Tablet Splitting of Meloxicam 15 mg
Splitting meloxicam 15 mg tablets is not recommended due to significant concerns about dose uniformity and content variability, which could compromise therapeutic efficacy and safety.
Evidence Against Tablet Splitting
Weight and Content Uniformity Failures
Meloxicam specifically failed standardized uniformity testing when subjected to tablet-splitting analysis, with half tablets falling outside acceptable United States Pharmacopeia specifications for both weight uniformity (16.2% failure rate) and drug content uniformity (15.0% failure rate) 1
The study evaluated meloxicam 15 mg tablets among 16 commonly prescribed medications, and meloxicam was one of only 6 drugs that failed both weight and content uniformity tests after splitting 1
Weight loss during the splitting process, though less than 1.5% on average, combined with uneven fragment distribution, resulted in unpredictable dosing in individual half tablets 1
Clinical Implications of Dose Variability
Meloxicam has a narrow therapeutic window where efficacy is dose-dependent: the 3.75 mg dose failed to reach statistical significance for all efficacy endpoints in osteoarthritis treatment, while 7.5 mg and 15 mg doses demonstrated clear therapeutic benefit 2
This dose-response relationship means that receiving less than the intended 7.5 mg from a split 15 mg tablet could result in inadequate pain control and anti-inflammatory effect 2
Conversely, receiving more than 7.5 mg approaches the full 15 mg dose, potentially increasing gastrointestinal and renal adverse event risk without physician awareness 3, 4
Safer Alternatives
Prescribe Appropriate Tablet Strengths
Request the 7.5 mg tablet formulation if dose reduction is needed, rather than splitting the 15 mg tablet 2
Meloxicam is commercially available in multiple strengths specifically to avoid the need for tablet splitting 2, 4
Clinical Considerations
The once-daily dosing of meloxicam makes precise dosing particularly important, as there is no opportunity for dose averaging across multiple daily administrations 3, 4
For patients with renal impairment or those requiring lower doses, the 7.5 mg formulation has been specifically studied and shown to be safe and effective 3, 2
Common Pitfalls to Avoid
Do not assume all scored tablets are suitable for splitting - meloxicam tablets may or may not be scored, but even scored tablets can fail uniformity testing 1
Avoid splitting to save costs without considering the clinical consequences of dose variability in a drug with demonstrated dose-dependent efficacy 2
Do not use tablet splitting as a substitute for proper dose titration - the 7.5 mg and 15 mg doses have distinct efficacy and safety profiles that should guide prescribing 2, 4