meloxicam, Mobic (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
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 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 three alcoholic beverages per day may be at increased risk of developing stomach ulcers when taking meloxicam or other NSAIDs.
Meloxicam oral suspension contains sorbitol. Combining sodium polystyrene sulfonate (Kayexalate) with sorbitol may cause fatal intestinal necrosis. Therefore, meloxicam oral solution should not be combined with Kayexalate.
Medically Reviewed by a Doctor on 7/31/2015
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