Meloxicam

Rheumatoid arthritis: The usual starting dose of meloxicam to treat the symptoms of rheumatoid arthritis is 15 mg once daily. For some people who may respond well to the medication, their doctor can reduce the dose to 7.5 mg once daily, according to need.

Osteoarthritis: The recommended dose to relieve osteoarthritis pain is 7.5 mg once daily. The doctor may increase this to 15 mg taken once daily if necessary.

For both conditions, the maximum dose of meloxicam is 15 mg taken once daily.

Meloxicam may be taken with or without food.

The use of Meloxicam should be limited to the lowest effective dose for the shortest period of time needed.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Meloxicam exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Meloxicam at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause diarrhea; it may cause indigestion; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may increase your blood pressure; it may cause nausea or, rarely, vomiting; it may make your skin more sensitive to UV rays (e.g., sunlight, tanning lamps) - avoid exposure to UV rays as much as possible and protect yourself when out in the sun. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

7.5 mg
Each yellow, circular, flat tablet marked with "7.5" over "M" on the scored side and the "P" logo on the other contains 7.5 mg of meloxicam. Nonmedicinal ingredients: colloidal silicon dioxide, lactose anhydrous, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium citrate, and starch.

15 mg
Each yellow, circular, flat tablet marked with "15" over "M" on the scored side and the "P" logo on the other contains 15 mg of meloxicam. Nonmedicinal ingredients: colloidal silicon dioxide, lactose anhydrous, magnesium stearate, microcrystalline cellulose, pregelatinized starch, sodium citrate, and starch.

Do not take Meloxicam if you:

• are allergic to meloxicam or any ingredients of the medication
• are about to have or have recently had coronary artery bypass graft (CABG) surgery
• are pregnant or breast-feeding
• are less than 18 years of age
• have active or recent stomach or intestinal ulcers or bleeding
• have bleeding of the brain or other bleeding disorders
• have experienced Asthma, Hives, nasal polyps, or allergic reactions after taking Asa or other NSAIDs
• have higher than normal levels of potassium in the blood
• have inflammatory bowel disease (Crohn's Disease or Ulcerative Colitis)
• have severely reduced kidney function or worsening kidney function
• have severely reduced liver function or active liver disease
• have severe uncontrolled heart failure

There may be an interaction between meloxicam and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• Aliskiren
• alteplase
• aminoglycoside antibiotics (e.g., Amikacin, gentamicin, tobramycin)
• angiotensin converting enzyme (ACE) inhibitors (e.g., ramipril, enalapril, Captopril, Quinapril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• Apixaban
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• beta-adrenergic blockers (e.g., atenolol, Propranolol, Sotalol)
• Bimatoprost
• bisphosphonates (e.g., Alendronate, etidronate)
• Bosentan
• Carbamazepine
• Celecoxib
• Cholestyramine
• Clopidogrel
• Colestipol
• Cyclosporine
• dabigatran
• Dabrafenib
• Dasatinib
• Deferasirox
• Desmopressin
• Digoxin
• Dipyridamole
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide, triamterene)
• Edoxaban
• Eplerenone
• glucosamine
• Haloperidol
• Heparin
• herbal products that affect blood clotting (e.g., cat's claw, chamomile, evening primrose, feverfew, fenugreek, garlic, ginger, ginseng, turmeric)
• Hydralazine
• Ibrutinib
• Latanoprost
• lithium
• low-molecular-weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• Mesalamine
• Methotrexate
• mifepristone
• milk thistle
• multivitamins (with vitamins A, E) with or without minerals
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., diclofenac, ibuprofen, Naproxen)
• Obinutuzumab
• omega-3 fatty acids
• oral corticosteroids (e.g., Dexamethasone, Hydrocortisone, Prednisone)
• Pemetrexed
• Pentoxifylline
• Prasugrel
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, Norfloxacin, Ofloxacin)
• rifampin
• Rivaroxaban
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• sodium phosphates
• sodium polystyrene sulfonate
• Sulfasalazine
• Tacrolimus
• tenofovir
• Ticagrelor
• Ticlopidine
• tipranavir
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• urokinase
• vancomycin
• vitamin E
• Warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Meloxicam. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Meloxicam.

HEALTH CANADA ADVISORY

June 8, 2021

Health Canada has issued new information concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.

A previous advisory on non-steroidal anti-inflammatory drugs (NSAIDs) was issued on October 30, 2020.

Alcohol: People taking Meloxicam should not drink alcohol, as this can increase the risk of stomach problems with the medication.

Allergic reactions: If you have had a reaction to acetylsalicylic acid (ASA) or other NSAIDs (e.g., Ibuprofen, Ketoprofen, Diclofenac) that included a runny nose, itchy skin rash, nasal polyps, or shortness of breath and wheezing, you should not take Meloxicam. If you experience symptoms of a severe allergic reaction (e.g., hives; difficulty breathing, wheezing; swelling of the face, tongue, or throat), get immediate medical attention.

Aseptic meningitis: Meloxicam can rarely cause symptoms of aseptic meningitis (inflammation or swelling of the membranes around the brain and spinal cord that is not caused by bacteria). If you have an autoimmune condition (e.g., systemic Lupus erythematosus, mixed connective tissue disease), you are more at risk for developing this. If you experience symptoms such as stiff neck, severe headache, nausea, vomiting, fever, or changes in consciousness, stop taking Meloxicam and get immediate medical attention.

Bladder symptoms: Meloxicam can cause bladder symptoms such as frequent or painful urination and blood in urine. If you develop these symptoms, stop taking Meloxicam and contact your doctor immediately.

Blood counts: Meloxicam can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do blood tests to monitor this. Contact your doctor immediately if you notice an increased occurrence of signs of infection (e.g., fever, chills, or sore throat), feel unusually tired, lack energy, or experience unusual bleeding or bruising.

Blood pressure: Like other NSAIDs, meloxicam can cause increased blood pressure, which may contribute to other heart conditions. If you have high blood pressure, discuss with your doctor how Meloxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Meloxicam, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Meloxicam may reduce mental or physical abilities required for performance of hazardous tasks such as operating machinery or driving a motor vehicle. Avoid these and other hazardous tasks until you are sure that Meloxicam does not affect your ability to do these safely.

Fertility: Fertility may be decreased in people taking Meloxicam. Meloxicam is not recommended for women who are trying to get pregnant.

Galactose intolerance/glucose malabsorption: Meloxicam medications are prepared with lactose. If you have lactose or galactose intolerance you should not take these medications.

Heart Attack and Stroke: The use of COX-2 NSAIDs, including meloxicam, is associated with an increased risk of heart attack and stroke. This risk is increased with higher total daily doses and taking the medication over long periods of time. If you have a history of heart disease, including heart attack and stroke, discuss with your doctor the benefits and risks of taking Meloxicam. Ask your doctor about all available treatment options that may be right for you.

Heart conditions: Meloxicam can cause fluid retention which will make symptoms of certain heart conditions worse. If you have heart failure, high blood pressure, or other medical conditions that increase your risk of fluid retention (e.g., kidney problems), discuss with your doctor how Meloxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Meloxicam, and whether any special monitoring is needed.

Infection: Meloxicam may mask signs of infection such as fever or muscle aches. If you notice other symptoms of infection (e.g., painful or frequent urination, sore throat, cough) contact your doctor.

Informing health professionals: Be sure to tell any health professionals (including your doctor, nurse, pharmacist, and dentist) involved in your care that you are taking Meloxicam, particularly if you are scheduled for heart surgery.

Kidney function: Meloxicam can affect kidney function. You have a higher risk of developing kidney problems if you are a senior, take diuretics (water pills; e.g., Hydrochlorothiazide, Furosemide), or already have Kidney Disease or heart failure. Your doctor may monitor your kidney function with blood tests when you are taking Meloxicam. Meloxicam is not recommended for people with severely reduced kidney function if they are not receiving dialysis.

Liver function: Meloxicam may affect your liver function or cause liver problems. If you experience symptoms of liver problems (e.g., nausea, vomiting, feeling tired, yellowing of the skin or eyes) contact your doctor immediately. If you have liver problems, discuss with your doctor how Meloxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Meloxicam, and whether any special monitoring is needed. People with severely reduced liver function or have active liver disease should not take Meloxicam.

Potassium levels: Meloxicam may cause high blood potassium levels. You are more at risk of high blood potassium if you are a senior, have Diabetes or kidney failure, or are taking beta-blockers (e.g., Metoprolol, Atenolol), angiotensin converting enzyme (ACE) inhibitors (e.g., Ramipril, Enalapril), or some diuretics (e.g., triamterene, Amiloride). Because extremely high blood potassium levels can contribute to other conditions, such as heart problems, your doctor will monitor your potassium level with blood tests while you are taking Meloxicam.

Ulcers and bleeding in the stomach and intestines: Meloxicam may cause stomach ulcers and bleeding from the stomach. These complications can occur at any time and are sometimes severe.

If you have had a stomach or intestinal ulcer, diverticulosis, Crohn's disease or ulcerative colitis, discuss with your doctor how Meloxicam may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Meloxicam, and whether any special monitoring is needed.

If you experience symptoms of an ulcer or other stomach problems (e.g., stomach or abdominal pain, black stools, blood or coffee grind-like vomit, weakness), contact your doctor immediately or get immediate medical attention.

Pregnancy: Meloxicam should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Meloxicam, contact your doctor immediately. It must not be used during the last 3 months of pregnancy as it may cause heart and kidney problems for the developing baby and cause prolonged labour with excessive bleeding during delivery.

Breast-feeding: Many anti-inflammatory medications are known to pass into breast milk. If you are a breast-feeding mother and are taking meloxicam, it may affect your baby. Breast-feeding is not recommended while you are taking meloxicam.

Children: The safety and effectiveness of using Meloxicam have not been established for children.

Seniors: Seniors may have a higher risk of side effects and should be closely monitored by their doctors while taking Meloxicam.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Depending on the treated condition, it may be used regularly or only as needed. Follow the instructions provided by your health care professional. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. This medication may be taken with or without food. Avoid consuming alcohol or alcohol-containing products while taking this medication.