MELOXICAM (mel-ox'-i-cam) Mobic Classifications: central nervous system agent (cns); analgesic; nonsteroidal anti-inflammatory drug (nsaid) Prototype: Ibuprofen Pregnancy Category: C (first and second trimesters); D (third trimester)
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7.5 mg tablets
Is a nonsteroidal anti-inflammatory drug (NSAID) that exhibits anti-inflammatory, analgesic, and antipyretic activities. The
mechanism of action, like other NSAIDs, may be related to prostaglandin synthetase (cyclooxygenase) inhibition.
Exhibits antiinflammatory, analgesic, and antipyretic actions.
Relief of the signs and symptoms of osteoarthritis, rheumatoid arthritis.
Hypersensitivity to meloxicam; rhinitis, urticaria/angioedema, asthma; allergic reactions to aspirin or other antiinflammatory
agents; NSAID hypersensitivity, severe renal or hepatic disease; salicylate hypersensitivity, pregnancy [(category C) first
and second trimester, (category D) third trimester)], lactation; bleeding.
Helicobacter pylori infections; history of coagulation defects, liver dysfunction, gastrointestinal disease or ulceration, anemia, anticoagulant
therapy; asthma; bone marrow suppression; corticosteroid therapy, dehydration, edema, older adults; females of childbearing
age; GI bleeding, GI diseases, GI perforation; heart failure; hepatic disease, hypertension, hypovolemia, immunosuppression;
jaundice, lactase deficiency, advanced renal dysfunction; hypertension or cardiac conditions aggravated by fluid retention
and edema.
Osteoarthritis Adult: PO 7.515 mg once daily
Rheumatoid Arthritis Adult: PO 15 mg once daily
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Oral
- Do not exceed the maximum recommended daily dose of 15 mg.
- Use the lowest effective dose for the shortest duration to minimize risk of serious adverse effects.
- Store at 15°30° C (59°86° F).
Body as a Whole: Edema, fall, flu-like syndrome, pain. GI: Abdominal pain, diarrhea, dyspepsia, flatulence, nausea, constipation, ulceration, GI bleed. Hematologic: Anemia. Musculoskeletal: Arthralgia. CNS: Dizziness, headache, insomnia. Respiratory: Pharyngitis, upper respiratory tract infection, cough. Skin: Rash, pruritus. Urogenital: Micturition frequency, urinary tract infection.
Drug: May decrease effectiveness of ace inhibitors, diuretics; aspirin may increase risk of GI bleed; may increase lithium levels and toxicity; warfarin may increase risk of bleeding. Herbal:
Feverfew,
garlic,
ginger,
ginkgo may increase bleeding potential.
Absorption: 89% bioavailable. Peak: 45 h. Distribution: >99% protein bound, distributes into synovial fluid. Metabolism: Metabolized in liver by CYP2C9. Elimination: Equally eliminated in urine and feces. Half-Life: 1520 h.
Assessment & Drug Effects
- Monitor for and immediately report S&S of GI ulceration or bleeding, including black, tarry stool, abdominal or stomach pain;
hepatotoxicity, including fatigue, lethargy, pruritus, jaundice, flu-like symptoms; skin rash; weight gain and edema.
- Withhold drug and notify physician if hepatotoxicity or GI bleeding is suspected.
- Monitor carefully patients with a history of CHF, HTN, or edema for fluid retention.
- Monitor diabetics using sulfonylureas for hypoglycemia.
- Lab tests: Hgb & Hct, CBC with differential, liver function tests, serum electrolytes, BUN, and creatinine within 3 mo of
initiating therapy and every 612 mo thereafter; with high-risk patients (e.g., >60 y, history of peptic ulcer disease,
prolonged or high-dose NSAID therapy, concurrent use of corticosteroids or anticoagulants) monitor within first 34 wk
and every 36 mo thereafter.
- Coadministered drugs: With warfarin, closely monitor INR when meloxicam is initiated or dose changed; monitor for lithium
toxicity, especially during addition, withdrawal, or change in dose of meloxicam.
Patient & Family Education
- Report any of the following to the physician immediately: nausea, black tarry stool, abdominal or stomach pain, unexplained
fatigue or lethargy, itching, jaundice, flu-like symptoms, skin rash, weight gain, or edema.
- Minimize alcohol intake and use of tobacco. Discontinue drug if hepatotoxicity or GI bleeding is suspected. Note that GI bleeding
may occur without forewarning and is more likely in older adults, in those with a history of ulcers or GI bleeding, and with
alcohol consumption and cigarette smoking.
- Do not take aspirin or other NSAIDs while on this medication.
- Do not breast feed while taking this drug.