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

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 cyclooxyrgenase, reducing prostaglandin and thromboxane synthesis

Comments

See Also

NSAID

References