors. Dosage may vary based on weight, especially in children and adolescents, and can be influenced by weight changes. Long-term use might necessitate regular medical tests. Store oral suspension, tablets, or capsules at room temperature, guarding them from moisture and heat by keeping the bottle securely closed when not in use.

What Happens if I Miss a Dose of Meloxicam? 

Take the medicine as soon as possible. However, if it’s nearly time for your next scheduled dose, skip the missed dose. Avoid taking two doses at the same time.

What Happens if I Overdose Meloxicam? 

Symptoms of a Meloxicam overdose may include various severe conditions such as blue lips, fingernails, or skin, pain in the chest, upper stomach, or throat, rapid weight gain, severe stomach pain, seizures, slow or fast heartbeat, as well as swelling around the eyes, face, lips, or tongue. If any of these symptoms occur, seek immediate medical attention or contact emergency services.

In case of a medical emergency, please seek immediate medical assistance or contact the Poison Help Line at 1-800-222-1222. Information is also available online at poisonhelp.org. Nevertheless, if you are experiencing severe symptoms, please do not hesitate to dial 911 (or your Local Emergency Number) immediately or proceed to the nearest emergency room for immediate medical attention. Your safety and well-being are paramount.

Pros and Cons of Meloxicam 

Pros	Cons
Cost Effective (Generic form) and taken once a day only	Prescription Medication only and Unsafe during Pregnancy
Causes less stomach upset compared to  some other NSAIDs	Might not be the best option for geriatric age group or have kidney, heart, liver, or bleeding problems
Effectively alleviates pain stemming from various forms of arthritis	Different dosage forms  (e.g., capsules, liquid) might not act as replacement for one another

Interaction between Meloxicam  and other Drugs

Combining this medicine with any of the following medicines is generally not advised, although there might be cases where it is necessary. If both medicines are prescribed together, your doctor may modify the dosage or the frequency of use for one or both of the medicines.

• Abciximab
• Aceclofenac
• Acemetacin
• Acenocoumarol
• Amiloride
• Amineptine
• Amitriptyline
• Amitriptylinoxide
• Amoxapine
• Amtolmetin Guacil
• Anagrelide
• Apixaban
• Ardeparin
• Argatroban
• Aspirin
• Balsalazide
• Bemetizide
• Bemiparin
• Bendroflumethiazide
• Benzthiazide
• Betamethasone
• Betrixaban
• Bismuth Subsalicylate
• Bivalirudin
• Bromfenac
• Budesonide
• Bufexamac
• Bumetanide

Combining this medicine with certain other medicines might elevate the risk of particular side effects. However, using both medications together could provide the best treatment for your condition. If both medicines are prescribed simultaneously, your doctor may adjust the dosage or frequency of one or both medicines.

• Acebutolol
• Atenolol
• Azilsartan
• Azilsartan Medoxomil
• Benazepril
• Betaxolol
• Bisoprolol
• Candesartan
• Captopril
• Carteolol
• Carvedilol
• Celiprolol
• Cholestyramine
• Enalapril
• Enalaprilat
• Eprosartan
• Esmolol
• Fosinopril
• Irbesartan
• Itraconazole
• Labetalol
• Levobunolol
• Lisinopril
• Losartan
• Metipranolol
• Metoprolol
• Moexipril
• Nadolol
• Nebivolol
• Olmesartan
• Oxprenolol
• Penbutolol
• Perindopril
• Pindolol
• Propranolol
• Quinapril
• Ramipril
• Sotalol
• Spirapril
• Telmisartan
• Timolol
• Trandolapril
• Valsartan
• Voriconazole

What are the Risks and Warnings for Meloxicam?

Meloxicam  and Allergy Warning

Some individuals might experience an allergic reaction to meloxicam. Mild allergic reactions could show as a skin rash, itchiness, or temporary flushing. Though uncommon, severe allergic reactions can present as swelling under the skin, often around the eyelids, lips, hands, or feet, and can also affect the tongue, mouth, or throat, potentially causing breathing difficulties.

Furthermore, severe skin reactions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) have been linked to meloxicam. These specific allergic reactions are serious and demand immediate medical attention. Symptoms of SJS and TEN may include skin rash with blistering, fever, body aches, red or stinging eyes, general feelings of being unwell, sore throat, and headaches.

Meloxicam  and Alcohol Warning

While using meloxicam, avoid alcohol consumption, as it can heighten the risk of stomach bleeding associated with the medication. Promptly contact your doctor if you experience signs of stomach or intestinal bleeding, such as black, bloody, or tarry stools, or if you cough up blood or vomit resembling coffee grounds. Inform your doctor about all medications, including vitamins and herbal supplements, that you are taking. Always consult your doctor before discontinuing any medication.

Meloxicam  and Birth Control Needs

Meloxicam might not be suitable for routine birth control purposes. However, inhibiting COX-2 pharmacologically could serve as an emergency contraception method for women. The potential implication is that COX-2 inhibitors can affect ovulation, but the direct contraceptive effectiveness of these types of medications has not been thoroughly tested. If considering birth control methods, it’s crucial to consult with a healthcare professional to explore suitable and tested contraceptive options rather than relying on meloxicam as a primary contraceptive.

Warning with People with Certain Health Conditions

• For individuals with heart or blood vessel diseases: This medication heightens the risk of blood clotting, which could result in a heart attack or stroke. It may also lead to fluid retention, which is a common occurrence in heart failure.
• For those with high blood pressure: This medication may exacerbate your blood pressure, increasing the risk of a heart attack or stroke.
• For those with stomach ulcers or bleeding: Meloxicam can exacerbate these conditions. If you have a history of these issues, there is a greater chance of their recurrence when taking this medicine.
• For individuals with liver damage: Meloxicam can contribute to liver disease and affect liver function. It may intensify existing liver damage.
• For those with kidney disease: Prolonged use of meloxicam can diminish kidney function, exacerbating kidney disease. Ceasing this drug may reverse any kidney damage caused by the medication.
• For those with asthma: Meloxicam can cause bronchial spasm and breathing difficulties, particularly if your asthma worsens upon taking aspirin.

There are 12 known disease interactions with meloxicam, encompassing various health conditions that may interact with this medication:

• Asthma
• Fluid Retention
• GI Toxicity
• Rash
• Renal Toxicities
• Thrombosis
• Anemia
• Heart Failure
• Hepatotoxicity
• Hyperkalemia
• Hypertension
• Platelet Aggregation Inhibition

Warning with other Groups

Meloxicam  and Breastfeeding

For breastfeeding individuals, it remains uncertain if meloxicam transfers into breast milk. If it does, it might lead to potential side effects in your child if you breastfeed while taking meloxicam. Your healthcare provider and you should collectively decide whether to continue meloxicam treatment or breastfeeding, considering the associated risks and benefits.

Meloxicam  and Pregnancy

For pregnant individuals, the use of meloxicam during the third trimester increases the likelihood of adverse effects on the pregnancy. It is strongly advised not to take meloxicam after reaching the 30th week of pregnancy. It’s crucial to discuss meloxicam usage during pregnancy with your healthcare provider. Meloxicam should only be considered during pregnancy if the potential benefits outweigh the potential risks.

If you are attempting to conceive, it’s important to consult with your doctor. Meloxicam has the potential to cause a temporary delay in ovulation. If you’re experiencing difficulty conceiving or undergoing infertility tests, avoid taking meloxicam until discussing it with your healthcare professional.

Meloxicam and Geriatric Age Group

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

Meloxicam and Pediatric Age Group 

For treating juvenile idiopathic arthritis (JIA), this medication has been determined as safe and effective for children aged 2 years and above. However, it is not recommended for use in children under 2 years old. Conversely, for other medical conditions, the drug has not shown to be safe or effective for children of any age and should not be administered to individuals under 18 years old.

Expiration, Storage and Disposal

The expiration date for meloxicam, as with most medications, is usually printed on the packaging or on the bottle label. It indicates the date until which the manufacturer guarantees the full potency and safety of the drug. Expired medications may not be as effective and can even be unsafe to use, potentially leading to adverse health effects. It’s advisable to discard medications, including meloxicam, once they have passed their expiration date.

Store this medication at room temperature, which is around 77°F (25°C). For short periods, it can be kept at temperatures between 59°F and 86°F (15°C and 30°C) if necessary. Keep this medication stored in its original container, tightly closed, and placed out of the reach of children. Store it at room temperature, away from excessive heat and moisture, and avoid keeping it in the bathroom. Some containers are not child-resistant, and young children can easily open them. To prevent accidental poisoning in young children, always lock safety caps and store the medication in a safe place, ensuring it’s up and away, out of their sight and reach. Visit http://www.upandaway.org to learn more. 

Dispose of any unneeded medications in a way that prevents access by pets, children, or other individuals. Never flush medications down the toilet. The best method for disposal is through a medicine take-back program. Discuss available take-back programs in your community with your pharmacist or local garbage/recycling department. If you lack access to a take-back program, refer to the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for additional guidance.

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What are the Alternatives of Meloxicam?

• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Naprosyn)
• Diclofenac (Voltaren)
• Celecoxib (Celebrex)
• Acetaminophen (Tylenol)

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