Dosing & Uses
Dosage Forms & Strengths
tablet (Mobic)
- 7.5mg
- 15mg
tablet, oral distintegrating (Qmiiz)
- 7.5mg
- 15mg
capsule (Vivlodex)
- 5mg
- 10mg
injection, IV aqueous dispersion (Anjeso)
- 30mg/mL single-dose vial
Osteoarthritis
Indicated to relieve signs and symptoms of osteoarthritis
Mobic or Qmiiz: 7.5-15 mg PO qDay; not to exceed 15 mg/day
Vivlodex: Start with 5 mg PO qDay; if needed, may increase to 10 mg/day
Use the lowest effective dose for shortest duration consistent with individual patient treatment goals
Rheumatoid Arthritis
Indicated to relieve signs and symptoms of rheumatoid arthritis
Mobic or Qmiiz: 7.5-15 mg PO qDay; not to exceed 15 mg/day
Moderate-to-Severe Pain
Indicated for management of moderate-to-severe pain, alone or in combination with non-NSAID analgesics
Anjeso: 30 mg IV qDay
Dosage Modifications
Hepatic impairment
- Mild-to-moderate: No dosage adjustment required
- Severe: Not studied
Renal impairment
- Mild-to-moderate: No dosage adjustment required
-
Severe
- Anjeso: : Not recommended; contraindicated in patients with moderate-to-severe renal insufficiency who are at risk for renal failure due to volume depletion
- Mobic or Qmiiz: Not recommended
-
Hemodialysis
- Mobic or Qmiiz: Not to exceed 7.5 mg/day
- Vivlodex: Not to exceed 5 mg/day
Dosing Considerations
Vivlodex capsules and Qmizz ODT are not interchangeable with other formulations of oral meloxicam even if the mg strength is the same
Anjeso alone is not recommended for situations when rapid onset of analgesia required owing to the drug’s delayed onset of analgesia (mean onset 2-3 hr)
Dosage Forms & Strengths
tablet (Mobic)
- 7.5mg
- 15mg
tablet, oral distintegrating (Qmiiz)
- 7.5mg
- 15mg
Juvenile Idiopathic Arthritis
Indicated for relief of signs and symptoms of pauciarticular or polyarticular course juvenile rheumatoid arthritis in patients who weigh ≥60 kg
60 kg or greater
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- sodium polystyrene sulfonate
meloxicam increases toxicity of sodium polystyrene sulfonate by Other (see comment). Contraindicated. Comment: Cases of intestinal necrosis (possibly fatal) described with concomitant sorbitol and sodium polystyrene sulfonate; due to sorbitol in meloxicam oral suspension, coadministration is not recommended.
Serious - Use Alternative (19)
- aminolevulinic acid oral
aminolevulinic acid oral, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
meloxicam, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- apixaban
meloxicam and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.
- benazepril
meloxicam, benazepril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- captopril
meloxicam, captopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- enalapril
meloxicam, enalapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- fosinopril
meloxicam, fosinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ketorolac
meloxicam, ketorolac. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- ketorolac intranasal
meloxicam, ketorolac intranasal. Either increases toxicity of the other by pharmacodynamic synergism. Contraindicated.
- lisinopril
meloxicam, lisinopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- methotrexate
meloxicam increases levels of methotrexate by decreasing renal clearance. Avoid or Use Alternate Drug. Concomitant administration of NSAIDs with high dose methotrexate has been reported to elevate and prolong serum methotrexate levels, resulting in deaths from severe hematologic and GI toxicity. NSAIDs may reduce tubular secretion of methotrexate and enhance toxicity. .
- methyl aminolevulinate
meloxicam, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- moexipril
meloxicam, moexipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- pemetrexed
meloxicam increases levels of pemetrexed by unspecified interaction mechanism. Avoid or Use Alternate Drug. Interrupt dosing in all patients taking NSAIDs with long elimination half-lives for at least 5d before, the day of, and 2d following pemetrexed administration. If coadministration of an NSAID is necessary, closely monitor patients for toxicity, especially myelosuppression, renal toxicity, and GI toxicity.
- perindopril
meloxicam, perindopril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- quinapril
meloxicam, quinapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- ramipril
meloxicam, ramipril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
- tacrolimus
meloxicam, tacrolimus. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Concomitant administration increases risk of nephrotoxicity.
- trandolapril
meloxicam, trandolapril. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Coadministration may result in a significant decrease in renal function. NSAIDs may diminish the antihypertensive effect of ACE inhibitors. The mechanism of these interactions is likely related to the ability of NSAIDs to reduce the synthesis of vasodilating renal prostaglandins.
Monitor Closely (238)
- acebutolol
acebutolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aceclofenac
aceclofenac and meloxicam both increase anticoagulation. Use Caution/Monitor.
aceclofenac and meloxicam both increase serum potassium. Use Caution/Monitor. - acemetacin
acemetacin and meloxicam both increase anticoagulation. Use Caution/Monitor.
acemetacin and meloxicam both increase serum potassium. Use Caution/Monitor. - agrimony
meloxicam and agrimony both increase anticoagulation. Use Caution/Monitor.
- albuterol
meloxicam increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfalfa
meloxicam and alfalfa both increase anticoagulation. Use Caution/Monitor.
- alfuzosin
meloxicam decreases effects of alfuzosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aliskiren
meloxicam will decrease the level or effect of aliskiren by Other (see comment). Use Caution/Monitor. In patients who are elderly, volume-depleted (including those on diuretic therapy), or with compromised renal function, coadministration of NSAIDs with drugs that affect RAAS may increase the risk of renal impairment (including acute renal failure) and cause loss of antihypertensive effect. Monitor renal function periodically.
- alteplase
meloxicam and alteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- American ginseng
meloxicam and American ginseng both increase anticoagulation. Use Caution/Monitor.
- amiloride
amiloride and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
- antithrombin alfa
antithrombin alfa and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- antithrombin III
antithrombin III and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- arformoterol
meloxicam increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- argatroban
argatroban and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- asenapine
meloxicam decreases effects of asenapine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- aspirin
aspirin and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin and meloxicam both increase serum potassium. Use Caution/Monitor. - aspirin rectal
aspirin rectal and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin rectal and meloxicam both increase serum potassium. Use Caution/Monitor. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and meloxicam both increase anticoagulation. Use Caution/Monitor.
aspirin/citric acid/sodium bicarbonate and meloxicam both increase serum potassium. Use Caution/Monitor. - atenolol
atenolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of atenolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - azficel-T
azficel-T, meloxicam. Other (see comment). Use Caution/Monitor. Comment: Patients taking anticoagulants may experience increased bruising or bleeding at biopsy and/or injection sites. Concomitant use of anticoagulants is not recommended. Decisions regarding continued use or cessation of anticoagulants should be made by a physician.
- azilsartan
meloxicam, azilsartan. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of azilsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - bemiparin
bemiparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- benazepril
benazepril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- bendroflumethiazide
meloxicam increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- betaxolol
betaxolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of betaxolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - betrixaban
meloxicam, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.
- bimatoprost
bimatoprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- bisoprolol
bisoprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of bisoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - bivalirudin
bivalirudin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- budesonide
meloxicam, budesonide. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- bumetanide
meloxicam increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
meloxicam decreases effects of bumetanide by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis. - candesartan
candesartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of candesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
candesartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - captopril
captopril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- carbenoxolone
meloxicam increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carvedilol
carvedilol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of carvedilol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celecoxib
celecoxib and meloxicam both increase anticoagulation. Use Caution/Monitor.
celecoxib and meloxicam both increase serum potassium. Use Caution/Monitor. - celiprolol
celiprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of celiprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - chlorothiazide
meloxicam increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpropamide
meloxicam increases effects of chlorpropamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- chlorthalidone
meloxicam increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cholestyramine
cholestyramine decreases levels of meloxicam by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- choline magnesium trisalicylate
meloxicam and choline magnesium trisalicylate both increase anticoagulation. Use Caution/Monitor.
meloxicam and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor. - cinnamon
meloxicam and cinnamon both increase anticoagulation. Use Caution/Monitor.
- ciprofloxacin
meloxicam, ciprofloxacin. Other (see comment). Modify Therapy/Monitor Closely. Comment: Mechanism: unknown. Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- citalopram
citalopram, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. If possible, avoid concurrent use.
- clomipramine
clomipramine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. Clomipramine inhib. serotonin uptake by platelets.
- clopidogrel
clopidogrel, meloxicam. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Clopidogrel and NSAIDs both inhibit platelet aggregation.
- cordyceps
meloxicam and cordyceps both increase anticoagulation. Use Caution/Monitor.
- cortisone
meloxicam, cortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- cyclopenthiazide
meloxicam increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cyclosporine
meloxicam, cyclosporine. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely.
- dabigatran
dabigatran and meloxicam both increase anticoagulation. Use Caution/Monitor. Caution is advised, both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dalteparin
dalteparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- deferasirox
deferasirox, meloxicam. Other (see comment). Use Caution/Monitor. Comment: Combination may increase GI bleeding, ulceration and irritation. Use with caution.
- defibrotide
defibrotide increases effects of meloxicam by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Defibrotide may enhance effects of platelet inhibitors.
- deflazacort
meloxicam, deflazacort. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- dexamethasone
meloxicam, dexamethasone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- diclofenac
diclofenac and meloxicam both increase anticoagulation. Use Caution/Monitor.
diclofenac and meloxicam both increase serum potassium. Use Caution/Monitor. - diflunisal
diflunisal and meloxicam both increase anticoagulation. Use Caution/Monitor.
diflunisal and meloxicam both increase serum potassium. Use Caution/Monitor. - digoxin
meloxicam and digoxin both increase serum potassium. Use Caution/Monitor.
- dobutamine
meloxicam increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dong quai
meloxicam and dong quai both increase anticoagulation. Use Caution/Monitor.
- dopexamine
meloxicam increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxazosin
meloxicam decreases effects of doxazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- drospirenone
drospirenone and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
- duloxetine
duloxetine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- edoxaban
edoxaban, meloxicam. Either increases toxicity of the other by anticoagulation. Modify Therapy/Monitor Closely. Both drugs have the potential to cause bleeding, monitor closely. Promptly evaluate any signs or symptoms of blood loss.
- efavirenz
efavirenz will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
- eltrombopag
eltrombopag increases levels of meloxicam by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- elvitegravir/cobicistat/emtricitabine/tenofovir DF
elvitegravir/cobicistat/emtricitabine/tenofovir DF, meloxicam. Either increases toxicity of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine and tenofovir with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- emtricitabine
emtricitabine, meloxicam. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of emtricitabine with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- enalapril
enalapril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- enoxaparin
enoxaparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- ephedrine
meloxicam increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
meloxicam increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
meloxicam increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epoprostenol
meloxicam and epoprostenol both increase anticoagulation. Use Caution/Monitor.
- eprosartan
eprosartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of eprosartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
eprosartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - escitalopram
escitalopram, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- esmolol
esmolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of esmolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ethacrynic acid
meloxicam increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- etodolac
etodolac and meloxicam both increase anticoagulation. Use Caution/Monitor.
etodolac and meloxicam both increase serum potassium. Use Caution/Monitor. - fennel
meloxicam and fennel both increase anticoagulation. Use Caution/Monitor.
- fenoprofen
fenoprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
fenoprofen and meloxicam both increase serum potassium. Use Caution/Monitor. - feverfew
meloxicam and feverfew both increase anticoagulation. Use Caution/Monitor.
- fish oil triglycerides
fish oil triglycerides will increase the level or effect of meloxicam by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
- fludrocortisone
meloxicam, fludrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- fluoxetine
fluoxetine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
fluoxetine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets. - flurbiprofen
flurbiprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
flurbiprofen and meloxicam both increase serum potassium. Use Caution/Monitor. - fluvoxamine
fluvoxamine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding; SSRIs inhib. srotonin uptake by platelets.
- fondaparinux
fondaparinux and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- formoterol
meloxicam increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- forskolin
meloxicam and forskolin both increase anticoagulation. Use Caution/Monitor.
- fosinopril
fosinopril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- furosemide
meloxicam increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- garlic
meloxicam and garlic both increase anticoagulation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- gentamicin
meloxicam increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ginger
meloxicam and ginger both increase anticoagulation. Use Caution/Monitor.
- ginkgo biloba
meloxicam and ginkgo biloba both increase anticoagulation. Use Caution/Monitor.
- glimepiride
meloxicam increases effects of glimepiride by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glipizide
meloxicam increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- glyburide
meloxicam increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- green tea
green tea, meloxicam. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding.
- heparin
heparin and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- horse chestnut seed
meloxicam and horse chestnut seed both increase anticoagulation. Use Caution/Monitor.
- hydralazine
meloxicam decreases effects of hydralazine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- hydrochlorothiazide
meloxicam increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hydrocortisone
meloxicam, hydrocortisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- ibrutinib
ibrutinib will increase the level or effect of meloxicam by anticoagulation. Use Caution/Monitor. Ibrutinib may increase the risk of hemorrhage in patients receiving antiplatelet or anticoagulant therapies and monitor for signs of bleeding.
- ibuprofen
ibuprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
ibuprofen and meloxicam both increase serum potassium. Use Caution/Monitor. - ibuprofen IV
ibuprofen IV and meloxicam both increase anticoagulation. Use Caution/Monitor.
ibuprofen IV and meloxicam both increase serum potassium. Use Caution/Monitor. - icosapent
icosapent, meloxicam. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Icosapent may prolong bleeding time. Periodically monitor if coadministered with other drugs that affect bleeding.
- imatinib
imatinib will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.
imatinib, meloxicam. Either increases toxicity of the other by Other (see comment). Modify Therapy/Monitor Closely. Comment: Imatinib may cause thrombocytopenia; bleeding risk increased when imatinib is coadministered with anticoagulants, NSAIDs, platelet inhibitors, and thrombolytic agents. - indapamide
meloxicam increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
indomethacin and meloxicam both increase anticoagulation. Use Caution/Monitor.
indomethacin and meloxicam both increase serum potassium. Use Caution/Monitor. - irbesartan
irbesartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of irbesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
irbesartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - isoproterenol
meloxicam increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketoprofen
ketoprofen and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketoprofen and meloxicam both increase serum potassium. Use Caution/Monitor. - ketorolac
ketorolac and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac and meloxicam both increase serum potassium. Use Caution/Monitor. - ketorolac intranasal
ketorolac intranasal and meloxicam both increase anticoagulation. Use Caution/Monitor.
ketorolac intranasal and meloxicam both increase serum potassium. Use Caution/Monitor. - labetalol
labetalol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of labetalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - latanoprost
latanoprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- latanoprostene bunod ophthalmic
latanoprostene bunod ophthalmic, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- levalbuterol
meloxicam increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
levofloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- levomilnacipran
levomilnacipran, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. SNRIs may further impair platelet activity in patients taking antiplatelet or anticoagulant drugs.
- lisinopril
lisinopril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- lithium
meloxicam increases levels of lithium by decreasing renal clearance. Use Caution/Monitor.
- lornoxicam
lornoxicam and meloxicam both increase anticoagulation. Use Caution/Monitor.
lornoxicam and meloxicam both increase serum potassium. Use Caution/Monitor. - losartan
losartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of losartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
losartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - meclofenamate
meclofenamate and meloxicam both increase anticoagulation. Use Caution/Monitor.
meclofenamate and meloxicam both increase serum potassium. Use Caution/Monitor. - mefenamic acid
mefenamic acid and meloxicam both increase anticoagulation. Use Caution/Monitor.
mefenamic acid and meloxicam both increase serum potassium. Use Caution/Monitor. - mesalamine
mesalamine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive nephrotoxicity.
- metaproterenol
meloxicam increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methyclothiazide
meloxicam increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methylprednisolone
meloxicam, methylprednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- metolazone
meloxicam increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
metoprolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of metoprolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - milnacipran
milnacipran, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- mipomersen
mipomersen, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.
- mistletoe
meloxicam increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- moexipril
moexipril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- moxifloxacin
moxifloxacin, meloxicam. Other (see comment). Modify Therapy/Monitor Closely. Comment: Increased risk of CNS stimulation and seizures with high doses of fluoroquinolones.
- moxisylyte
meloxicam decreases effects of moxisylyte by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- mycophenolate
meloxicam will increase the level or effect of mycophenolate by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- nabumetone
meloxicam and nabumetone both increase anticoagulation. Use Caution/Monitor.
meloxicam and nabumetone both increase serum potassium. Use Caution/Monitor. - nadolol
nadolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of nadolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - naproxen
meloxicam and naproxen both increase anticoagulation. Use Caution/Monitor.
meloxicam and naproxen both increase serum potassium. Use Caution/Monitor. - nebivolol
nebivolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of nebivolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nefazodone
nefazodone, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- nettle
meloxicam increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nevirapine
nevirapine will decrease the level or effect of meloxicam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- norepinephrine
meloxicam increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- olmesartan
olmesartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of olmesartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
olmesartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - oxaprozin
meloxicam and oxaprozin both increase anticoagulation. Use Caution/Monitor.
meloxicam and oxaprozin both increase serum potassium. Use Caution/Monitor. - panax ginseng
meloxicam and panax ginseng both increase anticoagulation. Use Caution/Monitor.
- parecoxib
meloxicam and parecoxib both increase anticoagulation. Use Caution/Monitor.
meloxicam and parecoxib both increase serum potassium. Use Caution/Monitor. - paroxetine
paroxetine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- pau d'arco
meloxicam and pau d'arco both increase anticoagulation. Use Caution/Monitor.
- pegaspargase
pegaspargase increases effects of meloxicam by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- penbutolol
penbutolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of penbutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - perindopril
perindopril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- phenindione
phenindione and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- phenoxybenzamine
meloxicam decreases effects of phenoxybenzamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phentolamine
meloxicam decreases effects of phentolamine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- phytoestrogens
meloxicam and phytoestrogens both increase anticoagulation. Use Caution/Monitor.
- pindolol
pindolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of pindolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - pirbuterol
meloxicam increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- piroxicam
meloxicam and piroxicam both increase anticoagulation. Use Caution/Monitor.
meloxicam and piroxicam both increase serum potassium. Use Caution/Monitor. - pivmecillinam
pivmecillinam, meloxicam. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
pivmecillinam, meloxicam. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - potassium acid phosphate
meloxicam and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
meloxicam and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
meloxicam and potassium citrate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium iodide
potassium iodide and meloxicam both increase serum potassium. Use Caution/Monitor.
- pralatrexate
meloxicam increases levels of pralatrexate by decreasing renal clearance. Use Caution/Monitor. NSAIDs may delay pralatrexate clearance, increasing drug exposure. Adjust the pralatrexate dose as needed.
- prasugrel
meloxicam, prasugrel. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Chronic use of NSAIDs with prasugrel may increase bleeding risk.
- prazosin
meloxicam decreases effects of prazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- prednisolone
meloxicam, prednisolone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- prednisone
meloxicam, prednisone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of GI ulceration.
- probenecid
meloxicam will increase the level or effect of probenecid by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- propranolol
propranolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of propranolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - protamine
protamine and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- quinapril
quinapril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- ramipril
ramipril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- reishi
meloxicam and reishi both increase anticoagulation. Use Caution/Monitor.
- reteplase
meloxicam and reteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- rivaroxaban
rivaroxaban, meloxicam. Other (see comment). Use Caution/Monitor. Comment: NSAIDs are known to increase bleeding. Bleeding risk may be increased when NSAIDs are used concomitantly with rivaroxaban. Monitor for signs/symptoms of blood loss.
- rivastigmine
rivastigmine increases toxicity of meloxicam by pharmacodynamic synergism. Use Caution/Monitor. Monitor patients for symptoms of active or occult gastrointestinal bleeding.
- sacubitril/valsartan
sacubitril/valsartan and meloxicam both increase serum potassium. Use Caution/Monitor.
sacubitril/valsartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
meloxicam decreases effects of sacubitril/valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect. - salicylates (non-asa)
meloxicam and salicylates (non-asa) both increase anticoagulation. Use Caution/Monitor.
meloxicam and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor. - salmeterol
meloxicam increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- salsalate
meloxicam and salsalate both increase anticoagulation. Use Caution/Monitor.
meloxicam and salsalate both increase serum potassium. Use Caution/Monitor. - saw palmetto
saw palmetto increases toxicity of meloxicam by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- sertraline
sertraline, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- Siberian ginseng
meloxicam and Siberian ginseng both increase anticoagulation. Use Caution/Monitor.
- silodosin
meloxicam decreases effects of silodosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
meloxicam, sodium picosulfate/magnesium oxide/anhydrous citric acid. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May be associated with fluid and electrolyte imbalances.
- sodium sulfate/?magnesium sulfate/potassium chloride
sodium sulfate/?magnesium sulfate/potassium chloride increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol
meloxicam, sodium sulfate/potassium chloride/magnesium sulfate/polyethylene glycol. Other (see comment). Use Caution/Monitor. Comment: Caution when bowel preps are used with drugs that cause SIADH or NSAIDs; increased risk for water retention or electrolyte imbalance.
- sodium sulfate/potassium sulfate/magnesium sulfate
sodium sulfate/potassium sulfate/magnesium sulfate increases toxicity of meloxicam by Other (see comment). Use Caution/Monitor. Comment: Coadministration with medications that cause fluid and electrolyte abnormalities may increase the risk of adverse events of seizure, arrhythmias, and renal impairment.
- sotalol
sotalol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of sotalol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sparsentan
meloxicam and sparsentan both increase nephrotoxicity and/or ototoxicity. Use Caution/Monitor. Coadministration of NSAIDS, including selective COX-2 inhibitors, may result in deterioration of kidney function (eg, possible kidney failure). Monitor for signs of worsening renal function with concomitant use with NSAIDs.
- spironolactone
spironolactone and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
- succinylcholine
meloxicam and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
meloxicam and sulfasalazine both increase anticoagulation. Use Caution/Monitor.
meloxicam and sulfasalazine both increase serum potassium. Use Caution/Monitor. - sulindac
meloxicam and sulindac both increase anticoagulation. Use Caution/Monitor.
meloxicam and sulindac both increase serum potassium. Use Caution/Monitor. - tafluprost
tafluprost, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- telmisartan
telmisartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of telmisartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
telmisartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - temocillin
temocillin, meloxicam. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
temocillin, meloxicam. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - tenecteplase
meloxicam and tenecteplase both increase anticoagulation. Use Caution/Monitor. Potential for increased risk of bleeding, caution is advised.
- tenofovir DF
tenofovir DF, meloxicam. Either increases levels of the other by decreasing renal clearance. Modify Therapy/Monitor Closely. Toxicity may result from coadministration of tenofovir DF with other drugs that are also primarily excreted by glomerular filtration and/or active tubular secretion including high-dose or multiple-dose NSAIDs; alternatives to NSAIDs should be considered.
- terazosin
meloxicam decreases effects of terazosin by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
- terbutaline
meloxicam increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ticagrelor
ticagrelor, meloxicam. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding with use of ticagrelor and chronic NSAID use. .
- ticarcillin
ticarcillin, meloxicam. Either increases levels of the other by plasma protein binding competition. Use Caution/Monitor.
ticarcillin, meloxicam. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - timolol
timolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of timolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolazamide
meloxicam increases effects of tolazamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolbutamide
meloxicam increases effects of tolbutamide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.
- tolfenamic acid
meloxicam and tolfenamic acid both increase anticoagulation. Use Caution/Monitor.
meloxicam and tolfenamic acid both increase serum potassium. Use Caution/Monitor. - tolmetin
meloxicam and tolmetin both increase anticoagulation. Use Caution/Monitor.
meloxicam and tolmetin both increase serum potassium. Use Caution/Monitor. - tolvaptan
meloxicam and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
meloxicam increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- trandolapril
trandolapril, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals.
- travoprost ophthalmic
travoprost ophthalmic, meloxicam. unspecified interaction mechanism. Use Caution/Monitor. There are conflicting reports from studies of either increased or decreased IOP when ophthalmic prostaglandins are coadministered with NSAIDs (either systemic or ophthalmic).
- trazodone
trazodone, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- triamcinolone acetonide injectable suspension
meloxicam, triamcinolone acetonide injectable suspension. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Concomitant use of NSAIDS and corticosteroids increases the risk of gastrointestinal side effects. .
- triamterene
triamterene and meloxicam both increase serum potassium. Modify Therapy/Monitor Closely.
- valsartan
valsartan and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of valsartan by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. NSAIDs decrease synthesis of vasodilating renal prostaglandins, and thus affect fluid homeostasis and may diminish antihypertensive effect.
valsartan, meloxicam. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: May result in renal function deterioration, particularly in elderly or volume depleted individuals. - venlafaxine
venlafaxine, meloxicam. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of upper GI bleeding. SSRIs inhib. serotonin uptake by platelets.
- vitamin K1 (phytonadione)
meloxicam increases and vitamin K1 (phytonadione) decreases anticoagulation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- voclosporin
voclosporin, meloxicam. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- vorapaxar
meloxicam, vorapaxar. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Additive antiplatelet effect may occur.
- vortioxetine
meloxicam, vortioxetine. Either increases effects of the other by anticoagulation. Use Caution/Monitor.
- warfarin
meloxicam, warfarin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Drugs with antiplatelet properties may increase anticoagulation effect of warfarin.
- zanubrutinib
meloxicam, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
- zotepine
meloxicam decreases effects of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NSAIDs decrease prostaglandin synthesis.
Minor (104)
- aceclofenac
aceclofenac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acemetacin
acemetacin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- acyclovir
meloxicam will increase the level or effect of acyclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- alendronate
meloxicam, alendronate. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of GI ulceration.
- amikacin
meloxicam increases levels of amikacin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- aminohippurate sodium
meloxicam will increase the level or effect of aminohippurate sodium by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- amiodarone
amiodarone will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- amobarbital
amobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- anamu
meloxicam and anamu both increase anticoagulation. Minor/Significance Unknown.
- aspirin
aspirin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin rectal
aspirin rectal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- balsalazide
meloxicam will increase the level or effect of balsalazide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- bosentan
bosentan will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- butabarbital
butabarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- butalbital
butalbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- carbamazepine
carbamazepine will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- cefadroxil
cefadroxil will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefamandole
cefamandole will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefixime
cefixime will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cefpirome
cefpirome will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ceftibuten
ceftibuten will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- celecoxib
celecoxib will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- cephalexin
cephalexin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorpropamide
meloxicam will increase the level or effect of chlorpropamide by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- chlorthalidone
chlorthalidone will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- choline magnesium trisalicylate
meloxicam will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- colestipol
colestipol decreases levels of meloxicam by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- creatine
creatine, meloxicam. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction) Combination may have additive nephrotoxic effects.
- cyclopenthiazide
cyclopenthiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- danshen
meloxicam and danshen both increase anticoagulation. Minor/Significance Unknown.
- devil's claw
meloxicam and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- diclofenac
diclofenac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- diclofenac topical
diclofenac topical, meloxicam. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Although low, there is systemic exposure to diclofenac topical; theoretically, concomitant administration with systemic NSAIDS or aspirin may result in increased NSAID adverse effects.
- diflunisal
diflunisal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- disulfiram
disulfiram will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- eplerenone
meloxicam decreases effects of eplerenone by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- etodolac
etodolac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- etravirine
etravirine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- felbamate
felbamate will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- fenoprofen
fenoprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- feverfew
meloxicam decreases effects of feverfew by pharmacodynamic antagonism. Minor/Significance Unknown.
- fluconazole
fluconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- flurbiprofen
flurbiprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- furosemide
meloxicam decreases effects of furosemide by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- ganciclovir
meloxicam will increase the level or effect of ganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- gentamicin
meloxicam increases levels of gentamicin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- hydrochlorothiazide
hydrochlorothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ibuprofen
ibuprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ibuprofen IV
ibuprofen IV will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- imidapril
meloxicam decreases effects of imidapril by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis.
- indapamide
indapamide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- indomethacin
indomethacin will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketoconazole
ketoconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- ketoprofen
ketoprofen will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac
ketorolac will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ketorolac intranasal
ketorolac intranasal will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- leflunomide
leflunomide will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- levoketoconazole
levoketoconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- lornoxicam
lornoxicam will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- meclofenamate
meclofenamate will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mefenamic acid
mefenamic acid will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- mesalamine
meloxicam will increase the level or effect of mesalamine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metolazone
metolazone will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- metronidazole
metronidazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- miconazole vaginal
miconazole vaginal will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- nabumetone
meloxicam will increase the level or effect of nabumetone by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- naproxen
meloxicam will increase the level or effect of naproxen by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- nateglinide
nateglinide will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- neomycin PO
meloxicam increases levels of neomycin PO by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- nilotinib
nilotinib will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- noni juice
meloxicam and noni juice both increase serum potassium. Minor/Significance Unknown.
- ofloxacin
ofloxacin, meloxicam. Other (see comment). Minor/Significance Unknown. Comment: Risk of CNS stimulation/seizure. Mechanism: Displacement of GABA from receptors in brain.
- oxaprozin
meloxicam will increase the level or effect of oxaprozin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- parecoxib
meloxicam will increase the level or effect of parecoxib by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- paromomycin
meloxicam increases levels of paromomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- pentobarbital
pentobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- phenobarbital
phenobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- piroxicam
meloxicam will increase the level or effect of piroxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- primidone
primidone will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- rifampin
rifampin will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
rifampin decreases levels of meloxicam by increasing metabolism. Minor/Significance Unknown. - rifapentine
rifapentine will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- rose hips
rose hips will increase the level or effect of meloxicam by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salicylates (non-asa)
meloxicam will increase the level or effect of salicylates (non-asa) by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- salsalate
meloxicam will increase the level or effect of salsalate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- secobarbital
secobarbital will decrease the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- streptomycin
meloxicam increases levels of streptomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- sulfamethoxazole
sulfamethoxazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- sulfasalazine
meloxicam will increase the level or effect of sulfasalazine by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- sulindac
meloxicam will increase the level or effect of sulindac by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- ticlopidine
ticlopidine will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- tobramycin
meloxicam increases levels of tobramycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in preterm infants.
- tolfenamic acid
meloxicam will increase the level or effect of tolfenamic acid by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- tolmetin
meloxicam will increase the level or effect of tolmetin by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- triamterene
triamterene, meloxicam. Other (see comment). Minor/Significance Unknown. Comment: Risk of acute renal failure. Mechanism: NSAIDs decrease prostaglandin synthesis, which normally protect against nephrotoxicity.
meloxicam increases toxicity of triamterene by pharmacodynamic antagonism. Minor/Significance Unknown. NSAIDs decrease prostaglandin synthesis, increasing the risk of nephrotoxicity. - valganciclovir
meloxicam will increase the level or effect of valganciclovir by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- valproic acid
valproic acid will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- vancomycin
meloxicam increases levels of vancomycin by decreasing renal clearance. Minor/Significance Unknown. Interaction mainly occurs in neonates.
- voriconazole
voriconazole will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
- willow bark
meloxicam will increase the level or effect of willow bark by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- zafirlukast
zafirlukast will increase the level or effect of meloxicam by affecting hepatic enzyme CYP2C9/10 metabolism. Minor/Significance Unknown.
Adverse Effects
1-10%
Indigestion (3.8-9.5%)
Upper respiratory infection (≤8.3%)
Headache (2.4-8.3%)
Diarrhea (1.9-7.8%)
Nausea (2.4-7.2%)
Abdominal pain (1.9-4.7%)
Edema (0.6-4.5%)
Anemia (≤4.1%)
Dizziness (1.1-3.8%)
Constipation (0.8-2.6%)
Angina (<2%)
Congestive heart failure (<2%)
Decreased platelet aggregation, purpuric disorder (<2%)
Gastrointestinal (GI) hemorrhage (<2%)
GI perforation, GI ulcer (<2%)
Hepatitis (<2%)
Hypertension (<2%)
Inflammatory disorder of digestive tract (<2%)
Myocardial infarction (<2%)
Vomiting (<3%)
IV
- Constipation (7.6%)
- GGT increased (2.8%)
- Anemia (2.4%)
<1%
Anaphylactoid reaction
Angioedema
Fever
Asthma, bronchospasm
Cerebrovascular accident
Erythema multiforme, erythroderma
Immune hypersensitivity reaction
Interstitial nephritis, renal failure
Jaundice, liver failure
Stevens-Johnson syndrome
Tinnitus, hearing loss
Toxic epidermal necrolysis
Warnings
Black Box Warnings
Cardiovascular risk
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke, which can be fatal
- Risk may increase with duration of use
- Patients with existing cardiovascular disease or risk factors for such disease may be at greater risk
- NSAIDs are contraindicated for perioperative pain in setting of coronary artery bypass graft (CABG) surgery
Gastrointestinal risk
- NSAIDs increase risk of serious GI adverse events, including bleeding, ulceration, and gastric or intestinal perforation, which can be fatal
- GI adverse events may occur at any time during use and without warning symptoms
- Elderly patients are at greater risk for serious GI events
Contraindications
Known hypersensitivity (eg, anaphylactic or serious skin reactions)
History of asthma, urticaria, or other allergic-type reactions after taking aspirin or other NSAIDs
Perioperative pain management in the setting of coronary artery bypass graft (CABG) surgery
Anjeso: Moderate-to-severe renal insufficiency in patients at risk for renal failure owing to volume depletion
Qmiiz: Phenylketonuria
Cautions
Cardiovascular thrombotic events
- 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
- Increased CV thrombotic risk has been observed most consistently at higher doses
-
Minimize potential risk by using lowest effective dose for the shortest duration possibleCABG
- 2 large, controlled clinical trials of a COX-2 selective NSAID for pain in the first 10-14 days following CABG surgery found an increased incidence of MI and stroke
- NSAIDs are contraindicated in the setting of CABG
-
Post-MI
- Observational studies conducted in the Danish National Registry have demonstrated that patients treated with NSAIDs post-MI were at increased risk of reinfarction, CV-related death, and all-cause mortality beginning in the first week of treatment
- Avoid in patients with recent MI unless benefits outweigh risk of recurrent CV thrombotic events; if used, monitor for cardiac ischemia
GI effects
- NSAIDs can cause serious GI adverse events including inflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small intestine, or large intestine, which can be fatal
- Patients with a prior history of PUD and/or GI bleeding who used NSAIDs have >10-fold increased risk for developing a GI bleed compared with patients without these risk factors
- Other risk factors include longer duration of NSAID therapy; concomitant use of oral corticosteroids, aspirin, anticoagulants, or SSRIs; smoking; use of alcohol; advanced liver disease and /or coagulopathy; older age; and poor general health status
Heart failure and edema
- The Coxib and traditional NSAID Trialists’ Collaboration meta-analysis of randomized controlled trials demonstrated an ~2-fold increase in hospitalizations for heart failure in COX-2 selective-treated patients and nonselective NSAID-treated patients compared with placebo-treated patients
- Fluid retention and edema observed in some patients treated with NSAIDs
- Meloxicam may blunt the CV effects of several therapeutic agents used to treat these medical conditions (eg, diuretics, ACE inhibitors, ARBs)
Renal toxicity and hyperkalemia
- Long-term administration of NSAIDs has resulted in renal papillary necrosis, renal insufficiency, acute renal failure, and other renal injury
- NSAIDs are not recommended with moderate to severe renal insufficiency and are contraindicated in patients with moderate to severe renal insufficiency at risk for renal failure due to volume depletion
- Increased serum potassium concentration, including hyperkalemia, reported with NSAIDs, even in some patients without renal impairment
Asthma exacerbation
- 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
- Contraindicated in aspirin-sensitive asthma owing to cross-reactivity
- Caution in patients with asthma without known aspirin sensivitiy
Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Drug Reaction reported in patients taking NSAIDs; 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; sometimes symptoms of DRESS may resemble an acute viral infection
- Eosinophilia is often present; because this disorder is variable in its presentation, other organ systems not noted here may be involved
- 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 therapy and evaluate the patient immediately
Additional cautions
- Hepatotoxicity: May increase ALT or AST
- Hypertension: Can lead to new onset of hypertension or worsening of pre-existing hypertension, either of which may contribute to the increased incidence of CV events
- Anaphylactic reactions reported in patients with and without known hypersensitivity to meloxicam and in patients with aspirin-sensitive asthma
- Serious skin reactions reported, including exfoliative dermatitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, which can be fatal
- Premature closure of fetal ductus arteriosus: Avoid NSAIDs in pregnant women starting at 30 weeks of gestation (third trimester)
- Hematologic toxicity: Anemia reported; causes vary including blood loss, fluid retention, or effect on erythropoiesis
- Masking of inflammation and fever: Reducing inflammation, and possibly fever, may diminish the utility of diagnostic signs in detecting infections
- Monitoring: Consider monitoring patients on long-term PO NSAID treatment with a CBC and a chemistry profile periodically to detect GI bleeding, hepatotoxicity, or renal injury
- IV meloxicam not indicated for long-term treatment
- Qmiiz ODT contains phenylalanine; contraindicated in patients with phenylketonuria
Drug interaction overview
-
CYP2C9 inhibitors
- Meloxicam is a CYP2C9 substrate
- Coadministration with CYP2C9 inhibitors (eg, amiodarone, fluconazole) may increase meloxicam plasma levels owing to reduced metabolic clearance
- Consider meloxicam dose reduction
-
Drugs that interfere with hemostasis
- Monitor if coadministered with anticoagulants (eg, warfarin), antiplatelet agents (eg, aspirin), selective serotonin reuptake inhibitors (SSRIs), and serotonin norepinephrine reuptake inhibitors (SNRIs) for signs of bleeding
- Coadministration with analgesic doses of aspirin is not recommended owing to increased risk of bleeding
- If coadministration with low-dose aspirin for cardiac prophylaxis, monitor closely for evidence of GI bleeding
-
ACE inhibitors, ARBs, or beta blockers
- NSAIDs may diminish antihypertensive effect of ACE inhibitors, angiotensin receptor blockers (ARBs), or beta blockers
- 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
- If coadministered, patients should be well hydrated; monitor for signs of worsening renal function
-
Diuretics
- NSAIDs may reduce the natriuretic effect of loop and thiazide diuretics
- This effect is attributed to the NSAID inhibition of renal prostaglandin synthesis
- However, studies with furosemide and meloxicam have not demonstrated a reduced natriuretic effect
-
Lithium
- NSAIDs elevate plasma lithium levels and reduce renal lithium clearance
- Mean minimum lithium concentration increased 15%; renal clearance decreased by ~20%
- Effect attributed to NSAID inhibition of renal prostaglandin synthesis
- Monitor for lithium toxicity
-
Methotrexate
- Coadministration of NSAIDs and methotrexate may increase risk for methotrexate toxicity (eg, neutropenia, thrombocytopenia, renal dysfunction)
-
Cyclosporine
- Coadministration may increase nephrotoxicity
- If coadministered, monitor for worsening renal function
-
NSAIDs or salicylates
- Coadministration with other NSAIDs or salicylates increases risk of GI toxicity, with little or no increase in efficacy
- Concomitant use no recommended
-
Pemetrexed
- Coadministration may increase risk of pemetrexed-associated myelosuppression, renal, and GI toxicity
- CrCl 45-79 mL/min: Interrupt meloxicam dosing for at least 5 days before, the day of, and 2 days after pemetrexed administration
- CrCl <45 mL/min: Concomitant administration of meloxicam with pemetrexed is not recommended
Pregnancy & Lactation
Pregnancy
Data from observational studies regarding potential embryofetal risks of NSAID use in women in the first or second trimesters of pregnancy are inconclusive
Fetal toxicity
- Avoid use of NSAIDs in pregnant women at about 30 weeks gestation and later; NSAIDs increase risk of premature closure of fetal ductus arteriosus at approximately this gestational age
- Use of NSAIDs at about 20 weeks gestation or later in pregnancy may also 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; complications of prolonged oligohydramnios may, for example, include limb contractures and delayed lung maturation
- In some postmarketing cases of impaired neonatal renal function, invasive procedures such as exchange transfusion or dialysis were required
- If NSAID treatment is necessary between about 20 weeks and 30 weeks gestation, limit use to the lowest effective dose and shortest duration possible
- Consider ultrasound monitoring of amniotic fluid if treatment extends beyond 48 hours; discontinue drug if oligohydramnios occurs and follow up according to clinical practice
Animal studies
- 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
Clinical considerations
- Human data are not available on the effects during labor or deliveryIn animal studies, NSAIDs inhibit prostaglandin synthesis, cause delayed parturition, and increase the incidence of stillbirth
Infertility
-
Females
- Based on the mechanism of action, prostaglandin-mediated NSAIDs may delay or prevent rupture of ovarian follicles, which has been associated with reversible infertility in some women
-
Males
- May compromise fertility in males of reproductive potential
- Oral administration of meloxicam to male rats for 35 days resulted in decreased sperm count and motility and histopathological evidence of testicular degeneration at 0.3-times the MRHD based on BSA comparison
- The clinical relevance of these findings is unknown
Lactation
Human data are not available on whether meloxicam is present in human milk, or on the effects on breastfed infants, or on milk production
Animal data
- Present in milk of lactating rats at concentrations higher than those in plasma
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Member of oxicam class; inhibits synthesis of prostaglandins in body tissues by inhibiting at least 2 cyclo-oxygenase (COX) isoenzymes, COX-1 and COX-2; COX-2 may be inhibited to a greater extent than COX-1 is
Absorption
Bioavailability: 89%
Peak plasma time
- Mobic tab: 6.57 hr
- Vivlodex cap: 2 hr (fasting); 5 hr (fed)
- Anjeso IV: 0.12 hr
Peak plasma concentration
- Mobic tab: 1221.9 ng/mL
- Anjeso IV: 5642.9 ng/mL
AUC
- Mobic tab: 53,988.8 ng⋅hr/mL
- Anjeso IV: 107,508.7 ng⋅hr/mL
Distribution
Protein bound: 99.4%; primarily to albumin
Vd: ~10 L
Metabolism
Metabolized in liver by CYP2C9 (major) and CYP3A4 (minor)
Metabolites (inactive): 5'-Carboxy meloxicam, 5'-hydroxymethyl meloxicam
Enzymes inhibited: COX-1, COX-2
Elimination
Half-life: 15-20 hr (PO); 24 hr (IV)
Plasma clearance: 7-9 mL/min
Dialyzable: No
Excretion: Equally excreted in urine and feces, mostly as metabolites
Pharmacogenomics
Poor CYP2C9 metabolizers
- Consider dose meloxicam reduction
- Abnormally high plasma levels owing to reduced metabolic clearance may occur
Administration
Oral Administration
Tablet, capsule, or ODT: May take with or without meals
Oral disintegrating tablet (ODT)
- Leave ODT in original package until the time of administration
- Use dry hands when handling ODT
- Open carton and peel back foil on the blister; do not push the tablet through the foil as this could damage the tablet
- Gently remove tablet from the blister and immediately place in mouth or onto tongue
- Tablet will disintegrate quickly in saliva and can be easily swallowed with or without drinking liquid
IV Administration
Anjeso: IV bolus injected over 15 seconds
Hydrate before administering to reduce risk of renal toxicity
Storage
Capsule or tablet
- Store at 25ºC (77ºF); excursions permitted to 15-30ºC (59-86ºF)
- Store in original container and keep the bottle tightly closed to protect from moisture
- Dispense in a tight container if package is subdivided
Oral disintegrating tablet
- Store at 20-25ºC (68-77ºF); excursions permitted to 15-30ºC (59-86ºF)
- Avoid high humidity and excessive heat above 40ºC (104ºF)
IV
- Store at 15-25ºC (59-77ºF); excursions permitted to 4-30ºC (40-86ºF)
- Do not freeze
- Protect from light
- Latex-free
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Anjeso intravenous - | 30 mg/mL vial |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 15 mg tablet |  | |
| meloxicam oral - | 7.5 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
meloxicam oral
MELOXICAM - ORAL
(mel-OX-i-kam)
COMMON BRAND NAME(S): Mobic, Vivlodex
WARNING: Nonsteroidal anti-inflammatory drugs (including meloxicam) may rarely increase the risk of a heart attack or stroke. This effect can happen at any time while taking this drug but is more likely if you take it for a long time. The risk may be greater in older adults or if you have heart disease or increased risk for heart disease (for example, due to smoking, family history of heart disease, or conditions such as high blood pressure or diabetes). Do not take this drug right before or after heart bypass surgery (CABG).Also, this drug may rarely cause serious (rarely fatal) bleeding from the stomach or intestines. This effect can occur without warning symptoms at any time while taking this drug. Older adults may be at higher risk for this effect. (See also Precautions and Drug Interactions sections.)Stop taking meloxicam and get medical help right away if you notice any of the following rare but serious side effects: stomach/abdominal pain that doesn't go away, bloody or black/tarry stools, vomit that looks like coffee grounds, chest/jaw/left arm pain, shortness of breath, unusual sweating, weakness on one side of the body, sudden vision changes, trouble speaking.Talk with your doctor or pharmacist about the risks and benefits of treatment with this medication.
USES: Meloxicam is used to treat arthritis. It reduces pain, swelling, and stiffness of the joints. Meloxicam is known as a nonsteroidal anti-inflammatory drug (NSAID).If you are treating a chronic condition such as arthritis, ask your doctor about non-drug treatments and/or using other medications to treat your pain. See also Warning section.
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start taking meloxicam and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth as directed by your doctor, usually once daily. If you are taking the tablet or capsule form of this medication, drink a full glass of water (8 ounces/240 milliliters) with it unless your doctor tells you otherwise. Do not lie down for at least 10 minutes after taking the tablet or capsule form of this medication.If you are taking the liquid form of this medication, shake the bottle gently before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.If you are taking the disintegrating tablet, do not remove the tablet from the packaging until you are ready to take it. With dry hands, peel back the foil to carefully remove the tablet. Do not push the tablet through the foil because doing so can damage it. Place the tablet on your tongue right away and allow it to dissolve. After the tablet has melted, it can be swallowed with or without liquid.If stomach upset occurs while taking this medication, take it with food, milk, or an antacid. The dosage is based on your medical condition and response to treatment. The lowest effective dosage should always be used, and only for the prescribed length of time. Do not take more of this medication than prescribed because higher doses increase the chance of stomach ulcers/bleeding.Meloxicam may come in different forms (such as tablet, capsule, liquid, disintegrating tablet). Do not switch between different forms without consulting your doctor.It may take up to two weeks before you get the full benefit of this drug. Use this medication regularly to get the most benefit from it. Remember to use it at the same time each day.Tell your doctor if your condition worsens.
SIDE EFFECTS: See also Warning section.Stomach upset, nausea, dizziness, or diarrhea may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: headache that is severe or doesn't go away, easy bruising/bleeding, mental/mood changes, signs of kidney problems (such as change in the amount of urine), unexplained stiff neck, symptoms of heart failure (such as swelling ankles/feet, unusual tiredness, unusual/sudden weight gain).This drug may rarely cause serious (possibly fatal) liver disease. Get medical help right away if you have any symptoms of liver damage, including: nausea/vomiting that doesn't stop, loss of appetite, dark urine, stomach/abdominal pain, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking meloxicam, tell your doctor or pharmacist if you are allergic to it; or to aspirin or other NSAIDs (such as ibuprofen, naproxen, celecoxib); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: asthma (including a history of worsening breathing after taking aspirin or other NSAIDs), liver disease, stomach/intestine/esophagus problems (such as bleeding, ulcers, recurring heartburn), heart disease (such as history of heart attack), high blood pressure, stroke, blood disorders (such as anemia, bleeding/clotting problems), growths in the nose (nasal polyps).Kidney problems can sometimes occur with the use of NSAID medications, including meloxicam. Problems are more likely to occur if you are dehydrated, have heart failure or kidney disease, are an older adult, or if you take certain medications (see also Drug Interactions section). Drink plenty of fluids as directed by your doctor to prevent dehydration and tell your doctor right away if you have a change in the amount of urine.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Talk to your doctor if you are using marijuana (cannabis).This medication may cause stomach bleeding. Daily use of alcohol and tobacco, especially when combined with this medication, may increase your risk for stomach bleeding. Limit alcohol and smoking. Consult your doctor or pharmacist for more information.The disintegrating tablet form of meloxicam may contain aspartame. If you have phenylketonuria (PKU) or any other condition that requires you to limit/avoid aspartame (or phenylalanine) in your diet, ask your doctor or pharmacist about using this medication safely.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be at greater risk for stomach/intestinal bleeding, kidney problems, heart attack, and stroke while using this drug.Before using this medication, women of childbearing age should talk with their doctor(s) about the benefits and risks. Tell your doctor if you are pregnant or if you plan to become pregnant. This medication may harm an unborn baby and cause problems with normal labor/delivery. It is not recommended for use in pregnancy from 20 weeks until delivery. If your doctor decides that you need to use this medication between 20 and 30 weeks of pregnancy, you should use the lowest effective dose for the shortest possible time. You should not use this medication after 30 weeks of pregnancy.It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk and are unlikely to harm a nursing infant. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aliskiren, ACE inhibitors (such as captopril, lisinopril), angiotensin II receptor blockers (such as losartan, valsartan), cidofovir, lithium, methotrexate (high-dose treatment), "water pills" (diuretics such as furosemide).This medication may increase the risk of bleeding when taken with other drugs that also may cause bleeding. Examples include anti-platelet drugs such as clopidogrel, "blood thinners" such as dabigatran/enoxaparin/warfarin, among others.If you are using the liquid form of meloxicam, tell your doctor if you are also using sodium polystyrene sulfonate.Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (aspirin, NSAIDs such as celecoxib, ibuprofen, or ketorolac). These drugs are similar to meloxicam and may increase your risk of side effects if taken together. However, if your doctor has directed you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should continue taking the aspirin unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, extreme drowsiness, severe stomach pain, vomit that looks like coffee grounds.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood counts, blood pressure, kidney/liver function) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Non-drug treatment for arthritis that is approved by your doctor (such as weight loss if needed, strengthening and conditioning exercises) may help improve your flexibility, range of motion, and joint function. Consult your doctor for more information.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised December 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
