What is the recommended dosage frequency for meloxicam (nonsteroidal anti-inflammatory drug)?

Meloxicam Dosage Frequency

Meloxicam is administered once daily, with a starting dose of 7.5 mg that can be increased to a maximum of 15 mg once daily if needed for adequate symptom control. 1, 2

Standard Dosing Regimen

• Meloxicam should be taken as a single daily dose, not divided throughout the day 2
• The initial dose is 7.5 mg once daily for most patients 1, 2
• If 7.5 mg provides insufficient relief, the dose may be increased to 15 mg once daily 1, 2
• The maximum recommended dose is 15 mg once daily 1

Special Population Considerations

Elderly Patients

• Start with 7.5 mg once daily and maintain this as the maximum dose in elderly patients (over 59-75 years) 1, 2
• Lower initial doses and slower titration are recommended due to increased risk of adverse events 1
• The risk of gastrointestinal bleeding increases dramatically with age, from 1 in 2,100 in adults under 45 years to 1 in 110 in adults over 75 years 1

Patients with Renal Impairment

• Avoid meloxicam entirely in patients with GFR < 30 mL/min/1.73 m² 1
• Prolonged therapy is not recommended in patients with GFR < 60 mL/min/1.73 m² 1
• Temporarily suspend meloxicam during intercurrent illness, planned IV radiocontrast administration, bowel preparation, or prior to major surgery 1

Duration and Monitoring

Treatment Duration Limits

• Meloxicam should not be used continuously for more than 2-4 weeks without reassessment, as prolonged NSAID use significantly increases gastrointestinal, cardiovascular, and renal complications 1
• For acute pain conditions, NSAID monotherapy should generally not exceed 1 month 1
• Continuing NSAID monotherapy beyond 2 months is inappropriate for patients with active arthritis 1

Required Monitoring

• Monitor renal function if treatment extends beyond 2 weeks, particularly in elderly patients or those with existing renal impairment 1
• Blood pressure monitoring is warranted, as NSAIDs can increase blood pressure by approximately 5 mm Hg with continued use 1
• Consider gastroprotection with proton pump inhibitors for patients requiring treatment beyond 2 weeks 1

Common Pitfalls to Avoid

• Do not prescribe meloxicam more than once daily - the medication is specifically formulated for once-daily dosing 2
• Do not continue monotherapy indefinitely without reassessing the need for alternative or adjunctive therapies 1
• Do not ignore cardiovascular risk factors, as long-term use increases risk of cardiac ischemic events by 3.5 per 1,000 persons 1
• Avoid combining with anticoagulants when possible, as this increases gastrointestinal bleeding risk five to six times 1
• Do not use in combination with corticosteroids like prednisone without proton pump inhibitor prophylaxis, as this combination significantly increases gastrointestinal adverse events 3

Alternative Dosing Strategies

• For step-by-step therapy, meloxicam may be given intramuscularly (1.5 mL) for 3-5 days, followed by transition to oral administration (7.5-15 mg once daily) for 14 days 4
• Intravenous meloxicam (30 mg) has been studied for moderate to severe postoperative pain, though this is not standard outpatient dosing 4