What is the recommended dosage of meloxicam (nonsteroidal anti-inflammatory drug (NSAID)) for osteoarthritis?

Dosage of Meloxicam for Osteoarthritis

The recommended dosage of meloxicam for osteoarthritis is 15 mg once daily. 1

Dosing Guidelines

• Meloxicam should be administered at a starting dose of 15 mg once daily for osteoarthritis 1, 2
• For some patients, a lower dose of 7.5 mg once daily may be sufficient to control symptoms 2, 3
• Meloxicam should be used at the lowest effective dose and for the shortest duration needed to minimize risks 1
• The medication can be taken with or without food 2

Evidence for Efficacy

• Clinical trials have demonstrated that meloxicam at doses of 7.5 mg and 15 mg daily is effective for the symptomatic treatment of osteoarthritis 2
• Meloxicam shows significant improvement in pain relief and function compared to placebo in patients with osteoarthritis 2, 4
• Efficacy is typically evident after 2 weeks of treatment and is maintained throughout the treatment period 2
• Higher doses (15 mg) may provide better symptom control for patients with more severe osteoarthritis pain 4

Safety Considerations

• NSAIDs including meloxicam should be used with caution, particularly in:

  • Older adults 1
  • Patients with cardiovascular comorbidities 1
  • Patients with chronic renal failure 1
  • Patients with previous gastrointestinal bleeding 1

• Meloxicam has demonstrated a better gastrointestinal safety profile compared to some other NSAIDs:

  • Similar GI adverse event rates to placebo at recommended doses 2
  • Lower incidence of GI adverse events compared to piroxicam and diclofenac 3, 5

Monitoring and Follow-up

• Regular assessment of pain relief and functional improvement is recommended during treatment 6
• Periodic evaluation of cardiovascular, renal, and gastrointestinal risk factors should be conducted 1, 6
• Consider gastroprotection with proton pump inhibitors in high-risk patients 1

Alternative Options

• For patients who cannot tolerate oral meloxicam or have contraindications:
  • Topical NSAIDs can be considered for knee or hand osteoarthritis 1
  • Paracetamol (acetaminophen) can be used as an alternative, though it may be less effective 1, 6
  • Duloxetine may be considered for patients with contraindications to NSAIDs 1

Important Precautions

• All NSAIDs carry risks of gastrointestinal, cardiovascular, and renal adverse effects 1, 6
• Use the lowest effective dose for the shortest duration possible to minimize risks 1
• In patients with increased gastrointestinal risk, consider adding a gastroprotective agent 1
• Meloxicam is contraindicated in patients with known hypersensitivity to NSAIDs 2

Remember that while meloxicam can effectively manage osteoarthritis symptoms, it should be part of a comprehensive approach that includes non-pharmacological interventions such as exercise, weight management, and physical therapy 1, 6.