Adult Dosing
Osteoarthritis and rheumatoid arthritis
- Initial: 7.5 mg PO qd; if needed, increase the dose to 15 mg qd
- Max: 15 mg/day
- Maintenance: 7.5 mg PO qd
Note:
- Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals
Pediatric Dosing
- Safety and efficacy in pediatric patients <2 years of age have not been established
Pauciarticular or polyarticular course juvenile rheumatoid arthritis
- 0.125 mg/kg oral suspension PO qd; Max dose: 7.5 mg/day
Note:
- Use the lowest effective dose for the shortest duration consistent with individual patient treatment goals
[Outline]
Renal Dose Adjustment (Based on CrCl)
- Mild to moderate renal impairment (>15 mL/min): No dose adjustments
- Severe renal impairment (CrCl <15 mL/min): Contraindicated
- Hemodialysis: Maximum 7.5 mg/day
Hepatic Dose Adjustment
- Mild to moderate hepatic impairment (Child-Pugh class A or B): No dose adjustments
- Severe hepatic impairment (Child-Pugh class C): Use cautiously, dose adjustments not defined
See Supplemental Patient Information
- Meloxicam is associated with an increased risk of serious and potentially fatal CV thrombotic events, MI and stroke. Risk increases with the duration of use, presence of CV disease or risk factors for CV disease [US Black Box Warning]
- Use lowest effective dose for patients treated with NSAIDs to minimize the potential risk for an adverse CV event
- NSAIDs may cause onset of new hypertension or worsening of pre-existing hypertension, which may contribute to increased incidence of CV events. Monitor BP closely during therapy
- Use with caution in patients taking ACE inhibitors, thiazides, or loop diuretics as it may impair the response to these therapies
- Use with caution in patients with fluid retention, hypertension, or heart failure because it could lead to fluid retention and edema
- Meloxicam may cause increased risk of adverse GI events such as inflammation, bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. Patients with a previous history of peptic ulcer disease and/or gastrointestinal bleeding are at greater risk. Other contributing factors include concomitant use of oral corticosteroids or anticoagulants, longer duration of NSAID therapy, smoking, alcohol use, older age, and poor general health status [US Black Box Warning]
- Patients and physicians should remain alert for signs and symptoms of GI ulcers and bleeding during therapy
- Prolonged use may be associated with renal papillary necrosis, renal insufficiency, acute renal failure, and other renal injuries. Use with caution in elderly patients and those with impaired renal function, heart failure, liver dysfunction, and those taking diuretics, ACE-inhibitors, or angiotensin II receptor antagonists. Use in patients with severe renal impairment is not recommended.
- Elevations in ALT or AST may occur during therapy. Discontinue use if clinical signs and symptoms consistent with liver disease develop, if systemic manifestations occur, or if elevation of liver enzymes persists or worsens
- Restrict administration in patients with aspirin triad, which occurs typically in asthmatic patients who experience rhinitis with or without nasal polyps, or in patients who exhibit severe, potentially fatal bronchospasm after taking aspirin or other NSAIDs
- Cautiously administer in patients with preexisting asthma/aspirin-sensitive asthma as it may exacerbate the symptoms
- Patients should be informed about the signs and symptoms of serious skin manifestations such as exfoliative dermatitis, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Discontinue the drug at the first appearance of skin rash or any other sign of hypersensitivity
- Avoid use of meloxicam starting at 30 weeks gestation as it may cause premature closure of the ductus arteriosus
- Anemia may occur due to fluid retention, occult or gross GI blood loss
- Perform periodic assessment of CBC and chemistry profile in patients on long-term therapy
- The pharmacological activity of meloxicam in reducing fever and inflammation may diminish the use of these diagnostic signs in detecting complications of presumed noninfectious and painful conditions
Cautions: Use cautiously in
- Coagulation disorder
- Dehydration
- Corticosteroid use
Supplemental Patient Information
- Inform patients about the potential serious adverse events associated with meloxicam treatment and to remain alert for the signs and symptoms associated with these events. Advise patients to seek immediate medical help if such events occur
Pregnancy Category:C (first and second trimester), D (third trimester)
Breastfeeding: Alternate agents may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 07 January 2011). According to manufacturer's data, it is not known whether meloxicam is excreted in breast milk. Due to the potential for serious adverse reactions in nursing infants from meloxicam, manufacturer recommends discontinuation of nursing or therapy, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Meloxicam 15 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
90 mg = $16.96
180 mg = $18.92 - Meloxicam 7.5 MG/5ML SUSP [Bottle] (ROXANE)
100 5ml = $86.99
200 5ml = $169.98 - Meloxicam 7.5 MG TABS [Bottle] (ZYDUS PHARMACEUTICALS (USA))
30 mg = $15.99
90 mg = $42.95 - Mobic 15 MG TABS [Bottle] (BOEHRINGER INGELHEIM)
30 mg = $230
90 mg = $659.97 - Mobic 7.5 MG TABS [Bottle] (BOEHRINGER INGELHEIM)
30 mg = $154.99
90 mg = $441.95
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
