In the U.S.—

• antirheumatic (nonsteroidal anti-inflammatory)

Meloxicam (mel-OX-i-kam) is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve some symptoms of arthritis, such as inflammation, swelling, stiffness, and joint pain. However, this medicine does not cure arthritis and will help you only as long as you continue to take it.

This medicine is available only with your doctor's prescription, in the following dosage forms:

Oral
• Tablets (U.S.)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For meloxicam, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to meloxicam, aspirin, or other nonsteroidal anti-inflammatory drugs. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Meloxicam has not been studied in pregnant women. However, studies in animals have shown that meloxicam causes birth defects. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—Studies to determine if meloxicam passes into human breast milk have not been done. However, meloxicam has been found in the milk of rats. Meloxicam may cause unwanted effects in nursing babies. It may be necessary for you to take another medicine or stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor.

Children—Children—Meloxicam has been studied only in adult patients, and there is no specific information comparing use of meloxicam in children with use in other age groups.

Older adults—Older adults—This medicine has been tested and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking meloxicam, it is especially important that your doctor and pharmacist know if you are taking any of the following:

• Aspirin—Use of aspirin with meloxicam may cause stomach or intestinal bleeding

• Lithium (e.g., Lithane)—When you take meloxicam, your dose of lithium may need to be changed because higher blood levels of lithium may occur

• Alcohol abuse or
• Bleeding problems or
• Stomach ulcer or other stomach problems or
• Tobacco (or recent history of )—The chance of side effects may be increased

• Anemia or
• Asthma or
• Dehydration or
• Fluid retention (swelling of feet or lower legs) or
• Heart disease or
• High blood pressure or
• Kidney disease or
• Liver disease—Meloxicam may make these conditions worse

• Aspirin triad (asthma, nasal polyps, and aspirin intolerance) or
• Previous allergic or anaphylactic response to aspirin or other nonsteroidal anti-inflammatory drugs—Use of meloxicam may cause a serious allergic reaction

For safe and effective use of this medicine, do not take more of it, do not take it more often, and do not take it for a longer time than ordered by your health care professional. Taking too much of this medicine may increase the chance of unwanted side effects.

Dosing—

The dose of meloxicam will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average dose of meloxicam. If your dose is different, do not change it unless your doctor tells you to do so.

• For oral dosage form (tablets):
  • For symptoms of osteoarthritis:
    • Adults—7.5 milligrams (mg) once a day
    • Children—Use must be determined by your doctor

Missed dose—

If you miss a dose of this medicine, take the missed dose as soon as possible. However, if you do not remember the missed dose until the next day, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not refrigerate or freeze.
• Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.

If you will be taking this medicine for a long time, it is very important that your doctor check you at regular visits for any blood problems that may be caused by this medicine.

Stomach problems may be more likely to occur if you drink alcoholic beverages while being treated with this medicine. Therefore, do not regularly drink alcoholic beverages while taking this medicine, unless otherwise directed by your doctor.

Taking two or more of the nonsteroidal anti-inflammatory drugs together on a regular basis may increase the chance of unwanted effects. Also, taking acetaminophen, aspirin or other salicylates, or ketorolac (e.g., Toradol) regularly while you are taking a nonsteroidal anti-inflammatory drug may increase the chance of unwanted effects. The risk will depend on how much of each medicine you take every day, and on how long you take the medicines together. If your health care professional directs you to take these medicines together on a regular basis, follow his or her directions carefully. However, do not take acetaminophen or aspirin or other salicylates together with this medicine for more than a few days, and do not take any ketorolac (e.g., Toradol) while taking this medicine, unless your doctor has directed you to do so and is following your progress.

Serious side effects can occur during treatment with this medicine. Sometimes serious side effects can occur without warning. However, possible warning signs often occur, including severe stomach pain, black tarry stools, and/or vomiting of blood or material that looks like coffee grounds; skin rash; swelling of face, fingers, feet and/or lower legs. Stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.

If you notice signs of liver toxicity including nausea, unusual tiredness, itching of the skin, stomach pain or fever,

stop taking this medicine and check with your doctor immediately if you notice any of these warning signs.

Meloxicam may cause a serious type of allergic reaction called anaphylaxis. Although this is rare, it may occur often in patients who are allergic to aspirin or other nonsteroidal anti-inflammatory drugs. Anaphylaxis requires immediate medical attention. The most serious signs of this reaction are very fast or irregular breathing, gasping for breath, wheezing , or fainting. Other signs may include changes in skin color of face; very fast but irregular heartbeat or pulse; hive-like swellings on the skin; puffiness or swelling of the eyelids or around the eyes. If these effects occur, get emergency help at once. Ask someone to drive you to the nearest hospital emergency room. Call an ambulance, lie down, cover yourself to keep warm, and prop your feet higher than your head. Stay in that position until help arrives.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

• Rare
  • Bloody or black, tarry stools;  difficulty swallowing;  puffiness or swelling of the eyelids or around the eyes, face, lips or tongue;  severe stomach pain;  shortness of breath;  tightness in chest;  vomiting of blood or material that looks like coffee grounds;  wheezing 
  
  

• Symptoms of overdose

  Get emergency help immediately if any of the following symptoms of overdose occur

  • Bloody or black tarry stools;  blue lips, fingernails or skin;  blurred vision;  confusion;  convulsions (seizures);  dark urine;  decreased urine output;  difficulty breathing;  difficulty swallowing ;  dizziness;  fever with or without chills;  pain in chest, upper stomach, or throat;  pounding in ears;  skin rash;  slow or fast heartbeat;  swelling around eyes, face, lips, or tongue;  shortness of breath;  severe stomach pain;  unusual tiredness or weakness;  tightness in chest ;  vomiting of blood or material that looks like coffee grounds;  weight gain (rapid);  wheezing;  yellow eyes or skin 
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

• More common
  • Diarrhea;  gas;  heartburn;  indigestion 
  
  

• Less common or rare
  • Abdominal pain;  anxiety;  confusion;  constipation;  nausea and/or vomiting;  nervousness ;  sleepiness 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.