Meloxicam

FDA label

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Renal No adjustment for mild–moderate; not recommended in severe impairment; max 7.5 mg/day on hemodialysis (not dialyzable).

Hepatic No adjustment for mild–moderate; not adequately studied in severe — use with caution.

Max 15 mg/day; doses ≥22.5 mg increase serious GI risk.

Instructions

• Use the lowest effective dose for the shortest duration.
• May take without regard to meals.
• Maximum 15 mg/day regardless of formulation.
• Not interchangeable with other oral meloxicam formulations even at the same mg strength.

Contraindications

• History of asthma, urticaria, or other allergic-type reactions to aspirin or other NSAIDs.
• In the setting of coronary artery bypass graft (CABG) surgery.
• Previous serious skin reactions to NSAIDs.

Cautions

• Cardiovascular thrombotic events (MI, stroke).
• GI bleeding, ulceration, perforation.
• Hepatotoxicity.
• Hypertension; heart failure and edema.
• Renal toxicity and hyperkalemia.
• Anaphylactic reactions; aspirin-sensitive asthma (contraindicated).
• Serious skin reactions (SJS, TEN, DRESS, GBFDE).
• Fetal toxicity; hematologic toxicity.

Adverse reactions

• diarrhea, dyspepsia, abdominal pain, nausea, flatulence
• upper respiratory tract infection
• influenza-like symptoms
• headache, dizziness
• edema
• rash, pruritus
• pediatric: abdominal pain, vomiting, diarrhea, headache, pyrexia

Pregnancy Avoid at ~30 weeks gestation and later (premature closure of fetal ductus arteriosus); limit dose/duration at 20–30 weeks (oligohydramnios/fetal renal dysfunction).

Lactation No human data; present in rat milk; weigh benefits against potential effects on the infant.