Meloxicam Can Be Safely Prescribed with Ezetimibe

Meloxicam can be safely prescribed with ezetimibe as there are no documented drug interactions between these medications. 1

Drug Information and Compatibility

Ezetimibe is a cholesterol absorption inhibitor that works by inhibiting the NPC1L1 protein in the small intestine, reducing cholesterol absorption 2
Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that selectively inhibits cyclooxygenase-2 (COX-2) enzyme, making it useful for treating conditions like osteoarthritis and rheumatoid arthritis 3, 4
Ezetimibe has documented drug-drug interactions with cyclosporine, fibrates, and bile acid sequestrants, but not with NSAIDs like meloxicam 2
Meloxicam has no clinically significant drug interactions reported with lipid-lowering medications 3, 4

Ezetimibe is rapidly absorbed and extensively metabolized (>80%) to the pharmacologically active ezetimibe-glucuronide, with an elimination half-life of approximately 22 hours 1
Ezetimibe is primarily excreted in feces (78%) with the remainder in urine 1
Meloxicam has a half-life of approximately 20 hours, making it suitable for once-daily administration 3
Meloxicam is 99% converted to inactive metabolites prior to excretion 3
The different metabolic pathways of these medications (ezetimibe via glucuronidation and meloxicam via CYP enzymes) reduce the likelihood of metabolic interactions 1, 3

Ezetimibe is generally well tolerated with common adverse effects including upper respiratory tract infection, diarrhea, arthralgia, sinusitis, and pain in extremities 2
Ezetimibe is not recommended in patients with moderate to severe hepatic impairment 2
Persistent elevations in hepatic transaminases may occur with concomitant statin therapy, requiring monitoring 2
Cases of myopathy and rhabdomyolysis have been reported when ezetimibe was used alone or with statins, but not with NSAIDs 2

Meloxicam has demonstrated good gastrointestinal and renal tolerability compared to some other NSAIDs 5, 3
Common side effects include abdominal pain, dyspepsia, edema, and anemia 4, 6
Studies have shown that meloxicam at doses of 7.5-15 mg daily does not compromise renal function in patients with mild renal impairment 5
The gastrointestinal tolerability of meloxicam at therapeutic doses (7.5-15 mg) has been reported as comparable to placebo in some studies 6

When prescribing both medications together, monitor for:
- Hepatic function, especially if the patient is also on statin therapy 2
- Renal function, particularly in elderly patients or those with pre-existing renal impairment 5, 3
- Gastrointestinal symptoms, as both medications can independently cause GI effects 2, 4
- Cardiovascular risk factors, as NSAIDs may increase cardiovascular risk in certain populations 4, 6

Ezetimibe is administered as 10 mg orally once daily, with or without food 2
Meloxicam is typically given in doses of 7.5-15 mg once daily 4, 6
Both medications can be administered at the same time due to their once-daily dosing schedules and lack of interaction 1, 3

In elderly patients, standard doses of ezetimibe can be used, while meloxicam should be started at the lower dose range (7.5 mg daily) 2, 6
For patients with mild renal impairment, no dosage adjustment is necessary for either medication 1, 5
Both medications should be used with caution during pregnancy due to limited safety data 2