Melgesic (Meloxicam)

Melgesic (meloxicam) is used to manage inflammatory conditions affecting the musculoskeletal system.

• Osteoarthritis: reduces joint pain and inflammation, improving mobility.
• Rheumatoid arthritis: alleviates chronic synovial inflammation and associated discomfort.
• Ankylosing spondylitis: diminishes spinal stiffness and pain.
• Acute musculoskeletal pain: provides rapid relief of pain and swelling after injury or overuse.

• Meloxicam selectively inhibits the cyclooxygenase‑2 (COX‑2) enzyme, which is responsible for converting arachidonic acid to prostaglandins that mediate inflammation, pain, and fever. By preferentially blocking COX‑2 while sparing COX‑1, meloxicam reduces prostaglandin synthesis at sites of inflammation, leading to decreased swelling and analgesic effects without markedly affecting gastric protective prostaglandins. The inhibition is dose‑dependent and contributes to sustained anti‑inflammatory activity over 24 hours.

Like other NSAIDs, meloxicam may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Headache: mild to moderate intensity.
• Dyspepsia: stomach discomfort or indigestion.
• Diarrhea: loose stools.
• Nausea: feeling of sickness.
• Edema: peripheral swelling, especially in the ankles.
• Elevated liver enzymes: mild, transient increase in hepatic markers.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding: potentially life‑threatening.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: significant liver injury.
• Renal impairment: acute kidney injury or worsening of chronic kidney disease.
• Cardiovascular events: increased risk of heart attack or stroke.
• Anaphylaxis: severe allergic reaction requiring immediate medical attention.

Before prescribing meloxicam, clinicians should evaluate patient risk factors and follow safety guidelines.

• Assess renal function: check creatinine clearance in patients with kidney disease.
• Monitor hepatic status: avoid use in severe liver impairment.
• Evaluate cardiovascular risk: use cautiously in patients with history of heart disease or stroke.
• Use gastro‑protective agents: consider concomitant proton pump inhibitor in patients with ulcer risk.
• Avoid in late pregnancy: meloxicam is not recommended during the third trimester.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and light.

Meloxicam can interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of bleeding.
• Other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• High‑dose aspirin: enhanced renal and gastrointestinal adverse effects.
• Selective serotonin reuptake inhibitors (SSRIs): heightened bleeding risk.
• Angiotensin‑converting enzyme inhibitors (ACEIs) or ARBs: may reduce renal function.

Moderate Interactions (Monitor Closely)

• Diuretics: potential for reduced diuretic effect and renal impairment.
• Lithium: increased lithium levels, risk of toxicity.
• Methotrexate: decreased clearance leading to toxicity.
• Corticosteroids: increased risk of gastrointestinal ulceration.
• Cyclosporine: enhanced nephrotoxic potential.