Meloxicam Flamingo (Meloxicam)

• Meloxicam is indicated for several inflammatory and pain‑related conditions affecting the musculoskeletal system.
• Osteoarthritis: reduces joint pain and improves mobility in patients with degenerative joint disease.
• Rheumatoid arthritis: alleviates inflammation and pain in chronic autoimmune joint inflammation.
• Ankylosing spondylitis: decreases spinal stiffness and discomfort associated with the disease.
• Acute pain: provides short‑term relief of moderate to severe pain from various causes.

• Meloxicam selectively inhibits cyclooxygenase‑2 (COX‑2) enzymes, with lesser effect on COX‑1, thereby decreasing the conversion of arachidonic acid to prostaglandins that mediate inflammation, pain and fever. By reducing prostaglandin synthesis at sites of tissue injury, it attenuates the inflammatory response while sparing gastric mucosal protection relative to non‑selective NSAIDs. The drug’s preferential COX‑2 inhibition contributes to its analgesic and anti‑inflammatory efficacy in chronic joint disorders.

Meloxicam may cause a range of adverse reactions, varying from mild to serious.

Common Side Effects

• Gastrointestinal discomfort or dyspepsia
• Headache or dizziness
• Peripheral edema or mild hypertension
• Skin rash or pruritus
• Elevated liver enzymes
• Mild renal function changes

Serious or Rare Side Effects

• Gastrointestinal ulceration or bleeding
• Severe liver injury (hepatitis, jaundice)
• Acute renal impairment or failure
• Cardiovascular thrombotic events (myocardial infarction, stroke)
• Stevens‑Johnson syndrome or toxic epidermal necrolysis
• Anaphylaxis or severe hypersensitivity reactions

• When prescribing meloxicam, clinicians should consider several safety aspects.
• Renal function: assess baseline kidney function and monitor during therapy, especially in patients with pre‑existing renal disease.
• Cardiovascular risk: use cautiously in patients with hypertension, heart failure or a history of thrombotic events.
• Gastrointestinal safety: consider gastroprotective agents for patients with prior ulcer disease.
• Pregnancy and lactation: category B; avoid use unless benefits outweigh risks.
• Concomitant NSAIDs or anticoagulants: increase risk of bleeding; avoid combination when possible.
• Store at ambient temperature: keep below 25 °C, protect from moisture and light in the original packaging.

Meloxicam can interact with several drug classes, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased bleeding risk.
• Selective COX‑2 inhibitors (e.g., celecoxib): additive toxicity.
• Methotrexate: reduced clearance leading to toxicity.
• Lithium: increased serum levels.
• Cyclosporine: heightened nephrotoxicity.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: possible reduction in renal function.
• Diuretics: enhanced risk of renal impairment and electrolyte imbalance.
• SSRIs or SNRIs: elevated bleeding tendency.
• Beta‑blockers: may mask tachycardia from NSAID‑induced fluid retention.
• Allopurinol: potential for hypersensitivity reactions.