Mexolan (Meloxicam)

Meloxicam is indicated for inflammatory joint disorders and related musculoskeletal pain.

• Osteoarthritis: reduces joint pain and improves function in patients with degenerative joint disease.
• Rheumatoid arthritis: alleviates inflammation and joint damage progression in autoimmune arthritis.
• Musculoskeletal pain: provides symptomatic relief for acute or chronic pain in muscles, tendons and ligaments.

• Meloxicam exerts its anti‑inflammatory and analgesic effects by reversibly inhibiting cyclooxygenase (COX) enzymes, with greater selectivity for COX‑2 over COX‑1. This inhibition decreases the synthesis of prostaglandins, which are mediators of inflammation, pain and fever, thereby reducing the inflammatory response in affected tissues. The drug’s preferential COX‑2 inhibition helps to maintain gastric mucosal protection while providing effective anti‑inflammatory activity in patients with chronic conditions.

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

Common Side Effects

• Gastrointestinal discomfort: nausea, dyspepsia or abdominal pain.
• Headache: mild to moderate intensity.
• Dizziness: transient sensation of light‑headedness.
• Edema: mild swelling of the extremities.
• Skin rash: mild erythema or itching.

Serious or Rare Side Effects

• Peptic ulcer or gastrointestinal bleeding: severe abdominal pain or blood in stool.
• Cardiovascular events: increased risk of heart attack or stroke.
• Hepatic dysfunction: elevated liver enzymes or jaundice.
• Renal impairment: reduced kidney function or fluid retention.
• Severe hypersensitivity: anaphylaxis, angioedema or severe skin reactions.

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

• Renal function: assess baseline kidney function and monitor during therapy.
• Cardiovascular risk: avoid in patients with uncontrolled hypertension or recent myocardial infarction.
• Gastrointestinal history: use cautiously in individuals with prior ulcer disease or bleeding.
• Concomitant NSAIDs: avoid concurrent use with other NSAIDs or aspirin to reduce bleeding risk.
• Pregnancy and lactation: contraindicated in the third trimester and use only if benefits outweigh risks during pregnancy; avoid breastfeeding.
• Store at ambient temperature: keep below 25 °C in the original packaging, protected from moisture and light.

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

Major Interactions (Avoid)

• Anticoagulants (e.g., warfarin): increased risk of serious bleeding.
• Selective COX‑2 inhibitors (e.g., celecoxib): additive cardiovascular and gastrointestinal toxicity.
• ACE inhibitors or ARBs: may reduce renal function when combined.

Moderate Interactions (Monitor Closely)

• Diuretics: potential for reduced antihypertensive effect and renal impairment.
• Lithium: increased lithium levels leading to toxicity.
• Methotrexate: decreased clearance may raise methotrexate toxicity.
• SSRIs or SNRIs: heightened risk of gastrointestinal bleeding.