Uses of Melcam: - Pain relief Rheumatoid arthritis, Osteoarthritis, Ankylosing spondylitis Hypersensitivity to meloxicam, aspirin or other NSAIDs; severe hepatic impairment; bleeding disorders; renal failure without dialysis. Rectal admin in patients with proctitis, haemorrhoids or rectal bleeding.

Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam family, with anti-inflammatory, analgesic and antipyretic properties. The bioavailability of Meloxicam following oral administration is 89% on the average. With the doses of 7.5 mg & 15 mg plasma concentrations are proportional to dose: 0.4 to 1.0 mg/litre for 7.5 mg & 0.8 to 2.0 mg/litre for 15 mg, on an average. Meloxicam is very strongly bound to plasma proteins, essentially albumin (99%). Meloxicam is extensively metabolised, chiefly by oxidation of the methyl redical attached to the thiazolyl ring. Elimination in unchanged form accounts for 3% of the dose. Half of the substance is eliminated in urine & the other half in the faeces. The mean elimination half life is 20 hours.

How to use Meloxicam: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Meloxicam may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. May be taken w/ meals if GI discomfort occurs. Adult Dose: Oral Rheumatoid arthritis; Ankylosing spondylitis Adult: 15 mg daily as a single dose. Patients w/ increased risk of adverse effects: Initially, 7.5 mg daily. Acute exacerbations of osteoarthritis Adult: 7.5 mg daily up to max 15 mg daily as a single dose. Elderly: 7.5 mg daily for long-term treatment. Child Dose: Oral Juvenile rheumatoid arthritis Child: >2 yr 0.125 mg/kg once daily. Max: 7.5 mg daily. Renal Dose: Renal impairment: Mild to moderate: No dosage adjustment needed. Severe: Not recommended. Dialysis patient: 7.5 mg daily.

Increased risk of severe GI effects w/ aspirin or warfarin. May antagonise antihypertensive effects of ACE inhibitors and angiotensin II receptor antagonists. May reduce natriuretic effects of furosemide and thiazides. Enhanced toxicity of methotrexate. May increase plasma lithium concentration.

Hypersensitivity to meloxicam, aspirin or other NSAIDs; severe hepatic impairment; bleeding disorders; renal failure without dialysis. Rectal admin in patients with proctitis, haemorrhoids or rectal bleeding.

Common - Vomiting - Stomach pain - Nausea - Indigestion - Diarrhea 1-10% Indigestion (3.8-9.5%),Upper respiratory infection (<8.3%),Headache (2.4-8.3%),Diarrhea (1.9-7.8%),Nausea (2.4-7.2%),Abdominal pain (1.9-4.7%),Edema (0.6-4.5%),Anemia (<4.1%),Dizziness (1.1-3.8%),Constipation (0.8-2.6%),Angina (<2%),Congestive heart failure (<2%),Decreased platelet aggregation, purpuric disorder (<2%),Gastrointestinal (GI) hemorrhage (<2%),GI perforation, GI ulcer (<2%),Hepatitis (<2%),Hypertension (<2%),Inflammatory disorder of digestive tract (<2%),Myocardial infarction (<2%),Vomiting (<3%) <1% Anaphylactoid reaction,Angioedema,Fever,Asthma, bronchospasm,Cerebrovascular accident,Erythema multiforme, erythroderma,Immune hypersensitivity reaction,Interstitial nephritis, renal failure,Jaundice, liver failure,Stevens-Johnson syndrome,Tinnitus, hearing loss,Toxic epidermal necrolysis Potentially Fatal: Stevens Johnson syndrome, thrombocytopenia, interstitial nephritis and idiosyncratic liver abnormality.

It is advisable to avoid the administration of Meloxicam during pregnancy. It is unknown whether Meloxicam passes into mother’s milk. Meloxicam should not be given to nursing mothers.

Precaution: History of GI disease, asthma, hypertension, CVD or risk factors, fluid retention or heart failure. Monitor patients with advanced renal disease. May impair ability to drive or operate machinery. Elderly. Pregnancy (avoid in the 3rd trimester) and lactation.

Store Meloxicam tablet in a cool & dry place and away from light. Store Meloxicam suppository below 25˚C protected from light and moisture.

Drugs for Osteoarthritis, Drugs used for Rheumatoid Arthritis, Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Meloxicam is an oxicam derivative which exhibits analgesic, antipyretic and anti-inflammatory actions. It reversibly inhibits the cyclooxygenase-1 and -2 (COX-1 and -2) enzymes, thus resulting in reduced synthesis of prostaglandin precursors.

Pregnancy category: C; D in third trimester of pregnancy; drug should be avoided in late pregnancy