Meloxicam

Meloxicam is a nonsteroidal anti-inflammatory drug (nsaid) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Symptomatic relief of osteoarthritis pain and inflammation.
• Symptomatic treatment of rheumatoid arthritis.
• Symptomatic treatment of ankylosing spondylitis where this indication is approved.
• Juvenile idiopathic/rheumatoid arthritis in children only when specifically prescribed with an appropriate formulation and dose.
• Short-term management of moderate to severe pain may be considered with injectable formulations where approved and clinically appropriate.

Use the lowest effective dose for the shortest possible time. For many adult inflammatory conditions, oral meloxicam is commonly taken once daily, but the exact dose, route, and duration depend on the condition, age, kidney and liver function, other medicines, and the dosage form. Injection, suppository, or bolus forms should be used only as directed by a registered healthcare professional. Do not exceed the prescribed dose or combine it with other NSAIDs unless a doctor advises.

• Common effects: indigestion, stomach pain, nausea, vomiting, diarrhoea, constipation, gas, dizziness, headache, and fluid retention or swelling.
• Stomach and intestinal irritation, ulceration, bleeding, or perforation may occur and can be serious.
• Raised blood pressure, worsening heart failure, heart attack, or stroke risk may increase, especially in people with cardiovascular disease or prolonged use.
• Kidney problems, reduced urine, or worsening kidney function may occur, particularly in dehydrated or elderly patients or those taking diuretics, ACE inhibitors, or ARBs.
• Liver enzyme changes, hepatitis, jaundice, or severe liver injury are rare but possible.
• Allergic reactions including rash, itching, swelling, wheezing, severe skin reactions, or anaphylaxis require urgent medical help.

Use extra caution in elderly patients; people with a history of stomach ulcer or bleeding; heart disease, high blood pressure, stroke risk, kidney disease, liver disease, asthma sensitive to aspirin/NSAIDs, dehydration, bleeding disorders, or those taking blood thinners. Avoid using multiple NSAIDs together. Stop and seek urgent care for black stools, vomiting blood, chest pain, shortness of breath, sudden weakness, severe rash, swelling of the face, or reduced urination. Use Meloxicam under the guidance of a registered doctor or pharmacist.

• Other NSAIDs, including ibuprofen, naproxen, diclofenac, and high-dose aspirin, increase the risk of side effects.
• Anticoagulants and antiplatelet medicines such as warfarin, heparin, rivaroxaban, apixaban, clopidogrel, and aspirin increase bleeding risk.
• Corticosteroids, SSRIs, SNRIs, and alcohol can increase the risk of stomach bleeding.
• ACE inhibitors, ARBs, beta-blockers, and diuretics may have reduced blood-pressure effect and may increase kidney risk.
• Lithium and methotrexate levels or toxicity may increase.
• Cyclosporine, tacrolimus, and similar nephrotoxic medicines can increase kidney damage risk.
• Cholestyramine may reduce meloxicam levels by increasing elimination.
• Food may reduce stomach upset but does not remove the risk of ulcer or bleeding.

• Known allergy or hypersensitivity to meloxicam or any component of the product.
• History of asthma, urticaria, or allergic-type reactions after aspirin or other NSAIDs.
• Active stomach or intestinal ulcer, bleeding, or perforation, or recurrent ulcer/bleeding related to NSAIDs.
• Use for pain around the time of coronary artery bypass graft (CABG) surgery.
• Severe heart failure, severe liver failure, or severe kidney failure unless a specialist decides it is appropriate.
• Third trimester of pregnancy.

Meloxicam should be avoided in the third trimester because it may harm the unborn baby and complicate delivery. From about 20 weeks of pregnancy, NSAIDs may affect the baby’s kidneys and amniotic fluid, so use only if a doctor decides it is necessary. In early pregnancy, use only on medical advice. Breastfeeding data for meloxicam are limited; a doctor may recommend an alternative NSAID with more breastfeeding safety experience, especially for newborn or premature infants.

Store at room temperature, away from excess heat, moisture, and direct sunlight. Keep in the original packaging and out of reach of children. Do not use after the expiry date, and follow the product label or pharmacist’s advice for any formulation-specific storage requirements.