COXICAM 7.5/MG TAB 10/TAB

Indications

Approved Uses

Osteoarthritis and rheumatoid arthritis (adults).

Off-Label Uses

Acute gout flare pain and primary dysmenorrhea (off-label; local practice-dependent).

Dosage & Administration

Dosing by Condition

Osteoarthritis: 7.5 mg orally once daily; may increase to 15 mg once daily if needed. Rheumatoid arthritis: 15 mg orally once daily; may reduce to 7.5 mg once daily depending on response/tolerability (max 15 mg/day).

Initial Dose

7.5 mg once daily

Maintenance Dose

7.5mg to 15mg once daily

Maximum Dose

15 mg per day

Children's Dosage

Approved for juvenile rheumatoid arthritis ≥2 years (oral suspension); tablets not recommended <18 years unless specialist.

Dose Adjustment Notes

Use the lowest effective dose for the shortest duration; in elderly or higher-risk patients consider starting/maintaining at 7.5 mg daily; avoid use in severe renal impairment not on dialysis and in severe hepatic impairment; in hemodialysis, do not exceed 7.5 mg/day.

How to Take

Swallow the tablet whole with water; may be taken with or without food, but taking with food or milk can reduce gastrointestinal upset; take once daily at the same time each day.

Side Effects

Common Side Effects

Dyspepsia, nausea, abdominal pain, diarrhea, headache, dizziness, rash, and peripheral edema.

Safety & Warnings

Contraindications

Contraindications: hypersensitivity to meloxicam; history of asthma/urticaria/other allergic-type reactions after aspirin/other NSAIDs (AERD); peri-operative pain in CABG surgery; (commonly also) active GI bleeding/peptic ulcer and third-trimester pregnancy are generally avoided/contraindicated per NSAID labeling.

Warnings & Precautions

Warnings/precautions: CV risk (MI/stroke) and avoid in CABG peri-op; GI bleeding/ulcer/perforation (higher risk in elderly/prior ulcer/with anticoagulants/SSRIs/steroids); renal toxicity/AKI risk (dehydration, CKD, HF, diuretics/ACEi/ARB); hypertension and fluid retention/edema/HF worsening; serious skin reactions; anaphylactoid reactions/AERD; monitor renal function, BP, and for GI bleeding.

Age Restriction

Generally adult use; pediatric use depends on local labeling-do not assume approval <18 years for this 7.5 mg tablet (JIA indication is formulation/label-specific).

Drug Interactions

Drug Interactions

Key interactions: anticoagulants/antiplatelets (e.g., warfarin) ↑ bleeding; aspirin/other NSAIDs ↑ GI/renal toxicity; ACEi/ARB/diuretics (“triple whammy”) ↑ AKI risk and may blunt antihypertensive/diuretic effect; lithium ↑ levels; methotrexate ↑ toxicity; SSRIs/SNRIs/corticosteroids ↑ GI bleed risk; cyclosporine/tacrolimus ↑ nephrotoxicity; cholestyramine ↑ meloxicam clearance.

Interaction Severity

MAJOR: Anticoagulants/antiplatelets (e.g., warfarin, DOACs, clopidogrel) and other NSAIDs (including aspirin) due to increased bleeding/GI toxicity. MODERATE: ACE inhibitors/ARBs and diuretics (renal risk/reduced antihypertensive effect), lithium (increased levels), methotrexate (increased toxicity), cyclosporine/tacrolimus (increased nephrotoxicity), SSRIs/SNRIs (increased GI bleeding risk).

Food Interaction

Take with food

Alcohol Interaction

Avoid

Special Populations

Pregnancy

Avoid in third trimester; Pregnancy Category C (first and second trimesters)

Breastfeeding

Caution

Children

Approved for juvenile rheumatoid arthritis ≥2 years (oral suspension); tablets not recommended <18 years unless specialist.

Elderly

Start at the lowest effective dose (7.5mg) for the shortest possible duration, with close monitoring for adverse effects.

Kidney Impairment

Mild-moderate renal impairment: usually no adjustment but monitor; severe renal impairment: avoid/not recommended; if on hemodialysis and therapy is necessary, do not exceed 7.5 mg/day.

Liver Impairment

Mild-moderate hepatic impairment: no dosage adjustment generally required; severe hepatic impairment: not well studied-avoid/use only with specialist oversight and close monitoring.

Storage & Patient Advice

Missed Dose

Take the missed dose as soon as remembered the same day; if it is close to the next dose, skip the missed dose and resume the regular schedule; do not double doses.

Stopping the Medicine

Safe to stop anytime; no tapering required for short-term use. Discuss with physician before stopping long-term therapy.

Overdose

Overdose: symptoms include nausea/vomiting, epigastric pain, GI bleeding, drowsiness/lethargy; severe cases may cause hypertension, acute kidney injury, respiratory depression/coma; management is supportive, consider activated charcoal if early, and cholestyramine can enhance elimination; urgent medical evaluation required.

Patient Counseling

Take COXICAM (meloxicam) exactly as prescribed, preferably with food or milk and a full glass of water; use the lowest effective dose for the shortest duration and do not exceed the prescribed dose. Avoid taking other NSAIDs (e.g., ibuprofen, naproxen, diclofenac) and limit/avoid alcohol due to increased GI bleeding risk. Seek urgent care for signs of GI bleeding (black/tarry stools, vomiting blood, severe/persistent stomach pain) or serious skin reactions; report symptoms of cardiovascular events (chest pain, shortness of breath, sudden weakness/slurred speech). Tell your prescriber if you have a history of ulcer/bleeding, kidney disease, heart failure, uncontrolled hypertension, or if you take anticoagulants/antiplatelets/SSRIs/SNRIs or steroids; monitor blood pressure and kidney function if at risk. Avoid use in the 3rd trimester of pregnancy and discuss use if pregnant/planning pregnancy or breastfeeding.

Monitoring Requirements

For long-term use, periodic monitoring of blood pressure, complete blood count (CBC), and renal and hepatic function tests is recommended.

Pharmacology

Mechanism of Action

Inhibits cyclooxygenase (COX) enzymes with preferential inhibition of COX-2 over COX-1, decreasing prostaglandin synthesis to reduce inflammation, pain, and fever.

Duration of Effect

Approximately 24 hours.

Half-Life

15-20 hours.

Bioavailability

89%.

Metabolism

Extensively hepatic metabolism primarily by CYP2C9 and to a lesser extent CYP3A4 to inactive metabolites (multiple metabolites described).

Excretion

Excreted approximately equally via urine and feces, predominantly as metabolites (about 50% renal and 50% fecal), with minimal unchanged drug.

Protein Binding

>99% protein bound (mainly to albumin).

Product Information

Available Dosage Forms

Tablet (oral); also capsule, oral suspension, injection, etc.

Composition per Dose

Each tablet: 7.5 mg meloxicam

Generic Availability

Yes

OTC Alternatives

Ibuprofen (OTC) and naproxen (OTC in many countries) for mild-to-moderate pain/inflammation, if no contraindications.

Pain Type

Joint/Muscular

Nsaid

Yes

Opioid

No

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