Meloxicam

Aka: Meloxicam, Mobic, Vivlodex

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II. Indications

  1. See NSAID
  2. FDA approved indications in Adults
    1. Rheumatoid Arthritis
    2. Osteoarthritis
  3. FDA approved indications in children
    1. Juvenile Rheumatoid Arthritis

III. Contraindications

  1. See NSAID

IV. Mechanism

  1. See NSAID
  2. NSAID in the Oxicam Class
  3. Meloxicam has a long half life and may be dosed daily

V. Medications

  1. Meloxicam tablets 7.5 mg, 15 mg
  2. Meloxicam capsules 5 mg, 10 mg
  3. Meloxicam suspension 1.5 mg/ml
    1. Shake suspension well before use

VI. Dosing: Adults

  1. Arthritis (OA, RA)
    1. Meloxicam 7.5 mg orally daily
    2. May advance to a maximum of 15 mg orally daily

VII. Dosing: Child

  1. Juvenile Rheumatoid Arthritis (age >=2 years old)
    1. Meloxicam 0.125 mg/kg orally daily (up to maximum of 7.5 mg/day)

VIII. Adverse Effects

  1. See NSAID
  2. Despite being touted as more COX-2 specific, still has moderate gastrointestinal adverse effects
    1. See NSAID Gastrointestinal Adverse Effects

IX. Safety

  1. See NSAID
  2. Unknown safety in Lactation
  3. Avoid NSAIDs in pregnancy outside the first part of the second trimester (13 to 20 weeks)
    1. Teratogenic in first trimester
    2. Risk of premature ductus arteriosus closure in the fetus in third trimester
    3. Most NSAIDs carry a legacy system Pregnancy Category B or C designation (aside from third trimester)
      1. However, many obstetricians avoid NSAIDs entirely in pregnancy (even in second trimester)

X. Resources

  1. Meloxicam (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=5fe76337-eae5-4e5c-96ef-6cfa97983c6e

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