Meloxicam
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
- pregnancy starting at 30wk gestation
- CABG surgery period use
- caution in elderly or debilitated patients
- caution if renal impairment
- caution if hepatic impairment
- caution if asthma
- caution if recent MI
- caution if cardiovascular dz
- caution if cardiac dz risk
- 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
Serious
- GI bleeding
- GI perforation/ulcer
- MI
- stroke
- thromboembolism
- HTN
- CHF
- renal papillary necrosis
- nephrotoxicity
- hyperkalemia
- hepatotoxicity
- pancreatitis
- anaphylactoid rxn
- bronchospasm
- exfoliative dermatitis
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- anemia
- blood dyscrasias
Common
- diarrhea
- nausea
- abdominal pain
- dyspepsia
- rash
- urticaria
- dizziness
- somnolence
- ALT/AST elevation
- fluid retention
- edema
- tinnitus
- ecchymosis
- photosensitivity
- 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 cyclooxyrgenase, reducing prostaglandin and thromboxane synthesis