Meloxicam Capsules

Generic name:

Meloxicam

Drug class:

Nonsteroidal anti-inflammatory drug (NSAID); oxicam subclass; preferential cyclooxygenase-2 (COX-2) inhibitor

Dosage form:

Oral capsules: 7.5 mg, 15 mg

Root of administration:

Oral

Dose:

Adults: 7.5 mg once daily; may increase to 15 mg once daily based on response and tolerability. Geriatric: initiate at lowest effective dose. Pediatrics (juvenile idiopathic arthritis): 0.125 mg/kg once daily (maximum 7.5 mg/day).

Mechanism of action:

Meloxicam selectively inhibits cyclooxygenase-2 (COX-2) over cyclooxygenase-1 (COX-1), reducing prostaglandin synthesis to decrease inflammation, pain, and fever.

Drug usage cases:

• Osteoarthritis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Juvenile idiopathic arthritis (for patients ≥ 2 years weighing ≥ 10 kg)
• Acute pain management
• Primary dysmenorrhea (off-label)

Drug contra indications:

• Hypersensitivity to meloxicam, other NSAIDs, or excipients
• History of asthma, urticaria, or allergic-type reactions after NSAID administration
• Active peptic ulcer disease or gastrointestinal bleeding
• Severe renal impairment (creatinine clearance < 15 mL/min)
• Severe hepatic impairment
• History of gastrointestinal perforation or ulceration related to previous NSAID therapy
• During the perioperative period of coronary artery bypass graft (CABG) surgery

Side effects:

• Gastrointestinal: dyspepsia, abdominal pain, nausea, diarrhea, constipation, flatulence, peptic ulceration, gastrointestinal bleeding, perforation
• Cardiovascular: hypertension, edema, increased risk of myocardial infarction and stroke
• Renal: increased serum creatinine, renal impairment, acute renal failure
• Hepatic: elevated liver enzymes (AST, ALT), hepatitis
• Central nervous system: headache, dizziness, somnolence
• Dermatologic: rash, pruritus, Stevens–Johnson syndrome, toxic epidermal necrolysis
• Hematologic: anemia, thrombocytopenia, leukopenia
• Respiratory: bronchospasm (in susceptible patients)
• Hypersensitivity reactions: anaphylaxis, angioedema

Warnings:

• Cardiovascular thrombotic events: avoid in patients with risk factors; use lowest effective dose for shortest duration
• Gastrointestinal toxicity: risk of bleeding, ulceration, and perforation; monitor for signs of GI events
• Renal toxicity: avoid in patients with severe renal disease; monitor renal function
• Hepatic effects: monitor liver function; use cautiously in hepatic impairment
• Hypertension: monitor blood pressure during therapy
• Fluid retention and edema: use with caution in patients with fluid retention conditions
• Anaphylactoid reactions: avoid in patients with NSAID-associated asthma
• Skin reactions: discontinue at first sign of skin rash or hypersensitivity
• Masking of inflammation and fever: may diminish signs of infection

Use during pregnancy or breastfeeding:

Pregnancy: Avoid use, especially in the third trimester (risk of premature closure of the fetal ductus arteriosus, renal dysfunction, and oligohydramnios). If used in the first or second trimester, only if clearly needed.

Breastfeeding: Meloxicam is excreted in breast milk; exercise caution. Use the lowest effective dose for the shortest duration. Monitor infants for adverse effects on renal function and gastrointestinal tolerance.