Meloxicam: Difference between revisions

(Created page with "==Administration== *Type: NSAID *Dosage Forms: 7.5, 15mg *Routes of Administration: PO *Common Trade Names: Mobic, Vivlodex ==Adult Dosing== Osteoarthritis *7.5-15mg PO Q...")
 
 
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==Adult Dosing==
==Adult Dosing==
Osteoarthritis
===[[Osteoarthritis]]===
*7.5-15mg PO QD
*7.5-15mg PO QD
*Max 15mg/day
*Max 15mg/day


Rheumatoid arthritis
===[[Rheumatoid arthritis]]===
*7.5-15mg PO QD
*7.5-15mg PO QD
*Max 15mg/day
*Max 15mg/day


==Pediatric Dosing==
==Pediatric Dosing==
Juvenile idiopathic arthritis (>60kg)
===[[Juvenile idiopathic arthritis]](>60kg)===
*7.5mg PO QD
*7.5mg PO QD
*Max 7.5mg/day
*Max 7.5mg/day
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*Allergy to class/drug
*Allergy to class/drug
*ASA or NSAID-induced asthma or urticaria
*ASA or NSAID-induced asthma or urticaria
*pregnancy starting at 30wk gestation
*caution if:
*CABG surgery period use
**renal impairment, dehydration, elderly or debilitated
*caution in elderly or debilitated patients
**history of GI bleed or ulcers, alcohol use, or coagulopathy
*caution if renal impairment
**hepatic impairment
*caution if hepatic impairment
**asthma
*caution if asthma
**cardiovascular disease (or high risk of), including CABG surgery periop use, recent MI, CHF, HTN, smoker
*caution if recent MI
**fluid retention
*caution if cardiovascular dz
**PKU
*caution if cardiac dz risk
**prolonged use
*caution if HTN
*caution if CHF
*caution if fluid retention
*caution if GI bleeding or ulcer hx
*caution if coagulation disorder
*caution if dehydration
*caution if hypovolemia
*caution if smoker
*caution if alcohol use
*caution if prolonged use


==Adverse Reactions==
==Adverse Reactions==
===Serious===
'''Serious'''
*GI bleeding
*GI bleed, ulcer, perforation
*GI perforation/ulcer
*blood dyscrasias, prolonged bleeding time, anemia
*MI
*nephrotoxicity, renal papillary necrosis
*stroke
*MI, stroke, thromboembolism, HTN, CHF
*thromboembolism
*hepatotoxicity, hepatic necrosis, pancreatitis
*HTN
*CHF
*renal papillary necrosis
*nephrotoxicity
*hyperkalemia
*hepatotoxicity
*pancreatitis
*anaphylactoid rxn
*bronchospasm
*bronchospasm
*exfoliative dermatitis
*exfoliative dermatitis, SJS/TEN
*Stevens-Johnson syndrome
*toxic epidermal necrolysis
*anemia
*blood dyscrasias


===Common===
'''Common'''
*diarrhea
*dyspepsia, nausea/vomiting, abdominal pain, diarrhea, constipation, flatulence
*nausea
*headache, dizziness, drowsiness, tinnitus
*abdominal pain
*dyspepsia
*rash
*urticaria
*dizziness
*dizziness
*somnolence
*rash, pruritus, urticaria, photosensitivity
*ALT/AST elevation
*fluid retention, peripheral edema
*fluid retention
*edema
*tinnitus
*ecchymosis
*ecchymosis
*photosensitivity
*elevated creatinine, ALT/AST
*sinusitis
*vomiting (peds)
*vomiting (peds)
*headache (peds)
*headache (peds)
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*Metabolism: liver extensively; CYP450 (2C9, 3A4 substrate)
*Metabolism: liver extensively; CYP450 (2C9, 3A4 substrate)
*Excretion: urine (0.2% unchanged); feces (1.6% unchanged)
*Excretion: urine (0.2% unchanged); feces (1.6% unchanged)
*Mechanism of Action: exact MOA unknown; inhibits cyclooxyrgenase, reducing prostaglandin and thromboxane synthesis
*Mechanism of Action: exact MOA unknown; inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis


==Comments==
==Comments==


==See Also==
==See Also==
[[NSAID]]
*[[NSAID]]
*[[NSAID toxicity]]


==References==
==References==
<references/>
<references/>
[[Category:Pharmacology]]
[[Category:Pharmacology]]

Latest revision as of 22:56, 7 March 2021

Administration

  • Type: NSAID
  • Dosage Forms: 7.5, 15mg
  • Routes of Administration: PO
  • Common Trade Names: Mobic, Vivlodex

Adult Dosing

Osteoarthritis

  • 7.5-15mg PO QD
  • Max 15mg/day

Rheumatoid arthritis

  • 7.5-15mg PO QD
  • Max 15mg/day

Pediatric Dosing

Juvenile idiopathic arthritis(>60kg)

  • 7.5mg PO QD
  • Max 7.5mg/day

Special Populations

Renal Dosing

  • Adult:
    • mild-mod impairment: no adjustment
    • CrCl <15: avoid use
    • HD: max 7.5mg/day
  • Pediatric: see Adult dosing

Hepatic Dosing

  • Adult:
    • Child-Pugh Class A or B: no adjustment
    • Child-Pugh Class: not defined
  • Pediatric: see Adult Dosing

Contraindications

  • Allergy to class/drug
  • ASA or NSAID-induced asthma or urticaria
  • caution if:
    • renal impairment, dehydration, elderly or debilitated
    • history of GI bleed or ulcers, alcohol use, or coagulopathy
    • hepatic impairment
    • asthma
    • cardiovascular disease (or high risk of), including CABG surgery periop use, recent MI, CHF, HTN, smoker
    • fluid retention
    • PKU
    • prolonged use

Adverse Reactions

Serious

  • GI bleed, ulcer, perforation
  • blood dyscrasias, prolonged bleeding time, anemia
  • nephrotoxicity, renal papillary necrosis
  • MI, stroke, thromboembolism, HTN, CHF
  • hepatotoxicity, hepatic necrosis, pancreatitis
  • bronchospasm
  • exfoliative dermatitis, SJS/TEN

Common

  • dyspepsia, nausea/vomiting, abdominal pain, diarrhea, constipation, flatulence
  • headache, dizziness, drowsiness, tinnitus
  • dizziness
  • rash, pruritus, urticaria, photosensitivity
  • fluid retention, peripheral edema
  • ecchymosis
  • elevated creatinine, ALT/AST
  • sinusitis
  • vomiting (peds)
  • headache (peds)
  • fever (peds)
  • delayed ovulation

Pharmacology

  • Half-life: 15-20 hours
  • Metabolism: liver extensively; CYP450 (2C9, 3A4 substrate)
  • Excretion: urine (0.2% unchanged); feces (1.6% unchanged)
  • Mechanism of Action: exact MOA unknown; inhibits cyclooxygenase, reducing prostaglandin and thromboxane synthesis

Comments

See Also

References

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