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Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) with analgesic and anti-pyretic effects. It is an oxicam closely related to piroxicam, and falls in the enolic acid group of NSAIDs.
As of 2015 the cost for a typical month of medication in the United States is less than $25 USD.
Contents
1 Adverse effects
1.1 Cardiovascular side effects
2 Mechanism of action
3 Veterinary use
3.1 Pharmacokinetics
3.2 Legal status
3.2.1 United States
3.2.2 European Union
3.2.3 Other countries
4 References
5 External links
Adverse effects
See also: Nonsteroidal anti-inflammatory drug
Meloxicam use can result in gastrointestinal toxicity and bleeding, headaches, rash, and very dark or black stool (a sign of intestinal bleeding). Like other NSAIDs, its use is associated with an increased risk of cardiovascular events such as heart attack and stroke. Although meloxicam inhibits formation of thromboxane A, it does not appear to do so at levels that would interfere with platelet function.
A pooled analysis of randomized, controlled studies of meloxicam therapy of up to 60 days duration found that meloxicam was associated with a statistically significantly lower number of thromboembolic complications than the NSAID diclofenac (0.2% versus 0.8% respectively) but a similar incidence of thromboembolic events to naproxen and piroxicam.
Cardiovascular side effects
Persons with hypertension, high cholesterol, or diabetes are at risk for cardiovascular side effects. Persons with family history of heart disease, heart attack, or stroke must tell their treating physician as the potential for serious cardiovascular side effects is significant.
Mechanism of action
Main article: Non-steroidal anti-inflammatory drug
Meloxicam blocks cyclooxygenase (COX), the enzyme responsible for converting arachidonic acid into prostaglandin H 2 —the first step in the synthesis of prostaglandins, which are mediators of inflammation.
Meloxicam has been shown, especially at its low therapeutic doses, selectively to inhibit COX-2 over COX-1.
Meloxicam concentrations in synovial fluid range from 40% to 50% of those in plasma. The free fraction in synovial fluid is 2.5 times higher than in plasma, due to the lower albumin content in synovial fluid as compared to plasma. The significance of this penetration is unknown,
Veterinary use
Meloxicam is used in veterinary medicine, most commonly in dogs and cats, but also sees off-label use in other animals such as cattle and exotics.
Side effects in animals are similar to those found in humans; the principal side effect is gastrointestinal irritation (vomiting, diarrhea, and ulceration ). Rarer but important side effects include liver and kidney toxicity.
In healthy dogs given meloxicam, no perioperative adverse effects on the cardiovascular system have been reported at recommended dosages.
A peer-reviewed journal article cites NSAIDs, including meloxicam, as causing gastrointestinal upset and, at high doses, acute renal failure and CNS signs such as seizures and comas in cats. It adds that cats have a low tolerance for NSAIDs.
Meloxicam has been investigated as an alternative to diclofenac by the RSPB to prevent deaths of vultures.
Pharmacokinetics
In dogs, the absorption of meloxicam from the stomach is not affected by the presence of food,
In the koala ( Phascolarctos cinereus ), very little meloxicam is absorbed into the blood after oral administration (that is, it has poor bioavailability ).
Legal status
United States
Since 2003, meloxicam has been approved in the U.S. for use in dogs for the management of pain and inflammation associated with osteoarthritis, as an oral ( liquid ) formulation of meloxicam.
In October 2004, a formulation for use in cats was approved for use prior to surgery only.
In 2005, the U.S. Food and Drug Administration sent a Notice of Violation to the manufacturer for its promotional materials which included promotion of the drug for off-label use.
European Union
In Europe, where the product has been available since the early 1990s, it is licensed for other anti-inflammatory benefits including relief from both acute and chronic pain in dogs. In June 2007, an oral version of meloxicam was licensed for the long-term relief of pain in cats.
Meloxicam is also licensed for use in horses, to relieve the pain associated with musculoskeletal disorders.
Other countries
As of June 2008, meloxicam is registered for long-term use in cats in Australia, New Zealand, and Canada.

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