Meloxicam
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Meloxicam
Mobic, Vivlodex (lower-dose capsules), Anjeso (IV)
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Summary
Common uses
Osteoarthritis (FDA)0, Rheumatoid arthritis (FDA, adult)0, Juvenile rheumatoid arthritis (FDA, ≥2 years)0, Ankylosing spondylitis (FDA)0, Acute pain (off-label oral; Anjeso IV formulation)0
Pharmacy
Starting dose
7.5 mg PO once daily; titrate to 15 mg daily if needed. Vivlodex 5 mg PO once daily, max 10 mg
Preparations
Tablets 7.5, 15 mg (Mobic); capsules 5, 10 mg (Vivlodex); oral suspension 7.5 mg/5 mL; injection 30 mg/mL (Anjeso)
US FDA Max
15 mg/day (oral); 30 mg IV once daily (Anjeso)
Pharmacology
Routes
Oral, intravenous
Onset
Analgesic effect within hours; full anti-inflammatory effect over 1-2 weeks
Duration
24 hours (once-daily dosing supported by long half-life)
Half-life
15-20 hours[1]
Bioavailability
~89% (oral)[1]
Pregnancy
Avoid from 20 weeks gestation onward per FDA's 2020 expanded NSAID warning (fetal renal dysfunction, oligohydramnios); contraindicated from 30 weeks (risk of premature ductus arteriosus closure)[1]
Legal status
Rx-only in US
Purported mechanism
Preferential COX-2 over COX-1 inhibitor (approximately 3:1 selectivity at therapeutic doses), giving somewhat less GI mucosal injury than non-selective NSAIDs but not the COX-2 specificity of celecoxib. Anti-inflammatory and analgesic effect derives from reduced prostaglandin synthesis; the cardiovascular and renal class effects of NSAIDs apply, with the standard FDA Boxed Warning for cardiovascular thrombotic events and gastrointestinal bleeding.0 Once-daily dosing is a clinical advantage over short-half-life NSAIDs[1].
References
- ↑ 1.0 1.1 1.2 1.3 FDA Prescribing Information, Mobic (meloxicam), Boehringer Ingelheim, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020938s022lbl.pdf