meloxicam (redirected from Movalis)

meloxicam /mel·ox·i·cam/ (mĕ-lok´sĭ-kam) a nonsteroidal antiinflammatory drug used in the treatment of osteoarthritis.

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meloxicam

[mĕlok′sĭkam]

a nonsteroidal antiinflammatory drug used in the treatment of osteoarthritis. It is administered orally.

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meloxicam

a nonsteroidal anti-inflammatory drug used in dogs for management of pain.

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meloxicam

Mobic, Mobicox (CA)

Pharmacologic class: Nonopioid analgesic, nonsteroidal anti-inflammatory drug (NSAID)

Therapeutic class: Analgesic, anti-inflammatory drug

Pregnancy risk category C

FDA Boxed Warning

• Drug may increase risk of serious cardiovascular thrombotic events, myocardial infarction (MI), and stroke. Risk may increase with duration of use. Patients with cardiovascular disease or risk factors for it may be at greater risk.
• Drug increases risk of serious GI adverse events, including bleeding, ulcers, and stomach or intestinal perforation. These events can occur at any time during use and without warning. Elderly patients are at greater risk.
• Drug is contraindicated for treatment of perioperative pain in setting of coronary artery bypass graft surgery.

Action

Unknown. Thought to reduce inflammation and pain by inhibiting prostaglandin synthesis of the enzyme cyclooxygenase.

Availability

Oral suspension: 7.5 mg/5 ml

Tablets: 7.5 mg, 15 mg

⊘Indications and dosages

➣ Osteoarthritis; rheumatoid arthritis

Adults: 7.5 mg P.O. once daily; may increase to 15 mg/day

Contraindications

• Hypersensitivity to drug, its components, or other NSAIDs

Precautions

Use cautiously in:
• bleeding disorders, GI or cardiac disorders, severe renal impairment, severe hepatic disease, asthma, peptic ulcer disease
• concurrent aspirin, oral anticoagulant, or corticosteroid therapy
• elderly or debilitated patients
• pregnant or breastfeeding patients
• children younger than age 18 (safety and efficacy not established).

Administration

• Before starting therapy, ask patient about aspirin sensitivity and allergies to other NSAIDs. If patient is dehydrated, provide adequate fluids.

Route	Onset	Peak	Duration
P.O.	Unknown	5-6 hr	24 hr

Adverse reactions

CNS: headache, dizziness, syncope, malaise, fatigue, asthenia, depression, confusion, nervousness, drowsiness, insomnia, vertigo, tremor, paresthesia, anxiety, seizures

CV: hypertension, hypotension, palpitations, angina, vasculitis, heart failure, arrhythmias , MI

EENT: abnormal vision, conjunctivitis, hearing loss, tinnitus, pharyngitis

GI: nausea, vomiting, diarrhea, constipation, colitis, GI ulcers with perforation, abdominal pain, dyspepsia, gastroesophageal reflux, esophagitis, flatulence, ulcerative stomatitis, dry mouth, pancreatitis, GI hemorrhage

GU: urinary frequency, urinary tract infection, albuminuria, hematuria, renal failure

Hematologic: anemia, purpura, leukopenia, thrombocytopenia

Hepatic: hepatitis

Musculoskeletal: joint pain, back pain

Metabolic: dehydration

Respiratory: upper respiratory infection, dyspnea, coughing, asthma, bronchospasm

Skin: rash, urticaria, pruritus, bullous eruption, sweating, alopecia, photosensitivity, angioedema

Other: altered taste, increased appetite, weight gain or loss, hot flashes, fluid retention and edema, masking of infection symptoms, hypersensitivity reactions including anaphylaxis

Interactions

Drug-drug. Angiotensin-converting enzyme inhibitors: decreased antihypertensive effect

Anticoagulants: increased risk of bleeding

Aspirin: increased meloxicam blood level, increased risk of toxicity

Cholestyramine: decreased meloxicam blood level

Furosemide, thiazides: decreased diuretic effect

Lithium: increased lithium blood level

Drug-diagnostic tests. Alanine aminotransferase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, gamma-glutamyl transferase: increased levels

Hemoglobin, platelets, white blood cells: decreased values

Drug-behaviors. Alcohol use, smoking: increased risk of GI irritation and bleeding

Patient monitoring

☞ Closely monitor patient with aspirin-sensitivity asthma, because of risk of severe bronchospasm.
• In prolonged therapy, monitor CBC and kidney and liver function tests.
☞ Assess for cardiovascular disorders and hepatotoxicity.
• Monitor patient for fluid retention and weight gain.

Patient teaching

☞ Instruct patient to immediately report signs and symptoms of hepatotoxicity, including right upper quadrant pain, nausea, fatigue, lethargy, pruritus, and jaundice.
• Tell patient to report abdominal pain, blood in stool or emesis, or black tarry stools.
• Instruct patient to avoid alcohol and smoking.
• Caution pregnant patient to avoid drug, especially during third trimester.
• Tell patient to consult prescriber before taking over-the-counter preparations.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and behaviors mentioned above.