Meloxicam: a reappraisal of pharmacokinetics, efficacy and safety

  title={Meloxicam: a reappraisal of pharmacokinetics, efficacy and safety},
  author={Brian J. Gates and Trang T. Nguyen and Stephen M. Setter and Neal M. Davies},
  journal={Expert Opinion on Pharmacotherapy},
  pages={2117 - 2140}
The discovery of two distinct isoenzymes of COX has led to the development and clinical introduction of COX-2 inhibitors with increased selectivity onto the market. Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class, and is a preferential inhibitor of COX-2, demonstrating effectiveness with anti-inflammatory, analgesic and antipyretic activity. Meloxicam is therapeutically utilised in the management of osteoarthritis and rheumatoid arthritis. Trials have examined… 

[Meloxicam in Russia: 20 years together].

The good tolerability of brand-name meloxicam (Movalis) is confirmed by a total of 120 spontaneous reports of the adverse events due to this drug, which were sent to the Federal Service for Health Supervision in December 2008 to July 2015.

Voriconazole Increases while Itraconazole Decreases Plasma Meloxicam Concentrations

Voriconazole increases plasma concentrations of meloxicam, whereas itraconazole, unexpectedly, decreases plasmameloxicam concentrations, possibly by impairing its absorption.

An old friend: 25 years of meloxicam use in Russia.

A series of large-scale, well-organized randomized controlled trials and observational post-registration studies have confirmed the good efficacy and low incidence of adverse reactions when using meloxicam.

Comparative plasma pharmacokinetics of meloxicam in sheep and goats following intravenous administration.

Single and Multiple-Dose Pharmacokinetics of Meloxicam After Oral Administration to the Rabbit (Oryctolagus cuniculus)

Meloxicam administered at 0.2 mg/kg p.o. daily for 10 day was well tolerated by the rabbits, and a higher dose may be required for optimum effects, this would require efficacy and safety studies in this species.


Meloxicam in healthy human volunteers from Pakistan was evaluated and then potential pharmacokinetic drug-drug interaction of meloxicam with selected co-prescribed drugs i.e. omeprazole and fluconazole was investigated, showing an increase in Cmax ofmeloxicam.

Suppression of follicular rupture with meloxicam, a cyclooxygenase-2 inhibitor: Potential for emergency contraception

The findings of this pilot study suggest that the administration of meloxicam 30 mg/d for 5 consecutive days during the late follicular phase is effective, safe, and may be an alternative to levonorgestrel for emergency contraception.

The effect of the withdrawal of rofecoxib on prescribing patterns of COX-2 inhibitors in Scotland.

Examination of the effect of the withdrawal of rofecoxib on the prescription of other COX-2 inhibitors and nonselective nonsteroidal anti-inflammatory drugs in Scotland found prescribers appear to have interpreted this effect to be class specific.

Pharmacokinetics of 3 formulations of meloxicam in cynomolgus macaques (Macaca fascicularis).

The results indicate that the sustained-release formulation of meloxicam can achieve an adequate steady-state plasma concentration for 2 to 3 d in nonhuman primates, with waxing and waning levels associated with daily dosing.

Single dose oral meloxicam for acute postoperative pain in adults.

It is concluded that in the absence of evidence of efficacy, at present, for oral meloxicam in acute postoperative pain, its use in this indication is not justified.



Clinical Pharmacokinetics of Meloxicam

Constant concentrations of meloxicam are attained in synovial fluid, the proposed site of action in chronic inflammatory arthropathies.

Safety of meloxicam: a global analysis of clinical trials.

Meloxicam's improved GI safety profile is likely to be due to its preferential inhibition of inducible COX-2 relative to constitutiveCOX-1, and was better tolerated than the comparators, reaching statistical significance for piroxicam and naproxen.

Gastrointestinal tolerability of meloxicam compared to diclofenac in osteoarthritis patients. International MELISSA Study Group. Meloxicam Large-scale International Study Safety Assessment.

The MELISSA trial confirms earlier studies suggesting that meloxicam has a significantly improved GI tolerability profile in comparison with other NSAIDs, including diclofenac, and provides support for the hypothesis that selective inhibition of COX-2 relative toCOX-1 might be an effective approach towards improved NSAID therapy.

Interaction of Meloxicam with Cimetidine, Maalox, or Aspirin

Meloxicam was well tolerated, and concomitant treatment with cimetidine or Maalox had little or no effect on the plasma concentration—time curves, maximum plasma concentration (Cmax), or the area under the plasma concentrations—time curve (AUC0‐∞) of meloxicam.

Pharmacokinetics and tolerability of meloxicam after i.m. administration.

The excellent tolerability of i.m. meloxicam together with its rapid and complete absorption may provide an alternative to oral administration of this drug.

Tolerability of meloxicam in patients with histories of adverse reactions to nonsteroidal anti-inflammatory drugs.

  • D. QuaratinoA. Romano A. Venuti
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2000

Evaluation of the safety, tolerability, and efficacy of meloxicam tablets in patients with osteoarthritis.

Review of clinical trials and benefit/risk ratio of meloxicam.

  • A. Barner
  • Medicine
    Scandinavian journal of rheumatology. Supplement
  • 1996
In a global safety analysis, both meloxicam doses produced significantly fewer gastrointestinal (GI) side effects than the comparators (p < 0/05) and this improved safety profile is likely to be due tomeloxicam's selective inhibition of COX-2 relative to COX1.

A long-term study to evaluate the safety and efficacy of meloxicam therapy in patients with rheumatoid arthritis.

Meloxicam 15 mg once daily was effective and compared favourably with standard NSAIDs regarding tolerance when administered to patients with RA over an 18 month period.