Meloxicam: Difference between revisions
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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 | ||
| Line 65: | Line 65: | ||
*headache, dizziness, drowsiness, tinnitus | *headache, dizziness, drowsiness, tinnitus | ||
*dizziness | *dizziness | ||
*rash, | *rash, pruritus, urticaria, photosensitivity | ||
*fluid retention, peripheral edema | *fluid retention, peripheral edema | ||
*ecchymosis | *ecchymosis | ||
| Line 79: | Line 79: | ||
*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 | *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
- Pregnancy Rating: C, category D if >30wk gestation
- Lactation risk: safety unknown, inadequate literature available to assess risk
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