Meloxicam

It is a new NSAID which has greater inhibitory action against the inducible form of cyclo-oxygenase (COX-2) which is implicated in the inflammatory response than against the constitutive form of this enzyme (COX-1) inhibition of, which is associated with gastric, renal and other adverse effects.

Indications

Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis.

Dosage

-Osteoarthritis and Rheumatoid Arthritis: Adults: 7.5 mg once daily, may increase to 15 mg once daily if needed. -Juvenile Rheumatoid Arthritis: Children (?2 years old): 0.125 mg/kg once daily (up to a maximum of 7.5 mg).

Contra-Indications

Meloxicam should not be used in patients with: -Known hypersensitivity to meloxicam or other NSAIDs -History of asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs -Active gastrointestinal bleeding or ulceration -Severe renal or hepatic impairment -Peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery

Special Precautions

Before taking meloxicam, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Side Effects

Common side effects include: -Gastrointestinal issues (nausea, vomiting, diarrhea, constipation) -Abdominal pain, dyspepsia, flatulence -Dizziness, headache -Rash Serious side effects can include: -Gastrointestinal bleeding or ulceration -Cardiovascular thrombotic events (e.g., heart attack, stroke) -Liver dysfunction -Kidney dysfunction -Severe allergic reactions (e.g., anaphylaxis, angioedema)

Drug Interactions

-Anticoagulants and antiplatelet agents: Increased risk of bleeding -Other NSAIDs and corticosteroids: Increased risk of gastrointestinal bleeding -ACE inhibitors, ARBs, and diuretics: Reduced effectiveness and increased risk of renal impairment -Lithium: Increased plasma levels of lithium -Methotrexate: Increased risk of toxicity -Cyclosporine: Increased risk of nephrotoxicity