Melox (Meloxicam)

Meloxicam is used to reduce pain and inflammation associated with several chronic musculoskeletal disorders.

• Osteoarthritis: alleviates joint pain, reduces swelling and improves functional mobility in adult patients.
• Rheumatoid arthritis: decreases synovial inflammation, limits joint damage and relieves chronic pain.
• Ankylosing spondylitis: reduces spinal stiffness, lowers inflammatory markers and improves range of motion.
• Juvenile rheumatoid arthritis: controls pain and swelling, helping maintain growth and activity levels in pediatric patients.

• Meloxicam preferentially inhibits cyclooxygenase‑2 (COX‑2) enzymes, leading to a decrease in prostaglandin synthesis that mediates inflammation, pain, and fever. By sparing COX‑1 activity to a greater extent, it aims to reduce gastrointestinal side effects while maintaining anti‑inflammatory efficacy in target tissues.

Adverse reactions may occur with meloxicam therapy and are categorized by frequency and severity.

Common Side Effects

• Gastrointestinal discomfort such as dyspepsia or abdominal pain.
• Nausea and occasional vomiting.
• Diarrhea or constipation.
• Headache and dizziness.
• Mild elevation of blood pressure.
• Skin rash or pruritus.

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding, which can be life‑threatening.
• Cardiovascular events including myocardial infarction or stroke.
• Hepatic enzyme elevation or hepatitis.
• Severe skin reactions such as Stevens‑Johnson syndrome.
• Renal impairment or acute kidney injury.
• Anaphylaxis or severe hypersensitivity reactions.

Before prescribing meloxicam, clinicians should evaluate patient‑specific risk factors and monitor for potential complications.

• Assess renal function: evaluate kidney status prior to initiation and periodically during therapy.
• Monitor hepatic enzymes: check liver function tests at baseline and during long‑term use.
• Avoid in patients with known hypersensitivity to NSAIDs or sulfonamides.
• Use caution in cardiovascular disease: consider increased risk of thrombotic events.
• Limit use in elderly patients: higher incidence of gastrointestinal complications.
• Store at ambient temperature: keep below 25°C, protect from moisture and light.

Meloxicam can interact with several drug classes, requiring either avoidance or close monitoring.

Major Interactions (Avoid)

• Concurrent use with anticoagulants (e.g., warfarin): heightened risk of bleeding.
• Combination with other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• Concomitant lithium therapy: potential for lithium toxicity.
• Use with methotrexate: may increase methotrexate plasma concentrations.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or diuretics: possible decline in renal function.
• SSRIs or other serotonergic agents: increased bleeding tendency.
• Co‑administration with corticosteroids: elevated risk of gastric ulceration.