Meloxicam is indicated in:

• Osteoarthritis,
• Rheumatoid arthritis,
• Ankylosing spondylitis.

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 average. With doses of 7.5 mg and 15 mg, plasma concentrations are proportional to dose: 0.4 to 1.0 mg/litre for 7.5 mg and 0.8 to 2.0 mg/litre for 15 mg on average. Meloxicam is very strongly bound to plasma proteins, essentially albumin (99%). It is extensively metabolised, mainly by oxidation of the methyl radical attached to the thiazolyl ring. Elimination in unchanged form accounts for 3% of the dose. About half of the substance is eliminated in urine and the other half in faeces. The mean elimination half-life is approximately 20 hours.

For Adults:

• Osteoarthritis: 7.5 mg/day. If necessary, in the absence of improvement, the dose may be increased to 15 mg/day.
• Rheumatoid arthritis: 15 mg/day. In elderly patients the recommended dose for long term treatment is 7.5 mg/day.
• Ankylosing spondylitis: 15 mg/day. In elderly patients the recommended dose is 7.5 mg/day.

Do not exceed the dose of 15 mg/day. The total daily amount should be taken as a single dose. Patients with increased risks for adverse reactions should start treatment with 7.5 mg/day. In dialysis patients with severe renal failure the dose should not exceed 7.5 mg/day.

For Children: The pharmacokinetics of Meloxicam in paediatric patients under 18 years of age have not been investigated.

• Other NSAIDs, including high doses of salicylates: Administration of several NSAIDs together may increase the risk of ulcers and gastrointestinal bleeding via a synergistic effect.
• Oral anticoagulants, heparin and ticlopidine: Increased risk of bleeding via inhibition of platelet function and damage to the gastroduodenal mucosa. Careful monitoring of anticoagulant effects is essential if combined use cannot be avoided.
• Lithium: NSAIDs increase blood lithium levels, which may reach toxic values.
• Methotrexate: NSAIDs may accentuate the haematologic toxicity of methotrexate.
• Intrauterine contraceptive devices: NSAIDs appear to decrease the efficacy of intrauterine contraceptive devices.

Meloxicam is contraindicated in patients hypersensitive to this drug. Meloxicam should not be given to patients who have developed signs of asthma, nasal polyps, angioneurotic oedema or urticaria following administration of aspirin or NSAIDs. It is contraindicated in patients with active peptic ulcer within the last six months or a history of recurrent peptic ulcer disease, severe hepatic failure, non-dialysed severe renal failure, gastrointestinal bleeding, cerebrovascular bleeding or other bleeding disorders.

Nausea, vomiting, abdominal pain, dyspepsia, constipation or diarrhoea may occur. Ulcers or gastrointestinal bleeding may rarely occur. Skin rash or urticaria may occur in some individuals. Oedema of the lower limbs may occur during treatment. Onset of asthma attack has been reported in aspirin or NSAID allergic individuals. Headache, vertigo or drowsiness may occur.

It is advisable to avoid Meloxicam during pregnancy. It is unknown whether Meloxicam passes into breast milk. It should not be given to nursing mothers.

Patients with known cardiovascular disease or risk factors, fluid retention or heart failure, history of gastrointestinal bleeding or ulceration should use cautiously. Hepatic and renal impairment, elderly patients, pregnancy and lactation require special caution.

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

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