From the Research
The recommended dosage of meloxicam for adults with osteoarthritis or rheumatoid arthritis is 7.5 mg once daily, which can be increased to a maximum of 15 mg once daily if needed for better symptom control. This recommendation is based on the study by The Meloxicam Osteoarthritis Investigators 1, which demonstrated that meloxicam 7.5 and 15 mg daily were statistically significantly more effective than placebo for all end points, with gastrointestinal tolerability comparable to that of placebo.
Key Considerations
- Treatment should begin with the lowest effective dose and be adjusted based on individual response.
- Meloxicam should be taken with food to reduce gastrointestinal irritation, and the total daily dose should not exceed 15 mg.
- For elderly patients or those with renal impairment, starting at the lower 7.5 mg dose is particularly important.
- Meloxicam works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), which reduces prostaglandin production and decreases inflammation, pain, and joint stiffness.
- Patients should be monitored for potential side effects including gastrointestinal bleeding, cardiovascular events, and kidney problems, especially during long-term use.
Monitoring and Safety
- The medication should be used at the lowest effective dose for the shortest duration necessary to control symptoms, as NSAIDs carry risks that increase with higher doses and longer treatment periods.
- A study by the British journal of rheumatology 2 found that meloxicam was better tolerated in the gastrointestinal (GI) tract, with fewer GI adverse events compared to naproxen.
- Another study by the Scandinavian journal of rheumatology 3 found that meloxicam produced significantly fewer gastrointestinal side effects than comparators, with severe GI side effects occurring in only 0.1% of patients taking meloxicam 7.5 mg.
Long-term Use
- A long-term study by the British journal of rheumatology 4 found that meloxicam 15 mg daily was effective and compared favorably with standard NSAIDs regarding tolerance when administered to patients with rheumatoid arthritis over an 18-month period.
- The study found that only 11.4% of patients discontinued prematurely due to lack of efficacy, and 13.7% of patients discontinued due to adverse events.