meloxicam, Mobic (cont.)

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Medical and Pharmacy Editor:

DOSING: The lowest effective dose should be used for each patient. Meloxicam therapy usually is started at 7.5 mg daily. Some patients require a dose of 15 mg daily, but this larger dose should be taken only under the direction of a physician. Juvenile rheumatoid arthritis is treated with 0.125 mg/kg daily up to 7.5 mg per day. Meloxicam may be taken with or without food.

DRUG INTERACTIONS: Meloxicam may increase the blood levels of lithium (Eskalith, Lithobid) by reducing the excretion of lithium by the kidneys. Increased levels of lithium may lead to lithium toxicity.

Meloxicam may reduce the blood pressure-lowering effects of drugs that are given to reduce blood pressure. This may occur because prostaglandins play a role in the regulation of blood pressure.

When meloxicam is used in combination with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for example, gentamicin) the blood levels of the methotrexate or aminoglycoside may increase, presumably because their elimination from the body is reduced. This may lead to more methotrexate or aminoglycoside-related side effects.

Meloxicam increases the negative effect of cyclosporine on kidney function and reduces the effect of furosemide (Lasix) and thiazide diuretics because of prostaglandin inhibition.

Individuals taking oral blood thinners, for example, warfarin (Coumadin), should avoid meloxicam because meloxicam also thins the blood, and excessive blood thinning may lead to bleeding.

Meloxicam should be avoided by patients with a history of asthma attacks, hives or other allergic reactions to aspirin or other NSAIDs. If aspirin is taken with meloxicam there may be an increased risk for developing a gastrointestinal ulcer.

Persons who have more than 3 alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking meloxicam or other NSAIDs.

Cholestyramine (Questran), colestipol (Colestid) and colesevelam (Welchol) may decrease the effectiveness of meloxicam by preventing its absorption from the intestine.

Medically Reviewed by a Doctor on 10/11/2013


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