What Does The Pill Meloxicam Look Like?

What do 15 mg meloxicam pills look like?

Meloxicam tablets, USP: 7.5 mg: yellow coloured, round, biconvex, tablets, debossed with ‘158’ on one side and ‘C’ on the other.15 mg: yellow coloured, round, flat bevelled tablets, debossed with ‘CIPLA’ on one side and ‘159’ on the other.

What number is meloxicam on a pill?

This medicine is a light yellow, oblong, tablet imprinted with ‘UL’ and ’15’.

What does a 7.5 mg meloxicam look like?

S 160 – Strides Acrolab Limited is the company that makes the S 160 tablets. These are yellow tablets, shaped like ovals with slightly pointed tips. S 160 is imprinted on the side of the pill. The dosage of Meloxicam is 7.5 mg.

What happens if I take 2 meloxicam 7.5 mg?

Taking too much meloxicam can cause serious problems, like tears and bleeding in your stomach or gut and damage to your kidneys. Common signs of an NSAID overdose include nausea, vomiting, and stomach pain. Drowsiness and lack of energy are also possible.

Why can’t you drink coffee while taking meloxicam?

CONCLUSION – 1. Meloxicam (dose: 0.6 mg/kg) shows peripheral analgesic activity (63.6%) at the level of the reference drug (diclofenac sodium) (67.3%).2. Meloxicam in a lower dose (0.6 mg/kg) than piroxicam (1.3 mg/kg) demonstrates higher peripheral analgesic activity, 63.6% and 53.6%, respectively.3.

1. The peripheral analgesic activities of piroxicam (53.6%) and caffeine (64.5%) monopreparations have higher values than their pharmaceutical combination (40.9%).
2. Hence, further study of the analgesic activity of piroxicam combined with caffeine is considered inexpedient.4.
3. The pharmacological combination of meloxicam with caffeine demonstrated pain inhibition of 76.4%, which significantly exceeded the peripheral analgesic activity of the reference drug, diclofenac sodium, 67.3%, i.e.

caffeine effectively potentiates the analgesic activity of meloxicam. Thus, the combination of meloxicam with caffeine as a commercial source of a domestic analgesic drug could be subjected to further study.

Is meloxicam 15 mg very strong?

Meloxicam Despite being an NSAID, Meloxicam does not normally cause sleepiness, unlike Ibuprofen. Its typical side effects include dizziness, nausea or headaches, but not sleepiness. Meloxicam is more likely to cause insomnia. Consumption of a higher dosage normal than usual may lead to drowsiness and may require immediate medical attention.

Meloxicam is associated with extreme cardiovascular and gastrointestinal complications due to indiscriminate use. Higher doses than usual (up to 5 times) is associated with strokes and heart attacks, which may turn fatal. The oral LD50 dose is reported at 98 mg/kg and is highly toxic to the body. Do not alter your Meloxicam regimen without consulting a physician.

Meloxicam is not considered a controlled substance under the Controlled Substances Act (CSA). Instead, Meloxicam is suggested to play a significant role in pain management versus opioid alternatives. Meloxicam has been paired with Bupivacaine (an anaesthetic) to manage pain after painful surgeries and reduce their need for opioids, therefore reducing the risk for addiction.

1. Meloxicam is primarily used in veterinary medicine to treat dogs and cattle.
2. A study suggests that using NSAIDs like Meloxicam in cats can lead to gastrointestinal upset and seizures at higher doses.
3. Cats have a low tolerance for NSAIDs in general.
4. However, in 2020, Meloxicam injection was approved for use in cats only before an operation and as a single injection with explicit instructions to not administer a second dose.

Meloxicam is an NSAID that treats inflammation of the joints. It is not a muscle relaxer. However, Meloxicam has been reported to be effective as an analgesic to treat non-specific back pain in low doses. Meloxicam is one of the stronger NSAIDs available for use, much stronger than other alternatives like Ibuprofen or Celebrex.

Meloxicam is more potent than other over the counter drugs. However, in general, Diclofenac at a 150 mg/day dosage is reported to be the most effective NSAID in treating osteoarthritis. Meloxicam is one of the most potent and effective painkillers available for treating pain and inflammation caused by arthritis.

It is much more effective than other alternatives like Ibuprofen, Celebrex or Naproxen. Meloxicam also has significantly better tolerability than Diclofenac. Not only that, but Meloxicam coupled with Bupivacaine is also effective in pain management after extremely painful surgeries that typically require opioids.

Meloxicam has a half-life longer than other NSAIDs of around 20 hours. It requires a single dosage per day without the need for extended-release formulations. Meloxicam starts showing its effects around 30 minutes and peaks in efficacy at around 4 hours. It can relieve pain up to 24 hours, depending on the type of pain it is prescribed for.

Pairing alcohol with any NSAID is a bad idea. Alcohol combined with Meloxicam, specifically, puts you at a higher risk for stomach bleeding as well as stroke. Do not drink wine with Meloxicam. Look out for any symptoms that may indicate gastrointestinal complications like bloody stool, vomiting of blood, etc.

While uncommon, Meloxicam can affect your weight and lead to gain or loss. However, weight gain due to fluid retention is a much more common side effect associated with Meloxicam consumption, reported in up to 0.6% to 4.5% of patients. Consult a doctor if you notice unusual weight gain while consuming Meloxicam.

: Meloxicam

Is meloxicam stronger than ibuprofen 800?

The main differences between meloxicam and ibuprofen are:

Meloxicam is considered a stronger medicine than ibuprofen Meloxicam is only available on prescription and ibuprofen is available over the counter as well as on prescription Meloxicam is a long-acting medicine that only needs to be given once a day. Ibuprofen in its usual form needs to be given three to four times a day, although extended-release forms of ibuprofen that last 12 to 24 hours are available Ibuprofen is FDA approved to treat most mild-to-moderate painful conditions, such as toothache, back pain, and primary dysmenorrhea, as well as pain or inflammation caused by arthritis. Meloxicam is only approved to treat pain or inflammation caused by arthritis The risk of gastrointestinal disturbances (such as gastric ulcers) and cardiovascular events (such as heart attacks) appears higher with meloxicam compared to ibuprofen.

Both meloxicam and ibuprofen belong to the class of medicines known as nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs work by blocking enzymes that make prostaglandins, which are substances that contribute to inflammation and pain. Taking an NSAID such as ibuprofen or meloxicam reduces inflammation and pain.

How long does it take for meloxicam 15 mg to start working?

Is Meloxicam A Strong Drug? – Meloxicam is often used to treat symptoms that cannot be relieved with common over-the-counter medications like ibuprofen. That means that people with conditions like arthritis use it to treat their severe and lasting pain.

What is the strongest meloxicam?

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Meloxicam comes in 5 mg, 7.5 mg, 10 mg, and 15 mg dosages. A dose of 15 mg is the maximum daily dose of this medication. The pain associated with osteoarthritis (OA) and rheumatoid arthritis (RA) can be managed with 15 mg doses of meloxicam—though patients will be started on a lower dose at the beginning ( FDA, 2012 ).

Even though this is a higher dose of meloxicam, it still may take some time to feel its effects. People with RA may begin to feel relief as early as three weeks into treatment on either 7.5 mg or 15 mg dosages ( Reginster, 1996 ). Those with OA may feel the drug’s effects sooner.

• Researchers found evidence that meloxicam worked after two weeks in patients given daily doses of 7.5 mg or 15 mg ( Yocum, 2000 ).
• Meloxicam is also used short-term to manage post-operative pain for certain procedures, and 15 mg doses may be used.
• Single doses of 15 mg meloxicam have been shown in multiple studies to reduce the pain following certain surgical procedures (Kurukahvecioglu, 2007; Aghadavoudi, 2015).

For other procedures, such as tooth extractions, 15 mg meloxicam is taken once daily for less than a week ( Calvo, 2006 ). Although 15 mg meloxicam is approved for the management of arthritis -related joint pain, it’s not recommended for long-term use.

• There is a U.S.
• Food and Drug Administration (FDA) black box warning about the side effects of meloxicam.
• The FDA’s warning underscores that meloxicam may increase the risk of heart attack and stroke, especially in people with heart disease or other cardiovascular risk factors.
• This risk may be higher if you use meloxicam long-term.

These cardiovascular events can happen without warning and may be fatal ( NIH-a, 2020 ). Meloxicam can treat a wide range of pain and swelling but is frequently used for conditions like OA and RA. It can also be used off-label (in a way not specifically approved by the FDA) to treat a condition called gout.

• Osteoarthritis : OA is a condition that can make it hard to function on a day-to-day basis. It causes swelling, redness, pain, and deformities of the joints. More than 43 million people around the world suffer from OA, and it becomes more common as we age. Signs of this disease are present in more than 80% of people over the age of 60. Genetics, history of injury, increased body weight, other underlying conditions may increase your risk of developing OA ( Sen, 2020 ).
• Rheumatoid arthritis : RA is caused by the immune system inappropriately attacking certain areas of the body, including the joints, lungs, and other tissues. While rest often improves symptoms of OA, it exacerbates pain and stiffness associated with RA. Meloxicam helps treat RA by quelling the body’s immune response and alleviating pain.
• Gout: Meloxicam also manages pain and swelling from gout flare-ups. Signs of gout include sudden pain, redness, and swelling of joints. It may affect any joint in the body, although it commonly affects the big toe. Gout often results from a buildup of uric acid in the body, but behavioral factors can trigger flare-ups or attacks in susceptible individuals ( Jin, 2012), These factors include certain foods, like shellfish and red meat, and drugs like aspirin and certain diuretics ( ACR, 2019 ).
• Ankylosing spondylitis (AS) : Meloxicam has also been used off-label to manage the pain associated with AS, a rare chronic inflammatory condition that affects the spine ( Song, 2008 ). There’s cure for AS, but NSAIDs such as meloxicam can help manage the pain.

The most common side effects of meloxicam are diarrhea, indigestion, and flu-like symptoms (FDA, 2012). Other side effects include headache, dizziness, skin rash, and other digestive issues such as gas, heartburn, and nausea ( DailyMed, 2019 ). The U.S.

1. Food and Drug Administration (FDA) has a black box warning about serious potential side effects on the gastrointestinal system.
2. Meloxicam can increase your risk of bleeding, ulceration, and perforations in the stomach or intestines.
3. These conditions may occur without warning and may be fatal.
4. Older people and those with a prior history of GI problems using meloxicam are at higher risk for adverse effects (FDA, 2012).

Note that this drug does not need to be taken by mouth to cause digestive problems and does the same when administered as an injection. Non-steroidal anti-inflammatory drugs (NSAIDs) act on different parts of the inflammation pathway to decrease symptoms such as swelling.

1. Meloxicam also slows clotting time, which may increase the risk of bleeding ( Rinder, 2002; Martini, 2014 ).
2. You should seek medical attention immediately if you experience severe abdominal pain, black or bloody stool, dizziness, or loss of consciousness.
3. Allergic reactions to meloxicam are possible.
4. Signs of an allergic reaction include hives, trouble breathing, shortness of breath, or a blistering skin rash.

If you experience any of these symptoms, get medical help immediately (DailyMed, 2019). Meloxicam tablets are available in 5 mg, 7.5 mg, 10 mg, and 15 mg dosages, but there are multiple forms of this medication. Meloxicam comes as an oral suspension (7.5 mg/5 ml), a disintegrating tablet (7.5 mg and 15 mg dosages), and an intravenous (IV) solution (30 mg/mL).

• IV meloxicam is used in a hospital setting.
• Meloxicam is available under the brand name Mobic and as a generic drug.
• A 30-day supply costs between $4 to over $400, depending on the strength and whether it’s generic or brand name ( GoodRx.com ).
• Many insurance plans cover meloxicam.
• Most people on meloxicam take one pill by mouth daily.

If you miss a dose, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and take your next one as usual. Don’t take a double dose. Meloxicam tablets should be stored at room temperature and out of the reach of children.

1. Meloxicam may increase the risk of heart attack and stroke, especially in people with heart disease or other cardiovascular risk factors.
2. This risk may be higher if you use meloxicam long-term.
3. Do not use meloxicam to treat pain right before or after heart surgery, like a coronary artery bypass graft (CABG) procedure.

Meloxicam can also increase your risk of bleeding, ulceration, and holes (perforations) in the stomach or intestines (FDA, 2012). NSAIDs such as meloxicam should also not be taken after the second trimester of pregnancy. These medications may interfere with how the fetus’s heart develops and redirect blood flow in the fetus’s body, which may lead to heart problems later on ( Bloor, 2013 ; Enzensberger, 2012 ).

Talk to a healthcare professional before taking meloxicam if you’re nursing. We don’t know how much meloxicam gets into breast milk, but your healthcare provider can help you weigh the risks and benefits of taking it while breastfeeding (FDA, 2012). NSAIDs may also make it harder for the embryo to implant ( Bermas, 2014 ).

If you take meloxicam regularly, talk to your healthcare provider if you’re trying to conceive or plan to start trying. Meloxicam may affect how well blood pressure medications work. The drug may make medications that lower high blood pressure like ACE inhibitors, angiotensin receptor blockers (ARBs), and beta-blockers less effective ( Fournier, 2012 ; Johnson, 1994 ).

Meloxicam may have this effect on other medications such as diuretics (aka “water pills”), which are drugs that affect fluid retention. Meloxicam may make loop diuretics such as furosemide and thiazide diuretics such as hydrochlorothiazide (HCTZ) not work as well. If taken together, these medications may also worsen kidney function, potentially causing kidney failure (DailyMed, 2019).

Combining certain medications with meloxicam may increase your risk of bleeding. Blood thinners (such as the anticoagulant warfarin ) and antiplatelet agents (such as aspirin) should not be taken with meloxicam for this reason (DailyMed, 2019). Smoking while taking meloxicam also increases your risk of bleeding problems (FDA, 2012).

1. American College of Rheumatology (ACR). (2019). Gout. Retrieved on Sep.16, 2020 from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout
2. Bloor, M. & Paech, M. (2013). Nonsteroidal Anti-Inflammatory Drugs During Pregnancy and the Initiation of Lactation. Anesthesia & Analgesia, 116 (5), 1063-1075. doi:10.1213/ane.0b013e31828a4b54. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23558845/
3. Bermas, B.L. (2014). Non-steroidal anti inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs for the management of rheumatoid arthritis before and during pregnancy. Current Opinion in Rheumatology, 26 (3), 334-340. doi:10.1097/bor.0000000000000054. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24663106/
4. DailyMed. (2019). Meloxicam tablet. Retrieved on Sep.16, 2020 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d5e12448-1ca1-46a4-8de4-e8b94567e5a8
5. Enzensberger, C., Wienhard, J., Weichert, J., Kawecki, A., Degenhardt, J., Vogel, M., & Axt-Fliedner, R. (2012). Idiopathic Constriction of the Fetal Ductus Arteriosus. Journal of Ultrasound in Medicine, 31 (8), 1285-1291. doi:10.7863/jum.2012.31.8.1285. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22837295/
6. Food and Drug Administration (FDA). (2012). Mobic (meloxicam) tablets and oral suspension. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/012151s072lbl.pdf
7. Fournier, J.P., Sommet, A., Bourrel, R., Oustric, S., Pathak, A., Lapeyre-Mestre, M., & Montastruc, J.L. (2012). Non-steroidal anti-inflammatory drugs (NSAIDs) and hypertension treatment intensification: a population-based cohort study. European Journal of Clinical Pharmacology, 68 (11), 1533–1540. doi:10.1007/s00228-012-1283-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22527348/
8. Gaffo, A.L. (2019, December 4). Treatment of gout flares. Retrieved Sep.18, 2020, from https://www.uptodate.com/contents/treatment-of-gout-flares/
9. GoodRx.com. (n.d.). Meloxicam. Retrieved Sep.16, 2020 from https://www.goodrx.com/meloxicam
10. Huskisson, E.C., Ghozlan, R., Kurthen, R., Degner, F.L., & Bluhmki, E. (1996). A Long-Term Study to Evaluate the Safety and Efficacy of Meloxicam Therapy in Patients with Rheumatoid Arthritis. Rheumatology, 35 (Suppl 1), 29-34. doi:10.1093/rheumatology/35.suppl_1.29. Retrieved from https://academic.oup.com/rheumatology/article/35/suppl_1/29/1782379
11. Jin, M., Yang, F., Yang, I., Yin, Y., Luo, J.J., Wang, H., & Yang, X.F. (2012). Uric acid, hyperuricemia and vascular diseases. Frontiers in Bioscience (Landmark edition), 17, 656–669. doi:10.2741/3950. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247913/
12. Johnson, A.G., Nguyen, T.V., & Day, R.O. (1994). Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis. Annals of Internal Medicine, 121 (4), 289–300. doi:10.7326/0003-4819-121-4-199408150-00011. Retrieved from https://pubmed.ncbi.nlm.nih.gov/8037411/
13. Martini, A.K., Rodriguez, C.M., Cap, A.P., Martini, W.Z., & Dubick, M.A. (2014). Acetaminophen and meloxicam inhibit platelet aggregation and coagulation in blood samples from humans. Blood Coagulation & Fibrinolysis, 25 (8), 831-837. doi:10.1097/mbc.0000000000000162. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25004022/
14. National Institutes of Health (NIH-a). (2020, April 15). Meloxicam: MedlinePlus Drug Information. Retrieved Sep.23, 2020 from https://medlineplus.gov/druginfo/meds/a601242.html
15. National Institutes of Health (NIH-b). (2020, August 17). Ankylosing spondylitis – Genetics Home Reference. Retrieved Sep.22, 2020 from https://medlineplus.gov/genetics/condition/ankylosing-spondylitis/
16. Reginster, J.Y., Distel, M., & Bluhmki, E. (1996). A Double-Blind, Three-Week Study to Compare the Efficacy and Safety of Meloxicam 7.5 mg and Meloxicam 15 mg in Patients with Rheumatoid Arthritis. Rheumatology, 35 (Suppl 1), 17-21. doi:10.1093/rheumatology/35.suppl_1.17. Retrieved from https://www.researchgate.net/profile/Erich_Bluhmki/publication/14569192_A_Double-Blind_Three-Week_Study_to_Compare_the_Efficacy_and_Safety_of_Meloxicam_75_mg_and_Meloxicam_15_mg_in_Patients_with_Rheumatoid_Arthritis/links/599d516745851574f4b258e4/A-Double-Blind-Three-Week-Study-to-Compare-the-Efficacy-and-Safety-of-Meloxicam-75-mg-and-Meloxicam-15-mg-in-Patients-with-Rheumatoid-Arthritis.pdf
17. Rinder, H.M., Tracey, J.B., Souhrada, M., Wang, C., Gagnier, R.P., & Wood, C.C. (2002). Effects of Meloxicam on Platelet Function in Healthy Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Clinical Pharmacology, 42 (8), 881-886. doi:10.1177/009127002401102795. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12162470/
18. Song, I.H., Poddubnyy, D.A., Rudwaleit, M., & Sieper, J. (2008). Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs. Arthritis & Rheumatism, 58 (4), 929-938. doi:10.1002/art.23275. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/art.23275
19. Yocum, D. (2000). Safety and Efficacy of Meloxicam in the Treatment of Osteoarthritis. Archives of Internal Medicine, 160 (19), 2947-2954. doi:10.1001/archinte.160.19.2947. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485487

Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.

What should you avoid when taking meloxicam?

Meloxicam can increase your risk of fatal heart attack or stroke. Do not use this medicine just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Meloxicam may also cause stomach or intestinal bleeding, which can be fatal. Meloxicam may also cause stomach or intestinal bleeding, which can be fatal.

heart disease, high blood pressure, high cholesterol, diabetes, or if you smoke;a heart attack, stroke, or blood clot;ulcers or stomach bleeding;asthma;kidney disease (or if you are on dialysis);liver disease; orfluid retention.

If you are pregnant, you should not take meloxicam unless your doctor tells you to. Taking an NSAID during the last 20 weeks of pregnancy can cause serious heart or kidney problems in the unborn baby and possible complications with your pregnancy. Meloxicam may cause a delay in ovulation (the release of an egg from an ovary).

Should I take meloxicam at night or in the morning?

It is best to take MELOXICAM AN immediately after food to avoid the chance of an upset stomach. Try to take MELOXICAM AN at the same time each day, either morning or evening. Keep taking MELOXICAM AN every day until your doctor tells you to stop.

How long can you stay on meloxicam?

NSAID Warnings – If prescribed for pain, NSAIDs like meloxicam are typically meant to be taken for short periods of time. In fact, it’s usually not used for more than 10 days in a row. There are times when your doctor will prescribe an NSAID to be taken for longer periods, but those are special circumstances that your doctor will outline for you.

NSAIDs like meloxicam can cause an increase in blood pressure. Taking NSAIDs can increase the risk of both heart attacks and strokes. The risk is higher when the drug is taken at higher doses and over a long period of time. In some instances, there’s also an increased risk of these problems when you first start taking the medication.

The chances of a serious reaction are greater if you have a pre-existing heart condition, However, a heart attack or stroke can occur even if you have no history of heart disease. NSAIDs may also cause stomach and bowel disorders such as ulcers or stomach bleeding.

Is 7.5 mg of meloxicam very strong?

Dear Doctor: I’ve suffered joint pain for years. Being prescribed 15 milligrams of Meloxicam has been wonderful. What are your thoughts on Meloxicam use? Meloxicam (Mobic) is a non-steroidal anti-inflammatory drug (NSAID) that, like all such drugs, inhibits the formation of the enzyme cyclooxygenase (COX).

This inhibition leads to a decrease in the production of molecules that boost inflammation and help the blood clot. There are two forms of the COX enzyme, aptly named COX-1 and COX-2. COX-1 is involved in protecting the lining of the stomach, promoting the blood’s clotting ability and aiding kidney function.

COX-2 is involved in the inflammatory response in the body. Many of the side effects seen with older NSAIDs such as ibuprofen, naproxen and diclofenac are related to the inhibition of COX-1. The side effects include gastritis or gastric ulcers, blood thinning and kidney damage.

• Inhibiting COX-2 leads to a decrease in inflammation and a decrease in pain.
• Meloxicam at low doses (7.5 milligrams) inhibits COX-2 and not COX-1.
• That means it can reduce pain and inflammation, without irritation of the stomach lining or an increased risk of stomach ulcers.
• Research has found that serious upper gastrointestinal events at the 7.5 mg dose occur in fewer than 1 in 3,000 people.

But note that follow-up studies didn’t last more than 60 days, so it’s unclear if these rates would hold up over the long term. Further, at low doses, meloxicam may not show the kidney problems that other NSAIDs cause. The rates of heart attacks appear comparable to those of other NSAIDs, with a slight increase in risk at all doses.

However, when meloxicam dosage is increased to 15 milligrams, the medication does inhibit COX-1, leading to a significant increase in the rates of serious upper gastrointestinal events. One study found that, while the number of events was less than with the NSAID naproxen, the number of events at 15 mg was six times higher than the lower dose of meloxicam (1 in 500 people).

Another study showed a greater proportion of people with a slight decrease in kidney function when 22.5 mg of meloxicam was taken for 12 weeks. This was not seen at the 15 mg dosage. Lastly, for people on two types of blood pressure drugs – ACE-inhibitors and angiotensin receptor blockers, meloxicam (like other NSAIDs) may make those medications less effective.

• One note for people who take either ACE inhibitors or angiotensin receptor blockers for high blood pressure: Meloxicam may make these medication less effective In summary, meloxicam works well for pain and swelling.
• The higher doses do decrease pain more than the 7.5mg dosage, and the medication is comparable to the NSAID diclofenac for both pain relief and decreasing inflammation.

I have frequently recommended the medication for joint inflammation, bone bruises, pain from fractures and tendonitis, and it’s worked well for the vast majority of my patients. For older adults, I lean toward the 7.5 mg dose, but I have recommended 15 mg in more severe cases.

1. Some of the latter group have complained of gastrointestinal discomfort, but this stopped when they discontinued the medication.
2. I rarely give this medication for greater than one month, but have had some patients who have been on this medication for years for severe arthritis.
3. I don’t know how frequently you are using meloxicam, but if you’re using it on an as-needed basis, it should be safe.

If you’re using this medication daily, you should consider its potential for side effects. Robert Ashley, MD, is an internist and assistant professor of medicine at the University of California, Los Angeles. Ask the Doctors is a syndicated column first published by UExpress syndicate.

What is the best time of day to take meloxicam 7.5 mg?

WARNING RISK OF SERIOUS CARDIOVASCULAR AND GASTROINTESTINAL EVENTS Cardiovascular Thrombotic Events Nonsteroidal anti-inflammatory drugs (NSAIDs) cause an increased risk of serious cardiovascular thrombotic events, including myocardial infarction and stroke, which can be fatal. This risk may occur early in treatment and may increase with duration of use, Meloxicam is contraindicated in the setting of coronary artery bypass graft (CABG) surgery, Gastrointestinal Bleeding, Ulceration, and Perforation NSAIDs cause an increased risk of serious gastrointestinal (GI) adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients and patients with a prior history of peptic ulcer disease and/or GI bleeding are at greater risk for serious GI events,1 INDICATIONS AND USAGE 1.1 Osteoarthritis (OA) Meloxicam is indicated for relief of the signs and symptoms of osteoarthritis,1.2 Rheumatoid Arthritis (RA) Meloxicam is indicated for relief of the signs and symptoms of rheumatoid arthritis,1.3 Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course Meloxicam is indicated for relief of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in 2 DOSAGE AND ADMINISTRATION 2.1 General Dosing Instructions Carefully consider the potential benefits and risks of meloxicam and other treatment options before deciding to use meloxicam. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals, After observing the response to initial therapy with meloxicam, adjust the dose to suit an individual patient’s needs. In adults, the maximum recommended daily oral dose of meloxicam is 15 mg regardless of formulation. In patients with hemodialysis, a maximum daily dosage of 7.5 mg is recommended, Meloxicam may be taken without regard to timing of meals.2.2 Osteoarthritis For the relief of the signs and symptoms of osteoarthritis the recommended starting and maintenance oral dose of meloxicam is 7.5 mg once daily. Some patients may receive additional benefit by increasing the dose to 15 mg once daily.2.3 Rheumatoid Arthritis For the relief of the signs and symptoms of rheumatoid arthritis, the recommended starting and maintenance oral dose of meloxicam is 7.5 mg once daily. Some patients may receive additional benefit by increasing the dose to 15 mg once daily.2.4 Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course For the treatment of juvenile rheumatoid arthritis, the recommended oral dose of meloxicam is 7.5 mg once daily in children who weigh ≥ 60 kg. There was no additional benefit demonstrated by increasing the dose above 7.5 mg in clinical trials. Meloxicam tablets should not be used in children who weigh <60 kg.2.5 Renal Impairment The use of meloxicam in subjects with severe renal impairment is not recommended. In patients on hemodialysis, the maximum dosage of meloxicam is 7.5 mg per day,2.6 Non-Interchangeability with Other Formulations of Meloxicam Meloxicam tablets have not shown equivalent systemic exposure to other approved formulations of oral meloxicam. Therefore, meloxicam tablets are not interchangeable with other formulations of oral meloxicam product even if the total milligram strength is the same. Do not substitute similar dose strengths of meloxicam tablets with other formulations of oral meloxicam product. Meloxicam tablets, USP: 7.5 mg: yellow coloured, round, biconvex, tablets, debossed with "158" on one side and "C" on the other.15 mg: yellow coloured, round, flat bevelled tablets, debossed with "CIPLA" on one side and "159" on the other. Meloxicam is contraindicated in the following patients:

Known hypersensitivity (e.g., anaphylactic reactions and serious skin reactions) to meloxicam or any components of the drug product History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs. Severe, sometimes fatal, anaphylactic reactions to NSAIDs have been reported in such patients In the setting of coronary artery bypass graft (CABG) surgery

5.1 Cardiovascular Thrombotic Events Clinical trials of several COX-2 selective and nonselective NSAIDs of up to three years duration have shown an increased risk of serious cardiovascular (CV) thrombotic events, including myocardial infarction (MI) and stroke, which can be fatal.

Based on available data, it is unclear that the risk for CV thrombotic events is similar for all NSAIDs. The relative increase in serious CV thrombotic events over baseline conferred by NSAID use appears to be similar in those with and without known CV disease or risk factors for CV disease. However, patients with known CV disease or risk factors had a higher absolute incidence of excess serious CV thrombotic events, due to their increased baseline rate.

Some observational studies found that this increased risk of serious CV thrombotic events began as early as the first weeks of treatment. The increase in CV thrombotic risk has been observed most consistently at higher doses. To minimize the potential risk for an adverse CV event in NSAID-treated patients, use the lowest effective dose for the shortest duration possible.

• Physicians and patients should remain alert for the development of such events, throughout the entire treatment course, even in the absence of previous CV symptoms.
• Patients should be informed about the symptoms of serious CV events and the steps to take if they occur.
• There is no consistent evidence that concurrent use of aspirin mitigates the increased risk of serious CV thrombotic events associated with NSAID use.

The concurrent use of aspirin and an NSAID, such as meloxicam, increases the risk of serious gastrointestinal (GI) events, Status Post Coronary Artery Bypass Graft (CABG) Surgery Two large, controlled clinical trials of a COX-2 selective NSAID for the treatment of pain in the first 10-14 days following CABG surgery found an increased incidence of myocardial infarction and stroke.

1. NSAIDs are contraindicated in the setting of CABG,
2. Post-MI Patients Observational studies conducted in the Danish National Registry have demonstrated that patients treated with NSAIDs in the post-MI period were at increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment.

In this same cohort, the incidence of death in the first year post-MI was 20 per 100 person years in NSAID-treated patients compared to 12 per 100 person years in non-NSAID exposed patients. Although the absolute rate of death declined somewhat after the first year post-MI, the increased relative risk of death in NSAID users persisted over at least the next four years of follow-up.

Avoid the use of meloxicam in patients with a recent MI unless the benefits are expected to outweigh the risk of recurrent CV thrombotic events. If meloxicam is used in patients with a recent MI, monitor patients for signs of cardiac ischemia.5.2 Gastrointestinal Bleeding, Ulceration, and Perforation NSAIDs, including meloxicam, can cause serious gastrointestinal (GI) adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal.

These serious adverse events can occur at any time, with or without warning symptoms, in patients treated with NSAIDs. Only one in five patients who develop a serious upper GI adverse event on NSAID therapy is symptomatic. Upper GI ulcers, gross bleeding, or perforation caused by NSAIDs occurred in approximately 1% of patients treated for 3-6 months, and in about 2-4% of patients treated for one year.

1. However, even short-term NSAID therapy is not without risk.
2. Risk Factors for GI Bleeding, Ulceration, and Perforation Patients with a prior history of peptic ulcer disease and/or GI bleeding who used NSAIDs had a greater than 10-fold increased risk for developing a GI bleed compared to patients without these risk factors.

Other factors that increase the risk of GI bleeding in patients treated with NSAIDs include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or selective serotonin reuptake inhibitors (SSRIs); smoking; use of alcohol; older age; and poor general health status.

1. Most postmarketing reports of fatal GI events occurred in elderly or debilitated patients.
2. Additionally, patients with advanced liver disease and/or coagulopathy are at increased risk for GI bleeding.
3. Strategies to Minimize the GI Risks in NSAID-treated patients: Use the lowest effective dosage for the shortest possible duration.

Avoid administration of more than one NSAID at a time. Avoid use in patients at higher risk unless benefits are expected to outweigh the increased risk of bleeding. For such patients, as well as those with active GI bleeding, consider alternate therapies other than NSAIDs.

Remain alert for signs and symptoms of GI ulceration and bleeding during NSAID therapy. If a serious GI adverse event is suspected, promptly initiate evaluation and treatment, and discontinue meloxicam until a serious GI adverse event is ruled out. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, monitor patients more closely for evidence of GI bleeding,5.3 Hepatotoxicity Elevations of ALT or AST (three or more times the upper limit of normal ) have been reported in approximately 1% of NSAID-treated patients in clinical trials.

In addition, rare, sometimes fatal, cases of severe hepatic injury, including fulminant hepatitis, liver necrosis, and hepatic failure have been reported. Elevations of ALT or AST (less than three times ULN) may occur in up to 15% of patients treated with NSAIDs including meloxicam.

1. Inform patients of the warning signs and symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, diarrhea, pruritus, jaundice, right upper quadrant tenderness, and “flu-like” symptoms).
2. If clinical signs and symptoms consistent with liver disease develop, or if systemic manifestations occur (e.g., eosinophilia, rash, etc.), discontinue meloxicam immediately, and perform a clinical evaluation of the patient,5.4 Hypertension NSAIDs, including meloxicam, can lead to new onset or worsening of preexisting hypertension, either of which may contribute to the increased incidence of CV events.

Patients taking angiotensin converting enzyme (ACE) inhibitors, thiazide diuretics, or loop diuretics may have impaired response to these therapies when taking NSAIDs, Monitor blood pressure (BP) during the initiation of NSAID treatment and throughout the course of therapy.5.5 Heart Failure and Edema The Coxib and traditional NSAID Trialists’ Collaboration meta-analysis of randomized controlled trials demonstrated an approximately two-fold increase in hospitalizations for heart failure in COX-2 selectivetreated patients and nonselective NSAID-treated patients compared to placebo-treated patients.

1. In a Danish National Registry study of patients with heart failure, NSAID use increased the risk of MI, hospitalization for heart failure, and death.
2. Additionally, fluid retention and edema have been observed in some patients treated with NSAIDs.
3. Use of meloxicam may blunt the CV effects of several therapeutic agents used to treat these medical conditions (e.g., diuretics, ACE inhibitors, or angiotensin receptor blockers ),

Avoid the use of meloxicam in patients with severe heart failure unless the benefits are expected to outweigh the risk of worsening heart failure. If meloxicam is used in patients with severe heart failure, monitor patients for signs of worsening heart failure.5.6 Renal Toxicity and Hyperkalemia Renal Toxicity Long-term administration of NSAIDs, including meloxicam, has resulted in renal papillary necrosis, renal insufficiency, acute renal failure, and other renal injury.

Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation.

Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia, heart failure, liver dysfunction, those taking diuretics and ACE inhibitors or ARBs, and the elderly. Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.

• The renal effects of meloxicam may hasten the progression of renal dysfunction in patients with preexisting renal disease.
• Because some meloxicam metabolites are excreted by the kidney, monitor patients for signs of worsening renal function.
• Correct volume status in dehydrated or hypovolemic patients prior to initiating meloxicam.

Monitor renal function in patients with renal or hepatic impairment, heart failure, dehydration, or hypovolemia during use of meloxicam, No information is available from controlled clinical studies regarding the use of meloxicam in patients with advanced renal disease.

Avoid the use of meloxicam in patients with advanced renal disease unless the benefits are expected to outweigh the risk of worsening renal function. If meloxicam is used in patients with advanced renal disease, monitor patients for signs of worsening renal function, Hyperkalemia Increases in serum potassium concentration, including hyperkalemia, have been reported with use of NSAIDs, even in some patients without renal impairment.

In patients with normal renal function, these effects have been attributed to a hyporeninemic-hypoaldosteronism state.5.7 Anaphylactic Reactions Meloxicam has been associated with anaphylactic reactions in patients with and without known hypersensitivity to meloxicam and in patients with aspirin-sensitive asthma,

Seek emergency help if an anaphylactic reaction occurs.5.8 Exacerbation of Asthma Related to Aspirin Sensitivity A subpopulation of patients with asthma may have aspirin-sensitive asthma which may include chronic rhinosinusitis complicated by nasal polyps; severe, potentially fatal bronchospasm; and/or intolerance to aspirin and other NSAIDs.

Because cross-reactivity between aspirin and other NSAIDs has been reported in such aspirin-sensitive patients, meloxicam is contraindicated in patients with this form of aspirin sensitivity, When meloxicam is used in patients with preexisting asthma (without known aspirin sensitivity), monitor patients for changes in the signs and symptoms of asthma.5.9 Serious Skin Reactions NSAIDs, including meloxicam, can cause serious skin adverse reactions such as exfoliative dermatitis, Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal.

These serious events may occur without warning. Inform patients about the signs and symptoms of serious skin reactions, and to discontinue the use of meloxicam at the first appearance of skin rash or any other sign of hypersensitivity. Meloxicam is contraindicated in patients with previous serious skin reactions to NSAIDs,5.10 Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) has been reported in patients taking NSAIDs such as meloxicam.

Meloxicam 15 mg 7.5 mg dosage and side effects

Some of these events have been fatal or life-threatening. DRESS typically, although not exclusively, presents with fever, rash, lymphadenopathy, and/or facial swelling. Other clinical manifestations may include hepatitis, nephritis, hematological abnormalities, myocarditis, or myositis.

1. Sometimes symptoms of DRESS may resemble an acute viral infection.
2. Eosinophilia is often present.
3. Because this disorder is variable in its presentation, other organ systems not noted here may be involved.
4. It is important to note that early manifestations of hypersensitivity, such as fever or lymphadenopathy, may be present even though rash is not evident.

If such signs or symptoms are present, discontinue meloxicam and evaluate the patient immediately 5.11 Fetal Toxicity Premature Closure of Fetal Ductus Arteriosus Avoid use of NSAIDs, including meloxicam, in pregnant women at about 30 weeks gestation and later.

• NSAIDs, including meloxicam, increase the risk of premature closure of the fetal ductus arteriosus at approximately this gestational age.
• Oligohydramnios/Neonatal Renal Impairment Use of NSAIDs, including meloxicam, at about 20 weeks gestation or later in pregnancy may cause fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment.

These adverse outcomes are seen, on average, after days to weeks of treatment, although oligohydramnios has been infrequently reported as soon as 48 hours after NSAID initiation. Oligohydramnios is often, but not always, reversible with treatment discontinuation.

1. Complications of prolonged oligohydramnios may, for example, include limb contractures and delayed lung maturation.
2. In some postmarketing cases of impaired neonatal renal function, invasive procedures such as exchange transfusion or dialysis were required.
3. If NSAID treatment is necessary between about 20 weeks and 30 weeks gestation, limit meloxicam use to the lowest effective dose and shortest duration possible.

Consider ultrasound monitoring of amniotic fluid if meloxicam treatment extends beyond 48 hours. Discontinue meloxicam if oligohydramnios occurs and follow up according to clinical practice,5.12 Hematologic Toxicity Anemia has occurred in NSAID-treated patients.

This may be due to occult or gross blood loss, fluid retention, or an incompletely described effect on erythropoiesis. If a patient treated with meloxicam has any signs or symptoms of anemia, monitor hemoglobin or hematocrit. NSAIDs, including meloxicam, may increase the risk of bleeding events. Co-morbid conditions such as coagulation disorders or concomitant use of warfarin, other anticoagulants, antiplatelet agents (e.g., aspirin), serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) may increase this risk.

Monitor these patients for signs of bleeding,5.13 Masking of Inflammation and Fever The pharmacological activity of meloxicam in reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections.5.14 Laboratory Monitoring Because serious GI bleeding, hepatotoxicity, and renal injury can occur without warning symptoms or signs, consider monitoring patients on long-term NSAID treatment with a CBC and a chemistry profile periodically,

The following adverse reactions are discussed in greater detail in other sections of the labeling: Cardiovascular Thrombotic Events GI Bleeding, Ulceration, and Perforation Hepatotoxicity Hypertension Heart Failure and Edema Renal Toxicity and Hyperkalemia Anaphylactic Reactions Serious Skin Reactions Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Fetal Toxicity Hematologic Toxicity 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Adults Osteoarthritis and Rheumatoid Arthritis The meloxicam Phase 2/3 clinical trial database includes 10,122 OA patients and 1012 RA patients treated with meloxicam 7.5 mg/day, 3505 OA patients and 1351 RA patients treated with meloxicam 15 mg/day.

• Meloxicam at these doses was administered to 661 patients for at least 6 months and to 312 patients for at least one year.
• Approximately 10,500 of these patients were treated in ten placebo- and/or active-controlled osteoarthritis trials and 2363 of these patients were treated in ten placebo- and/or active-controlled rheumatoid arthritis trials.

Gastrointestinal (GI) adverse events were the most frequently reported adverse events in all treatment groups across meloxicam trials. A 12-week multicenter, double-blind, randomized trial was conducted in patients with osteoarthritis of the knee or hip to compare the efficacy and safety of meloxicam with placebo and with an active control.

Two 12-week multicenter, double-blind, randomized trials were conducted in patients with rheumatoid arthritis to compare the efficacy and safety of meloxicam with placebo. Table 1a depicts adverse events that occurred in ≥2% of the meloxicam treatment groups in a 12-week placebo- and active-controlled osteoarthritis trial.

Table 1b depicts adverse events that occurred in ≥2% of the meloxicam treatment groups in two 12-week placebo-controlled rheumatoid arthritis trials. Table 1a Adverse Events (%) Occurring in ≥2% of Meloxicam Patients in a 12-Week Osteoarthritis Placebo- and Active-Controlled Trial

Placebo	Meloxicam 7.5 mg daily	Meloxicam 15 mg daily	Diclofenac 100 mg daily
No. of Patients	157	154	156	153
Gastrointestinal	17.2	20.1	17.3	28.1
Abdominal pain	2.5	1.9	2.6	1.3
Diarrhea	3.8	7.8	3.2	9.2
Dyspepsia	4.5	4.5	4.5	6.5
Flatulence	4.5	3.2	3.2	3.9
Nausea	3.2	3.9	3.8	7.2
Body as a Whole
Accident household	1.9	4.5	3.2	2.6
Edema1	2.5	1.9	4.5	3.3
Fall	0.6	2.6	0.0	1.3
Influenza-like symptoms	5.1	4.5	5.8	2.6
Central and Peripheral Nervous System
Dizziness	3.2	2.6	3.8	2.0
Headache	10.2	7.8	8.3	5.9
Respiratory
Pharyngitis	1.3	0.6	3.2	1.3
Upper respiratory tract infection	1.9	3.2	1.9	3.3
Skin
Rash2	2.5	2.6	0.6	2.0

1WHO preferred terms edema, edema dependent, edema peripheral, and edema legs combined 2WHO preferred terms rash, rash erythematous, and rash maculo-papular combined Table 1b Adverse Events (%) Occurring in ≥2% of Meloxicam Patients in two 12-Week Rheumatoid Arthritis Placebo-Controlled Trials

Placebo	Meloxicam	Meloxicam
		7.5 mg daily	15 mg daily
No. of Patients	469	481	477
Gastrointestinal Disorders	14.1	18.9	16.8
Abdominal pain NOS2	0.6	2.9	2.3
Dyspeptic signs and symptoms1	3.8	5.8	4.0
Nausea2	2.6	3.3	3.8
General Disorders and Administration Site Conditions
Influenza-like illness2	2.1	2.9	2.3
Infection and Infestations
Upper respiratory tract infections-pathogen class unspecified1	4.1	7.0	6.5
Musculoskeletal and Connective Tissue Disorders
Joint related signs and symptoms1	1.9	1.5	2.3
Nervous System Disorders
Headaches NOS2	6.4	6.4	5.5
Skin and Subcutaneous Tissue Disorders
Rash NOS2	1.7	1.0	2.1

1 MedDRA high level term (preferred terms): dyspeptic signs and symptoms (dyspepsia, dyspepsia aggravated, eructation, gastrointestinal irritation), upper respiratory tract infections-pathogen unspecified (laryngitis NOS, pharyngitis NOS, sinusitis NOS), joint related signs and symptoms (arthralgia, arthralgia aggravated, joint crepitation, joint effusion, joint swelling) 2 MedDRA preferred term: nausea, abdominal pain NOS, influenza-like illness, headaches NOS, and rash NOS The adverse events that occurred with meloxicam in ≥2% of patients treated short-term (4 to 6 weeks) and long-term (6 months) in active-controlled osteoarthritis trials are presented in Table 2.

4 to 6 Weeks	Controlled Trials	6 Month	Controlled Trials
	Meloxicam 7.5 mg daily	Meloxicam 15 mg daily	Meloxicam 7.5 mg daily	Meloxicam 15 mg daily
No. of Patients	8955	256	169	306
Gastrointestinal	11.8	18.0	26.6	24.2
Abdominal pain	2.7	2.3	4.7	2.9
Constipation	0.8	1.2	1.8	2.6
Diarrhea	1.9	2.7	5.9	2.6
Dyspepsia	3.8	7.4	8.9	9.5
Flatulence	0.5	0.4	3.0	2.6
Nausea	2.4	4.7	4.7	7.2
Vomiting	0.6	0.8	1.8	2.6
Body as a Whole
Accident household	0.0	0.0	0.6	2.9
Edema1	0.6	2.0	2.4	1.6
Pain	0.9	2.0	3.6	5.2
Central and Peripheral Nervous System
Dizziness	1.1	1.6	2.4	2.6
Headache	2.4	2.7	3.6	2.6
Hematologic
Anemia	0.1	0.0	4.1	2.9
Musculoskeletal
Arthralgia	0.5	0.0	5.3	1.3
Back pain	0.5	0.4	3.0	0.7
Psychiatric
Insomnia	0.4	0.0	3.6	1.6
Respiratory
Coughing	0.2	0.8	2.4	1.0
Upper respiratory tract infection	0.2	0.0	8.3	7.5
Skin
Pruritus	0.4	1.2	2.4	0.0
Rash2	0.3	1.2	3.0	1.3
Urinary
Micturition frequency	0.1	0.4	2.4	1.3
Urinary tract infection	0.3	0.4	4.7	6.9

1 WHO preferred terms edema, edema dependent, edema peripheral, and edema legs combined 2 WHO preferred terms rash, rash erythematous, and rash maculo-papular combined Higher doses of meloxicam (22.5 mg and greater) have been associated with an increased risk of serious GI events; therefore, the daily dose of meloxicam should not exceed 15 mg. Pediatrics Pauciarticular and Polyarticular Course Juvenile Rheumatoid Arthritis (JRA) Three hundred and eighty-seven patients with pauciarticular and polyarticular course JRA were exposed to meloxicam with doses ranging from 0.125 to 0.375 mg/kg per day in three clinical trials. These studies consisted of two 12-week multicenter, double-blind, randomized trials (one with a 12-week open-label extension and one with a 40-week extension) and one 1-year open-label PK study. The adverse events observed in these pediatric studies with meloxicam were similar in nature to the adult clinical trial experience, although there were differences in frequency. In particular, the following most common adverse events, abdominal pain, vomiting, diarrhea, headache, and pyrexia, were more common in the pediatric than in the adult trials. Rash was reported in seven (<2%) patients receiving meloxicam. No unexpected adverse events were identified during the course of the trials. The adverse events did not demonstrate an age or gender-specific subgroup effect. The following is a list of adverse drug reactions occurring in <2% of patients receiving meloxicam in clinical trials involving approximately 16,200 patients.

Body as a Whole	allergic reaction, face edema, fatigue, fever, hot flushes, malaise, syncope, weight decrease, weight increase
Cardiovascular	angina pectoris, cardiac failure, hypertension, hypotension, myocardial infarction, vasculitis
Central and Peripheral Nervous System	convulsions, paresthesia, tremor, vertigo
Gastrointestinal	colitis, dry mouth, duodenal ulcer, eructation, esophagitis, gastric ulcer, gastritis, gastroesophageal reflux, gastrointestinal hemorrhage, hematemesis, hemorrhagic duodenal ulcer, hemorrhagic gastric ulcer, intestinal perforation, melena, pancreatitis, perforated duodenal ulcer, perforated gastric ulcer, stomatitis ulcerative
Heart Rate and Rhythm	arrhythmia, palpitation, tachycardia
Hematologic	leukopenia, purpura, thrombocytopenia
Liver and Biliary System	ALT increased, AST increased, bilirubinemia, GGT increased, hepatitis
Metabolic and Nutritional	dehydration
Psychiatric	abnormal dreaming, anxiety, appetite increased, confusion, depression, nervousness, somnolence
Respiratory	asthma, bronchospasm, dyspnea
Skin and Appendages	alopecia, angioedema, bullous eruption, photosensitivity reaction, pruritus, sweating increased, urticaria
Special Senses	abnormal vision, conjunctivitis, taste perversion, tinnitus
Urinary System	albuminuria, BUN increased, creatinine increased, hematuria, renal failure

6.2 Postmarketing Experience The following adverse reactions have been identified during post approval use of meloxicam. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Decisions about whether to include an adverse event from spontaneous reports in labeling are typically based on one or more of the following factors: (1) seriousness of the event, (2) number of reports, or (3) strength of causal relationship to the drug. Adverse reactions reported in worldwide postmarketing experience or the literature include: acute urinary retention; agranulocytosis; alterations in mood (such as mood elevation); anaphylactoid reactions including shock; erythema multiforme; exfoliative dermatitis; interstitial nephritis; jaundice; liver failure; Stevens-Johnson syndrome; toxic epidermal necrolysis, and infertility female.

See Table 3 for clinically significant drug interactions with meloxicam. See also Warnings and Precautions (5.2, 5.6, 5.12) and Clinical Pharmacology (12.3). Table 3 Clinically Significant Drug Interactions with Meloxicam

Drugs that Interfere with Hemostasis
Clinical Impact:	Meloxicam and anticoagulants such as warfarin have a synergistic effect on bleeding. The concomitant use of meloxicam and anticoagulants have an increased risk of serious bleeding compared to the use of either drug alone. Serotonin release by platelets plays an important role in hemostasis. Case-control and cohort epidemiological studies showed that concomitant use of drugs that interfere with serotonin reuptake and an NSAID may potentiate the risk of bleeding more than an NSAID alone.
Intervention:	Monitor patients with concomitant use of meloxicam with anticoagulants (e.g., warfarin), antiplatelet agents (e.g., aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) for signs of bleeding,
Aspirin
Clinical Impact:	Controlled clinical studies showed that the concomitant use of NSAIDs and analgesic doses of aspirin does not produce any greater therapeutic effect than the use of NSAIDs alone. In a clinical study, the concomitant use of an NSAID and aspirin was associated with a significantly increased incidence of GI adverse reactions as compared to use of the NSAID alone,
Intervention:	Concomitant use of meloxicam and low dose aspirin or analgesic doses of aspirin is not generally recommended because of the increased risk of bleeding, Meloxicam is not a substitute for low dose aspirin for cardiovascular protection.
ACE Inhibitors, Angiotensin Receptor Blockers, or Beta-Blockers
Clinical Impact:	NSAIDs may diminish the antihypertensive effect of angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or beta-blockers (including propranolol). In patients who are elderly, volume-depleted (including those on diuretic therapy), or have renal impairment, coadministration of an NSAID with ACE inhibitors or ARBs may result in deterioration of renal function, including possible acute renal failure. These effects are usually reversible.
Intervention:	During concomitant use of meloxicam and ACE inhibitors, ARBs, or beta-blockers, monitor blood pressure to ensure that the desired blood pressure is obtained. During concomitant use of meloxicam and ACE inhibitors or ARBs in patients who are elderly, volume-depleted, or have impaired renal function, monitor for signs of worsening renal function, When these drugs are administered concomitantly, patients should be adequately hydrated. Assess renal function at the beginning of the concomitant treatment and periodically thereafter.
Diuretics
Clinical Impact:	Clinical studies, as well as post-marketing observations, showed that NSAIDs reduced the natriuretic effect of loop diuretics (e.g., furosemide) and thiazide diuretics in some patients. This effect has been attributed to the NSAID inhibition of renal prostaglandin synthesis. However, studies with furosemide agents and meloxicam have not demonstrated a reduction in natriuretic effect. Furosemide single and multiple dose pharmacodynamics and pharmacokinetics are not affected by multiple doses of meloxicam.
Intervention:	During concomitant use of meloxicam with diuretics, observe patients for signs of worsening renal function, in addition to assuring diuretic efficacy including antihypertensive effects,
Lithium
Clinical Impact:	NSAIDs have produced elevations in plasma lithium levels and reductions in renal lithium clearance. The mean minimum lithium concentration increased 15%, and the renal clearance decreased by approximately 20%. This effect has been attributed to NSAID inhibition of renal prostaglandin synthesis,
Intervention:	During concomitant use of meloxicam and lithium, monitor patients for signs of lithium toxicity.
Methotrexate
Clinical Impact:	Concomitant use of NSAIDs and methotrexate may increase the risk for methotrexate toxicity (e.g., neutropenia, thrombocytopenia, renal dysfunction).
Intervention:	During concomitant use of meloxicam and methotrexate, monitor patients for methotrexate toxicity.
Cyclosporine
Clinical Impact:	Concomitant use of meloxicam and cyclosporine may increase cyclosporine’s nephrotoxicity.
Intervention:	During concomitant use of meloxicam and cyclosporine, monitor patients for signs of worsening renal function.
NSAIDs and Salicylates
Clinical Impact:	Concomitant use of meloxicam with other NSAIDs or salicylates (e.g., diflunisal, salsalate) increases the risk of GI toxicity, with little or no increase in efficacy,
Intervention:	The concomitant use of meloxicam with other NSAIDs or salicylates is not recommended.
Pemetrexed
Clinical Impact:	Concomitant use of meloxicam and pemetrexed may increase the risk of pemetrexed-associated myelosuppression, renal, and GI toxicity (see the pemetrexed prescribing information).
Intervention:	During concomitant use of meloxicam and pemetrexed, in patients with renal impairment whose creatinine clearance ranges from 45 to 79 mL/min, monitor for myelosuppression, renal and GI toxicity. Patients taking meloxicam should interrupt dosing for at least five days before, the day of, and two days following pemetrexed administration. In patients with creatinine clearance below 45 mL/min, the concomitant administration of meloxicam with pemetrexed is not recommended.

8.1 Pregnancy Risk Summary Use of NSAIDs, including meloxicam, can cause premature closure of the fetal ductus arteriosus and fetal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. Because of these risks, limit dose and duration of meloxicam use between about 20 and 30 weeks of gestation, and avoid meloxicam use at about 30 weeks of gestation and later in pregnancy (see Clinical Considerations, Data).

1. Premature Closure of Fetal Ductus Arteriosus Use of NSAIDs, including meloxicam, at about 30 weeks gestation or later in pregnancy increases the risk of premature closure of the fetal ductus arteriosus.
2. Oligohydramnios/Neonatal Renal Impairment Use of NSAIDs at about 20 weeks gestation or later in pregnancy has been associated with cases of fetal renal dysfunction leading to oligohydramnios, and in some cases, neonatal renal impairment.

Data from observational studies regarding potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive. In animal reproduction studies, embryofetal death was observed in rats and rabbits treated during the period of organogenesis with meloxicam at oral doses equivalent to 0.65- and 6.5-times the maximum recommended human dose (MRHD) of meloxicam.

Increased incidence of septal heart defects were observed in rabbits treated throughout embryogenesis with meloxicam at an oral dose equivalent to 78-times the MRHD. In pre- and post-natal reproduction studies, there was an increased incidence of dystocia, delayed parturition, and decreased offspring survival at 0.08-times MRHD of meloxicam.

No teratogenic effects were observed in rats and rabbits treated with meloxicam during organogenesis at an oral dose equivalent to 2.6 and 26-times the MRHD, Based on animal data, prostaglandins have been shown to have an important role in endometrial vascular permeability, blastocyst implantation, and decidualization.

• In animal studies, administration of prostaglandin synthesis inhibitors such as meloxicam, resulted in increased pre- and post-implantation loss.
• Prostaglandins also have been shown to have an important role in fetal kidney development.
• In published animal studies, prostaglandin synthesis inhibitors have been reported to impair kidney development when administered at clinically relevant doses.

The estimated background risk of major birth defects and miscarriage for the indicated population(s) is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.

• Clinical Considerations Fetal/Neonatal Adverse Reactions Premature Closure of Fetal Ductus Arteriosus: Avoid use of NSAIDs in women at about 30 weeks gestation and later in pregnancy, because NSAIDs, including meloxicam, can cause premature closure of the fetal ductus arteriosus (see Data).
• Oligohydramnios/Neonatal Renal Impairment: If an NSAID is necessary at about 20 weeks gestation or later in pregnancy, limit the use to the lowest effective dose and shortest duration possible.

If meloxicam treatment extends beyond 48 hours, consider monitoring with ultrasound for oligohydramnios. If oligohydramnios occurs, discontinue meloxicam and follow up according to clinical practice (see Data). Labor or Delivery There are no studies on the effects of meloxicam during labor or delivery.

In animal studies, NSAIDs, including meloxicam, inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth. Data Human Data Premature Closure of Fetal Ductus Arteriosus: Published literature reports that the use of NSAIDs at about 30 weeks of gestation and later in pregnancy may cause premature closure of the fetal ductus arteriosus.

Oligohydramnios/Neonatal Renal Impairment: Published studies and postmarketing reports describe maternal NSAID use at about 20 weeks gestation or later in pregnancy associated with fetal renal dysfunction leading to oligohydramnios, and in some cases, neonatal renal impairment.

These adverse outcomes are seen, on average, after days to weeks of treatment, although oligohydramnios has been infrequently reported as soon as 48 hours after NSAID initiation. In many cases, but not all, the decrease in amniotic fluid was transient and reversible with cessation of the drug. There have been a limited number of case reports of maternal NSAID use and neonatal renal dysfunction without oligohydramnios, some of which were irreversible.

Some cases of neonatal renal dysfunction required treatment with invasive procedures, such as exchange transfusion or dialysis. Methodological limitations of these postmarketing studies and reports include lack of a control group; limited information regarding dose, duration, and timing of drug exposure; and concomitant use of other medications.

• These limitations preclude establishing a reliable estimate of the risk of adverse fetal and neonatal outcomes with maternal NSAID use.
• Because the published safety data on neonatal outcomes involved mostly preterm infants, the generalizability of certain reported risks to the full-term infant exposed to NSAIDs through maternal use is uncertain.

Animal Data Meloxicam was not teratogenic when administered to pregnant rats during fetal organogenesis at oral doses up to 4 mg/kg/day (2.6-fold greater than the MRHD of 15 mg of meloxicam based on BSA comparison). Administration of meloxicam to pregnant rabbits throughout embryogenesis produced an increased incidence of septal defects of the heart at an oral dose of 60 mg/kg/day (78-fold greater than the MRHD based on BSA comparison).

The no effect level was 20 mg/kg/day (26-fold greater than the MRHD based on BSA conversion). In rats and rabbits, embryolethality occurred at oral meloxicam doses of 1 mg/kg/day and 5 mg/kg/day, respectively (0.65- and 6.5-fold greater, respectively, than the MRHD based on BSA comparison) when administered throughout organogenesis.

Oral administration of meloxicam to pregnant rats during late gestation through lactation increased the incidence of dystocia, delayed parturition, and decreased offspring survival at meloxicam doses of 0.125 mg/kg/day or greater (0.08-times MRHD based on BSA comparison).8.2 Lactation Risk Summary There are no human data available on whether meloxicam is present in human milk, or on the effects on breastfed infants, or on milk production.

1. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for meloxicam and any potential adverse effects on the breastfed infant from the meloxicam or from the underlying maternal condition.
2. Data Animal Data Meloxicam was present in the milk of lactating rats at concentrations higher than those in plasma.8.3 Females and Males of Reproductive Potential Infertility Females Based on the mechanism of action, the use of prostaglandin-mediated NSAIDs, including meloxicam, may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women.

Published animal studies have shown that administration of prostaglandin synthesis inhibitors has the potential to disrupt prostaglandin-mediated follicular rupture required for ovulation. Small studies in women treated with NSAIDs have also shown a reversible delay in ovulation.

Consider withdrawal of NSAIDs, including meloxicam, in women who have difficulties conceiving or who are undergoing investigation of infertility.8.4 Pediatric Use The safety and effectiveness of meloxicam in pediatric JRA patients from 2 to 17 years of age has been evaluated in three clinical trials,8.5 Geriatric Use Elderly patients, compared to younger patients, are at greater risk for NSAID-associated serious cardiovascular, gastrointestinal, and/or renal adverse reactions.

If the anticipated benefit for the elderly patient outweighs these potential risks, start dosing at the low end of the dosing range, and monitor patients for adverse effects,8.6 Hepatic Impairment No dose adjustment is necessary in patients with mild to moderate hepatic impairment.

• Patients with severe hepatic impairment have not been adequately studied.
• Since meloxicam is significantly metabolized in the liver and hepatotoxicity may occur, use meloxicam with caution in patients with hepatic impairment,8.7 Renal Impairment No dose adjustment is necessary in patients with mild to moderate renal impairment.

Patients with severe renal impairment have not been studied. The use of meloxicam in subjects with severe renal impairment is not recommended. In patients on hemodialysis, meloxicam should not exceed 7.5 mg per day. Meloxicam is not dialyzable, Symptoms following acute NSAID overdosages have been typically limited to lethargy, drowsiness, nausea, vomiting, and epigastric pain, which have been generally reversible with supportive care.

1. Gastrointestinal bleeding has occurred.
2. Hypertension, acute renal failure, respiratory depression, and coma have occurred, but were rare,
3. Manage patients with symptomatic and supportive care following an NSAID overdosage.
4. There are no specific antidotes.
5. Consider emesis and/or activated charcoal (60 to 100 grams in adults, 1 to 2 grams per kg of body weight in pediatric patients) and/or osmotic cathartic in symptomatic patients seen within four hours of ingestion or in patients with a large overdosage (5 to 10 times the recommended dosage).

Forced diuresis, alkalinization of urine, hemodialysis, or hemoperfusion may not be useful due to high protein binding There is limited experience with meloxicam overdosage. Cholestyramine is known to accelerate the clearance of meloxicam. Accelerated removal of meloxicam by 4 g oral doses of cholestyramine given three times a day was demonstrated in a clinical trial.

1. Administration of cholestyramine may be useful following an overdosage.
2. For additional information about overdosage treatment, call a poison control center (1-800-222-1222) Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID).
3. Each tablet contains 7.5 mg or 15 mg meloxicam, USP for oral administration.

Meloxicam is chemically designated as 4-hydroxy-2-methyl-N-(5-methyl-2-thiazolyl)-2H-1,2-benzothiazine-3-carboxamide-1,1-dioxide. The molecular weight is 351.4. Its empirical formula is C14H13N3O4S2 and it has the following structural formula: Meloxicam is a pale yellow solid, practically insoluble in water, with higher solubility observed in strong acids and bases. It is very slightly soluble in methanol. Meloxicam has an apparent partition coefficient (log P)app = 0.1 in n-octanol/buffer pH 7.4.

1. Meloxicam has pKa values of 1.1 and 4.2.
2. Meloxicam is available as a tablet for oral administration containing 7.5 mg or 15 mg meloxicam, USP.
3. The inactive ingredients in meloxicam tablets, USP include starch, microcrystalline cellulose, lactose anhydrous, colloidal silicon dioxide, sodium citrate dihydrate, magnesium stearate.

Meloxicam is a pale yellow solid, practically insoluble in water, with higher solubility observed in strong acids and bases. It is very slightly soluble in methanol. Meloxicam has an apparent partition coefficient (log P)app = 0.1 in n-octanol/buffer pH 7.4.

Steady State			Single Dose
Pharmacokinetic Parameters (%CV)	Healthy male adults (Fed)2	Elderly males (Fed)2	Elderly females (Fed)2	Renal failure (Fasted)	Hepatic insufficiency (Fasted)
	7.5 mg3 tablets	15 mg capsules	15 mg capsules	15 mg capsules	15 mg capsules
N	18	5	8	12	12
Cmax	1.05 (20)	2.3 (59)	3.2 (24)	0.59 (36)	0.84 (29)
tmax	4.9 (8)	5 (12)	6 (27)	4 (65)	10 (87)
t1/2	20.1 (29)	21 (34)	24 (34)	18 (46)	16 (29)
CL/f	8.8 (29)	9.9 (76)	5.1 (22)	19 (43)	11 (44)
Vz/f4	14.7 (32)	15 (42)	10 (30)	26 (44)	14 (29)

1 The parameter values in the table are from various studies 2 not under high fat conditions 3 Meloxicam tablets 4 Vz/f = Dose/ (AUC•Kel) Food and Antacid Effects Administration of meloxicam capsules following a high fat breakfast (75 g of fat) resulted in mean peak drug levels (i.e., Cmax) being increased by approximately 22% while the extent of absorption (AUC) was unchanged.

The time to maximum concentration (Tmax) was achieved between 5 and 6 hours. In comparison, neither the AUC nor the Cmax values for meloxicam suspension were affected following a similar high fat meal, while mean Tmax values were increased to approximately 7 hours. No pharmacokinetic interaction was detected with concomitant administration of antacids.

Based on these results, meloxicam can be administered without regard to timing of meals or concomitant administration of antacids. Distribution The mean volume of distribution (Vss) of meloxicam is approximately 10 L. Meloxicam is ~99.4% bound to human plasma proteins (primarily albumin) within the therapeutic dose range.

1. The fraction of protein binding is independent of drug concentration, over the clinically relevant concentration range, but decreases to ~99% in patients with renal disease.
2. Meloxicam penetration into human red blood cells, after oral dosing, is less than 10%.
3. Following a radiolabeled dose, over 90% of the radioactivity detected in the plasma was present as unchanged meloxicam.

Meloxicam concentrations in synovial fluid, after a single oral dose, range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid as compared to plasma.

1. The significance of this penetration is unknown.
2. Elimination Metabolism Meloxicam is extensively metabolized in the liver.
3. Meloxicam metabolites include 5′-carboxy meloxicam (60% of dose), from P-450 mediated metabolism formed by oxidation of an intermediate metabolite 5′-hydroxymethyl meloxicam which is also excreted to a lesser extent (9% of dose).

In vitro studies indicate that CYP2C9 (cytochrome P450 metabolizing enzyme) plays an important role in this metabolic pathway with a minor contribution of the CYP3A4 isozyme. Patients’ peroxidase activity is probably responsible for the other two metabolites which account for 16% and 4% of the administered dose, respectively.

All the four metabolites are not known to have any in vivo pharmacological activity. Excretion Meloxicam excretion is predominantly in the form of metabolites, and occurs to equal extents in the urine and feces. Only traces of the unchanged parent compound are excreted in the urine (0.2%) and feces (1.6%).

The extent of the urinary excretion was confirmed for unlabeled multiple 7.5 mg doses: 0.5%, 6%, and 13% of the dose were found in urine in the form of meloxicam, and the 5′-hydroxymethyl and 5′-carboxy metabolites, respectively. There is significant biliary and/or enteral secretion of the drug.

• This was demonstrated when oral administration of cholestyramine following a single IV dose of meloxicam decreased the AUC of meloxicam by 50%.
• The mean elimination half-life (t1/2) ranges from 15 hours to 20 hours.
• The elimination half-life is constant across dose levels indicating linear metabolism within the therapeutic dose range.

Plasma clearance ranges from 7 to 9 mL/min. Specific Populations Pediatric After single (0.25 mg/kg) dose administration and after achieving steady state (0.375 mg/kg/day), there was a general trend of approximately 30% lower exposure in younger patients (2 to 6 years old) as compared to the older patients (7 to 16 years old).

The older patients had meloxicam exposures similar (single dose) or slightly reduced (steady state) to those in the adult patients, when using AUC values normalized to a dose of 0.25 mg/kg, The meloxicam mean (SD) elimination half-life was 15.2 (10.1) and 13.0 hours (3.0) for the 2 to 6 year old patients, and 7 to 16 year old patients, respectively.

In a covariate analysis, utilizing population pharmacokinetics body-weight, but not age, was the single predictive covariate for differences in the meloxicam apparent oral plasma clearance. The body-weight normalized apparent oral clearance values were adequate predictors of meloxicam exposure in pediatric patients.

1. The pharmacokinetics of meloxicam in pediatric patients under 2 years of age have not been investigated.
2. Geriatric Elderly males (≥65 years of age) exhibited meloxicam plasma concentrations and steady-state pharmacokinetics similar to young males.
3. Elderly females (≥65 years of age) had a 47% higher AUCss and 32% higher Cmax,ss as compared to younger females (≤55 years of age) after body weight normalization.

Despite the increased total concentrations in the elderly females, the adverse event profile was comparable for both elderly patient populations. A smaller free fraction was found in elderly female patients in comparison to elderly male patients. Sex Young females exhibited slightly lower plasma concentrations relative to young males.

• After single doses of 7.5 mg meloxicam, the mean elimination half-life was 19.5 hours for the female group as compared to 23.4 hours for the male group.
• At steady state, the data were similar (17.9 hours vs 21.4 hours).
• This pharmacokinetic difference due to gender is likely to be of little clinical importance.

There was linearity of pharmacokinetics and no appreciable difference in the Cmax or Tmax across genders. Hepatic Impairment Following a single 15 mg dose of meloxicam there was no marked difference in plasma concentrations in patients with mild (Child-Pugh Class I) or moderate (Child-Pugh Class II) hepatic impairment compared to healthy volunteers.

Protein binding of meloxicam was not affected by hepatic impairment. No dosage adjustment is necessary in patients with mild to moderate hepatic impairment. Patients with severe hepatic impairment (Child-Pugh Class III) have not been adequately studied, Renal Impairment Meloxicam pharmacokinetics have been investigated in subjects with mild and moderate renal impairment.

Total drug plasma concentrations of meloxicam decreased and total clearance of meloxicam increased with the degree of renal impairment while free AUC values were similar in all groups. The higher meloxicam clearance in subjects with renal impairment may be due to increased fraction of unbound meloxicam which is available for hepatic metabolism and subsequent excretion.

• No dosage adjustment is necessary in patients with mild to moderate renal impairment.
• Patients with severe renal impairment have not been adequately studied.
• The use of meloxicam in subjects with severe renal impairment is not recommended,
• Hemodialysis Following a single dose of meloxicam, the free Cmax plasma concentrations were higher in patients with renal failure on chronic hemodialysis (1% free fraction) in comparison to healthy volunteers (0.3% free fraction).

Hemodialysis did not lower the total drug concentration in plasma; therefore, additional doses are not necessary after hemodialysis. Meloxicam is not dialyzable, Drug Interaction Studies Aspirin: When NSAIDs were administered with aspirin, the protein binding of NSAIDs were reduced, although the clearance of free NSAID was not altered.

When meloxicam is administered with aspirin (1000 mg three times daily) to healthy volunteers, it tended to increase the AUC (10%) and Cmax (24%) of meloxicam. The clinical significance of this interaction is not known. See Table 3 for clinically significant drug interactions of NSAIDs with aspirin, Cholestyramine: Pretreatment for four days with cholestyramine significantly increased the clearance of meloxicam by 50%.

This resulted in a decrease in t1/2, from 19.2 hours to 12.5 hours, and a 35% reduction in AUC. This suggests the existence of a recirculation pathway for meloxicam in the gastrointestinal tract. The clinical relevance of this interaction has not been established.

1. Cimetidine: Concomitant administration of 200 mg cimetidine four times daily did not alter the single-dose pharmacokinetics of 30 mg meloxicam.
2. Digoxin: Meloxicam 15 mg once daily for 7 days did not alter the plasma concentration profile of digoxin after β-acetyldigoxin administration for 7 days at clinical doses.

In vitro testing found no protein binding drug interaction between digoxin and meloxicam. Lithium: In a study conducted in healthy subjects, mean pre-dose lithium concentration and AUC were increased by 21% in subjects receiving lithium doses ranging from 804 to 1072 mg twice daily with meloxicam 15 mg QD every day as compared to subjects receiving lithium alone,

• Methotrexate: A study in 13 rheumatoid arthritis (RA) patients evaluated the effects of multiple doses of meloxicam on the pharmacokinetics of methotrexate taken once weekly.
• Meloxicam did not have a significant effect on the pharmacokinetics of single doses of methotrexate.
• In vitro, methotrexate did not displace meloxicam from its human serum binding sites,

Warfarin: The effect of meloxicam on the anticoagulant effect of warfarin was studied in a group of healthy subjects receiving daily doses of warfarin that produced an INR (International Normalized Ratio) between 1.2 and 1.8. In these subjects, meloxicam did not alter warfarin pharmacokinetics and the average anticoagulant effect of warfarin as determined by prothrombin time.

However, one subject showed an increase in INR from 1.5 to 2.1. Caution should be used when administering meloxicam with warfarin since patients on warfarin may experience changes in INR and an increased risk of bleeding complications when a new medication is introduced,13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility Carcinogenesis There was no increase in tumor incidence in long-term carcinogenicity studies in rats (104 weeks) and mice (99 weeks) administered meloxicam at oral doses up to 0.8 mg/kg/day in rats and up to 8.0 mg/kg/day in mice (up to 0.5- and 2.6-times, respectively, the maximum recommended human dose of 15 mg/day meloxicam based on body surface area comparison).

Mutagenesis Meloxicam was not mutagenic in an Ames assay, or clastogenic in a chromosome aberration assay with human lymphocytes and an in vivo micronucleus test in mouse bone marrow. Impairment of Fertility Meloxicam did not impair male and female fertility in rats at oral doses up to 9 mg/kg/day in males and 5 mg/kg/day in females (up to 5.8- and 3.2-times greater, respectively, than the MRHD based on BSA comparison).14.1 Osteoarthritis and Rheumatoid Arthritis The use of meloxicam for the treatment of the signs and symptoms of osteoarthritis of the knee and hip was evaluated in a 12-week, double-blind, controlled trial.

Meloxicam (3.75 mg, 7.5 mg, and 15 mg daily) was compared to placebo. The four primary endpoints were investigator’s global assessment, patient global assessment, patient pain assessment, and total WOMAC score (a self-administered questionnaire addressing pain, function, and stiffness). Patients on meloxicam 7.5 mg daily and meloxicam 15 mg daily showed significant improvement in each of these endpoints compared with placebo.

The use of meloxicam for the management of signs and symptoms of osteoarthritis was evaluated in six double-blind, active-controlled trials outside the U.S. ranging from 4 weeks’ to 6 months’ duration. In these trials, the efficacy of meloxicam, in doses of 7.5 mg/day and 15 mg/day, was comparable to piroxicam 20 mg/day and diclofenac SR 100 mg/day and consistent with the efficacy seen in the U.S.

trial. The use of meloxicam for the treatment of the signs and symptoms of rheumatoid arthritis was evaluated in a 12-week, double-blind, controlled multinational trial. Meloxicam (7.5 mg, 15 mg, and 22.5 mg daily) was compared to placebo. The primary endpoint in this study was the ACR20 response rate, a composite measure of clinical, laboratory, and functional measures of RA response.

Patients receiving meloxicam 7.5 mg and 15 mg daily showed significant improvement in the primary endpoint compared with placebo. No incremental benefit was observed with the 22.5 mg dose compared to the 15 mg dose.14.2 Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course The use of meloxicam for the treatment of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in patients 2 years of age and older was evaluated in two 12-week, double-blind, parallel-arm, active-controlled trials.

Both studies included three arms: naproxen and two doses of meloxicam. In both studies, meloxicam dosing began at 0.125 mg/kg/day (7.5 mg maximum) or 0.25 mg/kg/day (15 mg maximum), and naproxen dosing began at 10 mg/kg/day. One study used these doses throughout the 12-week dosing period, while the other incorporated a titration after 4 weeks to doses of 0.25 mg/kg/day and 0.375 mg/kg/day (22.5 mg maximum) of meloxicam and 15 mg/kg/day of naproxen.

The efficacy analysis used the ACR Pediatric 30 responder definition, a composite of parent and investigator assessments, counts of active joints and joints with limited range of motion, and erythrocyte sedimentation rate. The proportion of responders were similar in all three groups in both studies, and no difference was observed between the meloxicam dose groups.

• Meloxicam tablets, USP 7.5 mg are yellow coloured, round, biconvex tablets, debossed with “158” on one side and “C” on the other.
• Meloxicam tablets, USP 7.5 mg are available as follows: Bottles of 90 Tablets: 80425-0043-03 Storage Store at 20°C to 25°C (68°F to 77°F),
• Eep meloxicam tablets in a dry place.

Dispense tablets in a tight container. Keep this and all medications out of the reach of children. Advise the patient to read the FDA-approved patient labeling (Medication Guide) that accompanies each prescription dispensed. Inform patients, families or their caregivers of the following information before initiating therapy with an NSAID and periodically during the course of ongoing therapy.

• Cardiovascular Thrombotic Events Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their healthcare provider immediately,
• Gastrointestinal Bleeding, Ulceration, and Perforation Advise patients to report symptoms of ulcerations and bleeding, including epigastric pain, dyspepsia, melena, and hematemesis to their healthcare provider.

In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, inform patients of the increased risk for the signs and symptoms of GI bleeding, Hepatotoxicity Inform patients of the warning signs and symptoms of hepatotoxicity (e.g., nausea, fatigue, lethargy, diarrhea, pruritus, jaundice, right upper quadrant tenderness, and “flu-like” symptoms).

If these occur, instruct patients to stop meloxicam and seek immediate medical therapy, Heart Failure and Edema Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur,

Anaphylactic Reactions Inform patients of the signs of an anaphylactic reaction (e.g., difficulty breathing, swelling of the face or throat). Instruct patients to seek immediate emergency help if these occur, Serious Skin Reactions, including DRESS Advise patients to stop taking meloxicam immediately if they develop any type of rash or fever and to contact their healthcare provider as soon as possible,

Female Fertility Advise females of reproductive potential who desire pregnancy that NSAIDs, including meloxicam, may be associated with a reversible delay in ovulation, Fetal Toxicity Inform pregnant women to avoid use of meloxicam and other NSAIDs starting at 30 weeks gestation because of the risk of the premature closing of the fetal ductus arteriosus.

If treatment with meloxicam is needed for a pregnant woman between about 20 to 30 weeks gestation, advise her that she may need to be monitored for oligohydramnios, if treatment continues for longer than 48 hours, Avoid Concomitant Use of NSAIDs Inform patients that the concomitant use of meloxicam with other NSAIDs or salicylates (e.g., diflunisal, salsalate) is not recommended due to the increased risk of gastrointestinal toxicity, and little or no increase in efficacy,

Alert patients that NSAIDs may be present in “over the counter” medications for treatment of colds, fever, or insomnia. Use of NSAIDs and Low-Dose Aspirin Inform patients not to use low-dose aspirin concomitantly with meloxicam until they talk to their healthcare provider, Manufactured by: Cipla, Ltd., Kurkumbh, India Manufactured for: Cipla USA, Inc.10 Independence Boulevard, Suite 300, Warren, NJ 07059 Revised: 05/2021 MEDICATION GUIDE Medication Guide for Nonsteroidal Anti-inflammatory Drugs (NSAIDs) What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)? NSAIDs can cause serious side effects, including: Increased risk of a heart attack or stroke that can lead to death,

This risk may happen early in treatment and may increase: with increasing doses of NSAIDs with longer use of NSAIDs Do not take NSAIDs right before or after a heart surgery called a “coronary artery bypass graft (CABG).” Avoid taking NSAIDs after a recent heart attack, unless your healthcare provider tells you to.

1. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.
2. Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines: anytime during use without warning symptoms that may cause death The risk of getting an ulcer or bleeding increases with: ○ past history of stomach ulcers, or stomach or intestinal bleeding with use of NSAIDs ○ older age ○ taking medicines called “corticosteroids”, “anticoagulants”, “SSRIs”, or “SNRIs” ○ poor health ○ increasing doses of NSAIDs ○ advanced liver disease ○ longer use of NSAIDs ○ bleeding problems ○ smoking ○ drinking alcohol NSAIDs should only be used: exactly as prescribed at the lowest dose possible for your treatment for the shortest time needed What are NSAIDs? NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain.

Who should not take NSAIDs? Do not take NSAIDs: if you have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs. right before or after heart bypass surgery. Before taking NSAIDS, tell your healthcare provider about all of your medical conditions, including if you: have liver or kidney problems.

Have high blood pressure. have asthma are pregnant or plan to become pregnant. Talk to your healthcare provider if you are considering taking NSAIDs during pregnancy. You should not take NSAIDs after 29 weeks of pregnancy. are breastfeeding or plan to breast feed. Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins or herbal supplements.

NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first. What are the possible side effects of NSAIDs? NSAIDs can cause serious side effects, including: See “What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?” new or worse high blood pressure heart failure liver problems including liver failure kidney problems including kidney failure low red blood cells (anemia) life-threatening skin reactions life-threatening allergic reactions Other side effects of NSAIDs include : stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness.

Get emergency help right away if you get any of the following symptoms: ● shortness of breath or trouble breathing ● slurred speech ● chest pain ● swelling of the face or throat ● weakness in one part or side of your body Stop taking your NSAID and call your healthcare provider right away if you get any of the following symptoms: ● nausea ● there is blood in your bowel movement or it is black ● more tired or weaker than usual ● vomit blood ● diarrhea ● there is blood in your bowel movement or it is black and sticky like tar ● itching ● unusual weight gain ● your skin or eyes look yellow ● skin rash or blisters with fever ● indigestion or stomach pain ● swelling of the arms, legs, hands and feet ● flu-like symptoms If you take too much of your NSAID, call your healthcare provider or get medical help right away.

These are not all the possible side effects of NSAIDs. For more information, ask your healthcare provider or pharmacist about NSAIDs. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Other information about NSAIDs: Aspirin is an NSAID but it does not increase the chance of a heart attack.

• Aspirin can cause bleeding in the brain, stomach, and intestines.
• Aspirin can also cause ulcers in the stomach and intestines.
• Some NSAIDs are sold in lower doses without a prescription (over-the-counter).
• Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.
• General information about the safe and effective use of NSAIDs Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide.

Do not use NSAIDs for a condition for which it was not prescribed. Do not give NSAIDs to other people, even if they have the same symptoms that you have. It may harm them. If you would like more information about NSAIDs, talk with your healthcare provider.

You can ask your pharmacist or healthcare provider for information about NSAIDs that is written for health professionals. This Medication Guide has been approved by the U.S. Food and Drug Administration. Manufactured by: Cipla Ltd, Kurkumbh, India Manufactured for: Cipla USA, Inc.10 Independence Boulevard, Suite 300, Warren, NJ 07059 Distributed by: Advanced Rx Pharmacy of Tennessee LLC, Nashville, TN 37211.

Revised: 2/2020

Does meloxicam make you sleepy?

The side effects for meloxicam don’t mention drowsiness (actually meloxicam can cause insomnia) but does mention dizziness. But headache is a common, less serious side effect of meloxicam.

Should you drink a lot of water with meloxicam?

Tips and advice for taking Mobic – Here are some tips for taking Mobic safely and getting the best results:

Always follow your doctor’s advice carefully when taking Mobic. Never take this medication without professional medical guidance. Drink plenty of fluids while taking Mobic, as dehydration can worsen side effects. The drug works best when taken with food. If you are having trouble swallowing Mobic tablets, you can dissolve them in water before drinking. Tell your doctor about any side effects you experience when taking Mobic. Seek medical help if they continue or worsen, or if you develop any of the serious side effects listed above. If you become pregnant while taking Mobic, inform your doctor immediately.

How long does it take meloxicam to get rid of inflammation?

Meloxicam can start working within a few days, but it might take about 2 weeks for you to feel its full benefits. If you’re not feeling any improvement after a few weeks, check in with your healthcare provider.

What happens if you take meloxicam on an empty stomach?

Proper Use – Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. Taking too much of this medicine may increase the chance of side effects.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions. Shake the oral liquid well before each use. Measure the dose with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid.

Swallow the capsule or tablet whole. Do not crush, break, or chew it. To use the disintegrating tablet:

• Make sure your hands are dry before you handle the tablet.
• Do not open the blister pack that contains the tablet until you are ready to use it.
• Peel back the foil on the blister to remove the tablet. Do not push the tablet through the foil.
• Place the tablet in your mouth or onto your tongue. It should melt quickly. Swallow the melted tablet with or without drinking any liquid.

You may take this medicine with or without food. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. If you refill your medicine and it looks different, check with your pharmacist.

Can meloxicam 15 mg put you to sleep?

Does meloxicam make you sleepy? – No, it’s not known to do so. In studies of meloxicam, sleepiness wasn’t a reported side effect. But drowsiness is a known symptom of overdose from NSAIDs, the group of drugs meloxicam belongs to. Taking more meloxicam than prescribed could lead to overdose, which may cause drowsiness.

Can you take meloxicam daily for years?

Heart risk warning: This drug may increase your risk of developing a blood clot, heart attack, or stroke, which can be fatal. Your risk may be higher if you’re taking it long term, at high doses, or if you already have heart problems or risk factors for heart disease, such as high blood pressure.

Can I have one glass of wine on meloxicam?

Can a Patient Drink Alcohol While Taking Meloxicam? – Meloxicam is a prescription medication that has a clear and precise list of medical instructions that patients should follow when using the drug for the treatment of their health conditions. The standard Meloxicam box warning states that alcoholic beverages are prohibited when on treatment with this drug,

What color is meloxicam 15 mg?

14.2 Juvenile Rheumatoid Arthritis (JRA) Pauciarticular and Polyarticular Course – The use of meloxicam for the treatment of the signs and symptoms of pauciarticular or polyarticular course Juvenile Rheumatoid Arthritis in patients 2 years of age and older was evaluated in two 12-week, double-blind, parallel-arm, active-controlled trials. Both studies included three arms: naproxen and two doses of meloxicam. In both studies, meloxicam dosing began at 0.125 mg/kg/day (7.5 mg maximum) or 0.25 mg/kg/day (15 mg maximum), and naproxen dosing began at 10 mg/kg/day. One study used these doses throughout the 12-week dosing period, while the other incorporated a titration after 4 weeks to doses of 0.25 mg/kg/day and 0.375 mg/kg/day (22.5 mg maximum) of meloxicam and 15 mg/kg/day of naproxen. The efficacy analysis used the ACR Pediatric 30 responder definition, a composite of parent and investigator assessments, counts of active joints and joints with limited range of motion, and erythrocyte sedimentation rate. The proportion of responders were similar in all three groups in both studies, and no difference was observed between the meloxicam dose groups.

Meloxicam tablets, USP 7.5 mg are yellow coloured, round, biconvex tablets, debossed with “158” on one side and “C” on the other.

• Meloxicam tablets, USP 15 mg are yellow coloured, round, flat bevelled tablets, debossed with “CIPLA” on one side and “159” on the other.
• Meloxicam tablets, USP 7.5 mg are available as follows:
• NDC 69097-158-07 Bottles of 100
• NDC 69097-158-12 Bottles of 500
• NDC 69097-158-15 Bottles of 1000
• Meloxicam tablets, USP 15 mg are available as follows:
• NDC 69097-159-07 Bottles of 100
• NDC 69097-159-12 Bottles of 500
• NDC 69097-159-15 Bottles of 1000
• Storage

Store at 20°C to 25°C (68°F to 77°F), Keep meloxicam tablets in a dry place. Dispense tablets in a tight container. Keep this and all medications out of the reach of children.

1. Advise the patient to read the FDA-approved patient labeling (Medication Guide) that accompanies each prescription dispensed.
2. Inform patients, families or their caregivers of the following information before initiating therapy with an NSAID and periodically during the course of ongoing therapy.
3. Cardiovascular Thrombotic Events
4. Advise patients to be alert for the symptoms of cardiovascular thrombotic events, including chest pain, shortness of breath, weakness, or slurring of speech, and to report any of these symptoms to their healthcare provider immediately,
5. Gastrointestinal Bleeding, Ulceration, and Perforation

Advise patients to report symptoms of ulcerations and bleeding, including epigastric pain, dyspepsia, melena, and hematemesis to their healthcare provider. In the setting of concomitant use of low-dose aspirin for cardiac prophylaxis, inform patients of the increased risk for the signs and symptoms of GI bleeding,

• Heart Failure and Edema
• Advise patients to be alert for the symptoms of congestive heart failure including shortness of breath, unexplained weight gain, or edema and to contact their healthcare provider if such symptoms occur,
• Anaphylactic Reactions

Inform patients of the signs of an anaphylactic reaction (e.g., difficulty breathing, swelling of the face or throat). Instruct patients to seek immediate emergency help if these occur,

1. Serious Skin Reactions, including DRESS
2. Advise patients to stop taking meloxicam immediately if they develop any type of rash or fever and to contact their healthcare provider as soon as possible,
3. Female Fertility
4. Advise females of reproductive potential who desire pregnancy that NSAIDs, including meloxicam, may be associated with a reversible delay in ovulation,
5. Fetal Toxicity

Inform pregnant women to avoid use of meloxicam and other NSAIDs starting at 30 weeks gestation because of the risk of the premature closing of the fetal ductus arteriosus. If treatment with meloxicam is needed for a pregnant woman between about 20 to 30 weeks gestation, advise her that she may need to be monitored for oligohydramnios, if treatment continues for longer than 48 hours,

• Use of NSAIDs and Low-Dose Aspirin
• Inform patients not to use low-dose aspirin concomitantly with meloxicam until they talk to their healthcare provider,
• Manufactured by :
• Cipla, Ltd.,
• Kurkumbh, India
• Manufactured for:
• Cipla USA, Inc.
• 10 Independence Boulevard, Suite 300,
• Warren, NJ 07059
• Revised: 05/2021

1. Medication Guide for Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
2. What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?
3. NSAIDs can cause serious side effects, including:

• Increased risk of a heart attack or stroke that can lead to death, This risk may happen early in treatment and may increase :
  • with increasing doses of NSAIDs
  • with longer use of NSAIDs

Do not take NSAIDs right before or after a heart surgery called a “coronary artery bypass graft (CABG).” Avoid taking NSAIDs after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take NSAIDs after a recent heart attack.

• Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
  • anytime during use
  • without warning symptoms
  • that may cause death

The risk of getting an ulcer or bleeding increases with : NSAIDs should only be used :

• exactly as prescribed
• at the lowest dose possible for your treatment
• for the shortest time needed

• What are NSAIDs?
• NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions such as different types of arthritis, menstrual cramps, and other types of short-term pain.
• Who should not take NSAIDs?
• Do not take NSAIDs :

• if you have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAIDs.
• right before or after heart bypass surgery.

Before taking NSAIDS, tell your healthcare provider about all of your medical conditions, including if you:

• have liver or kidney problems
• have high blood pressure
• have asthma
• are pregnant or plan to become pregnant. Taking NSAIDs at about 20 weeks of pregnancy or later may harm your unborn baby. If you need to take NSAIDs for more than 2 days when you are between 20 and 30 weeks of pregnancy, your healthcare provider may need to monitor the amount of fluid in your womb around your baby. You should not take NSAIDs after about 30 weeks of pregnancy.
• are breastfeeding or plan to breast feed.

Tell your healthcare provider about all of the medicines you take, including prescription or over-the-counter medicines, vitamins or herbal supplements, NSAIDs and some other medicines can interact with each other and cause serious side effects. Do not start taking any new medicine without talking to your healthcare provider first.

1. What are the possible side effects of NSAIDs?
2. NSAIDs can cause serious side effects, including:
3. See “What is the most important information I should know about medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?”

• new or worse high blood pressure
• heart failure
• liver problems including liver failure
• kidney problems including kidney failure
• low red blood cells (anemia)
• life-threatening skin reactions
• life-threatening allergic reactions
• Other side effects of NSAIDs include : stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting, and dizziness.

• Get emergency help right away if you get any of the following symptoms :
• Stop taking your NSAID and call your healthcare provider right away if you get any of the following symptoms:
• If you take too much of your NSAID, call your healthcare provider or get medical help right away.

These are not all the possible side effects of NSAIDs. For more information, ask your healthcare provider or pharmacist about NSAIDs. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Other information about NSAIDs:

• Aspirin is an NSAID but it does not increase the chance of a heart attack. Aspirin can cause bleeding in the brain, stomach, and intestines. Aspirin can also cause ulcers in the stomach and intestines.
• Some NSAIDs are sold in lower doses without a prescription (over-the-counter). Talk to your healthcare provider before using over-the-counter NSAIDs for more than 10 days.

General information about the safe and effective use of NSAIDs Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use NSAIDs for a condition for which it was not prescribed. Do not give NSAIDs to other people, even if they have the same symptoms that you have.

1. Manufactured by:
2. Cipla Ltd,
3. Kurkumbh, India
4. Manufactured for:
5. Cipla USA, Inc.
6. 10 Independence Boulevard, Suite 300,
7. Warren, NJ 07059
8. Revised: 05/2021

• NDC 69097-158-07 Rx ONLY
• Meloxicam
• Tablets, USP
• 7.5 mg
• PHARMACIST : PLEASE DISPENSE
• WITH MEDICATION GUIDE
• 100 Tablets
• Cipla

1. NDC 69097-159-07 Rx ONLY
2. Meloxicam
3. Tablets, USP
4. 15 mg
5. PHARMACIST : PLEASE DISPENSE
6. WITH MEDICATION GUIDE
7. 100 Tablets
8. Cipla

: DailyMed – MELOXICAM tablet

Does meloxicam 15 mg work immediately?

Meloxicam can start working within a few days, but it might take about 2 weeks for you to feel its full benefits. If you’re not feeling any improvement after a few weeks, check in with your healthcare provider.

Does meloxicam come in 15mg?

DESCRIPTION – Meloxicam, an oxicam derivative, is a member of the enolic acid group of nonsteroidal anti-inflammatory drugs (NSAIDs). Each tablet contains 7.5 mg or 15 mg meloxicam for oral administration. Meloxicam is chemically designated as 4-hydroxy-2-methyl- N -(5‑methyl‑2‑thiazolyl)-2 H -1,2-benzothiazine-3-carboxamide-1,1-dioxide. Meloxicam is a pastel yellow powder, practically insoluble in water, slightly soluble in acetone, soluble in dimethyl formamide, very slightly soluble in ethanol (96%) and in methanol. Meloxicam has an apparent partition coefficient (log P) app = 0.1 in n -octanol/buffer pH 7.4.

Is 15 mg of meloxicam stronger than 800 mg of ibuprofen?

Ibuprofen vs. Meloxicam: Which Should You Take? – So, why can people take Ibuprofen 4-6 times a day but can only take Meloxicam once a day? Simply put, Meloxicam is much stronger than Ibuprofen. Since it is stronger, it may come with more intense risks.

For example, Meloxicam comes with a higher risk of gastrointestinal problems, heart attack, or stroke than Ibuprofen. However, Meloxicam may work better for individuals with severe pain, whereas Ibuprofen can be used for mild to moderate pain. Whether you should take Ibuprofen or Meloxicam depends solely on the severity of an individual’s condition and their tolerance for medication.

Using These Medications Safely While taking Meloxicam and Ibuprofen together isn’t toxic, it doesn’t offer any added benefit either. Also, combining these medications could increase a person’s risk for serious side effects like gastrointestinal ulcers and cardiovascular events.

Urinary issues Problems with stool Allergic reactions Headaches Vision problems Hearing issues Swelling Bruising Wheezing Shortness of breath Chest pain Rapid heartbeat Fatigue Weakness Flu-like symptoms Rapid weight gain Skin rash Coughing up blood Flu-like symptoms Lightheadedness

Since both Meloxicam and Ibuprofen come with risks, you should talk to your doctor before starting any type of pain management treatment medication. To learn more about Meloxicam, Ibuprofen, and other body pain relief medications, contact our team of substance abuse treatment representatives by calling, : Is Meloxicam Stronger Than Ibuprofen?