Meloxicam Eg (Meloxicam)

Meloxicam is indicated for several inflammatory and painful musculoskeletal conditions.

• Osteoarthritis: alleviates joint pain and reduces inflammation to improve mobility.
• Rheumatoid arthritis: decreases synovial inflammation and pain in adult patients.
• Juvenile rheumatoid arthritis: provides anti‑inflammatory relief in pediatric patients under specialist care.
• Ankylosing spondylitis: mitigates spinal stiffness and pain associated with the disease.
• Acute pain: offers short‑term relief for moderate to severe pain episodes.

• Meloxicam selectively inhibits the cyclooxygenase‑2 (COX‑2) enzyme, which reduces the conversion of arachidonic acid to prostaglandins that mediate inflammation, pain and fever. At higher doses, it also blocks COX‑1, contributing to additional anti‑inflammatory effects. By lowering prostaglandin synthesis, meloxicam diminishes inflammatory cell activity and peripheral sensitisation, resulting in analgesia and decreased swelling. The drug’s preferential COX‑2 activity helps maintain gastric mucosal protection while providing therapeutic benefit.

Like all NSAIDs, meloxicam may be associated with adverse reactions that vary in frequency and severity.

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness or vertigo.
• Peripheral edema: mild swelling of the lower limbs.
• Elevated liver enzymes: transient increases in laboratory tests.
• Diarrhoea: loose stools without blood.
• Rash: mild skin erythema.

Serious or Rare Side Effects

• Peptic ulcer disease or gastrointestinal bleeding.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Hepatotoxicity: significant liver injury.
• Renal impairment: acute kidney injury or worsening chronic kidney disease.
• Cardiovascular events: increased risk of myocardial infarction or stroke.

When prescribing meloxicam, clinicians should consider several precautionary measures to minimise risk.

• Assess renal function: evaluate creatinine clearance before initiating therapy.
• Monitor hepatic enzymes: periodic liver function tests are recommended.
• Use lowest effective dose: limit exposure to reduce gastrointestinal toxicity.
• Caution in cardiovascular disease: avoid in patients with recent myocardial infarction or uncontrolled hypertension.
• Avoid in known hypersensitivity: discontinue if allergic reactions occur.
• Store at ambient temperature: keep below 25°C in the original container, protected from moisture.

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

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Other NSAIDs or COX‑2 inhibitors: additive gastrointestinal toxicity.
• High‑dose aspirin: heightened bleeding risk.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: may reduce renal function when combined.
• Diuretics: potential for decreased kidney perfusion.
• Lithium: NSAIDs can raise lithium serum levels.
• Methotrexate: reduced clearance may increase toxicity.